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- Herausgeber: John Wiley & Sons
- Kategorie: Fachliteratur
- Sprache: Englisch
Nutrition and Disease Management for Veterinary Technicians and Nurses A fully updated edition of the student-friendly guide to veterinary nutrition Diet and nutrition are essential aspects of veterinary care. Proper care and feeding of companion animals can improve health outcomes and help to prevent disease. Meeting the altered dietary needs of a sick animal can facilitate recovery and improve quality of life. For veterinary technicians, nurses, and other veterinary practitioners, a working knowledge of companion animal nutrition is an essential component of overall patient care. Nutrition and Disease Management for Veterinary Technicians and Nurses offers an accessible, up-to-date introduction to the key concepts and elements of veterinary nutrition. With detailed coverage of the fundamentals of veterinary nutrition in addition to the nutritional management for many common small animal diseases, the third edition incorporates all the essentials of veterinary nutrition and dietary management for veterinary patients of any age or health status. Readers of the third edition of Nutrition and Disease Management for Veterinary Technicians and Nurses will also find: * Fourteen new chapters, plus additional species in some chapters * An added section on prebiotics, probiotics, and synbiotics * End-of-chapter summaries with multiple-choice questions and case reviews to facilitate use in the classroom Nutrition and Disease Management for Veterinary Technicians and Nurses is ideal for all veterinary technician students, working veterinary technicians, nurses, and students working towards specialty certification in veterinary nutrition.
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Veröffentlichungsjahr: 2024
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Table of Contents
Cover
Table of Contents
Title Page
Copyright
Preface
Acknowledgments
About the Companion Website
Section I: The Basics of Nutrition
1 Nutrients and Energy
Introduction
Nutrients
Measures of Energy
Gross Energy
Digestible Energy
Feeding Trials
Calculation Method
Energy Density
References
2 Water
Introduction
Water Quality
Water Loss
Water Gains
References
3 Carbohydrates
Introduction
Monosaccharides
Disaccharides
Oligosaccharides
Polysaccharides
Carbohydrate Types
Resistant Starches
Carbohydrate Digestion
Carbohydrate Functions
Cats and Carbohydrates
References
4 Fats
Introduction
Triglycerides
Lipoproteins
Cholesterol
Nutrient Density
Fat Digestion
Essential Fatty Acids
Short‐Chain Fatty Acids
Lipid Functions
Lipid Deficiencies
References
5 Protein and Amino Acids
Introduction
Functions of Proteins
Glucogenic and Ketogenic Amino Acids
Dietary Protein
Protein Quality
Taurine
References
6 Vitamins
Introduction
Fat‐Soluble Vitamins
Water‐Soluble Vitamins
Vitamin‐Like Substances
References
7 Minerals
Introduction
Macrominerals
Microminerals
References
8 Digestion and Absorption
Introduction
Digestive Tract
Mouth
Stomach
Small Intestine
Bile Salts
Hormones in Digestion
Digestion After the Intestines
Large Intestine
References
9 Energy Balance
Introduction
Units of Measure
Daily Energy Requirements
Resting Energy Requirements
Common Measurements of Energy
Energy Expenditure
Body Heat Production
Facultative Thermogenesis
Voluntary Oral Intake
Nutrient Composition
Estimated Energy Requirements
References
10 Gastrointestinal Microbiome
Introduction
Microbiome
Commensal Microbiota
Benefits to the Host
The Immune System
Bacteria
Other Components of the Microbiota
Effects of Diet on the Microbiota
Dysbiosis
Conclusion
References
11 Prebiotics, Probiotics and Synbiotics
Introduction
Definitions
The Intestines
Prebiotics
Probiotics
Synbiotics
Survivability and Label Claims
Conclusion
References
12 Nutrition Calculations
Introduction
Units of Measure
Converting Units
Calculating Resting Energy Requirements (RER)
Calculating Daily Energy Requirements (DER)
Calculating Feeding Amounts
Tube Feeding Calculations
Converting Guaranteed Analysis to Energy Density
Calculating Nutrients as a Percent Metabolizable Energy (ME) Total Calories in 100 g of Food
Calculating Meals per Can/Cup/Bag
Cost of Feeding
Conclusion
References
Section II: Nutritional Requirements of Dogs and Cats
13 History and Regulation of Pet Foods
Introduction
Marketing of Pet Foods
Production of Pet Foods
Regulatory Agencies
States
Food Recalls
Regulations
Conclusion
References
14 Pet Food Labels
Introduction
Definition of Terms
Regulations
Principal Display Panel
Product Naming
Nutritional Adequacy
Information Panel
Complete and Balanced for All Life Stages
Limited Claim
Intermittent or Supplemental
Therapeutic
Other Label Claims
References
15 Nutrient Content of Pet Foods
Introduction
Laboratory Analysis
Calculation
Final Product Analysis
Digestibility
Feeding Trials
Food Comparisons
Metabolizable Energy
References
16 Types of Pet Foods
Introduction
Pet Food Library
Commercial Diets
Dry Pet Foods
Moist Pet Foods
Semi‐Moist Foods
Raw
Snacks and Treats
Toxicity and Recalls
References
17 Raw Food Diets
Introduction
Government and Professional Associations
Nutritional Content
Bacterial Contamination in Food
Health of the Pets
Dental Health
Digestion and Digestive Enzymes
Options
Conclusion
References
18 Grain‐Free and Boutique Diets
Introduction
Marketing Versus Science
Grains
Carbohydrate Digestion
Grain Substitutes
Nutrient Profiles
Dilated Cardiomyopathy
Boutique Foods
References
19 Additives and Pet Food Preservatives
Introduction
Antioxidants
Naturally Derived Antioxidants
Synthetic Antioxidants
Antimicrobials
Functional Ingredients
Colors
Artificial Flavors and Flavor Enhancers
Texture and Mouth Feel
Smell
Need for Additives
References
20 Homemade Diets
Introduction
Why Home Made?
