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Therapeutic diets in clinical and pet nutrition

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 Clinical Nutrition of Livestock and Pets: An Advanced Short Course
CAS in Animal Nutrition, IVRI, lzatangar
November 3-23, 2006
dog has fresh and clean
Therapeutic Diets in Clinical Pet Nutrition
A. Sahoo and R.K. Singh
rblication, Association of
trol Officials Inc., Atlanta,

': Its Behavior, Nutrition, Environmental (climate, micorbes, rate, body temperature and oxidative damage to
owa: Iowa State University
fauna, parasites, toxicants, and injury) stimulus cells (Swick, 1995). Increased incidence and
29th World Congress of that initiates an adaptive change or stress severity of infections secondary to
I Animal Veterinary response, in the animal alters its normal immunological impairement as a result of
ier 6-9, 2004, Rhodes, generalized malnourishment as well as selective
physiological metabolism and hence the system
is in need of therapeutic support, viz. therapeutic nutrient deficiencies may result in vaccination
al Science. Albany, New
hers, Inc. treatment and supportive diets. While assessing failure, increased condemnation and mortality,
it. (1985). Nutrient the nutritional requirement of such clinically ill poor feed conversion, and increased morbidity
igs. Washington, D.C.: pet animals, it involves assessment of the and medication costs.
ress.
nutritional requirements for various life stages Nutritional support replenishes tissue
.. 2006. In: Proc. National
and operational tasks, and formulations of stores, improves immune function and wound
Practice and 3rd Annual
Society for Advancement balanced and complete diets and/or therapeutic healing and prevents death from cachexia. In
February 10-12, 2006, diets for different patho- or pathophysiological persistent clinical illness nutritional status can
5-193.
conditions. It involves nutrition of clinically ill be severely compromised by the combined
In: Significance of
animals, supportive nutrition for the effects of reduced feed intake and increased
Livestock Health and
., Garg, AX., Pattanaik, convalescent animals, and preventive nutrition metabolic demands secondary to fever and
:hra, U.R. (Eds). Centre to fight against the occurrence of clinical illness tissue catabolism. The clinically ill animals are
; in Animal Nutrition,
(Sahoo, 2002). Therapeutic nutrition thus plays usually less active and while calculating energy
:arch Institute, Izatnagar,
a fundamental role in determining the health and requirements, it is best to use the estimated
'cent Trends in Rumen performance of any animals, and also, a correctly requirement for animals confined to stalls and
technology. Chaudhary, balanced diet is essential to avoid disease multiply these basal energy requirement by a
unra, D.N. and Mehra, "fudge factor" that reflects the severity of the
f Advanced Studies in
associated with a deficiency or toxicity of a
an Veterinary Research particular nutrient. Furthermore, disease and disease and stress (Ralston, 1985). Oral
dia, pp. 83-88. nutrition are closely interlinked and dietary supplementation is preferred first, and extra-oral
modification forms an important part of the or parenteral nutrition are alternatives to feeding
veterinary management of the case and thus the animals that do not respond to managerial or
concept is coined in the name of 'therapeutic chemical stimulants of appetite.
diets'. The specificity of therapeutic diets with
Infection and dietetics respect to its composition, special/essential
supplements and/or additives, feeding and
Nutritional deficiency apparently
management for different disease conditions are
increases the severity of infection by viral,
briefed under specific disease conditions.
bacterial, fungal or paratsitic pathogens. Studies
indicate that most nutrition may affect Cardiovascular disease
pathogenesis either synergistically or The conditions are congestive heart
antagonistically (Scrimshow et al., 1968) and failure, hypertension, ascites and edema. The
also has significant impact on cell mediated diet should be highly digestible and easily
immunity (Latshaw, 1991). Infection induced metabolized with low sodium and saturated fat
immune stimulation decreases appetite and and extra potassium, B-complex vitamins and
muscle protein aceretion, increases metabolic taurine.

93
SAHOO AND SINGH _

Respiratory disorder resulting in disease conditions like hepatitis, triglycerides (MeT,:

