Page 1104 - Small Animal Clinical Nutrition 5th Edition

Acute and Chronic Pancreatitis 1149

VetBooks.ir Table 67-4. Key nutritional factors in selected commercial veterinary therapeutic foods for dogs with pancreatitis compared to recom-
mended levels.* (See Table 67-6 if patient is obese or hypertriglyceridemic.)
Moist foods
Recommended levels Fat (%) Protein (%)
≤15
15-30
Hill’s Prescription Diet i/d Canine 14.9 25.0
Iams Veterinary Formula Intestinal Low-Residue 13.2 35.9
Medi-Cal Gastro Formula 11.7 22.1
Purina Veterinary Diets EN GastroENteric Formula 13.8 30.5
Royal Canin Veterinary Diet Digestive Low Fat LF 6.9 31.9
Royal Canin Veterinary Diet Intestinal HE 11.8 23.1
Dry foods Fat (%) Protein (%)
Recommended levels ≤15 15-30
Hill’s Prescription Diet i/d Canine 14.1 26.2
Iams Veterinary Formula Intestinal Low-Residue 10.7 24.6
Medi-Cal Gastro Formula 13.9 22.9
Purina Veterinary Diets EN GastroENteric Formula 12.6 27.0
Royal Canin Veterinary Diet Digestive Low Fat LF 20 6.6 24.2
Royal Canin Veterinary Diet Intestinal HE 28 22.0 33.0

*Manufacturers’ published values. Nutrients expressed as % dry matter.

Table 67-5. Key nutritional factors in selected commercial veterinary therapeutic foods for cats with pancreatitis compared to recom-
mended levels.* (See Table 67-7 if patient is obese or hypertriglyceridemic.)
Moist foods Fat (%) Protein (%)
Recommended levels ≤25 30-40
Hill’s Prescription Diet i/d Feline 24.1 37.6
Iams Veterinary Formula Intestinal Low-Residue 11.7 38.4
Medi-Cal HYPOallergenic/Gastro 35.9 35.5
Medi-Cal Sensitivity CR 35.1 34.5
Dry foods Fat (%) Protein (%)
Recommended levels ≤25 30-40
Hill’s Prescription Diet i/d Feline 20.2 40.3
Iams Veterinary Formula Intestinal Low-Residue 13.7 35.8
Medi-Cal HYPOallergenic/Gastro 11.5 29.8
Purina Veterinary Diets EN GastroENteric 18.4 56.2
Royal Canin Veterinary Diet Intestinal HE 30 23.7 34.4
*Manufacturers’ published values. Nutrients expressed as % dry matter.

ually over several days. Normal feeding methods can be reintro- is minimal or nonexistent (Relly and Nahrwold, 1976; Betz-
duced after several days without clinical signs, unless dietary in- hold and Howard, 1986). Both total parenteral and partial par-
discretion or inappropriate foods or feeding methods initially enteral nutritional feeding have been used in patients with pan-
contributed to the problem. creatitis (Zsombor-Murray and Freeman, 1999; Zoran, 2007).
After three days (including periods of inappetence before In one review, pancreatitis was the most common diagnosis in
admission) of the NPO protocol, patients with severe pancreati- hospitalized patients receiving partial parenteral nutrition
tis should receive enteral or parenteral nutritional support. The (Chan et al, 2002). Intravenous administration of nutrients to
method deemed most desirable is the least invasive, supports the support patients with pancreatitis through a five- to 14-day
patient nutritionally and minimally stimulates pancreatic secre- course of vomiting is possible, safe and economical in most
tions. Some clinicians suggest feeding anorectic cats even earli- practices (Chapter 26). Parenteral solutions are of particular
er because of the risk of hepatic lipidosis (Zoran, 2007). benefit for managing pancreatitis in cats, especially when com-
Protracted cases of pancreatitis with intractable vomiting plicated by hepatic disorders, IBD or interstitial nephritis (Akol
often require parenteral nutrition to meet the patient’s energy, et al, 1993; Weiss et al, 1996).
protein, electrolyte and B-vitamin requirements while mini- Selection of parenteral solutions for feeding patients with
mizing pancreatic secretions (Chapter 26). This is particularly pancreatitis is controversial because of the association between
true for patients for which the general anesthesia required for hyperlipidemia and pancreatitis. Some authors suggest that
tube placement is considered too risky. Parenteral administra- selection of parenteral solutions be based on amino acid and
tion of nutritional solutions (including lipid solutions) has been dextrose content only, whereas others advocate the use of lipid
associated with pancreatic atrophy; thus, pancreatic stimulation solutions in the admixture if the patient is not hyperlipidemic.