Food Preparation
Ingredient Choices
Assess the Recipe
Selecting a Diet
Additional Instructions
Patient Assessment and Monitoring
References
21 Resources for Alternative Diets
Introduction
Descriptors
Natural
Free in Foods
Organic
Raw Foods
Client Communications
Guidelines
Options
References
Section III: Feeding Management for Dogs and Cats
22 Feeding Regimens for Dogs and Cats
Introduction
Dogs
Cats
What to Feed
Feeding Regimens
Free‐Choice Feeding
Time‐Controlled Feeding
Portion‐Controlled Feedings
Puzzle Feeders
Behavioral Problems
Introducing Puzzles
References
23 Nutritional Assessment
Introduction
Screening Evaluation
Extended Evaluation
Body Condition Scoring
Body Condition Score Uses
Muscle Condition Scoring
Communicating a Nutritional Recommendation
References
24 Pregnancy and Lactation in Dogs
Introduction
Pregnancy
Lactation
The Puppies
What to Feed
Nutrients
Water
Protein
Fats
Carbohydrates
Calcium and Phosphorus
Digestibility
References
25 Pregnancy and Lactation in Cats
Introduction
First Heat Cycle
Pregnancy
Lactation
The Kittens
What to Feed
Nutrients
Water
Protein
Fat
Digestible Carbohydrates
Calcium and Phosphorus
References
26 Neonatal Puppies and Kittens
Introduction
Nutrition
Water
Protein
Fat
Carbohydrate
Calcium and Phosphorous
Colostrum
Milk
Thermoregulation
Orphans
Milk Replacers
Weaning
References
27 Growth in Dogs
Introduction
Normal Growth
What to Feed
Feeding Regimens
Large and Giant Breed Puppies
Hip Dysplasia (CHD)
Osteochondrosis (OCD)
What to Feed Large and Giant Breed Puppies
References
28 Growth in Cats
Introduction
Normal Growth
What to Feed
References
29 Adult Maintenance in Dogs
Introduction
Maintenance
Gender and Neuter Status
Activity Level
Environment
Water
Energy
Fats and Fatty Acids
Fiber
Protein
Antioxidants
Stress
Obesity
Feeding Plan
References
30 Adult Maintenance in Cats
Introduction
Cats as Carnivores
Maintenance
Gender and Neuter Status
Environment and Activity Level
Water
Fats and Essential Fatty Acids
Fiber
Protein
Urinary pH
Antioxidants
Requirements
Canned Versus Dry Food
Obesity
References
31 Feeding the Healthy Geriatric Dog and Cat
Introduction
Feeding Requirements
Metabolism
Digestion
Protein
Fat
Fiber
Taste
Conclusion
References
32 Performance and Dogs
Introduction
Fats
Carbohydrate
Protein
Water
Supplements
Diet Requirements
Energy Considerations
Diet Calculations
Feeding Plan
References
33 Feeding Requirements of Cats
Introduction
Feeding Behaviors
Anatomic Adaptations
Physiologic Adaptations
Metabolic Adaptations
Energy
Water
Protein
Taurine
Methionine and Cystine
Arginine
Fats
Vitamin Metabolism
Conclusion
References
34 Nutrition Myths
Introduction
Myth: Meat By‐Products are Inferior in Quality Compared to Whole Meat in a Diet
Myth: Feeding Trials are not Necessary
Myth: Pet Food Preservatives are Bad
Myth: All Foods are Created Equally
Myth: Corn is just Filler
Conclusion
References
35 Cost of Feeding
Introduction
Cost per Bag‐Dry Food
Cost per Can
Conclusion
Section IV: Nutritional Disease Management for Dogs and Cats
36 Nutritional Management of Gastrointestinal Disorders
Assessment
Nutritional Factors
Further Reading
37 Critical Care Nutrition
What Patients Should be Fed?
How Should the Patient be Fed?
What Should the Patient be Fed?
Summary
Further Reading
38 Assisted Feeding in Dogs and Cats
Introduction
Feeding Tube Materials
Nasoesophageal/Nasogastric Tube
Esophagostomy Tube Placement
Gastrostomy Tube
Jejunostomy Tube
Beginning Enteral Feeding
Diet Choices
Mechanical Complications
Gastrointestinal Complications
Metabolic Complications
Infectious Complications
Hospital Management
Potential Post‐discharge Complications
Summary
References
39 Liver Disease
Key Nutritional Factors in Hepatobiliary Diseases
Chronic Hepatitis and Cirrhosis
Canine Copper Associated Hepatotoxicosis
Cholangitis
Portosystemic Shunts
Neoplasia
Hepatic Lipidosis
How Much to Feed?
Protein
Sodium and Chloride
Potassium
References
40 Dermatology
Patient History
Physical Examination
Common Skin Disorders in Dogs and Cats
Allergic Dermatitis
Adverse Reactions to Food
Nutritional Management
References
41 Fatty Acids in Disease Management
Fatty Acids
Fatty Acid Deficiencies and Cardiac Disease
Arrhythmia
Omega‐3 Fatty Acids and the Overall Effect on the Cardiac Patient
Omega‐3 Fatty Acids and Osteoarthritis
FLUTD
Cancer
References
42 Endocrinology
Diabetes Mellitus
Key Nutritional Factors
Hyperthyroidism
References
43 Cancer Nutrition
Nutritional Assessment
Metabolic Alterations in Patients with Cancer
Alterations in Carbohydrate Metabolism
Alterations in Protein Metabolism
Fat Metabolism Alterations
Starvation versus Cachexia
Prevalence and Diagnosis
Pathophysiology
Nutrients to Consider in Cancer Management
References
44 Refeeding Syndrome
Electrolytes
Managing Refeeding Syndrome
Summary
References
45 Cardiac Disease
Key Nutritional Factors
References
Further reading
46 Musculoskeletal
Obesity as a Risk Factor
Clinical Signs
Stages of Canine Osteoarthritis
Nutrigenomics and Osteoarthritis
Managing Mobility Nutritionally
Key Nutrients
Developmental Orthopedic Disease
Patient Assessment
Key Nutritional Factors
Energy
Protein
Fat
Calcium and Phosphorus
Digestibility
Carbohydrates
References
47 Weight Management
Causes of Obesity
Health Risks Associated with Obesity
The Largest Endocrine Organ
Evaluating Weight and Nutrition
Body Condition Scoring (BCS)
Body Fat Index Risk Chart Validation
Weight Management Program
Determining Ideal Weight Matters
Client/Behavioral Factors
Calorie Restriction
Exercise
Weight Management Guidelines
Summary