The commonly associated disease cirrhosis, hepatic encephalopathy, etc. The pets and w6 fatty acids, pI
conditions are bronchitis, pharyngitis and should have a maintenance balanced diet with care should be n
pneumonia. The ill pets should be provided with low fat, low protein with high biological value electrolytes and wat
a highly palatable balanced diet with readily (low purine containing foods), highly digestible and diarrhea.
metabolizable carbohydrate, added antioxidant starch and sugar, supplemental deficient Diarrhoea
vitamins (C, A and E) and expectorants digestive enzymes and B-complex vitamins with
Diet plays 1
(glycerine, honey). lipotropic factors.
of all aspects of d
Nephrotic disorder Toxicity and oxidative stress Inappropriate diet,
Renal failure is commonly associated Dietary components playa crucial role primary cause, bu
with early stages of congestive heart failure, in the health of companion animals, especially duration of diarrhc
hepatic disease associated with encephalopathy those exposed to elevated levels of toxins and cause is not diet-n
and hypertension. The therapeutic diet should free radicals. Investigation into animals' hepatic consideration of die
be balanced with caloric requirement from non- antioxidant and metabolite conjugation systems, some cases is an ess
protein sources and it should have low protein, and the metabolic processes that influence them, (Simpson, 1988). )
low P and Na, added K, water soluble vitamins provides some understanding regarding the water is reabsorbed j
and sources of 003 and ro6 FA. Renal calculi relationship of diet to disease prevention and small decrease in
(urolithiasis) are a systemic disease and in treatment. The results of recent in vivo secretion) can readi
majority cases it occurs because of disturbances assessments, clinical trials, and observational water content and (
in one way or the other in the uptake, metabolism studies show oral supplementation with vitamin Oral rehydration
or excretion of urolith constituents (struvite: E, selenium, glutathione, and taurine to be therapy is importan
magnesium ammonium phosphate, calcium beneficial for both maintaining natural excessive loss offlt
oxalate, urate, purines and cystine) (Senior et antioxidant systems and protecting against a depletion and acic
al., 1996). Cats are observed to be at higher risk number of degenerative diseases associated 1989). Fluids and e
than dogs. Typical diet for treatment of with free radical damage and toxin exposure orally in mild dise
urolithiasis in dog should contain 8%CP, 0.3% (Scanlan, 2001). In many instances, it has been severe cases. Oral
Ca, 0.12% P, 0.02% Mg and 1.2% Na in the DM observed that the introduction of specific the lower sodium
(Lewis, 1989). The factors that predispose cats nutrients positively influences the health status, appropriate for the
and dogs to urolithiasis include inadequate symptomatic presentation, and life span of in the dog, in whicl
liquid intake, sudden change to a dry diet with animals whose natural detoxification systems are
an important aet
excess total minerals (P, Mg or Na), alkaline diets compromised. solutions with big
or diets supplying inadequate K (Wolter, 1990). Gastro-intestinal diseases provide additional
Acidifying diets, often termed as 'struvite' diets hypertonic and rna:
Different disease conditions are
contain acidifiers like ammonium chloride with (Leiper, 1986; M
enteritis, gastritis and diarrhea, inflamatory bowel
low base (Na or Ca carbonates), DL-methionine increase luminal O!
disease, malabsorption and maldigestion,
and should be used judiciously. The diet should osmotic diarrho
exocrine pancreatic insufficiency,
have low mineral content (Ca, Mg, and P) and potentially, dam
lymphangiectasia, pancreatitis, hepatic disease
oxalates and may be enriched with alkalizing (Kameda et al, 19~
not associated with encephalopathy,
ingredients. Urate uroliths can be treated by solutions should
hyperlipidemia. The diet should be complete and
feeding low protein diets with low purine food cases with reduce
balanced for growth of puppies and maintenance
type and xanthine oxidase inhibitors and cystine villus atrophy or (
of adults that contains highly digestible
uroliths by low protein and low sodium diets. where the possib
carbohydrate and protein of high bilogical value,
Liver disorder low fiber and gluten free, low lactose, increased (Simrm
Various {Oxicmetabolites of food origin hypoallergenic food proteins, low long chain appears that hyp
or from infections impaired liver function triglycerides (LCT) , source of medium chain glucose polymers
isotonic or hypertc

