Nutrition Exam 2

Front 1

Which organizations oversee the pet food industry?

Back 1

1. AAFCO-voluntary nutrient profile standards; ingredient names.
2. FDA-marketing claims
3. USDA-inspection of research facilities, regulates ingredients
4. State agencies-mostly involved with food animal feeds.

Front 2

Understand how an ingredient list on a product package is arranged. What information is included or not included?

Back 2

Ingredients are listed in descending order according to pre-processed weight.
Does not include ingredient quality, or exact amount of ingredient. Can also be manipulated by including 2 different sources (eg. corn and corn meal), moving that ingredient further down the list, or only one source (all protein from chicken), moving it up the list.
Also includes, vitamins, minerals, and pereservatives.

Front 3

Know the sections that should be included in the nutritional adequacy statement; and understand the difference between an AAFCO feeding trial and profile comparison.

Back 3

Nutritional adequacy statement: "complete and balanced", lifestage(s) for which the diet is intended, and how the product was found adequate.
Food trial-product is fed to the intended animal during the intended lifestage according to AAFCO guidelines.
Calculation/profile comparison-Chemical analysis of food is compared to AAFCO nutrient profile for species and lifestage.

Front 4

Be able to convert nutrients on an "as fed" basis in to dry matter.

Back 4

Calculation: nutrient of interest/percent dry matter.
Rule of thumb:
1. Dry foods-add 10% to nutrient.
2. Wet foods-multiply nutrient by 4.

Front 5

Be familiar with the two body condition scales.

Back 5

1/5, 1/9-emaciated
2/5, 2-3/9-very thin or thin
3/5, 4-5/9-lean to ideal
4/5, 6-7/9-slightly overweight to overweight
5/5, 8-9/9-Obese and morbidly obese

Front 6

Compare the moisture content, cost, and kcal/gram of moist, semi-moist, and dry foods.

Back 6

Moist: 60-87% moisture, low kcal/gram, high cost.
Semi-moist: 25-35% moisture, med kcal/gram, med cost.
Dry: 3-11% moisture, high kcal/gram, low cost.

Front 7

What are the primary components of the principal display panel?

Back 7

Product name, species/lifestage for which it is intended, net weight, manufacture/brand names

Front 8

What is included, by law, in a guaranteed analysis label?

Back 8

Minimum crude protein
Minimum crude fat
Maxiumum crude fiber
Maxiumum moisture

Front 9

Understand how wild canid feeding behaviors are similar and different from feeding behaviors of domestic dogs.

Back 9

Wild canids: Omnivorous, 1-2 large meals per day, hunters.
Domestic dogs: Omnivorous, variety of meal schedules based on owner, scavengers.

Front 10

Know the components of a basic dietary history.

Back 10

Primary type of food
Supplements, treats, and snacks
Method of feeding
Amount fed
Level of activity
Gender and neuter status
Breed

Front 11

Be able to estimate daily fluid requirements for a dog

Back 11

Water requirements in dogs are similar to daily caloric requirement in mLs. Eg. caloric requirement of 250kcals=water requirement of 250mLs

Front 12

Know what factors determine the quality of a protein. How does protein quality impact overall protein requirments?

Back 12

Protein quality affected by:
1. Amino acid profile
2. Digestibility
3. Bioavailability
Higher quality protein=less total protein required to meet amino acid requirements.

Front 13

What are the essential fatty acids for dogs? For cats?

Back 13

Dogs: Linoleic acid and alpha-linolenic acid.
Cats: Linoleic acid, alpha-linolenic acid, and arachadonic acid.

Front 14

Name the fat soluble vitamins.

Back 14

A, D, E, and K

Front 15

Know how environmental conditions and antioxidants impact fats in pet foods.

Back 15

High temp and humidity promote oxidation of unsaturated fatty acids.
Antioxidants added to the pet food, and packaging that blocks moisture can prevent this.

Front 16

Know the ideal ranges for calcium:phosphorus in dogs.

Back 16

1.1:1 to 1.5:1

Front 17

Understand how geriatric dogs differ from adult dogs and how individual geriatric dogs may differ from each other.

