Download VNA Level II Module 7: Therapeutic Nutrition

VNA Level II
Module 7: Therapeutic
Nutrition-Gastrointestinal
Learning Objectives
Disease
Learning Objectives
After completing this module, your basic understanding should include:
• The importance of the gastrointestinal tract and how disease affects its function.
• How intervention with nutritional aids such as Hill’s® Prescription Diet® i/d® Canine,
i/d® Feline, w/d® Canine, w/d® Feline, z/d® Canine-Low Allergen, z/d® Feline-Low
Allergen, and z/d® Canine ULTRA Allergen Free may help enhance recovery and/or
lead to a longer, better quality of life for dogs and cats with gastrointestinal disorders.
• The features and benefits of Hill’s® Prescription Diet® brand pet foods for
gastrointestinal disorders.
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Introduction
VNA Level II Module 7:
Therapeutic NutritionGastrointestinal Disease
Introduction
Disorders of the gastrointestinal (“GI” or “digestive”) tract are among the most
common reasons clients bring dogs and cats to veterinary practices. Vomiting,
diarrhea, abdominal pain, constipation, blood or mucus in the stool, and excessive
intestinal gas production are some of the clinical signs noted by pet owners. These
signs may or may not be caused directly from GI disorders. For our purposes here
though, we’ll concentrate specifically on direct GI problems.
Signs of GI disorders may include vomiting, diarrhea,
abdominal pain, constipation, blood in the stool, and
excessive intestinal gas production. These are among
the most common reasons pets are evaluated at
veterinary practices.
Proper nutrition is usually a critical element for managing dogs and cats with GI
disorders. Depending on the cause and severity of the problem, nutrient
requirements may change very quickly, and in some cases, become life
threatening. In other cases, proper nutrition may help manage chronic disorders,
and in the process help lengthen the quality time pets can spend with their owners.
This module of VNA is designed to provide you with a variety of communication
points, to help you convey the importance of proper pet nutrition to clients whose
pets have GI problems. Emphasis will be placed on the proper use of Hill’s®
Prescription Diet® pet foods that aid in the management of pets with GI disorders.
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VNA Level II Module 7:
What The GI Tract Does
Therapeutic NutritionGastrointestinal Disease
What The GI Tract Does
The GI tract is a long muscular tube that runs from the mouth to the anus. The wall
of this tube acts as a barrier between the inside of the body and the outside
environment. This wall does not normally allow harmful substances to enter the
body, nor does it permit body fluids and other substances to leave.
Several structures make up the GI tract:
The GI tract is a long hollow tube. Food and fluids that
enter the GI tract do not become part of the internal
body environment until they are digested and
absorbed into the bloodstream.
• Mouth, including the teeth,
tongue, and salivary glands
• Esophagus
• Stomach
• Small intestine
• Liver and gallbladder
• Pancreas
• Large intestine (colon),
including the rectum.
Figure 1. Gross anatomical
structures that make up the GI tract.
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VNA Level II Module 7:
What The GI Tract Does
Therapeutic NutritionGastrointestinal Disease
What The GI Tract Does
The inside lining of the GI tract must be healthy and intact for proper digestion and
absorption of foods. Recall from Level I, Module 1 of the Veterinary Nutritional
AdvocateSM that infectious agents such as canine parvovirus can destroy part of
the GI tract lining, disrupting digestion and absorption of nutrients, which causes
diarrhea. In such cases, bacteria from inside the GI tract can then gain entry to the
body. The lining of the GI tract must be able to resist the potentially harmful effects
of its own digestive secretions. Acid secreted by the stomach and digestive juices
secreted by the pancreas would rapidly destroy body tissues without the protective
effects provided by a healthy GI tract lining.
Beyond its function to supply nutrients for the body,
the GI tract acts as a barrier that helps prevent harmful
substances that are ingested from gaining access to
the body.
Figure 2. The inside lining of the
small intestine contains many
microscopic, finger-like
projections called villi (Left). Villi
secrete enzymes necessary for
final digestion of food and
absorb nutrients. Certain drugs,
viruses, and bacteria can
shorten or destroy the cells
lining villi (Right). When this
occurs, undigested and
unabsorbed nutrients draw
water to the inside of the small
intestine causing diarrhea. The
destroyed cells grow back over
several days.