94 _

iditions like hepatitis,
lalopathy, etc. The pets
nee balanced diet with
1 high biological value
lOds),highly digestible
plemental deficient
complex vitamins with
ress
ents playa crucial role
onanimals, especially
d levels of toxins and
Il into animals' hepatic
econjugation systems,
es that influence them,
mding regarding the
sease prevention and
, of recent in vivo
Is, and observational
ientation with vitamin
e, and taurine to be
iaintaining natural
protecting against a
diseases associated
: and toxin exposure
instances, it has been
duction of specific
Ices the health status,
In, and life span of
xification systems are
se conditions are
ea,inflamatory bowel
and maldigestion,
insufficiency,
titis, hepatic disease
encephalopathy,
ouldbe complete and
lies and maintenance
highly digestible
high bilogical value,
ree, low lactose,
ins, low long chain
e of medium chain
••
__________________________
triglycerides (MCT, 22-34% of fat), source ofw3
and w6 fatty acids, probiotics(yogurt). However,
care should be taken to infuse parental
electrolytes and water replacement in vomiting
and diarrhea.
Diarrhoea
Diet plays a key role in the management
of all aspects of diarrhoea (Zimmer, 1986).
Inappropriate diet, for example, may be the
primary cause, but it may also prolong the
duration of diarrhoea even if the underlying
cause is not diet-related. Conversely, careful
consideration of diet can speed recovery and in
some cases is an essential component of therapy
(Simpson, 1988). Approximately 95% of this
water is reabsorbed from the colon, so a relatively
small decrease in absorption (or increase in
secretion) can readily result in increased colonic
water content and diarrhoea.
Oral rehydration therapy: Appropriate fluid
therapy is important in acute diarrhoea to check
excessive loss of fluids, dehydration, electrolyte
depletion and acidosis (Zenger and Willard,
1989). Fluids and electrolytes may be provided
orally in mild disease or parenterally in more
severe cases. Oral rehydration solutions with
the lower sodium concentration may be most
appropriate for the treatment of acute diarrhoea
in the dog, in which viral infection appears to be
an important aetiological factor. Further,
solutions with high concentrations of glucose
provide additional energy, but are considered
hypertonic and may reduce net water absorption
(Leiper, 1986; Maughan and Leiper, 1990),
increase luminal osmolality thus contributing to
osmotic diarrhoea (Farthing, 1988) and,
potentially, damage the intestinal mucosa
(Kameda et al, 1986). Use of highly hypertonic
solutions should be avoided, particularly in
cases with reduced absorptive capacity due to
villus atrophy or damage (rotavirus infection),
where the possibility of glucose overload is
increased (Simmons and Bywater, 1991). It
appears that hypotonic solutions containing
glucose polymers may be more beneficial than
isotonic or hypertonic solutions (Farthing, 1990;
_____________________________
Therapeutlc Diets in Pet Nutrition
,
Maughan and Leiper, 1990). Some dogs with
acute diarrhoea, concurrent with substantial
stool losses of potassium, may develop
hyperkalaemia. A potassium concentration in
the range of 20-30mmol/L is normally adequate
to replace existing losses (Farthing, 1988).
Substantial stool losses of chloride are known
to occur during acute diarrhoeal episodes
(Hirschhorn and Greenough, 1991). Chloride is
normally included in oral rehydration solution
as the anion of the sodium and, occasionally,
potassium salts. Citrate and other base
precursors (bicarbonate and acetate) have been
shown to promote sodium and water absorption
in normal mammalian intestine (Farthing, 1988).
Inclusion of glycine in oral rehydration solutions
may be of benefit since additional absorption of
this amino acid may enhance sodium and water
absorption and thereby reduce stool output.
(Hirschhorn and Greenough, 1991).
'Bland' diets: A bland diet can be defined as a
high quality, highly digestible, non-spicy diet
containing components that pose a low risk of
adverse reactions, such as a protein source that
is novel to the animal. Following an acute bout
of diarrhoea, this type of diet helps to ensure
that the enterocytes are presented with minimal
digestive challenge, and the acquired food
allergies or intolerance is minimised.
Elimination diet and/or hypoallergenic diet:
Acquired sensitivities may develop as a result
of increased permeability of the inflamed gut,
which facilitates the uptake of dietary antigens
that can then initiate a hypersensitivity response.
Potentially, hypersensitivity could develop to
one or more protein sources that are fed during
this critical period. Although the response is
normally short lived, it may be sustained
following repeated presentation of these
allergens resulting in chronic diarrhoea. To
reduce the risk of possible complications, a
minimal number of. protein sources should be
fed during, and following, a period of acute
diarrhoea. Preferably, the protein source should
be novel to the animal and should not form part
of the maintenance diet that will be used
95
SAHOOAND SINGH _