Back 17

Geriatric dogs have lower: metabolic rate, glucose tolerance, lean body mass, renal blood flow and GFR, immune function, hormone secretion, and neural function.
Geriatric dogs can differ from each other in: physiologic age (young vs. old), metabolism (efficient vs. inefficient), weight fluctuation (prone to gain vs. loss, or variable), and clinical disease status (normal vs. abnormal).

Front 18

Describe the controversy regarding protein restriction in geriatric dogs.

Back 18

Extra protein in geriatric diets may help maintain/increase lean body mass in dogs prone to losing weight; however, if renal disease is present, high protein may contribute to disease.
If renal disease is not present there is no need to restrict protein in older dogs, and extra protein may be beneficial.

Front 19

Understand the metabolic differences between different types of working dogs and how these differences impact nutritional management.

Back 19

Endurance: Aerobic energy metabolism predominates; energy should be supplied with high fat diets; 2 or more portioned meals with largest meal after work is complete.
Sprinters: Anaerobic energy metabolism predominates. Diet plays less of a role, but post exercise carbs may replenish glycogen stores.
Moderate (eg. hunters): Metabolically inbetween endurance and sprinter. Higher fat, calorie dense diet during training, provide extra meal the night before a hunt to prevent hunting dog hypoglycemia.

Front 20

Be able to design a feeding plan for a dog breeder that encompasses both pregnancy and lactation.

Back 20

Begin increasing food intake at 5-6 weeks gestation, gradually, up to 25-50% higher than maintenance.
Higher fat, quality protein diet (puppy food) provides nutrient dense energy.
Feed smaller more frequent meals.
Weight gain should not exceed 15-25% of body weight.
During lactation, provide pregnancy diet and water ad-lib, until 3-4 weeks post partum, then slowly decrease until weaning.

Front 21

Know the risk factors and clinical signs of periparturient hypoglycemia.

Back 21

Risk factors: poor body condition, malnutrition, feeding high-fat/carb-free diet.
Clinical signs: weakness, mental dullness, seizures.

Front 22

Understand how pregnancy diets differ from maintenance diets.

Back 22

Pregnancy diets are higher in fat and protein. Should be more calorically dense than maintenance food.
Most puppy foods work well as pregnancy diets.

Front 23

Understand how calcium supplementation can lead to eclampsia.

Back 23

Calcium supplementation down-regulates the parathyroid gland, which can then not adequately respond to increased calcium needs of lactation.

Front 24

Be able to design a feeding plan for weaning dams.

Back 24

Decrease intake gradually 3-4 weeks post-partum (as puppies begin to eat solids). If dam is in good condition, do not feed on the first day of full weaning; then increase to 25%, 50%, 75%, and 100% of maintenance each day after.
Decreased food intake will decrease milk production, preventing mastitis.

Front 25

If a client were to find a 2 day old orphan kitten or puppy, be able to describe how to feed, what to feed, and how to monitor the orphan's health and growth.

Back 25

1. Use a species specific milk replacer. Mix according to directions, do not over or under dilute.
2. Bottle feed while holding upright (natural nursing position). Or tube feed-measure tube from nose to last rib, mark, gently insert tube to back of mouth, animal should swallow and tube should pass easily; if correctly placed, animal should breath normally and be relaxed.
3. Feed slowly over 3-5 minutes, do not force feed if bottle feeding.
4. Feed 4-5 times/day minimum.
5. Weigh every day for first 2 weeks, then every 3-4 days until weaned.
6. Keep warm.

Front 26

How do nutritional plans differ for small and large breed puppies?

Back 26

Small breed-Higher metabolic rate, smaller stomach capacity; needs more energy dense food.
Large breed-Grow more rapidly, overfeeding can lead to skeletal malformations.

Front 27

How and why do large breed puppy foods differ from regular puppy foods?

Back 27

Lower energy density and Ca <3% of dry matter. Excess calories and high calcium can both lead to skeletal malformations in large breed dogs.
Any dog expected to be >50-60 lbs adult weight should be fed a large breed puppy food.

Front 28

What three anatomic differences mark felines as carnivores?

Back 28

Dentition: small incisors, sharp canines, sharp carnasial teeth, and vestigial molars are better equiped for shredding meat than grinding plant material.
Retractable claws, and whiskers aid hunting.
Gut to body ratio is much lower-protein is digested more rapidly, less transit time needed to absorb.

