Dietary management of GI diseases in dogs and cats (Proceedings)
Dietary management is a vital component of successful treatment of many Gastrointestinal (GI) diseases. Some conditions can be managed with diet alone, while others require concurrent medical management. In these cases, dietary management may facilitate the use of lower medication dosages, reducing the potential for side-effects. This seminar will provide an overview of "GI" diets and will briefly review the principles of dietary management of selected GI disorders of the dog and cat.
The traditional GI diet should be highly digestible, low in fat, low in fiber, and contain high quality nutrients. Some diets are lactose and gluten free, although the necessity of omitting these substances has not been proven. Decreasing fat content often reduces palatability, so many of the commercially available GI diets contain low-moderate fat levels compared to maintenance diets. Although many home-made recipes are available, most veterinarians utilize commercially available diets "GI" diets for client practicality and ease and consistency of treatment. Each of the major prescription pet food companies markets a "GI" diet. These diets adhere to the nutritional profile discussed above and are more similar to each other than different. Each company has components of their diet that they feel make it superior to their competitors, however published results proving benefits of these diets or direct comparisons between these diets in spontaneous canine and feline diseases are lacking.Hills markets dry and canned i/d which can be fed to puppies and kittens and adult dogs and cats. The diet contains a low level of soy fiber, which has properties of both insoluble and soluble fibers. Nestle Purina markets EN in both dry and canned formulations for dogs and as a pouch for cats. In the canine diet approximately 30% of the fat is supplied as medium chain triglycerides, which are easier to assimilate than long chain triglycerides and are absorbed directly into the portal system. EN can also be fed to puppies. The feline product contains added soluble fiber. Both diets contain a ratio of omega-3 and omega-6 fatty acids which may be beneficial in managing inflammation. The Iam's product is low-residue, available as a dry formulation for puppies, and dry and canned for adult dogs and cats. These products contain beet pulp fiber, which is insoluble, but highly fermentable. They also contain fructooligosaccharides, which are metabolized by enteric bacteria and promote a healthy gut flora. They also are enhanced with omega-3 fatty acids. Waltham diets are marketed by their recent merger partner Royal Canin. Their low fat diet is available as a dry and canned product which is suitable for puppies and adult dogs. It contains the lowest level of fat of any of the prescription products. Innovative Veterinary Diets markets canine sensitive for adult dogs in a dry and canned formulation and a dry formulation for adult cats. The canine diet contains fructooligosaccharides and is supplemented with amylase, lipase, and protease. The feline product has enhanced levels of omega-3 fatty acids.
Megaesophagus is a common cause of regurgitation in dogs. In many young dogs it is an idiopathic condition, while in adults it may be secondary to neuromuscular disorders, such as myasthenia gravis. The esophagus becomes dilated and lacks peristalsis. Food is retained within the dilated esophagus and can be regurgitated and also lead to aspiration pneumonia.
Dietary management consists of feeding in an elevated manner, allowing gravity to aid delivery of food into the stomach. A gruel of caloric-dense canned food and water should be administered in small frequent feedings. The dog should remain upright for 10-15 minutes after eating. Small dogs can be help by owners, larger dogs can be trained sit. Commercially produced feeding racks are available, or they can be constructed by owners. Daily water requirements (60-100 ml/kg) can be supplied. If regurgitation continues other consistencies of foods should be tried. Small diameter "meatballs" of canned food may work in some dogs that don't respond to gruel. Placement of a percutaneous gastrostomy tube may temporarily allow delivery of nutrients to the stomach in dogs with malnutrition and severe aspiration pneumonia. Long-term use is not often satisfactory due to client compliance difficulties encountered with long-term tube feeding and continued regurgitation and aspiration of saliva.