following recovery. It should have no additives some MCTs can be absorbed intact from the • Feed a highlj
or supplements and be fed to the exclusion of all gastrointestinal tract and can reach the amounts. base
other foods for at least 4 weeks before circulation via portal rather than lymphatic weight
considering an alternate diet. Components of channels, which suffers damage in many SID • Divide food a
the original diet may be introduced one at a time and are hydrolysed by gastric lipase more day
once the patient has responded to the elimination readily than long chain fatty acids. Moderate to
• Prescribe thea
diet (Patterson, 1995). The introduction of a high quantities of good quality protein are replacer.Dnc
second 'novel' protein diet after a minimum recommended, since protein deficiency may
gradually inc
period of 4 weeks is usually made in the long- further compromise a diseased intestinal tract
enzyme replac
term management of the patient. It is important through impairment of immune function and the
luminal barrier, arid through decreased formation • If diarrhoea re
that the diet is nutritionally complete and
food, or if the
balanced and that the actual level of protein is of brush border enzymes. Highly digestible
too quickly, fal
not compromised, since this· may hinder sources of carbohydrate, such as rice, are
recommended. Mono-and disaccharides, gradually rein
enterocyte repair. High digestibility of the protein
will help to reduce the amount ofluminal antigen particularly lactose, should be avoided because • Use only the :
they provide an osmotic load in the gut. of stabilisatio
available for absorption and, hence, the risk of
sensitization. Although dietary fibre is commonly used in the • For long term
non-specific therapy of acute diarrhoeas, it is or moderate j
Small intestinal disease (SID)
generally contraindicated in chronic diseases dietary chang
Specific causes of small intestinal because of its interference in digestion and and only afte
diarrhoea include exocrine pancreatic absorption thereby further compromising an sometime.
insufficiency (EPI), dietary sensitivity, neoplasia, impaired gastrointestinal tract. Specifically, • Any diet char
bile acid deficiency and short bowel syndrome. soluble fibre is contraindicated in exocrine in dose of the
Small intestinal bacterial overgrowth (SmO) is a pancreatic insufficiency (EPI) since this may
common problem that may occur asa Large intestinal I
interfere with pancreatic enzyme activity and
complication in up to 50% of dogs with chronic aggravate fat malabsorption. Several small Specific
diarrhoea. Idiopathic disorders include intestinal diseases can result in deficiencies of diarrhoea includ
inflammatory bowel disease (mD), which is water soluble B-complex vitamins. Patients with bacterial infectio
characterised most commonly by infiltration with EPI are particularly susceptible to cobalamin Escherichia coli e
lymphocytes and plasmacytes, or occasionally (vitamin B12) deficiency due to binding of the large intestinal di~
by eosinophils. Lymphangiectasia is a chronic vitamin by bacteria; decreased pancreatic supplementation v
condition characterised by insufficiency and intrinsic factor, which is essential for cobalamin responsive' whet
marked dilation of the intestinal lymphatics, which absorption in the ileum; and decreased as functional dian
may result in protein losing enteropathy and fat production of pancreatic proteases to release bowel syndrome'
malabsorption with diarrhoea (and steatorrhoea). cobalamin fromR-proteins (Simpsonetal, 1989). part in the mana.
Diets for small intestinal disease are, therefore, intestinal origin. I1
Diet plays an important role in the
supplemented with B-complex vitamins, although dietary proteins :
management of many small intestinal diseases,
additional parenteral administration of cobalamin aetiology of a nui
generally in conjunction with appropriate
may be necessary in cases of EPI. conditions, inclur
pharmacological therapy. High fibre diets are
Nutritional management of exocrine pancreatic which may be mo
contraindicated for the management of small
intestinal disease. Restriction of dietary fat (low insufficiency highly digestibl
fat: 12-20% of ME; moderate fat: 20-30% of ME) number of novel]
In EPI, there is impaired digestion and
source providinj
reduces the challenge to an already compromised absorption of fat and, toa lesser extent,
forms may be b
gastrointestinal tract and is recommended in a carbohydrate and protein, resulting in weight
treatment of sorm
range of small intestinal diseases. In some cases, loss, despite a ravenous appetite, and diarrhoea
helps to normalis
medium chain triglycerides (MCTs) may form a with steatorrhoea. Management of the condition
content (Lieb, 19
useful supplemental source of energy, since therefore involves:

