Pg 310-315 GI Disorders

GI disorders impair a pets ability to digest and absorb nutrients GI disorders impair a pets ability to digest and absorb nutrients. Factors may include: _________ change in diet Dietary ___________ Mal____________ _______________ ____________ Infectious agents/________ Reactions to _____________

Gastritis ______________ is usually self limiting. It is characterized by ___________ which __________ in _______ hours. Possible causes include dietary indiscretion _______________

Gastritis ______________ has intermittent vomiting over a period of weeks to months. Cause is ___________ determined. The inflammatory response __________ acid secretion and ________ normal mucosal barriers.

Small Bowel Disease Small bowel disease refers to _____ condition that affects the small intestine including ___________ and __________. Small bowel diarrhea is characterized by ________ amounts of _______ passed _____ times per day without straining. This stool can appear ______ and _______.

Large Bowel Disease ____________ (large bowel disease) may be caused by food sensitivity, parasites, infection or pancreatitis. Large amounts of _________ in the stool is typically seen.

Management Management is targeted at _____________ the underlying disease. Dietary _________ depends on which part of the GI tract is affected.

Bowel Disease Characteristics   Bowel Disease Characteristics Stool Color Likely Cause Likely Location Yellowish or greenish Rapid transit Small bowel Black, tarry Upper GI bleeding Stomach or small bowel Red blood or clots Lower GI bleeding Colon clots Pasty, light Lack of bile Liver Large, gray, rancid Inadequate digestion Small bowel or absorption

Bowel Disease Characteristics   Bowel Disease Characteristics Stool Consistency Likely Cause Likely Location Watery Rapid transit Small bowel Foamy Bacterial infection Greasy, often with oily hair around the anus Malabsorption Small bowel, Pancreas Glistening or jellylike Contains mucus Colon

Digestion and Metabolism The presence of food can have a _____________ effect, triggering a variety of signals that facilitate digestion and metabolism: ____________ of digestive enzymes ____________ blood flow to the small intestine Delivery of _________ to cells GI cell ______________

Digestion and Metabolism Food can also have a _________ effect: _____________ food can trigger inflammatory responses Alter _____________ Alter __________________ populations

Small Bowel Disorders Diet should be ______________, _____________________ High digestibility _____________ nutrient absorption and reduces the potential for diarrhea as large quantities of undigested food in the gut can cause water retention and trigger renewed diarrhea. Small Bowel Disorders

Small Bowel Disorders Protein turnover may be increased so it is important to _____________ absorption. The protein should contain a sufficient amount of the amino acid, _______________, as it is one of the main fuels for enterocytes

Small Bowel Disorders _______________________ is recommended. Although fat is easily digestible, the metabolism requires several steps. Undigested fat that reaches the colon can be altered by ________ to produce ____________ that increase mucosal permeability and alter motility.

Patients may benefit from _______________ amounts of soluble and insoluble fiber. Dietary fiber helps: ___________ normal intestinal motility _________ concentration of potential toxins _______ to excess water _______________ normal microflora populations provide _________ for colonocytes Large Bowel Disorders

Pancreatitis Dietary fat stimulates the pancreas to secrete ________. These digestive enzymes may leak into the bloodstream causing ________ and ________ damage. Clinical signs include: ___________ (fever) ______________________(irregular heartbeat) _________ damage ___________ (infection in the blood) ____________________ (inflammation of the lining of the abdominal cavity).

Pancreatitis Owners may notice the following clinical signs: Vomiting (emesis; usually profuse) Lack of ___________ (inappetence; anorexia; refusal to eat) Lack of ____________ (refusal to drink) Weight loss Weakness Depression Lethargy Diarrhea Dehydration ________________ pain (usually severe and sudden in onset) ________________ (“prayer position”)

 A __________ sign of stomach discomfort is when the dog adopts what's called the 'praying position’. This looks a lot like when your dog bows down in a playing position. Prayer Position

Enteral vs. Parenteral Nutrition Introducing nutrients to the gut to be broken down and utilized for energy i.e. normal eating or assisted enteral feeding using a feeding tube ___________ method of feeding; _____ expensive, __________ the immune system and _______ most metabolic complications. Introducing nutrition to the body, ____________ the gut. i.e. _______________ Pg. 310 - 315

Enteral Nutrition Experts recommend ______________________ in all patients with pancreatitis. Enteral nutrition ___________ the gut barrier ___________ enterocyte health immune ___________ ____________ GI motility Fluid therapy will help to combat dehydration and ____________ electrolyte imbalances.

Enteral Nutrition Enteral nutrition can be provided by a variety of feeding __________, including Naso______________ (NE) tubes – short term use Naso___________(NG) – short term use ___________________ tubes – long term ________ostomy tubes – long term ________ostomy tubes – long term, bypass the pancreas and can be used in patients when ___________ cannot be controlled. An ______________ feeding tube is the method of choice if enteral feeding is necessary for more than two days.   