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VNA Level II Module 7:
What The GI Tract Does
Therapeutic NutritionGastrointestinal Disease
What The GI Tract Does
A pet’s body needs a regular supply of externally supplied nutrients to grow,
replace worn out tissue, and provide energy for the thousands of chemical
reactions that occur continuously. The functions of the digestive system are to
ingest food, break it down, extract nutrients, and dispose of the remaining wastes
as feces. Food normally moves through the digestive tract at a rate that facilitates
digestion of food and absorption of nutrients, a process that typically takes several
hours. The digestive tract is remarkably complex, and can adapt to a variety of
foods to maximize absorbed nutrients.
Food enters the mouth where the teeth tear and grind it into smaller pieces that
can be swallowed and more easily digested later on. Chewing mixes food with
saliva, which in some species contains amylase, an enzyme that begins to digest
starches (carbohydrates) in the food. Saliva lubricates food so the tongue can
more easily direct food into the esophagus, the next part of the GI tract.
The nutrients in food must be broken down into
molecules that can be absorbed across the intestinal
wall.
Digestion begins in the mouth where food is torn and
ground into smaller pieces.
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VNA Level II Module 7:
What The GI Tract Does
Therapeutic NutritionGastrointestinal Disease
What The GI Tract Does
The esophagus is a muscular tube that connects the mouth to the stomach. A
muscular ring at the top of the esophagus remains closed when pets aren’t eating;
a muscular ring at the bottom helps prevent food from reentering the esophagus
from the stomach. A series of muscular contractions of the esophagus propel food
rapidly from the mouth to the stomach.
The next organ in the GI tract is the stomach. The stomach serves as a food
reservoir during the early stages of digestion. Gastric (pertaining to the stomach)
motility churns and grinds food and mixes it with digestive juices (the enzyme,
pepsin and hydrochloric acid), which chemically break food down into smaller
particles. Partially digested food may spend several hours in the stomach before it
is gradually released into the small intestine through another muscular ring.
Digestion of food (except fiber) is completed in the small intestine. When food
enters the first part of the small intestine (the duodenum) hormones are released
that stimulate the pancreas and gallbladder to release pancreatic juice and bile,
respectively. The liver forms bile, which is stored in the gallbladder until it is
needed. Bile helps make food entering the duodenum more alkaline (food leaving
the stomach is very acidic) and assists in fat digestion and absorption.
Figure 3. The stomach serves as
a food reservoir where early
stages of digestion occur.
Source: Hill’s Atlas of Veterinary
Clinical Anatomy.
Bile from the liver, digestive enzymes from the
pancreas, and brush border enzymes in intestinal
lining cells break proteins, fats, and carbohydrates into
molecules that can be absorbed from the intestine.
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VNA Level II Module 7:
What The GI Tract Does
Therapeutic NutritionGastrointestinal Disease
What The GI Tract Does
Digestion and absorption occur mainly in the small
intestine. Digestion is the breaking of food down into
its constituent parts. Absorption is the process of
transporting nutrients and other substances from the
external environment of the GI tract into the body.
Pancreatic juice also makes the contents of the small intestine less acidic and
completes the digestion of proteins, fats, and carbohydrates. Bile and pancreatic
juice enter the duodenum through special tubes called ducts. Enzymes called
brush border enzymes found in intestinal lining cells complete the digestive
process. After food is completely digested, nutrients are absorbed through the
small intestine and flow in the bloodstream to the liver and then to the body’s cells
for use. Recall from Level I, Module 1, Nutrients, that some fat in the diet is
necessary for absorption of fat-soluble vitamins, (A, D, E and K). Minerals and B
vitamins are absorbed as needed. Food is propelled through the small intestine by
waves of muscular contractions.
The liver and pancreas perform many other metabolic
processes in addition to their involvement with the
gastrointestinal tract.
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VNA Level II Module 7:
What The GI Tract Does
Therapeutic NutritionGastrointestinal Disease
What The GI Tract Does
Water and undigested food pass into the large intestine, (colon) from the small
intestine. Here, most of the water is reabsorbed and some fermentation of fiber
occurs. Wastes (undigested food and bacteria) enter the rectum, the final portion of
the large intestine, where they are periodically expelled through the anus as feces.
Figure 4. Bacteria in the colon
can ferment some of the fiber in
a pet’s food. Source: Hill’s Atlas
of Veterinary Clinical Anatomy.
