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Nutritional Diets Food Allergy - Terminology • Food intolerance or adverse food reactions account for 1 to 6% of all dermatoses in general practice. No immunological reaction • Food allergy constitutes 10 to 49% of allergic responses in dogs and cats Food Allergy – Clinical Signs • Canines: – Intense Pruritus (nonseasonal): feet, axillae, inguinal – Alopecia – hyperpigmentation – Chronic otitis externa – Peri-ocular dermatitis, Pododermatitis, anal sacculitis – Few have vomiting and diarrhea Food Allergy Hyperpigmentation Lichenification: Dff: All chronic and pruritic skin diseases Otitis externa Food Allergy Food Allergy – Clinical Signs – Felines – Intense Pruritus (nonseasonal): head and neck – Alopecia – Miliary dermatitis – Ulcerative dermatitis – Many have vomiting and diarrhea Food Allergy Food Allergy Food Allergy Food Allergy - Allergen • Protein: 18-36,000 Dalton's average molecular weight • Canine: Beef, dairy products, soy, chicken • Feline: Beef, dairy products, soy, fish Food Allergy - Diets • Protein: Novel or hydrolyzed – fish, rabbit, lamb, venison • Carbohydrate: Single easily digestible – rice, potatoes, barley, oats • Fats – Omega 3 and 6 • Vitamins – A and E • Minerals – Zn Food Allergy - Diagnosis • FOOD ELIMINATION TRIAL • The patient is fed a hypoallergenic diet for 6090 days. • This allows the body to become desensitized to the offending allergens. • When the previous diet is fed back to the pet, an acute hypersensitivity reaction may occur. • This helps to identify that a food was the source of the allergic signs Food Allergy – Novel Proteins – Novel proteins • Hills d/d Food Allergy – Novel Proteins Fish and Potato Food Allergy – Hydrolyzed Proteins • Z/D: Less than 18,000 dalton • Ultra z/d: less than 3,000 dalton Hydrolyzed chicken Food allergy: Challenging Diabetes Mellitus Diabetes Mellitus • Definition: Disorder of carbohydrate, fat and protein metabolism caused by an absolute or relative insulin deficiency • Type I –very low or absent insulin secretory ability • Type II – inadequate or delayed insulin secretion relative to the needs of the patient – More common in cats Diabetes Mellitus • Signalment: older patients, obese, top 3 disease in older cats • Clinical signs: polyuria, polydipsia, polyphagia, weight loss, cataracts – dogs, Plantigrade stance (neuropathy) - cats Diabetes Mellitus Diabetes Mellitus • Treatment options – Insulin – Oral hypoglycemic drugs – Dietary management • Frequent meals Diabetes Mellitus • Dietary GOALS – Stabilize blood glucose levels – Minimize hyperglycemia – Prevent hypoglycemia – Prevent or delay long term effects of the disease – Achieve and maintain an ideal body condition Diabetes Mellitus - Dogs • Carbohydrate – Complex – Fiber: High • Slows digestion, reduces the post-prandial glucose spike, promotes weight loss, reduces risk of pancreatitis –Vitamin E –Hill’s R/D or W/D Diabetes Mellitus - Cats • Protein: high • Carbohydrate: Low – Cats use protein as their primary source of energy – blood glucose is maintained primarily through liver metabolism of fats and proteins • Purina DM, Hill’s M/D • Often a diet change in cats can dramatically reduce or eliminate the need for insulin 70% of cats and 80% of dogs have periodontal disease. It is the most common health problem in pets. A difference in the oral pH causes plaque and tartar to build up 5 times quicker than in humans Calculus is mineralized plaque and can only be removed by mechanical action. The shape and density of the dental diets promotes chewing action that creates the abrasion of the bacteria and helps to slow plaque and calculus buildup. Unique kibble scrubs away laden plaque in the mouth to promote systemic health Clinically proven to reduce plaque, stain and tartar buildup Reduces bad breath Added antioxidants to control cell oxidation and promote a healthy immune system Awarded the Veterinary Oral Health Council (VOHC) Seal of Acceptance for helping reduce both plaque and tartar accumulation Optimal kibble size Patented kibble texture Added antioxidants A and E Natural source of glucosamine Moderate calories Exceptional palatability Perfect solution for everyday feeding of adult and senior dogs Canine Dental Chewz™ are a perfect complement when using the DH Formula. Urinary tract health: Feline Lower Urinary Tract Disease (FLUTD) is frequently seen in cats. This is a serious problem, especially in males. Unfortunately many cat owners do not realize their pet has FLUTD until the signs are severe. The term FLUTD is commonly used to descibe a group of diseases of the feline ureters, urinary bladder and/or urethra. They are often grouped together because they share similar clinical signs including Hematuria: bloody urine Dysuria: difficult urination Stranguria: slow or painful urination Pollakiuria: abnormally frequent urination Inappropriate urination (periuria) Partial or complete urethral blockage The most common types of FLUTD are Idiopathic cystitis Urethral obstruction Urolithiasis: fomation of calculi (stones) in the bladder Idiopathic cystitis: The most common diagnosis in cats with FLUTD. It is a painful, chronic, noninfectious inflammatory bladder condition that can not be attributed to a specific underlying cause. It typically affects cats 2 – 7 years of age. Dysuria and hematuria are the most common signs and clinical signs resolve in 4 – 7 days regardless of treatment. Signs may reoccur unpredictably. Stress appears to worsen clinical signs. Urolithiasis: Urinary stones can for in the urinary tract and cause signs of FLUTD. These stones consist of minerals plus a protein matrix. The most common types seen are struvite (magnesium ammonium phosphate) and calcium oxilate. The bladder is the most common location although they may be present anywhere in the urinary tract. Struvites stones are normally round to oval and have smooth edges. Females are more likely to develop struvite stones formed in basic urine pH. Calcium oxilate can also be found in the kidneys are hard with sharp, jagged edges formed in acidic urine pH. Males are more likely to develop calcium oxilate. Urethral obstruction: Urethral plugs are the most common cause of urethral obstruction in males. Uroliths and plugs are not the same. Urethral plugs are unorganized masses of mucus like protein containing varying amounts of minerals and cell debris. References • Miss Huff’s personal notes • http://www.veterinarypartner.com/Content.plx?P=A&A=652 • http://www.ansc.purdue.edu/swineclass/PDF/Companion%20 Animal%20Nutrition_1.pdf • Won-Seok Oh, DVM, PhD, Nutrition and Canine Skin Barrier, World Small Animal Veterinary Association World Congress Proceedings, 2011 • Case, L. et.al. 2000. 2nd edition. Canine and Feline Nutrition • Dr. Ralf S. Mueller, Dermatology for the Small Animal Practitioner