96 _
 ___________________ .•...•• Therapeutic Diets in Pet Nutrition

rbed intact from the • Feed a highly digestible, low fat diet in be managed with feeding of probiotics-
md can reach the amounts. based on the dog's current body Lactobacillus acidophilus (Pasupathyetal.,
her than lymphatic weight 200 1) or plant bioactive components like essential
amage in many SID • Divide food allowance into two meals per oil (Singh, 2(05).
~astric lipase more day Irritablebowel syndrome: It is thought to be
y acids. Moderate to associated with stressful situations that lead to
• Prescribe the appropriate amount of enzyme
quality protein are altered intestinal motility. Dietary fibre
replacer. Once faecal character is restored,
ein deficiency may supplementation may be beneficial in some cases
gradually increase food allowance and
.ased intestinal tract through its physical properties, which help to
enzyme replacer to allow body weight gain
tune function and the normalise colonic contractility. Although acute
.decreased formation • If diarrhoea recurs because of access to other
food, or if the food allowance is increased cases resolve spontaneously and chronic cases
. Highly digestible generally respond to antibiotic therapy, dietary
, such as rice, are too quickly, fast the animal for 24 hours before
gradually reintroducing the regimen fibre supplementation may be of benefit in
nd disaccharides,
intermittent cases which require long term
be avoided because • Use only the low fat diet during the period
therapy. This may be due to the effects of soluble
c load in the gut. of stabilisation
dietary fibre on microbial population and the
unmonly used in the • For long term maintenance, alternative (low production of an acidic environment from short
ute diarrhoeas, it is or moderate fat) diets may be tried but all chain fatty acids.
in chronic diseases dietary changes should be made gradually
:e in digestion and Idiopathic chronic colitis (ICC): It is one of the
and only after the dog has been stable for
r compromising an most common causes of chronic diarrhoea in
sometime.
tract. Specificaliy, the dog (Bush, 1985). Diet plays an important
• Any diet changes may necessitate a change
icated in exocrine role in the pathogenesis of this condition and it
in dose of the enzyme supplement.
iPI) since this may seems that both digestibility and the allergen
Large intestinal disease component of the diet are key factors in
nzyme activity and
on. Several small Specific causes of large intestinal successful dietary management (Leib, 1991;
It in deficiencies of diarrhoea include parasitism, neoplasia and Nelson et al, 1988). Studies involving dogs with
amins. Patients with bacterial infections (Clostridium perfringens, confirmed lymphocytic plasmacytic colitis have
xible to cobalamin Escherichia coli etc.). Some idiopathic cases of shown that the condition could be successfully
e to binding of the large intestinal diarrhoea may respond to dietary managed using a commercial low residue,
reased pancreatic supplementation with fibre and are termed 'fibre- 'hypoallergenic' diet, in which the protein
entialfor cobalamin responsive' whereas others may be classified sources were limited to chicken and rice (Nelson,
I; and decreased as functional diarrhoea, often known as 'irritable 1988; Simpsonetal, 1998). The rationale behind
roteases to release bowel syndrome'. Dietary fibre plays a major the use of a highly digestible, 'hypoallergenic'
iimpsonetal,1989). part in the management of diarrhoea of large diet can be based on three criteria: high
lease are, therefore, intestinal origin. However, sensitisation to certain digestibility of macro-nutrients reduces the
xvitamins, although dietary proteins appears to have a role in the digestive challenge to the terminal gut. Low
trationof cobalamin aetiology of a number of chronic inflammatory antigen content reduces the chance of an
fEP!. conditions, including idiopathic chronic colitis, immunological reaction and high digestibility;
~ocrine pancreatic which may be more effectively managed using a further limit the dietary antigens entering the
highly digestible diet based on a restricted colon. The rationale for using high fibre diets in
number of novel protein sources. Adding afibre colitis is primarily related to the fact that bacterial
aired digestion and
source providing both insoluble and soluble fermentation of dietary fibre results in changes
i.a lesser extent,
forms may be beneficial in the symptomatic in colonic flora and production short chain fatty
esulting in weight
treatment of SOmelarge bowel diseases, as fibre acids (SCF A), and epithelial energy deficit may
etite, and diarrhoea
helps to normalise transit time and faecal water be partly responsible for progression of colitis
entof the condition
content (Lieb, 1991). Infective diarrhea can also (Kripke et al., 1987; Roediger, 1982; Settle, 1988).

97
SAHOOANDSINGH •.•..•. ...•....
__

In dogs, however, high fibre diets have proven administration of certain hormones and drugs
r • Based on re
much less efficacious than 'hypoallergenic' diets (glucocorticoids, progesterone-like drugs). A with diabetes
in the management of ICCand there are juvenile form of diabetes mellitus sometimes 60% comple:
suggestions for supplementing various fiber. occurs in dogs of less than one year of age to and<25%fa
sources inhypoallergenic diets to obtain the best an extent of 1.5% of canine diabetes with a of fibre.
response (Guilford, 1996; Simpson, 1998). definite breed predisposition. Factors • Although, in
Appropriate ratios of (CIHi): (co- 3) polyunsaturated precipitatingthe development of diabetes fibre intake 0
fatty acids help in regulating the severity and mellitusare estrus, pregnancy, pancreatitis,
has not beet
chronicity of colitis (Simpson, 1998). genetic, pharmaceutical .• (glucocorticoids,
diabetic dog,
Diabetes magestrol acetate), hormonal, immunologic,
some of the I
infectious (viral), stress, illness and obesity.
Diabetes mellitus is characterized by an • Dietary then
Until the establishment of oral hypoglycemic
absolute or relative lack of the pancreatic depending 01
agents, insulin will remain the primary therapy
hormone, insulin,' resulting in glucose for canine diabetes mellitus. However, long- disorders, me
intolerance. It results from impaired or deficient term diabetic management involves weight Obesity
insulin secretion or impaired action of insulin in control and dietary management. Dietary Obesity i
peripheral tissues. Insufficiency of insulin has components may directly influence insulin energy, stored
consequences on carbohydrate, lipid and sensitivity and insulin output, and hence imbalances betwe
protein metabolism with secondary disturbances contribute to hyper-insulinaemic, insulin- energy. The incide
of water and electrolytes. Based on the causative resistant state independent of obesity. males (Mason, 19~
factors diabetes is of three main types, viz.
Dietary therapy should therefore be to play and intend
insulin-dependent diabetes mellitus (IODM) -
designed to enhance insulin therapy and effects (hypotl
Type 1, noninsulin-dependent diabetes mellitus
improve glycemic regulation of the diabetic dog. corticodism, diabe
(NIODM) - Type 2 and secondary diabetes
Commonly recommended guidelines for feeding approaches inch
mellitus. Type I is most common in the dog and
diabetic dogs are as follows: restriction by redu
is characterized by hypoinsulinaemia and
• Daily caloric intake should maintain the dog normal diet or
impaired insulin secretion even after a glucose
at its ideal body weight. If the diabetic dog concentration of tl
challenge with a necessity for insulin injection
is obese, a weight reduction program a-meal practice or
and a tendency to develop keto-acidosis. It
should be initiated. with the dog recei'
usually occurs between 5 and 12 years of age
• The daily caloric requirement should be mineral suppleme
and affects females twice as frequently as males
between 40 and 50 kcallkg of ideal body there are neuro-mi
and is seen commonly in small dogs. Type 2 is a
weight depending on age and activity. If leptin treatment fo
form of insulin resistant one, which is usually
the dog is obese, the calculated daily caloric 1996). Chromiun
diagnosed in older overweight ones. The
requirement should be reduced to an increase lean 1
increased amount of adipose tissue is believed
additional 40% to promote weight loss. percentage body
to inhibit the interaction of circulating insulin
humans (Andersoi
with fat cell-associated insulin receptors. • An ideal initial daily feeding schedule
Therapy for Type 2 diabetes mellitus includes consists of three meals, fed at 6 hr intervals, Geriatrics
dietary management and use of oral beginning at the time of the insulin injection. Dogs am
hypoglycaemic agents to stimulate insulin Subsequent adjustments in the time of age-related chan]
secretion or increase peripheral tissue sensitivity feeding should be based on results of serum twelve years old.
to the action of circulating insulin. Due to blood glucose determinations. result in health is
degeneration of pancreatic beta cells, Type 2 • Soft-moist foods should not be fed to of skin and coat,
may progress to Type I. The third type occur diabetic dogs; dry. and canned foods are frequent intestinal
secondary to conditions like, pancreatitis, more acceptable diets as the former mostly dental problems, ,
acromegaly (growth hormone overproduction), contains readily absorbable mono- and di- off infection. ~
Cushing's syndrome, and prolonged saccharides. unavoidable and '