References
48 Cachexia
Sarcopenia
Starvation versus Cachexia
Pathophysiology
Phases of Cachexia
Therapeutic Strategies
Managing Anorexia/Hyporexia
Key Nutritional Factors in the Management of Cachexia
Feeding Methods
Summary
References
49 Dental Health
Periodontal Disease
Risk Factors for Periodontal Disease
Nutrition and Tooth Development
Nutrition and Dental Health
Key Nutritional Factors
Dental Home Care
Dental Home Care Product Categories
Pet Owner Education and Compliance
References
50 Nutritional Management of Pancreatitis
The Function of the Pancreas
Pancreatitis
History and Physical Examination
Nutritional Evaluation
Key Nutritional Factors
Additional Nutritional Factors in Pancreatitis
References
51 Nutrition in Pancreatic Insufficiency
Pancreatic Acinar Atrophy
Exocrine Pancreatic Insufficiency
Clinical Signs
Laboratory Information
Nutritional Management
Key Nutritional Factors
Digestibility
Fat
Fiber
Vitamins
References
52 Nutritional Management of Hyperlipidemia in Dogs and Cats
Hyperlipidemia Classification
Key Nutritional Factors
References
53 Brain Aging/Cognitive Dysfunction
Aging and Its Effect on the Brain
Nutritional Management of Cognitive Dysfunction Syndrome
Cognitive Dysfunction Syndrome Summary
Brain Aging
Senior or Mature Adult Dogs
Senior or Mature Adult Cats
Completing a Nutritional Evaluation for Senior Pets
Scientific Tools
References
54 Kidney Disease
Prevalence
Clinical Signs
Staging of Chronic Kidney Disease
A New Kidney Biomarker
Nutritional Management of CKD
Transition
Palatability
Texture
Taste Aversion
Follow Up
Features of Therapeutic Renal Foods
Summary
References
55 Nutritional Management of Digestive Disease in Brachycephalic Dogs
Brachycephalic Anatomy
Alimentary Tract Signs
Digestive Disease
History and Physical Examination
Medical Management
Nutritional Management
Body Condition Score
Key Nutritional Factors
Brachycephalic Bowls
Other Digestive Disease Nutrition Suggestions
Summary
References
56 Feline Lower Urinary Tract Disease
Causes of FLUTD
Diagnostic Evaluation
Pathogenesis of FIC
Nutritionally Managing Cats with FIC
Managing Cats with Feline Idiopathic Cystitis
Environmental Enrichment
Managing Cats with Struvite Uroliths or Urethral Plugs
Managing Cats with Calcium Oxalate Uroliths
Summary
References
Further Reading
Section V: Feeding Management for other Companion Animals
57 Avian
Nutritional Overview
Nutritional Assessment
Commercially Prepared Diets
Avian Key Nutritional Factors
Poultry Nutrition for Backyard Flocks
References
58 Small Pet Mammals and Reptiles
Nutritional Assessment
Ferrets
Rabbits
Guinea Pigs
Other Small Mammals
References
59 Equine
Nutritional Physiology
Key Nutritional Factors for Horses
Types of Feed
Pediatric Equine Nutrition and Care
Energy Requirement
Critical Care Nutrition
Enteral Nutrition
Parenteral Nutrition
References
Index
End User License Agreement
List of Tables
Chapter 1
Table 1.1 Examples of AAFCO certification claims.
Table 1.2 Example of nutrient density and nutrient distribution.
Table 1.3 Examples of nutrient density and caloric distribution.
Table 1.4 Calculating nutrients as a percentage of metabolizable energy.
Chapter 3
Table 3.1 Resistant starch classification.
Chapter 4
Table 4.1 Lipoprotein classes.
Table 4.2 Parent Class for EFAs and derivative compounds.
Table 4.3 Fatty acid structure.
1,
2
Chapter 5
Table 5.1 Essential and nonessential amino acids for dogs and cats.
Table 5.2 Glucogenic and ketogenic amino acids.
Table 5.3 Protein quality of common pet food ingredients.
Chapter 6
Table 6.1 Essential vitamins for animals. Name, chemical forms and functions...
Chapter 7
Table 7.1 Essential minerals and functions.
Chapter 9
Table 9.1 Formula(s) for calculating RER in adult maintenance in kcals/day, ...
Table 9.2 Life stage factors.
Chapter 10
Table 10.1 Canine microbiota dysbiosis index.
Chapter 11
Table 11.1 Good and bad intestinal bacteria.
Chapter 13
Table 13.1 Regulatory agency that covers this area of Pet Food, and what the...
Chapter 14
Table 14.1 Percentage of content in food (using chicken as an example).
Table 14.2 Important elements found on pet food labels in the United States ...
Table 14.3 Common pet food ingredients.
Table 14.4 This table provides a list of common pet food ingredients, and wh...
Chapter 15
Table 15.1 Nutrients as a percentage of metabolizable energy.
Table 15.2 Energy density from guaranteed analysis.
Chapter 16
Table 16.1 AAFCO recognizes these various 3 main types of moist pet food pro...
Chapter 19
Table 19.1 Methods of preservation.
Table 19.2 Characteristics of some antioxidants.
Table 19.3 Common food additives.
Chapter 20
Table 20.1 Sources of homemade diet recipes from veterinary nutritionists.
Table 20.2 Veterinary schools/hospitals offering nutritional support service...
Chapter 23
Table 23.1 9‐point body condition score.
Table 23.2 Muscle condition scoring.
Chapter 24
Table 24.1 Recommended nutrient levels during canine pregnancy and lactation...
Table 24.2 Composition of mammals' milk as related to the growth rate.
Table 24.3 Sample calculation of bitch and puppy feeding requirements.
Chapter 25
Table 25.1 Composition of mammals milk as related to the growth rate.
Table 25.2 Recommended nutrient levels during feline pregnancy and lactation...
Chapter 26
Table 26.1 Nutrient composition of various milks.
Table 26.2 Optimal environmental temperatures for orphans.
Chapter 27
Table 27.1 Life‐stage factors for puppies based on estimated adult size.
3
Chapter 29
Table 29.1 Influence of age on daily energy requirements (DER) for dogs.