Front 29

What three evolutionary changes to enzyme pathways assist cats as carnivores?

Back 29

1. Enzyme low or missing: Carotene dioxygenase is absent because prey already contain converted vitamin A.
2. Alternative pathway more active-Picolinate carboxylase/Niacin. Shunts precoursers to other pathways.
3. Lack of enzyme adaptation-Nitrogen catabolic enzymes are always active; because cats eat sporatic high protein meals, it allows for instantaneous use of protein without having to produce new enzymes after fasting.

Front 30

How do a cat's protein requirements differ from other species?

Back 30

1. High protein requirement as adults
2. Low ability to conserve nitrogen-hepatic enzymes are always going, constant gluconeogenesis
3. Special amino acid requirements

Front 31

What are special amino acid requirements of cats?

Back 31

1. Taurine-deficiency leads to retinal degeneration, dilated cardiomyopathy, and skeletal/growth disorders in kittens of affected queens.
2. Arginine-cannot be readily converted from other enzymes. Functions as the rate limiting factor in the Urea cycle (protein catabolism). Will cause hepatic encephalitis if absent from the diet.
3. Sulfur containing AAs-incorporated into Felinine in urine.
4. Higher methionine and cysteine requirements
5. Decreased glutamic acid requirement (from plants).

Front 32

What factors affect carbohydrate metabolism in cats?

Back 32

1. Low salivary amylase
2. Low pancreatic amylase-limits carbohydrate digestion
3. Low hepatic glucokinase-prevents rapid clearing of simple sugars, BG will remain high. Better utilization of complex carbs, because digested more slowly.
4. Low rate of fructose utilization

Front 33

Why are arachadonic acid and EPA/DHA essential fatty acids in cats (but not dogs)?

Back 33

Cats have low levels of the enzymes which convert linoleic acid to arachadonic acid, and alpha-linoleic acid to EPA/DHA.

Front 34

Which vitamins are required in cats?

Back 34

Vitamin A-skeletal development
Vitamin D-skeletal development
Niacin-precursors shunted to other pathways, therefore required in diet
Vitamin B-required for nitrogen metabolism

Front 35

Know the prevalence and risk factors for canine and feline obesity.

Back 35

Risk factors: Middle age, gonadectomy, gender (in cats-male), breed (dogs), environment (exercise level, feeding frequency)

Front 36

Understand how leptin and adiponectin regulate body fat mass.

Back 36

1. Leptin-levels increase as fat increases. Increase activates the hypothalamus to decrease food intake, and increases energy expenditures in fat and muscle tissue. Leptin resistance occurs similar to insulin resistance in very obese individuals.
2. Adiponectin-levels decrease as fat increases. Low levels may play a role in diseases such as insulin resistance and diabetes, metabolic syndrome, and atherosclerosis.

Front 37

What are some consequences of obesity in pets?

Back 37

Increased incidence of:
1. Lameness/orthopedic problems
2. Diabetes mellitus
3. Nonallergic skin conditions
4. Many chronic disease conditions
Exacerbates pre-existing:
1. Cardiovascular disease
2. Respiratory disease
Shortens life-span

Front 38

Know the steps to designing and implementing a weight loss plan for a pet.

Back 38

1. Rule out other medical conditions
2. Estimate current BCS and body fat %
3. Estimate ideal body weight
4. Determine current caloric intake
5. Calculate desired caloric intake
6. Implement an exercise plan.
7. Recheck after two weeks, then every month if weight loss is appropriate.

Front 39

What is an appropriate rate for a pet to be losing weight?

Back 39

1-2% of body fat per week.

Front 40

What is the rational behind using a weight loss diet?

Back 40

Weight loss diets are formulated to provide adequate vitamins, minerals, and protein while being less calorically dense. When normal foods are reduced well below feeding recommendations to restrict calories, deficiencies can occur.

Front 41

What is the mechanism of action of Slentrol, and its side effects.

Back 41

Slentrol blocks MTPs that transport lipids out of enterocytes. As lipid builds up in the enterocyte, peptide YY is released, signaling a decrease in appetite.
Main side effect is intermittent vomiting, and dogs will regain weight after stopping the medication.
Should not be used in people or cats as it will cause hepatic lipidosis.

