Page 970 - Small Animal Clinical Nutrition 5th Edition

1006 Small Animal Clinical Nutrition

Table 48-1. Gastrointestinal and exocrine pancreatic diseases Box 48-1. Herbal Remedies for
amenable to dietary management.
VetBooks.ir Oral Gastrointestinal Disorders.
Inflammatory disorders (stomatitis, radiation-induced mucositis)
Physical abnormalities (trauma, neoplasia, congenital malforma- Herbal remedies have become a major factor in human health
tions) care. Various botanicals have become household words, and
Pharynx and esophagus sales of herbal remedies are increasing dramatically. As herbs
Inflammatory disorders (esophagitis)
Motility disorders (cricopharyngeal achalasia, megaesophagus) move out of health food stores and into mainstream supermar-
Obstructive disorders (vascular ring anomalies, strictures, neo- kets, drug stores and even pet stores, use of these products in
plasia) pets will also increase.
Stomach A wide variety of herbal or botanical products are advocated
Gastric dilatation/gastric dilatation-volvulus for patients with gastrointestinal (GI) disorders, including individ-
Gastric motility/emptying disorders
Gastritis uals with diarrhea, vomiting, constipation, stomatitis, colitis and
Gastroduodenal ulceration flatus. There are also long lists of herbs and botanicals that are
Hairballs described as “gastrointestinal agents.” Although today’s herbal
Small intestine remedies exhibit varying degrees of therapeutic value, most
Acute enteritis
Inflammatory bowel disease have not been investigated thoroughly for safety and efficacy. It
Intestinal neoplasia is beyond the scope of this textbook to list all the herbal and
Lymphangiectasia botanical remedies that may have use in pets. Interested read-
Protein-losing enteropathy ers are referred to books listed in the Bibliography for further
Short bowel syndrome information about human herbal remedies that might be used in
Small intestinal bacterial overgrowth
Wheat-sensitive enteropathy pets with GI disorders.
Large intestine
Colitis The Bibliography for Box 48-1 can be found at
Constipation www.markmorris.org.
Flatulence
Irritable bowel syndrome
Pancreas
Exocrine pancreatic insufficiency
Pancreatitis
Box 48-2. Performing Dietary Trials in
Patients with Gastrointestinal Disease.

• Introduction to Small Intestinal Diseases (Chapter 55) Nutritional therapies are extremely useful for treating gastroin-
• Acute Gastroenteritis and Enteritis (Chapter 56) testinal (GI) disease in dogs and cats. Several commercial and
• Inflammatory Bowel Disease (Chapter 57) homemade foods are available to practitioners and pet owners
• Protein-Losing Enteropathies (Chapter 58) for this purpose. Unfortunately, there is no historical or clinical
finding that will predict the success of a specific food type.
• Short Bowel Syndrome (Chapter 59)
Therefore, selection of the most appropriate food for an individ-
• Small Intestinal Bacterial Overgrowth (Chapter 60)
ual patient is often based on results of a dietary trial.
• Introduction to Large Intestinal Diseases (Chapter 61)
Dietary trials are easily performed in most clinical and home
• Large Bowel Diarrhea: Colitis (Chapter 62)
settings. Oral food consumption is preferred for managing GI
• Large Bowel Diarrhea: Idiopathic Bowel Syndrome in diseases, except in those rare situations in which the patient is
Dogs (Chapter 63) intolerant of enteral feeding.
• Constipation/Obstipation/Megacolon (Chapter 64) After the veterinarian identifies those foods to be included in
• Flatulence (Chapter 65) the trial, selection of the initial test food is often based on clini-
• Exocrine Pancreatic Insufficiency (Chapter 66) cal experience and the patient’s nutritional history. In general,
• Acute and Chronic Pancreatitis (Chapter 67) foods that have been used unsuccessfully in the past to manage
the patient should be avoided. Typically, highly digestible GI or
elimination foods are good first choices for patients with gastric
Vomiting and diarrhea have a myriad of causes and feeding
or small intestinal disorders. Fiber-enhanced foods are often the
plans vary according to the underlying condition. The feeding
initial selection when large bowel signs predominate.
plans for acute gastroenteritis are most appropriate when a spe-
No other foods, supplements, table foods or treats should be
cific cause of acute vomiting or diarrhea is unknown. When a
offered during the dietary trial. Dietary trials are most useful if
specific cause of chronic small bowel diarrhea is not identified, continued for at least seven to 10 days. In certain settings (e.g.,
then feeding plans as outlined for exocrine pancreatic insuffi- adverse reactions to food), trials lasting two to four weeks (12
ciency are most appropriate. Finally, when a specific cause of weeks in cases with dermatologic signs) may be necessary to
chronic large bowel diarrhea is not identified, then feeding determine efficacy (Chapter 31). Successful dietary trials are
plans for colitis are most appropriate. marked by partial or complete resolution of clinical signs.
Each patient should be seen as an individual variant of the
norm; therefore, multiple dietary manipulations should be con- The Bibliography for Box 48-2 can be found at
www.markmorris.org.
sidered, as needed, for each patient (Box 48-2). Because of the