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Common GI DisordersVNA Level II Module 7:
Therapeutic NutritionGastrointestinal Disease
Common GI Disorders
Many cats and dogs will be brought to your veterinary practice for evaluation of
problems such as vomiting, diarrhea, constipation, excessive intestinal gas
production, loss of appetite, weight loss, and blood or mucus in the stools.
Oftentimes, these signs will be the direct result of altered GI tract function. Such
alterations may be acute or chronic and range from minor disturbances to lifethreatening illnesses. Some of these problems may respond to short-term therapy;
other situations require long-term therapy and continual re-evaluation. Disorders
may only affect a certain portion (e.g., the stomach) of the GI tract; others affect
several sections. Understanding the normal function of each organ of the GI tract
will help you understand the clinical signs that arise when that organ functions
abnormally.
Understanding the function of each part of the GI tract
will help you understand the clinical signs that occur
with GI disorders.
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Common GI DisordersVNA Level II Module 7:
Therapeutic NutritionGastrointestinal Disease
Common GI Disorders
Table 1-6 describes some of the more common GI problems of pets seen in
practice. This is by no means a comprehensive list. GI problems, as with all
medical conditions in pets, are to be diagnosed by a veterinarian.
Table 1. Some conditions that affect the MOUTH
Condition: Periodontal disease
Signs/presenting complaint:
Difficulty eating, red gums, loss of gum tissue, bad breath,
tooth loss, weight loss, poor body condition
Examples of treatment/nutritional aids:
• Frequent dental cleanings above and below the gumline.
• Frequent tooth care at home to remove plaque, the cause
of periodontal disease: regular tooth brushing (which most
pet owners find difficult to do) and/or feeding a dry food
that gently scrubs the entire supragingival tooth surface,
for example: Hill’s® Prescription Diet® t/d Canine® and
t/d Feline®.
DENTAL DISEASE
Figure 5. Example of periodontal
disease.
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Common GI DisordersVNA Level II Module 7:
Therapeutic NutritionGastrointestinal Disease
Common GI Disorders
Table 2. Some conditions that affect the ESOPHAGUS
Condition: Disorders that impair swallowing:
inflammation, foreign objects, impaired esophageal motility
Signs/presenting complaint:
Coughing or gagging when the pet eats, regurgitation,
bad breath, pain when swallowing, profound
Malnutrition in some pets, poor body condition.
Examples of treatment/nutritional aids:
• Remove foreign material.
• Feed foods with high digestibility.
• Mix foods into gruels.
• Feed pet in an elevated head position
(i.e., placing food bowl on stairs above the pet,
putting food bowl on a stool or counter, etc.).
Figure 6. Example of a feeding
device to help maintain an upright
feeding position.
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Common GI DisordersVNA Level II Module 7:
Therapeutic NutritionGastrointestinal Disease
Common GI Disorders
Table 3 Part 1. Some conditions that affect the STOMACH
Condition: Gastritis (inflammation of the inside stomach lining)
Signs/presenting complaint:
• Vomiting is the hallmark of gastric diseases
• Gastritis may be acute or chronic.
• Acute causes include garbage eating or ingesting a foreign object.
• Chronic causes include long-term use of anti-inflammatory drugs, food intolerances, and liver and kidney disorders.
Examples of treatment/nutritional aids:
• Stabilize the patient.
• Treat the cause; remove foreign material if possible, prevent
access to garbage, treat liver or kidney disease, etc.
• De-worm pet if intestinal parasites are present.
• Drugs that improve motility of stomach.
• In general, feed pet foods that are easy to digest and have
moderate levels of protein and fat, in several small meals per
day. Hill’s® Prescription Diet® i/d® Canine and i/d® Feline are
often recommended as nutritional aids for these reasons.
Line of dissection
Figure 7. Example of a normal stomach lining
and one with hemorrhagic gastritis with ulcers.
Source: Hill’s Atlas of Veterinary Clinical
Anatomy.
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Common GI DisordersVNA Level II Module 7:
Therapeutic NutritionGastrointestinal Disease
Common GI Disorders
Table 3 Part 2. Some conditions that affect the STOMACH
Condition: Gastric motility/emptying disorders
Signs/presenting complaint:
• Delayed gastric emptying results in vomiting.
• Weight loss and poor body condition occur in chronic cases.