Front 42

Understand the metabolic differences between simple and stress starvation.

Back 42

Simple starvation: patient is deprived of food but otherwise healthy. Glycogen used in the first 12 hours, then muscle catabolism through 24 hours, then fat metabolism after that and base metabolic rate drops.
Stress starvation: Increased metabolic rate, and increased production of glucose cause breakdown of protein alone.

Front 43

Know the metabolic changes that occur during stress starvation.

Back 43

Disease causes alterations in cytokines and hormones->increased metabolic rate and production of glucose->only protein is broken down->slowed wound healing, impaired immune function, decreased strength/mobility, poorer prognosis

Front 44

Know the main strategies for managing hyporexia.

Back 44

1. Offer palatable foods, only if animal is not nauseated. May have to hand or syringe feed, but should not FORCE feed.
2. Place a feeding tube
3. Use Parenteral nutrition
4. May use a combination of the above.

Front 45

Based on history and exam findings, know when a critically ill patient should be given extra nutritional support.

Back 45

1. 3 or more days of anorexia-including anorexia at home.
2. Partial anorexia lasting more than 4-5 days
3. Treat more quickly if animal is in poor body condition.
4. Body weight reduction of >5% after rehydration.
5. Elevated CK or excessively low CK
6. Low total protein or hypoalbuminemia.

Front 46

Know when it is appropriate to use enteral vs. parenteral nutrition.

Back 46

1. Enteral feeding is always preferred! If the gut works, use it.
2. Perenteral feeding recommended if protracted vomiting, severe diarrhea or malabsorption, severe hypoproteinemia, acute pancreatitis, recumbent or comatose patients, and patients whose caloric needs cannot be met 100% with enteral feeding.
3. Can use a combination of enteral and parenteral.
4. Microenteral feeding is recommended while doing parenteral feeding to stimulate enterocytes.

Front 47

Know the different options for feeding tubes and when to choose each type.

Back 47

1. Nasogastric/nasoesophageal-short term feeding (<7 days), limited to liquids.
2. Esophagostomy-can be used for several months, slurry canned foods can be used. Does require anesthesia.
3. Gastrostomy-Used for longer-term assisted feedings, or when the esophagus needs to be bypassed. Does require anesthesia.

Front 48

Know the risks associated with enteral and parenteral nutrition and how to minimize those risks.

Back 48

Enteral: tubes can be accidentally placed in the trachea->aspiration pneumonia; feeding excessive volume rapidly may induce vomiting, and tube can be regurgitated. Avoid by taking 2 view rads to verify tube position and feed slowly and cautiously.
Parenteral: Nutritional formulas are high in osmolarity which will cause irritation to the veins. Central PN can only be done through a central venous line. Solution is also a good media for bacterial growth. Parenteral nutrition should be used for as short a time as possible, lines and catheters should be handled as aseptically as possible; drugs should not be given through the nutritional line.

Front 49

Understand the pathophysiology of refeeding syndrome.

Back 49

Feeding after 4-5 days of fasting causes insulin release. Potassium, magnesium, and phosphorous shift into cells with glucose, causing plasma levels to drop.
Avoid by reintroducing food slowly, and checking electrolytes approximately 12 hours after the first meal. Low carb diets will reduce the risk of drastic electrolytes drop.
Signs will typically appear 2-3 days after feeding.

Front 50

Understand why hypoglycemia can occur with severe liver disease.

Back 50

Functional or structural loss of hepatic parechyma leads to decreased glycogen stores, and decreased ability to maintain blood glucose levels.

Front 51

Understand why ammonia levels can increase with liver disease and how amino acid ratios are altered.

Back 51

Ammonia levels increase because:
1. decrease blood flow=decreased delivery of ammonia to the liver for detox.
2. decreased liver mass=decreased urea cycle.

Aromatic amino acids accumulate (decreased liver metabolism), while branched chain amino acids decrease (increased muscle usage).

Front 52

Be familiar with the theories behind the development of hepatic encephalopathy.

