Nutritional management of gastrointestinal disease

The gastrointestinal (GI) tract is primarily responsible for acquiring and digesting food, absorbing nutrients and water, and expelling wastes from the body as feces. A proper diet and normally functioning GI tract are integral for the delivery of nutrients, prevention of nutrient deficiencies and malnutrition, repair of damaged intestinal epithelium, restoration of normal luminal bacterial populations, promotion of normal GI motility, and maintenance of normal immune functions (eg, both tolerance and protection from pathogens). The amount of food, its form, the frequency of feeding, and the composition of diet each have important effects on GI function and may be used to help ameliorate signs of GI disease. Although both nutrients and nonnutritional components of a diet are important to GI health, they also may cause or influence the development of GI pathology (eg, antibiotic responsive diarrhea, inflammatory bowel disease, dietary intolerance, or sensitivity and/or allergy). The appropriate diet may have a profound effect on intestinal recovery and successful management of chronic or severe GI disease.     

Nutritional management of chronic renal disease in dogs and cats.

Chronic renal disease is a leading cause of death in dogs and cats. Recent clinical studies show that nutrition plays a key role in improving quality of life and life expectancy of these patients. Typical nutritional interventions include modifying the protein, phosphorus, and lipid concentrations. Nutritional therapy, however, does not simply mean changing the diet; consideration must also be given to ensuring adequate caloric intake and to the method of feeding. Monitoring the effects of the dietary therapy is also crucial to ensure that the patients are responding appropriately to the selected nutritional modifications. Nutritional management must be coordinated with medical management for long term successful treatment.     

Nutritional management of hyperlipaemia

Hyperlipaemia is a disease resulting from excessive mobilisation of triglyceride stores such that plasma clearance processes become overwhelmed. Consequently increased plasma triglyceride concentrations (>5.6 mmol/l), visibly cloudy plasma and a sick, anorexic or hypophagic subject follow. Epidemiological studies have identified many predisposing and triggering factors and the attentive carer or veterinary surgeon should be alert to such risk factors so that the disease can be prevented, or at least identified and treated at an early stage. Hyperlipaemic subjects are invariably in a negative energy balance, and nutritional management therefore plays a central role in both the prevention and resolution of the disease.     

Nutritional management of gastric ulceration

Gastric ulcers are common in horses and equine gastric ulcer syndrome describes ulcers in the distal oesophagus, nonglandular and glandular stomach as well as the proximal duodenum. Ulcers in the distal oesophagus and nonglandular region of the stomach are probably caused by hydrochloric acid, whereas ulcers in the glandular stomach and proximal duodenum are likely to be caused by a breakdown in the mucosal defence mechanisms. Regardless of the location of ulcers, initial treatment with pharmacological agents is necessary to suppress hydrochloric acid; however, nutrition and management changes are required to maintain ulcer healing and help prevent recurrence. In addition, many dietary supplements have been marketed to help maintain stomach health and some scientific data on their effects on gastric ulcer scores and gastric juice pH are presented.     

Nutritional management of grazing beef cows.

In grazing operations, forage quality and availability are sometimes limited, and cattle are unable to consume enough nutrients from pasture forage to fulfill requirements. During such situations, supplemental or replacement feeding is necessary to meet production goals. A fundamental understanding of ruminant nutrition and forage management is helpful in deciding which feed or supplement type (ie, energy versus protein) best fits the goals of a specific beef production system. It is important to choose a delivery method and supplement form that provide the targeted amount of desired nutrients to each animal in the herd and that minimize input costs. The objective of this article is to serve as a resource for veterinarians as they provide nutritional management support to beef cow producers.     

Nutritional management of the foal with diarrhoea

Diarrhoea is a common problem in the neonatal and suckling foal. In certain circumstances supplemental nutrition is necessary depending on the age of foal, severity of diarrhoea and presence of other systemic manifestations. Nutritional supplementation can be provided either enterally or parenterally. Enteral nutrition is superior to parenteral nutrition because it is the most natural and physiologically sound means to provide nutritional support. Parenteral nutrition may be warranted if the foal is unable to receive or tolerate enteral nutrition. Dextrose alone or with amino acids and lipids can provide appropriate nutrition when enteral feeding is not tolerated. As soon as the foal stabilises enteral feeding can be reintroduced.     