2
Table 29.2 Calculating daily energy requirements (DER).
Chapter 30
Table 30.1 Nutrient levels found in a rat carcass.
Table 30.2 Calculating daily energy requirements (DER).
Chapter 31
Table 31.1 The onset of old age.
2–4
Table 31.2 Most common causes of mortality in cats.
Table 31.3 Practical feeding tips for senior dogs and cats.
Chapter 32
Table 32.1 This list represents products with the largest market share, and ...
Table 32.2 Total calories in 100 g of food
Table 32.3 Recommended caloric distribution for Canine Athletes
Chapter 34
Table 34.1 To determine ME
Table 34.2 Energy density from guaranteed analysis
Chapter 36
Table 36.1 Identifying small and large intestine signs in gastrointestinal d...
Table 36.2 GI history questionnaire.
Chapter 38
Table 38.1 Tube feeding comparisons.
Table 38.2 Feeding schedule for a 12# cat with a DER calculated at 280–303 k...
Chapter 40
Table 40.1 Skin lesions in dogs caused by adverse food reactions.
Chapter 43
Table 43.1 Effects of cytokines on nutrient metabolism in patients with canc...
Chapter 47
Table 47.1 Body condition and muscle condition scoring system.
Chapter 48
Table 48.1 The effects of cytokines on nutrient metabolism in patients with ...
Table 48.2 Strategies to increase consumption in anorectic/hyporectic patien...
Chapter 49
Table 49.1 Risk factors for periodontal disease in cats and dogs.
Table 49.2 Overall nutrient guidelines for foods designed to prevent periodo...
Chapter 53
Table 53.1 Clinical signs of brain aging.
Chapter 56
Table 56.1 Clinical signs of FLUTD
Chapter 57
Table 57.1 Avian history questionnaire.
Table 57.2 Nutrition recommendations for avian foods
4
Table 57.3 Fats used in poultry diets
List of Illustrations
Chapter 1
Figure 1.1 Radiograph of a Great Dane puppy with hypertrophic osteodystrophy...
Figure 1.2 A Great Dane puppy showing the joint enlargement seen with hypert...
Figure 1.3 Weight loss secondary to diabetes mellitus. A common complication...
Chapter 3
Figure 3.1 6‐carbon hexagon glucose.
Figure 3.2 6‐carbon pentagon fructose.
Figure 3.3 Glucose and galactose molecules.
Figure 3.4 (a) Glucose molecules are connected with alpha bonding. Enzymatic...
Figure 3.5 Dietary fiber fermentation in dogs.
Chapter 4
Figure 4.1 Triglyceride molecule.
Chapter 5
Figure 5.1 Liebig's barrel https://en.wikipedia.org/wiki/Liebig.
Chapter 9
Figure 9.1 Calculation of Resting Energy Requirements (RER) and Daily Energy...
Chapter 10
Figure 10.1 Sample dysbiosis index, compiled from 116 healthy dogs.
Chapter 11
Figure 11.1 The difference between prebiotics, probiotics and synbiotics....
Chapter 14
Figure 14.1 This is an example of a pet food label with the information that...
Chapter 15
Figure 15.1 Examples of nutrient density and caloric distribution (Purina Pr...
Chapter 18
Figure 18.1 Reports of Dilated Cardiomyopathy in dogs and cats received by t...
Figure 18.2 DCM cases: Breeds most frequently reported to the FDA.
Source
: F...
Figure 18.3 Primary ingredients or characteristics of diets reported to the ...
Chapter 22
Figure 22.1 Dogs being group fed using the portion‐controlled method.
Figure 22.2 Cats being group fed using ad libitum feeding.
Figure 22.3 Adlib feeding a special needs kitten in a multi‐cat household to...
Figure 22.4 Portion control of the same special needs cat as an adult. He of...
Figure 22.5 Active dog competing in Frisbee tournament.
Figure 22.6 Automated timed feeder.
Figure 22.7 A dog using a Kong™ puzzle feeder.
Figure 22.8 A DIY puzzle feeder made out of bottles.
Figure 22.9 The amount to be placed into the feeder is written on the top. T...
Chapter 23
Figure 23.1 Canine body condition scorecard.
Figure 23.2 Feline body condition scorecard.
Figure 23.3 A cat with a BCS of 1/9 had undergone 3 months of starvation.
Figure 23.4 A dog with a BCS of 1/9. The ribs and vertebral spines are clear...
Figure 23.5 A cat with a 9/9+ BCS. This cat would be at a high risk of malnu...
Figure 23.6 Muscle condition Scoring, demonstrating the differences in muscl...
Figure 23.7 A dog with an MCS of 3‐extreme loss. The wings of the ilium are ...
Figure 23.8 A frisbee dog with a MCS of 0‐normal. Even though the ribs are e...
Figure 23.9 A hospital discharge for a cat with hepatic lipidosis. The techn...
Figure 23.10 This cat developed diabetes mellitus after years of obesity.
Chapter 27
Figure 27.1 Nutrient Profiles. (a) Small breed puppy food dry. (b) Large bre...
Chapter 28
Figure 28.1 Nutrient profiles. (a) Kitten food dry. (b) Cat adult maintenanc...
Figure 28.2 An example of an exclusion device to keep adult cats out of a ki...
Figure 28.3 This kitten was received in foster care as part of a litter of f...
Chapter 29
Figure 29.1 This Labrador is enjoying a Kong™ toy with some of her food.
Figure 29.2 A selection of different interactive feeding toys for dogs.
Chapter 30
Figure 30.1 Author's catio enclosure for the cats.
Figure 30.2 The family cats enjoy the multiple levels, the actual tree trunk...
Figure 30.3 Author's multilevel indoor resting areas close to the family liv...
Figure 30.4 Author's cat's favorite hiding place. This is a converted 5‐gall...
Chapter 32
Figure 32.1 An owner and his dog competing in a Frisbee competition.
Source
:...
Chapter 36
Figure 36.1 Fecal scoring chart.
Chapter 38
Figure 38.1 Neck wrap being used at home on an esphagostomy tube.
Figure 38.2 Example of an in‐hospital “t‐shirt” using tube gauze. Be sure to...
Figure 38.3 Hair regrowth around a tube site.