Back 52

1. Ammonia as a neurotoxin
2. Increased aromatic amino acids inhibit neurotrasmitters.
3. Ammonia causes increase in GABA (neuroinhibitor)
4. Increase in brain concentrations of benzodiazepine-like substances.

Front 53

Know the treatment options, and their mechanisms, for hepatic encephalopathy.

Back 53

1. Lactulose-lowers gut pH, causes conversion of ammonia to ammonium, that cannot be absorbed.
2. Probiotic-May decrease urease producing bacteria.
3. Increasing ammonia metabolism-Ornithine, Aspartamine, and Zinc.
4. Increasing BCAA:AAA ratio in the diet-plant/soy/dairy proteins.

Front 54

Know the commonly used liver supplements and their proposed mechanism of action

Back 54

1. Fat soluble vitamin supplement-Vit K required to produce clotting factors, Vit E has antioxidant properties.
2. Water soluble vitamins-Vit B complex helps with appetite
3. L-carnitine-required for fatty acid metabolism, becomes deficient in liver disease.
4. SAMe-precursor to glutathione synthesis, antioxidant.
5. Ursodiol-promotes bile flow, cytoprotective, anti-inflammatory, antifibrotic, antioxidant.
6. Milk Thistle-anti-inflammatory

Front 55

Know the medical and dietary treatment options for copper hepatopathies.

Back 55

1. Copper restricted diet-eg. Hills L/D.
2. Chelating agents- D-penicillamine
3. Zinc-prevents intestinal absorption of copper.

Front 56

Know how to diagnose and medically/dietarily treat hyperlipidemia.

Back 56

Diagnosis:
1. Hypertrigliceridemia-chylomicorns and VLDLs >500mg/dl, serum will be turbid to lactescent. If >1000, risk of disease.
2. Hypercholesterolemia-primarily HDLs, serum not lipemic. Typically secondary to other metabolic disease.
Both can only be diagnosed on a 12 HOUR FASTED sample
Treatment:
1. Medication-statins, fibrates, sequestrants.
2. Low fat diet, +/-fish oil and niacin.
Goal is to get triglycerides <500.

Front 57

Common feeding errors in cats.

Back 57

1. Excess intake/low exercise->obesity
2. Anorexia with obesity->hepatic lipidosis
3. Thiamine Deficiency->polyneuritis
4. Vitamin E deficiency->Steatitis
5. Vitamin K deficiency(rare)->internal bleeding
6. Inadequate calcium->Nutritional secondary hyperparathyroidism
7. Inadequate K/excess dietary acidification->hypokalemia, neuropathy
8. Zinc/copper deficiency->repro failure, cleft palate
9. Hypervitaminosis A->bony exostoses
10. Excess dietary base/magnesium->Struvite LUTD
11. Excess dietary acid->metabolic acidosis

Front 58

What is the best/most natural feeding strategy for pet cats?

Back 58

Free choice or frequent (every few hours) meals.

Front 59

How does meal feeding affect feline urine pH? Why is this important?

Back 59

Feeding sporadic meals causes post-prandial alkaline tide, which will increase urine pH for several hours after a meal. If you are managing urine pH for struvite stones (acidified diet), it is important to feed more frequent small meals, and know how recently the patient was fed when monitoring urine pH.

Front 60

Types of diet used to treat/manage GI disease

Back 60

Bland diets
Fiber-enhanced diets
Restricted/moderate fat diets
Elimination diets
Gluten/Gliadin free diets
Monomeric diets
Homemade diets

Front 61

Characteristics of bland diets

Back 61

Highly digestible
Refined ingredients
Carbs in largest amount
Low fiber
Moderate fat

Front 62

Characteristics of fiber-enhanced diets

Back 62

Higher fiber than bland diet
Can be soluble or insoluble.
Goal: delay gastric emptying, slow transit time, bind toxins and bile acids.

Front 63

Characteristics of restricted or moderate fat diets

Back 63

Bland and fiber enhanced diets are moderate fat.
High fiber/weight reduction diets are very low fat (higher fiber may not be appropriate for GI disease).
Use for: Steatorrhea, acute or chronic gastritis, pancreatitis, and lymphangiectasia.