Examples of treatment/nutritional aids:
• Stabilize patient and remove foreign material if that is the cause.
• Drug therapy to improve gastric function.
• Frequent small meals fed at room temperature (dry foods and cold foods are digested more slowly and
may complicate recovery). Fat levels in the canned food should be moderate. Several small meals per
day tend not to overload the stomach. Canned Prescription Diet® i/d® Canine and i/d® Feline are often
recommended as nutritional aids for these reasons.
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Common GI DisordersVNA Level II Module 7:
Therapeutic NutritionGastrointestinal Disease
Common GI Disorders
Table 4 Part 1. Some conditions that affect the SMALL INTESTINE
Condition: Gastritis (inflammation of the inside stomach
lining)
Signs/presenting complaint:
• May be chronic or acute.
• This is one of the most common illnesses of dogs and • Signs include diarrhea, depression, and dehydration.
cats. Causes include ingesting foreign material, garbage
toxicity, viruses, bacteria, intestinal parasites, chemicals
and drugs, food allergies, lactose intolerance, etc.
Examples of treatment/nutritional aids:
• For suspected adverse reactions to foods, (see Figure 8) it
• Stabilize the patient.
may be appropriate to feed foods with reduced quantities of
• Treat the cause specifically, for example, de-worm
highly digestible protein from ingredients that the pet hasn’t been
patient, avoid milk containing products if lactose
exposed to before, (food trial).
intolerance is the cause, etc.
• Prescription Diet® d/d® Feline, and d/d® Canine were
• Antibiotics and drugs to modify motility of the GI tract
formulated for this purpose. Alternatively, a food containing a
may be prescribed in some cases.
protein hydrolysate (small proteins that are unable to cause a
food reaction) should be fed.
Adverse Reactions to
food
• Prescription Diet® z/d® Canine - Low Allergen, z/d® Canine
ULTRA Allergen Free, and z/d® Feline - Low Allergen are
Non-immunologic
Immunologic
examples of foods containing protein hydrolysates.
• Many dogs and cats with gastroenteritis respond well to such
foods as Prescription Diet® i/d® Canine and i/d® Feline
Food
Dietary
Food
Food
respectively. These foods contain easily digested ingredients
intolerance
indiscretion
anaphylaxis
allergy
and moderate amounts of fat and protein.
Metabolic
food reaction
Food
poisoning
Food
idiosyncrasy
Pharmacologic
reaction to food
Figure 8. Classification of adverse reactions to food. Source:
Small Animal Clinical Nutrition, 4th Edition.
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Common GI DisordersVNA Level II Module 7:
Therapeutic NutritionGastrointestinal Disease
Common GI Disorders
Table 4 Part 2. Some conditions that affect the SMALL INTESTINE
• Some pets with gastroenteritis respond to foods containing increased amounts of fiber to help normalize intestinal motility.
Prescription Diet® w/d® Canine and w/d® Feline are such foods.
Figure 9. Example of a section of normal small intestine
and one with considerable dilation and inflammation, (as a
result of ingestion and subsequent lodging of a ball).
Source: Hill’s Atlas of Veterinary Clinical Anatomy.
Condition: Inflammatory bowel disease (IBD)
Signs/presenting complaint:
• IBD is a special subset of chronic gastroenteritis (it may also affect the large intestine and stomach).
• Several types are seen but the cause is not always known.
• Chronic vomiting, diarrhea, and weight loss are seen.
Examples of treatment/nutritional aids:
• Drugs are often prescribed to lessen the inflammatory response.
• Any of the three nutritional approaches listed above (foods for adverse reactions to food, highly digestible, or increased
fiber) may be effective for a particular pet. A food trial may be needed to determine which is most effective.
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Common GI DisordersVNA Level II Module 7:
Therapeutic NutritionGastrointestinal Disease
Common GI Disorders
Table 5 Part 1. Some conditions that affect the LARGE INTESTINE
Condition: Colitis (inflammation of the colon)
Signs/presenting complaint:
• Colitis is a common disorder of dogs and cats. Causes may include ingesting foreign objects, garbage ingestion,
intestinal parasites, bacteria, viruses, food intolerances, etc.
• Clinical signs usually include frequent diarrhea, straining to have a bowel movement, and passage of mucus and blood
in the stool.