Figure 38.4 This stoma hole is almost 3 years old. The Great Dane developed ...
Figure 38.5 An example of a low‐profile feeding tube being used in an oral c...
Chapter 40
Figure 40.1 Nutritional History Questionnaire.
Chapter 57
Figure 57.1 Smaller pellets: Left (cockatiels) and the larger; right (small ...
Figure 57.2 Meyer's parrot with Seed Ball/Nutriberries® Lafeber Co., Cornell...
Figure 57.3 Lovebird with a water bowl. (© Kara M. Burns.)
Chapter 58
Figure 58.1 Rex rabbit (exhibiting Broken Rex color pattern). (Reproduced wi...
Figure 58.2 Silkie breed of Cavy. (Reproduced with permission from Kara M. B...
Figure 58.3 Silkie breed of Cavy – young adult. (Reproduced with permission ...
Figure 58.4 Blue tongue skink cage and nutrition example. (© Kara M. Burns.)...
Chapter 59
Figure 59.1 American quarter horse grazing.
Figure 59.2 Roughage that meets quality criteria. (Reprinted with permission...
Figure 59.3 A complete feed. (Reprinted with permission from S. Loly, H. Hop...
Figure 59.4 Aseptic technique is used for placement of a bilumen catheter th...
Guide
Cover
Table of Contents
Title Page
Copyright
Preface
Acknowledgments
About the Companion Website
Begin Reading
Index
End User License Agreement
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Nutrition and Disease Management for Veterinary Technicians and Nurses
Third Edition
Ann Wortinger and Kara M. Burns
Copyright © 2024 by John Wiley & Sons, Inc. All rights reserved.
Published by John Wiley & Sons, Inc., Hoboken, New Jersey.Published simultaneously in Canada.
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Preface
Nutrition is an area of veterinary medicine that is very easy for the veterinary nurse/technician to have an active role. Many of the commercial food producers have even concentrated on educating veterinary nurses/technicians on nutrition through webinars, conference tracks, and self‐paced courses.
As with any other area of education, you still need to know the fundamentals to understand what is being taught. Unfortunately, the nutrition fundamentals are often not taught in veterinary technology education. While chemistry, microbiology, and math are required at most schools, even these do not adequately address basic animal nutrition. We all are taught the basic nutrients in a diet: water, protein, fats, vitamins, minerals, and carbohydrates but what is lacking is, how do they work together, what happens to them inside the body, and what changes occur with aging or disease?
So where does this leave a veterinary technician or veterinary nurse who wants to know more about nutrition, who wants to really understand what is going on inside the animal and how nutrients play a role? Usually, they start by going through the available veterinary nutrition books if they are not overwhelmed and terrified by the first chapter, it is a miracle! These books are often more detailed than a technician needs or wants to know; one can get lost in these details and miss the basic points. If you go to human nutrition books, the unique nutritional needs of our most common species dogs, cats, horses, birds, and pocket pets, are not addressed, although basic nutrition may be presented in a less technical manner. Some people enroll in an online program, but the basics are still often missing from these, and referencing these, later on, can be challenging. We love having reference books available whenever we have a question or need clarification on a point of interest, and we often have questions and need clarification. Many commercial food producers also provide technical helplines, but you still need to understand the basics before you can ask for clarification!
We have plowed through nutrition books from the very basic pet owner books to the extremely technical veterinary books, and all of them have something to offer but will you read long enough to understand them? We were fortunate to have veterinarians willing to explain misunderstood points and concepts and encourage us to review specific tools and areas of interest. Without them, we would have had a much more difficult time understanding and utilizing nutrition in our day‐to‐day practice. After all, that is the ultimate goal of nutrition, is it not?
Ann Wortinger and Kara M. Burns, 2024
My goal in writing this book was to provide a book for a technician and nurse, that was both relevant and technical but understandable and usable. This is not a dummied‐down version of a veterinary nutrition book, but one that focuses on the unique interests of technicians and nurses and how we use nutrition in practice and at home. For the third edition, I have asked my good friend and partner in nutrition, Kara M. Burns to provide her spin on disease management and alternate species nutrition. I am very excited to have Kara helping contribute to the third edition.
The book is organized into five sections. The first section addresses the basics of nutrition by looking at energy and nutrients; how the individual nutrients of water, carbohydrates, fats, proteins, vitamins, and minerals are utilized by the body; digestion; absorption of these nutrients; energy balance; the GI microbiome; and prebiotics, probiotics, and synbiotics, and finally those ever‐popular, nutrition calculations!
Section II covers nutritional requirements for cats and dogs by going through the history and regulation of pet food, understanding how to read pet food labels, understanding nutrient content and types of foods and how they differ, and evaluating raw food diets, preservatives, and home‐made diets, as well as offering resources for alternative diets.
Section III covers different feeding regimens and body condition scoring both definition and use and takes feeding from pregnancy and lactation through neonatal, growth, and adult maintenance feeding and into geriatrics. Section III will also cover feeding for performance animals, special feeding requirements for cats, nutrition myths, and how to calculate the cost of feeding.
Section IV covers the nutritional management of disease, looking at GI disease, critical care nutrition, assisted feeding techniques, hepatic disease, dermatology, the role of fatty acids in disease management, endocrine and metabolic diseases, cancer, trauma and infection, weight management, FLUTD, and others. This section includes a lot of new content on commonly seen diseases and newer areas of research.
The final section addresses the feeding management of other species, including horses, birds, and pocket pets. Each section will build on the information covered in previous sections, allowing for practical use of the information learned.
My cats and chickens are not thrilled when I start calculating caloric intake, nutrient distribution, or metabolizable energy. I am sure that Kara's varied pet population feels much the same way, but they too will ultimately benefit from our knowledge, as have innumerable clients, patients, coworkers, and students.
My hope is that through this edition of our nutrition book, you too will come to appreciate the important role nutrition plays in veterinary medicine, both through prevention and therapeutic use. You will have a better understanding of basic digestion, nutrient use by the body, and how food can affect our patients from the prenatal period through their death (hopefully many years down the line). And lastly that you will bring nutrition into your practice and use it to improve the quality of care that is provided to your patients. Nutrition is an ever‐evolving field in veterinary medicine, and I hope this book serves as a stepping stone for future learning. Kara and I love veterinary nutrition, and we hope that you will come to love it too! #nutritionnerds!