Front 64

Elimination diets

Back 64

Several types:
-Novel Protein
-Hydrolysate
-Homemade

Front 65

Gluten/Gliadin free diets

Back 65

Similar to most standard diets except uses rice and corn as only grain sources.
Used to treat gluten-enteropathy.

Front 66

Monomeric diets

Back 66

Liquid diet
Truely hypoallergenic-all components broken down to single amino acids, mono- or disaccharides, and single fatty acids.
Use: Tube feeding
Disadvantages: Hyperosmotic, may cause osmotic diarrhea.

Front 67

Nutritional management of dental disease.

Back 67

Plaque is the only portion of dental disease that can be controlled with diet.
Dental diets should be fibrous in texture and hard (does not have to be dry), and in a form that promotes the animal to CHEW it's food. Ideally the food is processed so that it dents and scrapes the tooth when penetrated instead of shattering.
Added chemicals:
1. Antimicrobials (treats and water additives)
2. Enzyme systems (treats, water additives, and toothpastes)
3. Chelators (food)

Front 68

Nutritional management of oral disease

Back 68

Primary problem is inability to prehend food.
Provide calorically dense, soft food (liquid or slurry); consider tube feeding.

Front 69

Nutritional management of pharyngeal/esophageal disease

Back 69

Calorically dense (smaller volume)
High protein will promote LES tone
If reflux, low fat to prevent delayed gastric emptying
Liquid/slurry for pharyngeal disease; soft canned for esophageal if tolerated.
Give multiple small meals (>3-4x/day)
Feed upright

Front 70

Nutritional management of gastritis

Back 70

Bland diet used most often-high protein, low fat, moderate fiber best.
Consider withholding food for 24 hours if animal has good BCS and is otherwise healthy.
Reintroduce food slowly-frequent small meals.

Front 71

Nutritional management of GDV

Back 71

Linked to: One meal per day, large volumes of food, rapid eating, aerophagia, small food particle size, overeating/drinking, postprandial excercise.
Prevention: Feed mixed forms of high quality food in several smaller meals per day. Avoid rapid eating (special bowl, food toys), limit water and food before and after exercise.

Front 72

Nutritional management of Acute enteritis

Back 72

Withhold food for 24-48 hours if good BCS and otherwise healthy.
Reintroduce bland diet
Control vomiting/diarrhea

Front 73

Nutritional management of Inflammatory bowel disease

Back 73

Consider elimination diets. These also tend to be fiber enhanced which helps firm stool and promotes enterocyte health.

Front 74

Nutritional management of protein-losing enteropathy/lymphangiectasia

Back 74

Causes malabsorption of all nutrients!
Diet factors:
1. Fat-must be LOW fat to control/reduce lymphatic flow.
2. Protein-consider novel protein if IBD is suspect cause
3. Fiber-do not use high fiber diet; PLE/lymphangiectasia patients are often already underweight.

Front 75

Nutritional management of small intestinal bacterial overgrowth/dysbiosis/antibiotic responsive diarrhea.

Back 75

1. Use bland, intestinal, or low residue diets.
2. Probiotics (fiber)-FOS/MOS absorb water, feed colonocytes; MOS will bind bacteria in the gut.
3. Probiotics-Fortiflora and Prostora; restores normal/helpful intestinal flora

Front 76

Nutritional management of Exocrine Pancreatic Insufficiency

Back 76

Consider bland diet
Requires pancreatic enzyme replacement: viokase (powder not tablets!), or frozen raw pancreas
Frequent small feedings best

Front 77

Nutritional management of Colitis

Back 77

Provide highly digestible protein. N3 fatty acids may reduce inflammation.
Fiber-based on primary disease, can go low or high.

Front 78

Nutritional management of Megacolon/constipation

Back 78

Provide highly digestible diet.
Consider low residue diet (reduced stool amount)
Start with moderate fiber and adjust up or down based on patient response.

Front 79

Nutritional management of Anal pruritis/fistulas

Back 79

Low antigen diet
Immune-mediate response is suspected cause.

Front 80

Nutritional management of Flatulence

Back 80

Decrease dietary protein
Avoid highly fermentable fibers (guar, locust bean, soy)
Change protein or carb source
Small meals and slow eating to reduce aerophagia.
Minimize dietary indiscretion

Front 81

What are the 5 "conditionally essential nutrients?

