Page 1007 - Small Animal Clinical Nutrition 5th Edition

Gastric Motility/Emptying Disorders 1045

VetBooks.ir Table 54-3. Key nutritional factors in selected moist commercial veterinary therapeutic foods compared to recommended levels for dogs
with gastric motility and emptying disorders.*
Energy density
Crude
Factors
(kcal/g) Potassium Chloride Sodium Fat fiber (%)
(%)
(%)
(%)
(%)
Recommended levels 4.0-4.5 0.8-1.1 0.5-1.3 0.3-0.5 ≤ ≤15 ≤ ≤5
Hill’s Prescription Diet i/d Canine 4.4 0.95 1.22 0.44 14.9 1.0
Iams Veterinary Formula Intestinal Low-Residue 4.6 0.84 0.84 0.53 13.2 3.9
Medi-Cal Gastro Formula na 0.6 na 0.6 11.7 1.0
Purina Veterinary Diets EN GastroENteric 4.0 0.61 0.78 0.37 13.8 0.9
Royal Canin Veterinary Diet Digestive Low Fat LF 4.0 0.74 1.06 0.39 6.9 3.0
Royal Canin Veterinary Diet Intestinal HE 4.3 0.8 0.92 0.57 11.8 1.4
Key: na = information not available from manufacturer.
*From manufacturers’ published information or calculated from manufacturers’ published as fed values; all values are on a dry matter
basis unless otherwise stated. Moist foods, foods with liquid or semi-liquid consistency are preferred. Foods should be offered at
temperatures between 70 to 100°F (21 to 38°C).
Table 54-4. Key nutritional factors in selected moist commercial veterinary therapeutic foods compared to recommended levels for cats
with gastric motility and emptying disorders.*

Factors Energy density Potassium Chloride Sodium Fat Crude
(kcal/g) (%) (%) (%) (%) fiber (%)
Recommended levels 4.0-4.5 0.8-1.1 0.5-1.3 0.3-0.5 ≤ ≤25 ≤ ≤5
Hill’s Prescription Diet i/d Feline 4.2 1.06 1.18 0.33 24.1 2.4
Iams Veterinary Formula Intestinal Low-Residue 4.0 0.93 0.69 0.40 11.7 3.7
Medi-Cal Hypoallergenic/Gastro na 1.1 na 0.7 35.9 1.2
Medi-Cal Sensitivity CR na 1.1 na 1.1 35.1 2.5
Key: na = information not available from manufacturer.
*From manufacturers’ published information or calculated from manufacturers’ published as fed values; all values are on a dry matter
basis unless otherwise stated. Moist foods, foods with liquid or semi-liquid consistency are preferred. Foods should be offered at
temperatures between 70 to 100°F (21 to 38°C).

unrelenting vomiting secondary to gastric outflow obstruction. day) are preferred. In some cases of complete pyloric outflow
In such patients, oral consumption of food is not possible and obstruction, parenteral nutritional support may be necessary to
intravenous fluid administration with electrolyte therapy meet the patient’s needs before surgical alleviation of the
should be used to correct this profound acid-base disturbance. obstruction.This is indicated when the patient’s body condition
A highly digestible food formulated for GI disease should be is poor (BCS of 1/5 or 2/5) and the patient is deemed at
fed after the gastric outflow obstruction has been resolved by increased risk for postsurgical complications.
surgical or endoscopic means. Late evening feedings are recommended for dogs with the
Foods with lower energy density require larger or more fre- so-called “bilious vomiting” syndrome. Gastroduodenal reflux
quent meals to meet the patient’s daily energy requirement. in these patients probably arises secondarily to a gastric motili-
Larger meals may promote more vomiting and can slow gastric ty disorder.Late evening meals with or without prokinetic ther-
emptying. Optimal energy and fat levels should be determined apy may resolve clinical signs in affected dogs (Simpson, 2005).
according to the patient’s ability to tolerate meal size and main- Most patients can be fed using a feeding method similar to
tain optimal body condition. that used for normal pets, if normal gastric function is restored
after surgery. The best feeding method will need to be individ-
Assess and Determine the Feeding Method ualized for each patient and determined by trial and error based
Patients with gastric motility disorders often require specialized on remaining gastric function.
feeding methods; the current feeding protocol is rarely appro-
priate. A thorough assessment includes verification of the feed-
ing method currently used. Items to consider include feeding REASSESSMENT
frequency, amount fed, how the food is offered, access to other
food, relationship of feeding to exercise and who feeds the pet. Body weight and condition should be assessed every two to
All of this information should have been gathered when the four weeks. Document the presence or absence of vomiting. If
history of the patient was obtained. If the patient has a normal vomiting continues, alter the food or feeding pattern. Dividing
body condition score (BCS of 2.5/5 to 3.5/5), the amount of the daily food intake into additional meals also may increase GI
food fed previously was probably appropriate. tolerance. Use of prokinetic agents (e.g., metoclopramide, cis-
Offer foods between room and body temperature (70 to apride) should be considered if vomiting persists despite imple-
100°F [21 to 38°C]). Frequent small meals (at least three per mentation of these therapeutic strategies.