98
 ___________ ••••• ••••• T,herapeutic Diets in Pet Nutrition
,
,

.hormones and drugs -Based on recommendations for humans diet. Nutritionaladjustment should begin early,
erone-like drugs). A with diabetes, the. diet should contain 55- but the exact age in dogs is not as simple as it is
• mellitus sometimes 60% complex carbohydrates, 20% protein in cats. Cats should start eating a senior diet at
in one year of age to and < 25% fat and reasonably good amount about 7 years of age. The age for dogs depends
nine diabetes with a of fibre. upon its size. Since smaller dogs live longer and
iposition. Factors - Although, influence of increased dietary don't experience the age-related changes as
opment of diabetes fibre intake on improving glycemic control early as bigger dogs and thus size is used to
nancy, pancreatitis, has not been completely established in determine the time to change diets.
I•• (glucocorticoids, diabetic dog, it proved to be beneficial in The main objectives in the feeding of
tonal, immunologic, geriatric dogs. and cats should be to maintain
some of the patients.
illness and obesity.
- Dietary therapy may need modification health and optimum body weight, slow or
f oral hypoglycemic
depending on the presence of concurrent prevent the development of chronic disease and
I the primary therapy
disorders, most notably pancreatitis. minimize or improve clinical signs of diseases
tus. However, long-
Obesity that may already be present. Older dogs and
mt involves weight
cats have been shown to progressively put on
nagement. Dietary Obesity is the accumulation of excess
body fat in spite of consuming fewer calories.
y influence insulin energy, stored as fat in the body due to
output, and hence This change in body composition is inevitable
imbalances between intake and expenditure of
rlinaemic, insulin- and may be aggravated by either reduced energy
energy. The incidence was higher in females than
It of obesity. expenditure or a change in metabolic rate. Either
males (Mason, 1970). Drugs usually have no role
way, it is important to feed a diet with a lower
should therefore be to play and intended at treating the progressive
caloric density to avoid weight gain from fat and
.sulin therapy and effects (hypothyroidism, hyperadreno-
with a normal protein level to help maintain muscle
,nof the diabetic dog. corticodism, diabetes mellitus, etc.). The dietary
mass. Studies have shown that the protein
midelines for feeding approaches include partial or total calorie
requirement for older dogs does not decrease
s: restriction by reducing the quantity of the dog's
with age and that protein levels do not contribute
mid maintain the dog normal diet or by diluting the calorie
concentration of the diet or by starvation or skip- to the development or progression of renal
t. If the diabetic dog
failure. It is important to feed older dogs diets
'eduction program a-meal practice or by prolonged hospitalization
with the dog receiving only water and a vitamin! that contain optimum levels of highly digestible
mineral supplement (Markwell, 1990). Besides, protein to help maintain good muscle mass.
uirement should be Avoid "senior"diets that have reduced levels
:al/kg of ideal body there are neuro-molecular approaches involving
leptin treatment for the control of obesity (Wood, of protein. Other special nutrients with beneficial
age and activity. If role in older animals are:
lculated daily caloric 1996). Chromium has also been reported to
increase lean body mass and decrease Vitamin E for senior cats can increase their
be reduced to an
percentage body fat leading to weight loss in antibody level back to levels seen in younger
aote weight loss.
humans (Anderson, 1998). cats.
r feeding schedule
fed at 6 hr intervals, Geriatrics Gamma-linolenic acid (GLA), an ~6 fatty acid
the insulin injection. Dogs and cats begin to show visible that acts like an 0>-3 plays a role in the
nts in the time of age-related changes when they are seven to maintenance of a healthy skin and coat. It is
I on results of serum twelve years. old. Changes in body tissues may normally produced in the dog's liver, but at old
nations. result in health issues, including deterioration age its levels may be diminished and therefore,
of skin and coat, loss of muscle mass, more needs supplementation.
iuld not be fed to
I canned foods are frequent intestinal problems,arthritis, obesity, Fiber and fructooligosaccharides (FOS) in
s the former mostly dental problems; and decreased ability to fight senior diets promote the growth of beneficial
able mono- and di- off infection. Some of the changes are bacteria at the expense of detrimental ones since
unavoidable and others can be managed with older dogs often have changes in the intestinal