Examples of treatment/nutritional aids:
• Stabilize the patient.
• Treat the cause specifically, for example, de-worm patient, remove foreign materials, etc.
• Antibiotics and drugs are often prescribed to lessen the inflammatory
response.
• Any of the three nutritional approaches listed in Table 4 in the
small Intestine section (foods for adverse reactions to food, highly
digestible, or increased fiber) may be effective for a particular pet. A
food trial may be needed to determine which is most effective.
Figure 10. Example of the linings of a normal
colon of a dog and one with chronic colitis.
Source: Hill’s Atlas of Veterinary Clinical
Anatomy.
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Common GI DisordersVNA Level II Module 7:
Therapeutic NutritionGastrointestinal Disease
Common GI Disorders
Table 5 Part 2. Some conditions that affect the LARGE INTESTINE
Condition: Constipation
Signs/presenting complaint:
Infrequent defecations, straining to have bowel movements.
Examples of treatment/nutritional aids:
• Laxatives, increase water intake.
• Feeding foods with higher fiber levels, for example Prescription Diet®
w/d® Canine or w/d® Feline.
Figure 11. Extreme dilation of the
descending colon due to impacted feces.
Source: Hill’s Atlas of Veterinary Clinical
Anatomy.
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Common GI DisordersVNA Level II Module 7:
Therapeutic NutritionGastrointestinal Disease
Common GI Disorders
Table 6. Some conditions that affect the PANCREAS
Condition: Exocrine pancreatic insufficiency (EPI)
Signs/presenting complaint:
This disorder is characterized by a partial to complete deficiency in pancreatic enzymes needed for digestion of food. As a
result, a patient’s history often includes chronic diarrhea, weight loss, and poor body condition.
Examples of treatment/nutritional aids:
• Provide pancreatic enzymes.
• Provide a food with highly digestible ingredients, for example,
Prescription Diet® i/d® Canine or i/d® Feline.
Figure 12. Example of a normal pancreas (left) and
one with exocrine pancreatic insufficiency (right).
Source: Hill’s Atlas of Veterinary Clinical Anatomy.
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VNA Level II Module 7:
Diagnosing GI Tract Disorders
Therapeutic NutritionGastrointestinal Disease
Diagnosing GI Tract Disorders
Presence of the signs listed in Tables 1-6 suggests GI tract disorders. Pets with
serious GI disorders usually have one or more of the following signs: dehydration,
distended abdomen, depression, abdominal pain, fever, and red and white blood
cells in the stool.
If the veterinarian suspects a GI tract disorder, he or she may request that the
veterinary technician collect, for example, blood and fecal samples for laboratory
testing. Evaluation of stool specimens may detect such things as intestinal
parasites or their eggs, blood from the upper or lower GI tract, white blood cells
(indicating inflammation), and undigested food. Radiographs and ultrasound may
show changes in the size, shape, or position of the GI tract. Parts of the upper GI
tract (esophagus, stomach, and parts of the duodenum) and lower GI tract (large
intestine) may be evaluated by endoscopy. Often intestinal tissue samples, (biopsy
specimens) are collected during an endoscopic procedure and sent to a pathologist
for evaluation. Foreign material may be removed by surgery, or in some cases
during endoscopy. The tests required and how often they are repeated depend on
each individual case.
Dehydration, a distended abdomen, depression,
abdominal pain, fever, and red and white blood cells in
the stool are signs of a serious GI disorder.
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VNA Level II Module 7:
Risk Factors For GI Tract Disorders
Therapeutic NutritionGastrointestinal Disease
Risk Factors For GI Tract Disorders
There are many causes of GI disorders and consequently many risk factors. A few
of the more common ones follow:
Age. Younger pets are more likely to present with congenital and traumatic
disorders. This group also is more vulnerable to garbage and foreign material
ingestion. Young pets are generally more susceptible to deleterious effects of
intestinal parasites, viruses, and bacteria. Older pets are more likely to
develop inflammatory disorders and cancer of the GI tract. Older pets
receiving certain pain medications for arthritis are more likely to develop
ulcers of the GI tract.
Breed. Larger breed dogs are more likely to develop a serious, usually acute
condition called gastric dilatation-volvulus. Gastric motility disorders are more
common in small, middle-aged, purebred dogs. German shepherd dogs are
susceptible to a condition called exocrine pancreatic insufficiency, EPI.
