Page 1047 - Small Animal Clinical Nutrition 5th Edition

1088 Small Animal Clinical Nutrition

Table 59-2. Key nutritional factors in selected commercial veterinary therapeutic foods for dogs with short bowel syndrome compared to
VetBooks.ir recommended levels.*
Protein
Fat
Primary
digestibility digestibility Carbohydrate Fat Fiber sources Lactose
free
digestibility
Dry foods (%) (%) (%) (%) (%)** of fiber** (Yes/No)
Recommended levels ≥87 ≥90 ≥90 12-15 ≤5 – Yes
Hill’s Prescription Diet i/d Canine 92 93 94 14.1 2.7 Cellulose, beet pulp Yes
Iams Veterinary Formula
Intestinal Low-Residue na na na 10.7 2.1 Beet pulp Yes
Medi-Cal Gastro Formula na na na 13.9 1.9 Flax meal, pea fiber Yes
Medi-Cal Low Fat Formula na na na 6.6 5.2 Beet pulp, cellulose Yes
Purina Veterinary Diets EN
GastroENteric Formula 84.5 91.4 94.4 12.6 1.5 – Yes
Royal Canin Veterinary Diet
Digestive Low Fat LF 20 na na na 6.6 2.3 Beet pulp, cellulose Yes
Royal Canin Veterinary Beet pulp,
Diet Intestinal HE 28 na na na 22.0 1.6 psyllium husks Yes
Protein Fat Carbohydrate Primary Lactose
digestibility digestibility digestibility Fat Fiber sources free
Moist foods (%) (%) (%) (%) (%)** of fiber** (Yes/No)
Recommended levels ≥87 ≥90 ≥90 12-15 ≤5 – Yes
Hill’s Prescription Diet i/d Canine 88 94 93 14.9 1.0 Soy fiber Yes
Iams Veterinary Formula
Intestinal Low-Residue na na na 13.2 3.9 Beet pulp Yes
Medi-Cal Gastro Formula na na na 11.7 1.0 Oat bran, guar gum, No
flax meal
Medi-Cal Low Fat Formula na na na 9.0 3.1 Cellulose, beet pulp, Yes
guar gum, carrageenan
Purina Veterinary Diets EN
GastroENteric Formula 85.1 95.6 92.2 13.8 0.9 Gum arabic Yes
Royal Canin Veterinary Diet
Digestive Low Fat LF na na na 6.9 3.0 Cellulose, guar gum Yes
Royal Canin Veterinary Diet
Intestinal HE na na na 11.8 1.4 Oat bran, guar gum, No
carrageenan, flaxseed
Key: Fiber = crude fiber, na = information not available from manufacturer.
*Manufacturers’ published values; nutrients expressed as % dry matter; dry foods are preferred because they have slower gastric
emptying compared to moist foods.
**Foods with soluble or mixed fiber sources are best (see text).

sources or mixed fiber sources (rice, oat and wheat brans; soy Other Nutritional Factors
fibers; soy hulls and beet pulp). Patients that have undergone Prebiotic Fibers
ileal resection do not absorb bile acids well, which may cause Fructooligosaccharides and other prebiotic fibers have been
secretory diarrhea. In such cases, dietary intake of mixed fibers proposed for use in the management of dogs with small intes-
may bind bile salts. Several manufacturers include small a- tinal bacterial overgrowth and, therefore, may be useful in cases
mounts of a mixed fiber source in their highly digestible foods of short bowel syndrome in which the ileocolic valve has been
intended for GI diseases. This is the most desirable option if it resected. However, clinical evidence to support use of these
can be done without negatively affecting digestibility. Lower ingredients remains sparse in dogs and cats.
levels of fiber (≤5% [DM]) are generally recommended and
facilitate high digestibility and higher energy density while pro- Vitamins
viding the benefits described above. Fat-soluble vitamins are malabsorbed in many canine and feline
patients with steatorrhea. Although commercial foods are sup-
Digestible Carbohydrate plemented with fat-soluble vitamins, fat-soluble vitamins may
The digestible carbohydrate fraction of the selected food should need to be administered by intramuscular or subcutaneous
be highly digestible (≥90%). Lactose-containing ingredients routes until intestinal adaptation occurs and diarrhea resolves.
should be avoided because extensive small bowel resection re- It is simple and cost effective to administer 1 ml of a vitamin A,
a
sults in loss of lactase and other brush border disaccharidases. D and E solution, divided into two intramuscular sites. This
should supply fat-soluble vitamins for approximately three
Food Form months. Vitamin K at a dosage of 0.5 to 1 mg/kg subcuta-
1
Dry foods may be preferred because they may increase gastric neously is recommended if a vitamin K-responsive coagulopa-
retention time; it takes longer to lower the digesta osmolality of thy is suspected.
dry foods compared to moist foods. If the distal ileum has been surgically removed, cobalamin