Nasoesophageal(NE)/ Nasogastric(NG) tube Esophagostomy tube Gastrostomy tube

Nasoesophageal (NE) Tube Nasoesophageal (NE) tubes are used ______________ to provide enteral nutritional support. ______________ NE tubes are placed to end in the distal third of the esophagus/caudal esophagus, not in the stomach. The reason for this is that gastric acid will reflux back into the distal esophagus if a tube is holding open the lower esophageal sphincter, causing esophagitis. https://youtu.be/6Uemr4UaA_w

Parenteral Nutrition (PN) When patients ____________ be fed using the enteral route parenteral nutrition, which is providing nutrients _____________ may be indicated. Patients that may benefit from PN include Those with _________ intestinal disease _________________ GI tract Those at risk for __________ if fed (i.e., lack of gag reflex) Those _________ to be sedated or anesthetized for placement of a feeding tube. The patient should be _______, not have fluid or electrolyte imbalances, be able to tolerate IV fluids and should not be returning to an enteral diet within 3 days.

Parenteral Nutrition (PN) IV types for PN: Central IV catheter (usually ___________) _________ because of the high osmolality of the nutritional solution infused. Called _______ Parenteral Nutrition (CPN) or ___________ Parenteral Nutrition (TPN) Peripheral catheter Used for _________ PN Called Partial (or ___________) Parental Nutrition (PPN) Formulation must be more ________ to a lower osmolaity.

Parenteral Nutrition (PN) Central parenteral nutrition “aka” Total Parenteral nutrition (TPN) – the main goal of CPN/TPN is to _______________ energy to meet RER and amino acids to achieve a nitrogen balance. The ________________ form is a sterile admixture of an amino acid solution, a lipid solution, a dextrose solution, a vitamin B complex injection, and sometimes other minerals, such as potassium, magnesium, and trace elements. Special equipment is needed to make the solution A sterile ___________ (IV catheter) is placed and the CPN solution is infused using an IV pump.

Parenteral Nutrition (PN) Partial or peripheral parenteral nutrition is the use of a _________ or __________ vein (if a central line is not available) to administer a dilute form of the sterile admixture solution. All patients receiving CPN or PPN must be carefully __________. The entire veterinary staff should be aware of how to monitor animals receiving PN so that complications can be _________ if possible, or _________ early before more serious problems occur.

Parenteral Nutrition (PN) What To Monitor Complications During infusion the technician should Check blood _______ q 4 - 6 hours at start then daily once rate is stabilized Check serum or plasma for ____________ or high triglycerides daily Check patients _______ q12h Record patient's body _______ q24h PCV/TP, Blood urea nitrogen (BUN), albumin, and electrolytes K, P, & Mg. ____________ – detected by physical examination observations and lab work. ____________ – infections starting at the catheter site and spreads through the bloodstream ___________ – catheter disfunction or dislodgment, pinched or twisted lines, and equipment failure.

Gastrointestinal System (GI) The GIs main function is to ______ and ______ nutrients. It also has a role in __________ the body. The GI system represents a first line of defense against potential pathogens, toxins and allergens. The GI is the bodies largest ___________ system. About ______ of the body’s immune system is located in the GI tract

Gastrointestinal System (GI) The bacteria population is organized into a complex ecosystem that balances __________ and _______ bacteria. The function of the bacteria is to _______ in digestion and absorption of nutrients _________ infection.

GI System Factors that can upset the balance between beneficial and harmful bacteria include: ________ – exp. Parvo _____________

Drugs _____________: micro-organisms that are introduced into the gut to ensure healthy bacterial population.

Beet pulp, soy beans, fructo-oligosaccharide (FOS) ___________: food ingredients that act as nutrition for existing gut bacteria, promoting healthy bacteria flora. Beet pulp, soy beans, fructo-oligosaccharide (FOS) Drugs

GI Diets ROYAL CANIN VETERINARY DIET® GASTROINTESTINAL LOW FAT DRY Highly digestible Palatable Complete and balanced dog food. The diet is restricted in fat.

GI Diets EN Gastroenteric® Canine Formula Highly digestible Low in fiber to help support digestion Complete and balanced formula for adult dogs Contains a prebiotic, moderate fat and low fiber to help support intestinal health. Highly digestible for optimal nutrient absorption.

GI Diets Hill's® Prescription Diet® i/d® Canine Helps improve digestion, stool quality and supports regularity Promotes growth of beneficial bacteria in the gut Replaces lost nutrients and ensures easy absorption Supports a healthy immune system Meets the special nutritional needs of puppies and adult dogs

GI Diets Hill's® Prescription Diet® i/d® Canine Especially formulated to help manage cats with digestive health problems Highly digestible protein and fat help assimilate nutrients and repair tissues faster while a mixed fiber source helps maintain gastrointestinal health An optimal balance of nutrients helps replenish the body and encourage recovery while added antioxidants help control cell oxidation This highly palatable recipe is suitable for adults and growing kittens Easily digestible ingredients, helpful for cats recovering from gastrointestinal upset and routine surgery

Questions?