99
SAHOOAND SINGH _

bacterial population which can result in clinical Skeletal abnormalities

(Zn, Fe, Ca, P, I
signs of gastrointestinal disease (e.g. diarrhea) The major osteopathic conditions are
(lysine, methion
(Simpson, 1998; Pasupathy et al., 2002). Inulin rickets and osteomalacia, osteoporosis, arthritis
and Fructo-oligosaccharides (POS) are the newly Further Readin
and abnormal bone growth. The diet of diseased
discovered members of the carbohydrate family animals should be balanced for growing pups Abdulla, M., Ande
thatact asprebiotics and their beneficial role is Svensson,
(extra protein for growth) and adult maintenance
86-92.
summarized in Table 1. with meat and bone based supplement. It should
Anderson; RA. 11
Bush, B.M. (1985:
Table 1. Beneficial role of inulin and fructo-oligosaccharides and Raw,
Farthing, MJ.G.lI
Benefits Purpose
. .. Guilford, W.G. 19'
Promotes the growth of beneficial bacteria Formation of soft stools, supportive therapy in 'TX, pp. 5
in the intestine animals exposed to strong antimibioticslhigh Hirschhorn, N. al
Parenteral
stress levels. and in constipation (supports good
Kameda, H., Abe
bowel movement) Physiol., ;
Enhances mineral absorption, especially Maintenance of adults, supports during Kripke, S.A, Fox,
Surgery F<
Ca for healthy bones osteoporosis, osteomalacia, arthritis
Latshaw, D.L. 19!
Lowers triglycerides, LDL and total cholesterol Supports to hypereholesterolemic/dyslipidemic 30: t n-r:
adults Leib, M.S. (1991).
Philadelph
Controls blood glucose Supports to diabetic patients
Leiper, J.B. (1986)
Reduces calorie intake Weight management in obese/overweight adults
Lewis, L.D. 1989.
Delays gastric emptying time Early satiety- supports to diabetic, obese/ 165: 665.
overweight pets Markwell, PJ., val
and Shant
Anim. Pra

Antioxidant such as vitamin E and beta-carotene have added Ca and P at proper ratio (1.3:1) and Mason, E. 1970. V
help eliminate the free radical particles, which adequate vitamin A and D. In conditions like Maughan, R.J. a
accumulate and can damage body tissues and arthritis and joint pain, the protein content Therapeutii

contribute to the signs of aging. Antioxidants should be low to support minimum maintenance Nelson, R.W., Stoc
and should have prebiotics like. inulin and Vet. Intern
can also increase the effectiveness of the immune
system in senior cats and dogs. oligofructans and nutraceuticals (glucosamine, Pasupathy, K., Sal
chondroitin sulfate). N.N.2002
Routine care for geriatric pets should 364.
involve adherence to a consistent daily routine, Surgical operations
Pasupathy, K, Saho
regular attention to normal health care Various surgical conditions are Anim. Nut!
procedures and periodic veterinary examinations gastrectomy and intestinal surgery, wounds or
for assessment of the presence or progression burns, surgery of joints or bones, etc. The
of chronic disease. Stressful situations and patients should have provision for complete and
abrupt changes in daily routines should be balanced diet with emphasis on pre and
avoided and if at all a drastic change must be postoperative nutrition, viz. liquid preparations,
made, attempts should be made to minimize high protein and calorie based diet, nutrient
stress and to accomplish the change in a gradual dense low volume diet, enzyme preparations,
manner. added vitamins (A, C and E), added minerals