Ann Wortinger, 2024
Acknowledgments
Working on this third edition has been challenging on many fronts. I changed jobs towards the final chapters, weathered a global pandemic, continued with my speaking schedule (virtually), became more comfortable with Zooming, and decided to add a sunroom on to our house! Enough activities to distract the hardiest of writers.
Kara and I have expanded the chapters and information provided, allowing both of us to further spread the nutrition word! As many of you know, Kara and I were on the organizing committee for the Academy of Veterinary Nutrition Technicians (AVNT) and are still on the Executive Committee for the VTS (Nutrition). We are very lucky that in 2022, the AVNT attained full recognition from the NAVTA CVTS. A labor of love for both of us!
My feline editorial staff has changed since the last edition; Dusty, our blind Detroit stray, remains in the chief lap warmer and contributor position, and Poppy, our TNR rescue, has stepped up to be my Zoom buddy. Jack, Millie, and BeeGee have the enviable job of seeing how much hair can be released on my desk, as well as making much use of our window cat‐ledge. All of the cats had the unfailing ability to know exactly which book or article I was currently working on or would need next. You very kindly marked it with your furry bodies. Supervision was conducted from my lap, my desk, and the pet stairs. How does anyone work without a feline editorial staff?
And last but not least, my husband, Todd, who has had to undergo nightly discussions on new points of interest in nutrition, challenges with computers, and lots of late dinners! Thank you all for your continued support and for ensuring that I ate on a regular basis and knew I was appreciated and loved!
Ann Wortinger
I am honored to have again partnered with my good friend Ann Wortinger to write Nutrition and Disease Management for Veterinary Technicians and Nurses, 3rd Edition. We have seen this dream come to fruition, along with our other passion project: the Academy of Veterinary Nutrition Technicians. In 2022, the AVNT gained full recognition – a huge milestone which Ann and I are thrilled to see continue to grow. We both see the value of proper nutrition and the foundation for health that proper nutrition provides to veterinary patients.
Finding one's soul mate is a true gift from God. I am truly blessed to have been given the gift of Ellen Lowery, DVM, PhD, MBA, as my wife and best friend. You make my life complete and give me the courage to pursue all of my dreams. Thank you for your encouragement and support in this endeavor and for constantly supporting my desire to write this book! Thank you for being the love of my life!
Thank you to my parents, Bernard “Red” and Marilyn Burns who instilled in me a love of all of God's creatures.
I would like to thank the entire team at Wiley Blackwell for their support and expertise in making this third edition a reality!
I continue to have an expansive editorial staff that has contributed their supervisory abilities along this writing journey. Our cats O'Malley (our snowshoe) and Oliver Queen – “Ollie” (our Persian) have been consistently trying to help me with chapters by walking across my keyboard. Our French bulldogs Molly and Maggie, each trying to move their beds in my office to be the closest to me while I write. And Brees, our Border collie/Australian shepherd cross who has to put up with the Frenchies and keep them in line. Our Meyer's Parrot Bella, our Green Cheek Conure Loki, and our lovebirds Sookie, Stevie, and Mick. Thank you all for bringing such joy to my life.
Kara M. Burns
About the Companion Website
This book is accompanied by a companion website:
www.wiley.com/go/wortinger/3e
This website includes:
Cases and the Keys.
Review Questions with the Answers.
Section IThe Basics of Nutrition
1Nutrients and Energy
Introduction
Animals, unlike plants, cannot generate their own energy and require a balanced diet to grow normally, maintain health once they are mature, reproduce and perform physical work.1,2 Plants can convert solar energy from the sun into carbohydrates through photosynthesis, but they too require water, vitamins and minerals for optimal growth and production. Animals, in turn, either eat plants or eat other animals that eat plants to obtain their energy.1,2
Nutrients
For animals, energy is provided in the diet through nutrients. Nutrients are components of the diet with specific functions within the body and contribute to growth, tissue maintenance and optimal health.1,2 Essential nutrients are those components that the body cannot synthesize at a rate adequate to meet its needs, so they must be included in the diet. These nutrients are used as structural components in bone and muscle, enhancing or being involved in metabolism, transporting substances such as oxygen and electrolytes, maintaining normal body temperature and supplying energy.1,2 Nonessential nutrients can be synthesized by the body and obtained either through production by the body or through the diet.1,2 Nutrients are further divided into six major categories: water, carbohydrates, proteins, fats, vitamins and minerals.
Energy is not one of the major nutrients, but after water, it is the most critical component of the diet, energy needs always being the first requirement to be met in an animal's diet.1,2 After energy needs have been met, nutrients become available for other metabolic functions.1,2 Approximately 50–80% of the dry matter (DM) in a dog's or cat's diet is used for energy.1,2 The body obtains energy from nutrients by oxidation of the chemical bonds found in proteins, carbohydrates and fats.2
Oxidation is the process of a substance combining with oxygen, resulting in the loss of electrons.3 This oxidation occurs during digestion, absorption and transport of nutrients into the body's cells.2 An essential energy‐containing compound produced during this oxidative process is adenosine triphosphate (ATP), a common high‐energy compound composed of a purine (adenosine), a sugar (ribose) and three phosphate groups.2,3
The biochemical reactions that occur within the body either use or release energy. Anabolic reactions require energy for completion, and catabolic reactions release energy upon completion.2 ATP and other energy‐trapping compounds pick up part of the energy released from one process and transfer it to other processes.2 This energy is used for pumping ions, molecular synthesis and activating contractile proteins. These three processes essentially describe the total use of energy by the animal.2 Without the energy supplied through the diet, these reactions would not occur, and death would follow.2
ATP is a usable form of energy for the body but not a good form of energy storage because it is used quickly after being produced.2 Glycogen and triglycerides are longer‐term storage forms of energy.2 In fasting animals, when the body needs energy, it uses stored glycogen first, stored fat second, and finally, amino acids from body protein as a last resort.2 The triglycerides found in fats cannot be converted into glucose. Only the glycerol backbone can be utilized for this purpose. For proteins/amino acids, they must undergo gluconeogenesis to be converted into usable glucose.4
Measures of Energy
Energy is the capacity to do work. This is measured most commonly in the United States as a calorie. A calorie is the amount of heat required to increase 1 g of water from 14.5 to 15.5 °C (or 1 °C) in a bomb calorimeter.4,10 As this unit of measure is very small, we commonly use the term kilocalorie (1000 cal). When looking at food labels, this is the unit that is being referenced, a kilocalorie or kcal.