Drug therapy. Some analgesic pain medications may predispose to GI tract
ulcers.
Disease in other organs. Dogs and cats with liver and kidney disorders may
develop GI tract disorders.
Feeding-related factors. Feeding one large meal a day, rapid eating, and
exercising immediately after eating are risk factors for gastric dilatationvolvulus.
Environmental factors. Pets that are allowed to roam outside are more likely
to ingest garbage and toxic substances, including poisons, and are more
likely to be exposed to intestinal viruses and parasites. Pets kept in
unsanitary, overcrowded environments are more susceptible to problems
involving viruses, bacteria, and parasites.
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VNA Level II Module 7:
Treating GI DisordersTherapeutic
NutritionGastrointestinal Disease
Treating GI Disorders
Tables 1-6 list some of the more common treatments/nutritional aids for pets with
GI disorders. Because vomiting and diarrhea are not diseases themselves, but
rather signs of an underlying disease, veterinary care is directed toward identifying
and treating the underlying cause if possible.
Proper nutrition plays an important role in managing dogs and cats with GI tract
disorders. Nutritional factors of prime importance depend on the GI disorder.
Common key nutritional factors include:
The feeding method is a critical element in feeding
pets with GI disorders. It is often best to avoid
overloading the GI tract by feeding small meals
several times per day.
• Water (many pets with acute GI disorders are dehydrated).
• Minerals (depending on the severity and duration of vomiting and/or
diarrhea, pets may have severe disturbances in sodium, potassium, and
chloride balance).
• Protein (some proteins may cause adverse food reactions in certain pets;
foods with high protein levels are emptied more slowly from the stomach than
other foods).
• Fat (high fat foods are emptied more slowly from the stomach than other
foods).
• Fiber (may help regulate GI motility and add bulk to the stool).
• Carbohydrate (milk-containing products may cause diarrhea in lactosedeficient pets).
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VNA Level II Module 7:
Treating GI DisordersTherapeutic
NutritionGastrointestinal Disease
Treating GI Disorders
• Vitamins (patients unable to digest or absorb fat may be unable to absorb
sufficient amounts of fat-soluble vitamins).
• Digestibility (many patients with GI tract disorders benefit from foods with
highly digestible ingredients).
• Food form (More liquid forms are emptied more quickly from the stomach).
• Feeding method (multiple small meals per day may be most beneficial).
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Food Types Useful In The Management Of
Pets With GI Tract
VNA Level II Module 7:
Therapeutic NutritionDisorders
Gastrointestinal Disease
Food Types Useful In The Management Of
Pets With GI Tract Disorders
As previously mentioned, there are three nutritional approaches commonly used in
the management of dogs and cats with GI tract disorders: highly digestible,
enhanced-fiber, and foods for suspected adverse reactions to food.
Highly Digestible GI Foods
Veterinary therapeutic foods have been specially formulated for managing dogs
and cats with GI diseases. Veterinarians recommend highly digestible foods most
often for managing acute gastroenteritis or disorders associated with small
intestinal disease or EPI. Some practitioners also recommend these foods for
patients with certain colonic disorders.
Three nutritional approaches are commonly used for
the management of dogs and cats with GI tract
disorders: highly digestible, enhanced-fiber, and foods
for suspected adverse reactions to foods. A dietary
feeding trial is often necessary to determine which is
best for an individual pet.
Examples: Prescription Diet® i/d® Canine and i/d® Feline pet foods.
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Food Types Useful In The Management Of
Pets With GI Tract
VNA Level II Module 7:
Therapeutic NutritionDisorders
Gastrointestinal Disease
Food Types Useful In The Management Of
Pets With GI Tract Disorders
Fiber-Enhanced Foods
Soluble fibers delay gastric emptying and slow the time it takes for food to move
through the intestinal tract. Bacteria in the colon ferment soluble fiber to shortchain fatty acids, which are used to nourish the cells lining the colon. Short-chain
fatty acids also discourage growth of potentially harmful bacteria. Certain fiber
types may be of benefit in GI disease because they bind toxins and irritating bile
acids. This binding effect prevents these substances from further damaging the
intestinal mucosal surface. Insoluble fibers also normalize intestinal transit time,
but have little or no effect on gastric emptying.