100. _

teopathic conditions are
ia,osteoporosis, arthritis
wth.The diet of diseased
anced for growing pups
It} and adult maintenance
ed supplement. It should
..
supportive therapy in
\ antimibiotics/high
tipation (supports good
ipports during
a, arthritis
:rolemicldyslipidemic
nts
lese/overweight adults
diabetic, obese/
iroper ratio (1.3:1) and
D. In conditions like
, the protein content
minimum maintenance
otics like inulin and
euticals (glucosamine,
cal conditions are
u surgery, wounds or
s or bones, etc. The
ision for complete and
iphasis on pre and
z. liquid preparations,
: based diet, nutrient
enzyme preparations,
d E), added minerals
View publication stats
_______ ...••.
(Zn, Fe, Ca, P, etc.),supplemental amino acids
(lysine, methionine, arginine).
Further Readings
Abdulla, M., Anderson, B., Evander, A., Lundquist, I,
Svensson, S. and Ihse,I. 1978. Digestion, 18:
86-92.
Anderson" R.A. 1998. Nutr. Rev., 56: 266-270.
Bush, B.M. (1985). In: Grunsell, C.S.G, Hill, F.W.G.
and Raw, M.E. (Eds). pp 189.-194.
Farthing, M.I.G.1988. Drug, 36 (Supplement4):80-90.
Guilford, W.G. 1996. In: Proc.: ACVIM, San Antonio,
'TX, pp. 50-51 ..
Hirschhorn, N. and OreenoughIII, W.B. 1991. I.
Parenteral Enteral Nutr., 12: 104S.
Kameda, H., Abei, T. and Iber, F.L. 1986. Am. I.
PhysioI., 214: 1090-1095.
Kripke, S.A, Fox, A.D., Berman, I.M. et al. (1987)
Surgery Forum, 38: 47-49.
Latshaw, D.L. 1991. Vet. Immunol. ImmunopathoI.,
30: 111-120.
Leib, M.S. (1991). Canine and Feline Gastroenterology.
Philadelphia: WB Saunders pp 221-256.
Leiper, J.B. (1986), Proc, Nutrition Society, 45: 78A.
Lewis, L.D. 1989. Recueil-de-Medicine-veterenaire,
165: 665.
Markwell, P.I., vanErk, W., Parkin, G.D., Sloth, C.J.
and Shantz-Christienson, T. 1990. J. Small
Anim. Pract., 31: 533-537.
Mason, E. 1970. Vet. Rec., 86: 612-616.
Maughan, R.I. and Leiper, I.B. 1990. Clinical
Therapeutics, 12 (Supplement A): 63-72.
Nelson, RW., Stookey, L.I. and Kazacos, E. 1988. I.
Vet. Intern. Med., 2: 133-137.
Pasupathy, K., Sahoo, A., Kamra, D.N. and Pathak,
N.N. 2002. Indian I Anim. Nutr., 19: 359-
364.
Pasupathy, K., Sahoo, A. and Pathak, N.N. 2001. Arch.
Anim. Nutr., 55: 243-253.
____________________________
Therapeutic Diets in Pet Nutrition
Paterson, S. 1995. I. Small Anim. Pract., 36: 529-534.
Ralston, S.L. 1985. I. Equine Vet. Sci., 5: 336.
Roediger, W.E.W. (1982). In: Colon and Nutrition.
Goebbel,H. and Kaspar, H. (Eds), MTP Press,
Lancaster. pp 1l-26.
Sahoo, A. 2002. Compendium, IVth Biennial
, Conference & Exhibition, WBUAFS, Kolkata,
pp 69-83.
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37.
Scrimshow, N.S., Taylor, C.E.'and Hordan, I.E. 1968.
Interactions of Nutrition and Infection. WHO,
Geneva.
Senior, D.F., Kelly, N.C. and Wills, I.M. 1996. In:
Manual of Companion Animal Nutrition and
Feeding. N.C. Kelles (Ed.). pp. 188-197.
Settle, R.G. (1988). Scientific Am., 264: 16-22.
Simmons, R.D. and Bywater, R.I. (1991). Cont. Ed.,
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Simpson, I.W. (1988). Vet. Pract., 20: 5.
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Simpson, K.W., Morton, D.B. and Batt, RM. (1989).
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Singh, R.K. 2005. Nutrient utilization and growth
performance of pups fed on essential oil
supplemented diet. M.V.Sc. Thesis, Indian
Veterinary Research Institute, Izatnagar, India
Swick, R.A. 1995. Zootrech. International, 18: 40-45.
Weibel E. W., Taylor C. R, Weber I., Vock R., Roberts
T. I., Hoppeler H. 1996. I. Exp. BioI., 199:
1699-1709.
Wolter, R 1990. Practique-Medicale and Chirurgicale-
de-I Animal-de-Compagnie, 25: 255.
Wood, P.D. 1996. Nutr. Rev., 54: Sl3I-Sl35.
Zenger, E. and Willard, M.D. (1989). Compo Anim.
Pract., 19: 6-11.
Zimmer, I.F. (1986) In: Current Veterinary Therapy.
R.W. Kirk (Ed.), IX W.B. Saunders,
Philadelphia. p 909.
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