Back 81

1. Glutamine-fuel for enterocytes, high in most foods.
2. Fiber
3. Beta-hydroxybuterate-fuel for colonocytes, acidifies bowel, alters microbial population
4. N3 fatty acids-antiinflammatory affects
5. Cobalamin-necessary for 1 carbon metabolism for cellular energy

Front 82

Name some examples in which a homemade diet may be beneficial for treating clinical cases.

Back 82

1. Elimination diets for food allergies.
2. Increasing palatability for sick patients.
3. Managing disease combos that do not have a commercially available diet (eg. renal disease and food allergies).

Front 83

If given a homemade recipe, be able to determine if it is NOT balanced based on ingredient list.

Back 83

1. Five food groups present: Carb/fiber source, protein source, fat source, mineral source, multivitamin source.
2. Carb:protein ratio- dogs 2-3:1; cats 1-2:1
3. Protein-animal source preferred, egg can be used for vegetarian diet, soy/veggie protein will need to be supplemented.
4. Fat-May be provided from meat source (eg. 20% fat ground beef), or supplemented with canola oil, omega 3's can be beneficial to add.
5. Calcium source-calcium carbonate, bone meal
6. Vitamin source-use human strength multivitamin. Pet vitamins assume already balanced diet.

Front 84

Discuss the pros and cons of feeding raw food diets.

Back 84

Pros:
1. Testimonials
2. Processing MIGHT decrease nutritional value
Cons:
1. No controlled studies
2. Formulation problems (Ca:P ratio most common)
3. Mechanical problems (eg. bone fragments)
4. Infectious agents-Salmonella and E. coli are common contaminants of raw food. Can cause zoonotic infection even if animal is asymptomatic.
5. Not supported by the FDA

Front 85

Understand the metabolic changes associated with cancer.

Back 85

1. Carb metabolism-tumor cells use lots of glucose and generate lots of lactate (anaerobic). Causes increase serum lactate, altered insulin and glucagon secretion, and insulin resistance.
2. Protein-competes for host amino acid pool. Muscle wasting, hypoalbuminemia, decreased immunity, and delayed healing.
3. Lipids-Increased lipolysis causes increase in triglyceride levels. Omega 3 fatty acid supplementation may reduce inflammation and make tumor cells more susceptible to chemotheraputics.
4. Other effects:
a. Tumor effects-obstruct GI tract, inhibit eating (oral/esophageal), anorexia induced by brain tumor.
2. treatment-almost all therapies may cause anorexia and alter nutritional requirements.

Front 86

Know the nutritional risk factors associated with pancreatitis in the dog and cat.

Back 86

Dogs: Dietary indiscretion, sudden diet change, and high fat diets (esp with low protein)
Cats: Unknown, but no association with high fat diet.
Non-nutritional factors: Miniatures schnauzers, hyperlipidemia, obesity, age, some drugs and concurrent diseases.

Front 87

Know key nutritional factors and rational for their importance in pancreatic disease.

Back 87

Moderate protein and low fat-both protein and fat will stimulate CCK release and subsequently stimulate pancreatic secretions.
Vitamins-Antioxidants and B12 will help support GI tract and digestion while reducing inflammation.

Front 88

Design a feeding plan for animals with pancreatitis.

Back 88

1. Rest GI tract! Typically 24-48 hours. If >3 days, place feeding tube, trickle feed, or provide parenteral nutrition.
2. Reintroduce bland diet-moderate protein, moderate to low fat. Consider low fat, high fiber diet for chronic management.
3. Feed small frequent meals.
4. Advise owner to avoid treats, table scraps, and high fat foods.

Front 89

Select and optimal diet and feeding plan for the diabetic animal.

Back 89

General:
1. Mod to high protein, level in most pet foods will be adequate; cats can tolerate very high protein diet. Arginine=insulin secretagogue.
2. Fat-decrease fat to control obesity and insulin resistance. Max of 25% dmb suggested.
3. Carbs-avoid simple sugars/fructose. Dogs tolerate higher fiber/carbs than cats.
4. Fiber-based on carb level. If using a moderate carb diet, higher fiber will slow carb breakdown and increase intestinal transit time.