One of the most profound effects of fiber on the GI tract is the normalization of
motility, particularly in the stomach, upper small intestine, and colon. In general,
increasing the insoluble fiber content of the food resolves or modulates many
cases of colitis.
Prescription Diet ® w/d® Canine and w/d® Feline pet foods are examples of
fiber-enhanced foods.
Three nutritional approaches are commonly used for
the management of dogs and cats with GI tract
disorders: highly digestible, enhanced-fiber, and foods
for suspected adverse reactions to foods. A dietary
feeding trial is often necessary to determine which is
best for an individual pet.
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Food Types Useful In The Management Of
Pets With GI Tract
VNA Level II Module 7:
Therapeutic NutritionDisorders
Gastrointestinal Disease
Food Types Useful In The Management Of
Pets With GI Tract Disorders
Foods for Suspected Adverse Reactions to Food
Foods for suspected adverse reactions to foods are most often recommended for
patients with GI signs possibly due to one or more of the Adverse Reaction to Food
Classifications in Figure 8. A feeding trial with a food containing protein sources to
which the pet has never been exposed, or a protein hydrolysate, (containing
protein fragments too small to cause adverse food reactions) may lead to
improvement in clinical signs. As mentioned in Table 1, Prescription Diet® d/d®
Feline, d/d® Canine, z/d® Canine ULTRA Allergen Free, and z/d® Feline-Low
Allergen may be very beneficial in treating some of the classifications in Figure 8,
particularly food allergies and intolerances. If these types of foods prove beneficial
in managing the problem, the veterinarian may place the pet on this food longterm.
Highly digestible foods, and foods for suspected
adverse reactions to food are usually good first
choices for patients with gastric or small intestinal
disorders. Fiber-enhanced foods are often the first
choice when large intestinal signs predominate.
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Food Types Useful In The Management Of
Pets With GI Tract
VNA Level II Module 7:
Therapeutic NutritionDisorders
Gastrointestinal Disease
Food Types Useful In The Management Of
Pets With GI Tract Disorders
Selected benefits of Prescription Diet® i/d® Canine and i/d® Feline pet foods
include:
• Highly digestible protein, fat, and carbohydrate sources to facilitate
healing of the GI tract
• Mixed fiber (soluble and insoluble fiber) source to help support volatil fatty
acid production and modify intestinal transit time
• Moderate fat levels for patients with pancreatic disorders
• May be fed long-term to patients with GI tract disorders
• i/d Canine® has passed Association of American Feed Control (AAFCO)
animal feeding tests for growing puppies
• Formulated by Hill’s Pet Nutrition, Inc., the industry leader in therapeutic
nutrition
• Available in canned and dry formulations for dogs and cats
• Highly palatable
• 100% Guarantee on all Hill’s® Prescription Diet® products: Hill’s
guarantees Prescription Diet brand pet food for quality, consistency and
taste. If you are not completely satisfied with any purchase of Prescription
Diet brand pet food for these reasons, simply return the unused portion to
your veterinarian for a full refund or replacement. (Hill’s will reimburse the
practice).
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Food Types Useful In The Management Of
Pets With GI Tract
VNA Level II Module 7:
Therapeutic NutritionDisorders
Gastrointestinal Disease
Food Types Useful In The Management Of
Pets With GI Tract Disorders
Selected benefits of Prescription Diet® w/d® Canine and w/d® Feline pet
foods include:
• High fiber level to help modify intestinal transit time and provide bulk and
form to the stool
• High fiber level helps absorb water to moisten the stool and increase
intestinal motility
• Low fat level for patients with pancreatic disorders
• May be fed long-term to patients with GI tract disorders
• Formulated by Hill’s Pet Nutrition, Inc., the industry leader in therapeutic
nutrition
• Available in canned and dry formulations for dogs and cats
• Highly palatable
• 100% Guarantee on all Hill’s® Prescription Diet® products: Hill’s
guarantees Prescription Diet brand pet food for quality, consistency and
taste. If you are not completely satisfied with any purchase of Prescription
Diet brand pet food for these reasons, simply return the unused portion to
your veterinarian for a full refund or replacement. (Hill’s will reimburse the
practice).