Although kcal is used in the United States, a joule is the International System of Units (abbreviated SI) unit measure of energy. 1 kcal = 4.184 J. As with calories, a joule is a small unit of measure, and megajoule (1,000,000 J, 106, abbreviated MJ) and kilojoule (1000 J, 103, abbreviated KJ) are the units most commonly used in animal nutrition.4,10 For small animal nutrition, the kilojoule is used most. For large animal nutrition, the megajoule is used.
Gross Energy
The total amount of potential energy contained within a diet is called gross energy (GE). GE in food is determined by burning the food in a bomb calorimeter and measuring the total amount of heat produced. Unfortunately, animals are not able to use 100% of the energy contained in food. Some are lost during digestion and assimilation of nutrients and in urine, feces, respiration and heat production.1,2
Digestible Energy
Digestible energy (DE) refers to the energy available for absorption across the intestinal mucosa, the energy lost is found in the feces. Metabolizable energy (ME) is the amount of energy actually available to the tissue for use. The energy lost is that found in the feces and urine. ME is the value most often used to express the energy content in pet foods.1,2
When GE values are readjusted for digestibility and urinary losses, ME values of 3.5 kcal/g are assigned to proteins and carbohydrates and 8.5 kcal/g to fats. These values are called modified Atwater factors.1,2 These were developed by American Association of Feed Control Officials () to produce an equation that would more accurately reflect the digestibility of commercial pet foods, which tend to have a lower digestibility than typical human foods.4
The ME of a diet or food ingredient depends on its nutrient composition and the animal consuming it.1,2 If a dog and horse eat the same high‐fiber diet, the horse will have a higher ME value due to its better fiber digestion ability than a dog. These differences in digestion can also be seen between dogs and cats, though not to the same extent as with an herbivore.
There are three methods to determine the ME in a diet: direct determination using feeding trials and total collection methods, calculation from analyzed protein levels, carbohydrates, and fats in the diet and extrapolating data collected from other species.1,2
Feeding Trials
Feeding trials using the species of concern are the most accurate method of determining a food's ME content. However, this can be time‐consuming and expensive and requires access to large numbers of test animals.1,2 The AAFCO, the government body that oversees pet food production, has specific requirements for feeding trials; in general, they require a minimum of eight animals for a maintenance diet, at least l year of age, being fed the food in question for a minimum of 26 weeks. Food consumption is measured and recorded daily. Individual body weights should be recorded at the beginning, weekly and end, and a minimum database of blood work is required at the beginning and end of the study. A veterinarian must give all animals a complete physical exam at the beginning and end of the study; they are evaluated for general health, body and hair condition with comments recorded. Animals, not to exceed 25% (2 animals), may be removed for non‐nutrition‐related reasons only during the first two weeks of the study. A necropsy is conducted on any animal that dies during the study. There are additional conditions for foods used during pregnancy, lactation or growth.5 Manufacturers of some of the premium pet foods routinely measure the ME of their formulated diets and ingredients through the use of controlled feeding trials.1,2 Feeding trials are a time‐consuming and expensive way to test ME in pet foods. Still, it is also the most accurate method and has the greatest potential to expose any deficiencies or excesses in a particular diet.
Calculation Method
ME values can also be determined using the calculation method. This involves using mathematical formulas to estimate a food's ME from its analyzed protein, carbohydrate and fat content. The formulas used for dog and cat diets have constants that account for fecal and urinary energy losses.1,2 The method does not account for the digestibility or quality of ingredients. Therefore, excesses or deficiencies may not be apparent. ME is calculated using standard values for each nutrient. But each nutrient's actual energy may be different from the standard (see Table 1.1).
Table 1.1 Examples of AAFCO certification claims.
Animal feeding trials using AAFCO's procedures substantiate that … provides complete and balanced nutrition for maintenance.
This product is formulated to meet the nutritional levels established by the AAFCO dog food profile for adult dogs.
Animal feeding tests using AAFCO's procedures substantiate that … provides complete and balanced nutrition for all life stages of cats.
…is formulated to meet nutritional levels established by the AAFCO cat food nutrient profiles for growth and maintenance.
1
,
2
Actual GE for triglycerides ranges from 6.5 to 9.5 kcal/g, proteins range from 4.0 to 8.3 kcal/g and carbohydrates range from 3.7 to 4.3 kcal/g. The standard values assigned to these nutrients are triglycerides 9.4 kcal/g, proteins 5.65 kcal/g and carbohydrates 4.15 kcal/g.4 These values reflect GE rather than the modified Atwater numbers typically assigned when doing pet food calculations. GE does not account for fecal or urinary losses in a diet or the energy used during digestion.4
Data from other species can be used when direct data is not available for particular food ingredients in a particular species. This is especially common with cat food ingredients. The species most often used for comparison is the pig. Although this method of estimating ME is not as accurate as direct measurement, data collected from swine experiments have been reported to correlate well with values from other species with simple stomachs.1,2
The method used to attain AAFCO certification is required to be listed on the product label. Most companies that use feeding trials clearly state this; those using calculation methods or extrapolation methods may be a little vague in how the certification is obtained (see Table 1.2).1,2
Energy Density
The energy density of a pet food refers to the number of kilocalories provided in a given weight or volume. In the United States, energy density is expressed as kilocalories (kcal) of ME per kg or pound of food.1,2 The energy density must be high enough for the animal to consume enough food to meet its daily energy requirements. Energy density will be the primary factor that determines the amount of food eaten each day.1,2 The ability to maintain normal body weight and growth rate is the criteria used to determine the appropriate quantity of food fed.
Table 1.2 Example of nutrient density and nutrient distribution.
