Therapeutic Nutrition III:Lower Urinary Tract Disease

Gastrointestinal DiseaseLiver Disease

“Fella” 9 yrs old M(I) Beagle

Inflammation

Infection

Blockages

Formation of Uroliths

© Hill’s Pet Nutrition, Inc.

Struvite Calcium Oxalate

Usually associated with bacterial urinary tract infection

High sodium, calcium and oxalate correlation

Source: University of California – San Diego

Canine ProfileAverage

AgeGender Breeds

CalciumCalcium

OxalateOxalate8 years

Males > Female

Min. Schnauzers, Min. Poodles, Yorkies, Bichons, Shih Tzus

StruviteStruvite 6 yearsFemale> Male

Min. Schnauzers, Min. Poodles, Cocker Spaniels, Bichons

Struvite Calcium Oxalate

Persistent alkaline urine pH Persistent acidic urine pH

Source: University of California – San Diego

Feline Profile

Avg. Age

Gender & Neuter Status

BCS & Environment

Breeds

CalciumCalcium

OxalateOxalateOldercats

Neutered Males

Obese, indoor,

multiple cats

Himalayan,Burmese, Persian

StruviteStruviteYounger

Cats

Non-specific

Neutered

Obese, indoor,

multiple cats

Non-specific

● Identify urolith type● Dissolve – struvite only● Treat infection if present● Target appropriate pH● Increase water intake in order to promote

diluted urine

Water, water, water!

Increases urine volume More dilute urine Decreased mineral concentration in urine Increased frequency of urinating Decreased urine retention Less time for crystals to form

DIETARY MANAGEMENT IS MOST EFFECTIVE!!!!

UR Urinary® St/Ox

Urinary S - Low pH/S Feline dry & canned

Urinary O - Moderate pH/O Feline dry & canned

Prescription Diet® c/d Multicare (for cats)

Prescription Diet® s/d Prescription Diet® u/d

Prescription Diet® x/d Prescription Diet® r/d

Prescription Diet® w/d

Urinary SO 30 Urinary SO 13Dissolution FormulaVegetarian Formula

Samantha, 9-years old, Standard PoodleSamantha, 9-years old, Standard Poodle

Normal GI Function

Digestion of ingredientsAbsorption of nutrientsMove food through GI tractEliminate waste (undigested) or

by-products (bile acids, nitrogen)

“Gracie Whitesox” 2 yrs ©GBS 2006

Gastritis & Enteritis

• VomitingVomiting• DiarrheaDiarrhea

• VolumeVolume• ConsistencyConsistency• FrequencyFrequency

“Going to California” 2yrs F(n) Miniature Pinscher

Gastric Dilatation & Volvulus“Bloat”

• Secondary damage to GI mucosa

• Tissue necrosis• Impaired digestion,

absorption

Source: Long Beach Animal Hospital; Long Beach, CA

Maldigestion/Malabsorption

• Inability to absorb nutrients

• Inability todigest/metabolize

Mink, 14 yrs © G. Santiago 2002

Soluble vs.

Insoluble

Slowly Fermentable

Rapidly Fermentable

Fiber

pectinpectin

guar gumguar gum

soy fibersoy fiber

branbran

beet pulpbeet pulp

soybean hullssoybean hulls

peanut hullspeanut hulls

cellulosecellulose

Small Animal Clinical Nutrition, 4th ed. Hand, Thatcher, Remillard, Roudebush

1.1. Restore fluid and electrolyte losses via oral Restore fluid and electrolyte losses via oral or IV fluid therapyor IV fluid therapy

3.3. Initially NPO to “rest” the entire GI tractInitially NPO to “rest” the entire GI tract

5.5. Gradual introduction of highly digestible Gradual introduction of highly digestible nutrients in small, controlled quantitiesnutrients in small, controlled quantities

Inflammatory GI Disease: Goals

Examples: “Bloat”, Gastritis, Inflammatory Bowel Disease, Exocrine Pancreatic Insufficiency, GI Surgery

1.1. Provide low residue (low fiber) to reduce Provide low residue (low fiber) to reduce the work of the GI tract.the work of the GI tract.

3.3. High digestibility to increase absorptionHigh digestibility to increase absorption

5.5. High fiber in colitis & constipationHigh fiber in colitis & constipation

Inflammatory GI Disease: KNF

1.1. Reduce contributing causesReduce contributing causes2.2. Provide “bulk” to stoolProvide “bulk” to stool3.3. Highly digestible ingredientsHighly digestible ingredients4.4. Provide water absorption in colonProvide water absorption in colon

Examples: Obstipation, Constipation, Mega Colon, Fiber Responsive Diarrhea

Increase water consumption Increase insoluble fiber

Start low, then increase slowly each week Moderate fiber 10 – 15%; high fiber >15%

Highly digestible fat & carbohydrates Highly digestible protein

Would You Recommend an Increase or Decrease in Fiber?

Parvo Virus

Constipation

Bloat Surgery

Dietary Indiscretion

or

or

or

or

X

X

X

X

XX

Needs decreased levels of fiber

Needs increased levels of fiber

EN Gastroenteric®

DCO Dual Fiber Control®

FortiFlora® Canine Nutritional Supplement

Low-Residue Feline & Canine formulas

Prescription Diet® d/d

Prescription Diet® z/d

Prescription Diet® i/d Prescription Diet® w/d

Hypoallergenic HP 19

Sensitivity RC, LR, RD 30, VRDiabetic HF 18

www.greatdogsite.com

Drug and Toxin Metabolism Ammonia detoxification Protein catabolism Fat synthesis and fat-soluble vitamin

storage Glucose mobilization storage

Acute Toxins Feline Hepatic Lipidosis

Chronic Portosystemic Shunt Cirrhosis Glucocorticoid Induced Copper Storage Problems

● Highly digestible energy from carbohydrates and fat, to spare protein catabolism

● Moderate levels of high quality protein Milk, egg or vegetable proteins are best

● High vitamin level (Vitamins K, E, and C)

● Reduced selected minerals (especially copper in some dog breeds)

High energy density

High fat

Controlled, high quality protein

High vitamin content, including antioxidants

Carnitine

EN Gastroenteric®

NF Kidney Function®

Prescription Diet® l/d Prescription Diet® k/d

Hepatic LS 14 Formula