Your progress is saved. Slide 27 of 31
Food Types Useful In The Management Of
Pets With GI Tract
VNA Level II Module 7:
Therapeutic NutritionDisorders
Gastrointestinal Disease
Food Types Useful In The Management Of
Pets With GI Tract Disorders
Selected benefits of Prescription Diet® d/d® Canine and d/d® Feline pet foods
include:
• Conpotentially novel (new to the pet) protein sources that are highly
digestible and provided in reduced amounts
• Provides highly digestible, single carbohydrate (rice) source
• d/d Canine® is available with rice and egg, potato and duck, potato and
salmon, and potato and venison protein sources
• d/d Feline® is available with Duck and green pea and venison and green
pea protein sources
• All formulations are highly digestible
• Highly palatable
• May be fed long-term to patients with GI tract disorders
• Formulated by Hill’s Pet Nutrition, Inc., the industry leader in therapeutic
nutrition
• Highly palatable
• 100% Gutains arantee on all Hill’s® Prescription Diet® products: Hill’s
guarantees Prescription Diet brand pet food for quality, consistency and
taste. If you are not completely satisfied with any purchase of Prescription
Diet brand pet food for these reasons, simply return the unused portion to
your veterinarian for a full refund or replacement. (Hill’s will reimburse the
practice).
Your progress is saved. Slide 28 of 31
Food Types Useful In The Management Of
Pets With GI Tract
VNA Level II Module 7:
Therapeutic NutritionDisorders
Gastrointestinal Disease
Food Types Useful In The Management Of
Pets With GI Tract Disorders
Selected benefits of Prescription Diet® z/d® Canine-Low Allergen, z/d®
Canine ULTRA Allergen Free, and z/d® Feline-Low Allergen include:
• z/d Feline® -Low Allergen has a hydrolyzed protein source, (with no intact
animal protein) and is highly digestible. The protein source is smaller than
the body’s immune system can recognize; thus, it helps eliminate certain
adverse reactions to food.
• Provides highly digestible carbohydrate source
• z/d Canine® ULTRA Allergen Free contains a hydrolyzed protein source
and a refined carbohydrate source to further minimize intact protein in the
food
• All formulations are highly digestible
• Contains high levels of omega-3 and omega-6 fatty acids to promote
healthy skin and coat
• May be fed long-term
• Formulated by Hill’s Pet Nutrition, Inc., the industry leader in therapeutic
nutrition
• Highly palatable
• 100% Guarantee on all Hill’s® Prescription Diet® products: Hill’s
guarantees Prescription Diet brand pet food for quality, consistency and
taste. If you are not completely satisfied with any purchase of Prescription
Diet brand pet food for these reasons, simply return the unused portion to
your veterinarian for a full refund or replacement. (Hill’s will reimburse the
practice).
Your progress is saved. Slide 29 of 31
VNA Level II Module 7:
Monitoring Patients With GI Disorders
Therapeutic NutritionGastrointestinal Disease
Monitoring Patients With GI Disorders
Patients with GI disorders should be monitored at regular intervals, depending on
the severity of their disease and the therapy prescribed. Some pets may recover
from acute illnesses within a week. Pets with chronic GI illnesses may need to be
evaluated every one to three months. In any GI incident, long-term nutritional
guidance is usually appropriate, either to prevent/minimize reoccurrences or to
assist the pet owner in controlling the problem as best as possible.
Your progress is saved. Slide 30 of 31
Summary / Are you ready?
VNA Level II Module 7:
Therapeutic NutritionGastrointestinal Disease
Summary
Alterations in function of the GI tract-oral cavity, esophagus, stomach, small
intestine, large intestine, liver, and pancreas-are among the most common reasons
dogs and cats are presented to veterinary practices. Altering food ingredients,
nutrient profiles, food form, and feeding methods can be powerful tools in
successfully managing pets with GI disorders. Drug therapy instituted without
concurrent dietary therapy often yields less than desirable results in the long-term
management of most GI diseases.
This overview of GI disorders and the importance of proper pet nutrition should
help with your ability to assist the veterinarian, and in communications with pet
owners. GI problems in dogs and cats can be very frustrating for pet owners to
deal with, and they are usually quite eager for some form of resolution. As you can
see, Hill’s® is there to support your health care team, and the pets and people you
serve, with efficacious nutritional products for the management of GI tract
disorders for dogs and cats.
Are you ready?
To continue, you will need to complete the quiz for this module. When you are
ready, click on the forward arrow below to take you to the quiz.
Your progress is saved. Slide 31 of 31
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