1. Pg
GI Disorders

2. 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 _____________

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

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

5. 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 _______.

6. 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.

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

9. 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

10. 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

11. 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 ______________

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

13. 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

14. 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

15. 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.

16. 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

17. 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).

18. 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”)

19.  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

20. 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

21. 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.

22. 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.   

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

24. 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.

25. 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.

26. 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.

27. 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.

28. 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.

29. Parenteral Nutrition (PN)
What To Monitor
Complications
During infusion the technician should
Check blood _______ q 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.

30. 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

31. 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.

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

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

34. 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

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

36. 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.

37. 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

38. 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

39. Questions?