Nutritional support for treatment of hepatic lipidosis in a llama

A 3-year-old female llama that was 3 months into her first lactation and 10 weeks pregnant was evaluated for anorexia of 24 hours' duration. On physical examination, the llama was in lateral recumbency, bradycardic, tachypneic, and hyperthermic. Palpation per rectum confirmed the presence of a possible dry fecal mass in the spiral colon. A tissue biopsy specimen of the liver was obtained, and histologic examination revealed moderate diffuse lipid accumulation within the hepatocytes. Lactated Ringer's solution was administered for rehydration, and partial parenteral nutrition was then initiated. Hepatic lipidosis is a disease characterized by abnormal accumulation of lipid in the liver and is associated with high mortality in camelids. Anorexia associated with hepatic lipidosis promotes further lipid mobilization and fatty infiltration of the liver. Partial parenteral nutrition with enteral supplementation may be used to maintain adequate energy intake and minimize further lipid mobilization. The distinctive metabolism of camelids may require higher amino acid supplementation relative to nonprotein calories in parenteral solutions than those traditionally provided to other species. Treatment with insulin may be effective     

Nutritional factors in bovine gastrointestinal disease

Gastrointestinal disorders may be prevented through proper nutrition. Attention should be placed on establishing optimum feeding programs for cattle in all stages of the life and production cycle. Normal reticuloruminal development in calves and maintenance of gastrointestinal function in adult cattle is dependent upon adequate nutrition. Nutrition is also an important part of therapy of many gastrointestinal disorders.     

Nutritional management of recurrent colic and colonic impactions

Although diagnosis and treatment of horses with colic have improved in the last 30 years, horses with recurrent colic can be a diagnostic and management challenge for both owners and veterinarians, and colic remains a high priority health concern of owners (Mellor et al. 2001 ). Nutritional management of these cases is often based on previous experience combined with recommendations from the evidence‐based literature. This review will briefly summarise the aetiologies of recurrent colic and primarily focus on evidence‐based nutritional management of colonic impactions, sand enteropathy, inflammatory bowel disease, and idiopathic recurrent colic, which is limited. Additional topics to be covered elsewhere in this series that are relevant to this topic include nutritional management of gastric ulceration, liver disease, colitis, geriatric horses, and feeding the horse pre‐ and post surgery.     

Nutritional management and practical feeding of the orphan foal

Foals are dependent on a milk‐based diet for the first 3–4 months of life. If they are orphaned during this period they require appropriate nutritional and behavioural management to allow them to develop into sound, well‐grown horses and ponies with well established normal behavioural patterns. In order to meet these needs it is necessary to understand the metabolic requirements of the foal and the composition of mares' milk. Usually managing these foals requires short‐term, emergency feeding of the foal while a long‐term option is sought. Long‐term options include use of a foster mare, induction of lactation in a parous, barren mare or hand rearing with suitable equine company. It is important to monitor growth and development of these foals to ensure that over the long term their nutritional needs are being met to allow normal growth and development.     

Nutritional management of horses competing in 160 km races

A survey was taken of dietary management and training schedules of 54 horses competing in two 160 km endurance races. A total of 52 owners, representing 54 horses, responded to a questionnaire distributed prior to the races. Diet and training schedules were compared between horses that successfully completed the races and those that were eliminated for metabolic reasons. Horses that completed the races were 11.5 +/- 4 years old, weighed 429 +/- 4.5 kg and were ridden 61 +/- 32 km a week when training. Feed intake was reported as "free choice hay or pasture" by 34 of the respondents. Dry matter (DM) hay intake in these horses was estimated to be 3% body weight (kg) minus the kg DM of grain fed, assuming a maximum intake. They were fed 12.3 +/- 2.3 kg feed per day consisting of 10 +/- 2.3 kg hay and 2.3 +/- 1.4 kg of grain. Most had free access to salt and were fed 1 +/- 1 vitamin/mineral supplement per day. Based on Nutritional Research Council (NRC) values for nutrient content of the reported feeds, diets contained 60 +/- 5% total digestible nutrients (TDN), 12 +/- 2% crude protein, 27 +/- 4% crude fiber, 0.72 +/- 0.4% calcium and 0.29 +/- 0.06% phosphorus. Maximum caloric intake was estimated to be 31.9 Mcal per day. Ratios of nutrients fed per kilometer trained were: kg TDN/km = .14 +/- .08, kg crude protein/km trained = .03 +/- .02, and kg crude fiber/km trained = .06 +/- .04.(ABSTRACT TRUNCATED AT 250 WORDS)     

Nutritional plan: matching diet to disease

Institution of appropriate, timely nutritional support in the anorexic or critically ill patient has become accepted medical practice in people and animals. This article focuses on the benefits of appropriate nutrient intake in critically ill animals, recommended nutrient requirements for dogs and cats receiving enteral feeding, and mechanics of food preparation and delivery for a variety of feeding tubes. General nutrient requirements for all patients, specific recommendations for certain illnesses such as renal failure, pancreatitis, and hepatic disease, and nutritional alterations for critical illness are reviewed. Commercial liquid diets manufactured for people and pets, and pet-food diets practical for formulation of gruel are presented. Institution of and weaning from feeding are explained.