Cats: Consider a high protein, low carb diet. Minimizes BG fluctuations, higher rate of remission.
Dogs: High fiber diet for obese animals. Moderate fiber for normal animals.

Timing: Insulin dosing time and amount needs to be paired with a meal. Depending on diet choice, cats may be able to free feed.

Front 90

What are the classifications of adverse food reactions?

Back 90

Adverse food reaction-any abnormal response to an ingested food or food additive.
Food allergy/hypersensitivity-immunologic reaction to a food component (typically protein).
Food intolerance-non-immunologic reaction to a food component.

Front 91

What normal physiologic mechanisms are responsible for the exclusion of food particles (antigens)?

Back 91

1. Mucosal barrier-minimizes antigen exposure. Physiologic barriers (digestive enzymes and unstirred water layer/mucous coat) breakdown antigens and prevent penetration of undigested antigens. Immunologic barriers (IgA and monocyte-macrophage system) block penetration of antigens or clear antigens that do penetrate.
2. Galt-4 lymphoid compartments. Should remain unresponsive to food antigens.
3. Oral tolerance-Cell mediated suppression of response to absorbed food antigens presented to the GALT.

Front 92

Discuss types of non-immunogenic ARFs and give examples.

Back 92

1. Dietary indiscretion
2. Indiosyncratic response to food additives
3. Food Poisoning/toxicosis-nutrient excess, microorganisms contamination, toxic foods (chocolate), toxic food preservatives, metals/minerals (lead), melamine-cyanuric acid
4. Parmacologic reaction-vasoactive amines (histamines)
5. Metabolic reactions-disease states, malnutrition, errors of metabolism (eg. lactose intolerance).

Front 93

Describe a food allergen.

Back 93

Food particle capable of eliciting and binding to IgE and inducing mast cell degranulation.
Typically between 10k-70k daltons: less=non antigenic, greater=not absorbed.
Dogs: Beef, dairy and wheat most common, then lamb, egg, chicken and soy.
Cats: Beef, dairy, and fish most common.

Front 94

Understand the pathophysiologic mechanisms of immunogenic AFRs.

Back 94

Mucosal barrier failure
Defective immunoregulation

In cats and dogs, it may be Type I, III or IV hypersensitivity. Mechanism not entirely known.

Front 95

Components of an appropriate food history, and diagnostic plan for a patient with AFRs.

Back 95

History should include: Commercial foods, commercial snacks/treats, human food, supplements, chew toys with food components, chewable medications, and access to other food sources (neighbor, trash, wildlife, coprophagia).
PE: dogs most affected on the face, feet, axillae, perineum, inguinal region, ears. Cats most affected on the head, neck, and ears. Dogs tend to have diarrhea, cats have vomiting if GI involvement.
Diagnosis: Elimination trial is the only true diagnostic test. use 8-12 weeks for cutaneous signs, 2-4 weeks for GI signs. Challenge after resolution of clinical signs to confirm (o may not want to do).

Front 96

Characteristics for an ideal elimination diet.

Back 96

1. Novel protein
2. Reduced number of protein sources
3. Avoid protein excess
4. High protein digestibility or hydrolysed protein
5. Avoid vasoactive amines
6. Nutritionally adequate
7. Avoid N3 fatty acids-anti-inflammatory effect may confuse diagnosis.

Front 97

What is the best dietary (related) method of managing osteoarthritis?

Back 97

Weight loss to ideal weight!

Front 98

What supplements may or may not be helpful in managing osteoarthritis?

Back 98

Omega 3's-good association with reduced radiographic changes, better force plate readings, and lower concentrations of inflammatory prostaglandins in the synovial fluid.
Antioxidants-no evidence of benefit.
Glucosamine/Chondroitin sulfate-mixed results, may be helpful in some patients, therefore worth trying for a month (but use a good product).

Front 99

What is the proposed benefit of "joint diets".

Back 99

High levels of omega-3's in the diet without having to add a supplement.

Front 100

Explain the principle behind the Y/D diet for feline hyperthyroidism.

Back 100

Y/D is very restricted in iodine. By limiting iodine, the production of thyroid hormones is limited, allowing for a euthyroid state.
Works as primary therapy without other medical intervention.