Nutrient density:
Protein 21 g/96.25 g/100 kcal
Fat 23.8 g/96.25 g/100 kcal
Carbs 51.45 g/96.25 g/100 kcal
Nutrient distribution:
Protein 21 g/96.25 g/100 kcal = 22% (21 ÷ 96.25) × 100 = 22%
Fat 23.8 g/96.25 g/100 kcal = 25% (23.8 ÷ 96.25) × 100 = 25%
Carbs 51.45 g/96.25 g/100 kcal = 53% (51.45 ÷ 96.25) × 100 = 53%
Calorie calculation:
Protein 22% of 100 kcal = 22 kcal/96.25 g of food
Fat 25% of 100 kcal = 25 kcal/96.25 g of food
Carbs 53% of 100 kcal = 53 kcal/96.25 g of food
Because energy intake determines total food intake, diets must be appropriately balanced so that requirements for all other nutrients are met at the same time that energy requirements are met.1,2 For this reason, it is more appropriate to express nutrient energy levels in a diet in terms of ME than as a percentage of the food's weight or DM (see Table 1.3).1,2
Table 1.3 Examples of nutrient density and caloric distribution.
Dog food for growth, dry:
Calories (ME): 4491 kcal/kg, 485 kcal/cup
Caloric distribution:
Protein 29%
Fat 46%
Carbohydrate 25%
Dog food for maintenance, canned:
Calories (ME): 1108 kcal/kg, 409 kcal/can
Caloric distribution:
Protein 34%
Fat 58%
Carbohydrate 8%
Cat food for maintenance, dry:
Calories (ME): 4490 kcal/kg, 459 kcal/cup
Caloric distribution:
Protein 29%
Fat 47%
Carbohydrate 24%
Cat food, hairball formula, dry:
Calories (ME): 3692 kcal/kg, 280 kcal/cup
Caloric distribution:
Protein 30%
Fat 29%
Carbohydrate 41%
Therapeutic recovery diet, canned:
Calories (ME): 2000 kcal/kg, 340 kcal/can
2.14 kcal/ml‐canine
2.11 kcal/ml‐feline
Caloric distribution:
Protein 29%
Fat 66%
Carbohydrate 5%
Expressing nutrient content as units per 1000 kcal of ME is called nutrient density.1,2 Remember, fats contain almost three times the energy of proteins or carbohydrates and may only be a small portion of the weight of the diet but supply most of the calories. If looking only at weight, a diet may look low in fat, but be just the opposite.
When evaluating different diets, it is important to look at the caloric distribution and nutrient density rather than the percentage of the food's weight, typically expressed as DM. This will allow you to compare foods of differing moisture or energy contents. This method is somewhat limited compared to nutrient density because caloric distribution only considers the energy‐containing nutrients of the food. The AAFCO requires that the energy value of a pet food be expressed in kcal of ME (see Table 1.4).1,2
Table 1.4 Calculating nutrients as a percentage of metabolizable energy.
Total calories in 100 g of food
Protein = 3.5 kcal/g × grams in food
Fat = 8.5 kcal/g × grams in food
Carbohydrate = 3.5 kcal/g × grams in food
Total calories/100 g = protein calorie + fat calorie + carbohydrate calorie
Percentage of ME contributed by each nutrient (caloric distribution)
Protein = (protein calories/100 g divided by total calories/100 g) × 100 = %ME
Fat = (fat calories/100 g divided by total calories/100 g) × 100 = %ME
Carbohydrate = (carbohydrate calories/100 g divided by total calories) × 100 = %ME
Excess energy intake is much more common in dogs and cats than energy deficiency. The current estimates given by the American Veterinary Medical Association (AVMA) show that greater than 50% of dogs and cats are overweight (10–15% above their desired body weight) or obese (20–25% above their desired body weight)6 Excessive energy intake has been shown to have several detrimental effects on dogs during growth, especially those of large and giant breeds. Feeding growing puppies to attain a maximal growth rate appears to be a significant contributing factor in developing skeletal disorders such as osteochondrosis and hip dysplasia (see Figures 1.1 and 1.2).1,2
Figure 1.1 Radiograph of a Great Dane puppy with hypertrophic osteodystrophy due to overnutrition. This X‐ray shows a line of lucency where destruction of the bone has occurred adjacent to the growth plates in the distal ulna. New bone production can also be seen outside of the bones.
(Courtesy of Dr. Dan Degner.)
Excessive energy intake during growth also affects the total number of fat cells the animal has. If the animals overconsume during their growth phase, this can contribute to obesity later in life. Once a fat cell has been formed, it will never go away, and research has shown that individual cells produce hormones that help them retain their stored fat.1,2,7 Obesity has been linked to the development of orthopedic problems later in life and increased diabetes, hyperlipidemia, pancreatitis and heart failure. A study conducted by Nestle Purina demonstrated that by simply reducing the amount of food fed to a controlled group of Labradors by 25%, they, on average, lived 1.5 years longer than their pair mate, had less incidence of orthopedic problems, cancer and metabolic diseases (see Figure 1.3).8
Figure 1.2 A Great Dane puppy showing the joint enlargement seen with hypertrophic osteodystrophy due to overnutrition.
(Courtesy of Dr. Dan Degner, with permission.)
Figure 1.3 Weight loss secondary to diabetes mellitus. A common complication of this disease is weight loss due to lack of glucose utilization by the cells, causing protein catabolism of the muscle to meet the body's energy requirements with the decreased energy availability.
Inadequate energy intake results in reduced growth rate and compromised development in young dogs and cats and weight loss and muscle wasting in adult animals. In healthy animals, this is most commonly seen in hardworking dogs and pregnant or lactating females fed a diet too low in energy density.1,2 Weight loss is also seen in sick animals that are either unable or unwilling to eat adequate amounts of food or whose disease process causes energy loss or increased energy use.9
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Whitney E, Rolfes SR (2008)
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Delaney SJ, Fascetti AJ (2012) Basic nutrition overview. In AJ Fascetti, SJ Delaney (eds),
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6
Study: Over half of pet dogs and cats were overweight in 2015.
https://www.avma.org/javma-news/2016-06-15/study-over-half-pet-dogs-and-cats-were-overweight-2015
. Accessed June 6, 2021.
7
Toll PW, Yamka RM, Schoenherr WD, Hand MS (2012) Obesity. In MS Hand, CD Thatcher, RL Remillard
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Kealy RD, Lawler DF, Ballam JM
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Donoghue S, Kronfeld DS, Case LP
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