Vet Expert Veterinary Diets
Veterinary Diet – law regulation
Vet Expert Veterinary Diets
• Mobility - Dog
• Urinary - Cat
• Obesity – Dog and Cat
• Renal – Dog and Cat
• Dermatosis – Dog
• Hypallergenic Insect - Dog
• Intestinal – Dog and Cat
• Intestinal Elimination - Dog
• Hepatic - Dog
Osteoarthritis
• Arthritis
• Inflammation of a joint
• Osteoarthritis
• Marked by inflammation, degeneration or metabolic derangement of the connective tissue and cartilage surrounding the joint
Johnston SA. Vet Clin N Amer 1997
OsteoarthritisRisk Factors
• Age
• Size / breed
• Genetic predisposition• Large, fast-growing
breeds
• Nutritional risk factors
• Trauma
• Obesity
Lund EM, et al. 1999
Breed /size of dogs vs
ostroarthritis risk
Dog breed Risk of disease
Germen shepherd 4,5
Rottweiler 3,2
Labrador 2,8
Golden retriever 2,1
Shetland shepherd 1,8
Mixed-breed 1,5
Clinical signs of OA
• Observed by owner:• Rigid gait
• Lameness
• Difficulties in getting up after rest
• Vocalisation suggesting pain
• Reluctance to:
• walk
• play
• run
• Visible behavioural changes sometimes mislead with ageing
• The change in relation with the owner –change of daily routine, every-day habits
Cartilage - Functions
• Avascular, aneural
• Composed of chondrocytes with extracellular matrix
• Smooth, resilient, wear resistant
• Frictionless motion
• Transmits loads/ forces to subchondral bone
Cartilage - Structure
Articular cartilage
• Chondrocytes • 5% tissue volume
• metabolically active
• produce & maintain extracellular matrix
• Extracellular matrix• water (70 – 80%)
• collagen
• aggrecans [proteoglycans & GAGs]
• other (glycoproteins, minerals, lipids)
10
Normal Early Late
Aggrecan (Proteoglycans) + Degradative Enzymes Matrix Damage Cartilage Erosion & chondrocyte loss
Caterson B, et al. Matrix Biol 2000
Pathophysiology of osteoarthritis
Lipooxygenase
Inflammation
Injury of cell membrane
Destruction of cell membrane
Release of arachidonic acid (n-6)
Cyclooxygenase
(COX-1 and COX-2)
Leukotriene and
lipoxins
Prostaglandins (PGE2)
and thromboxane
The role of omega-3 fatty acids in inflammation
• Arachidonic acid (n-6) is a precursor of inflammatory prostaglandins and leukotrienes
• Eicosapentaenoic acid (n-3) could replace arachidonic acid in cell membranes what prevents from the release of proinflammatory prostaglandins and leukotrienes
• The influence of mega-3 fatty acids on gene expression is suggested
Pathophysiology of osteoarthritis
Lipooxygenase
Inflammation
Injury of cell membrane
Destruction of cell membrane
Release of arachidonic acid (n-6))
Cyklooksygenaza
(COX-1 i COX-2)
Leukotriene and
lipoxins
Prostaglandins (PGE2)
and thromboxane
EICOSAPENTAENOIC ACID (n-3)
Fatty acid vs inflammation
What is important :
• The total content of selected omega-3 fatty acids
• The omega-6:omega-3 fatty acid ratio
The role of EPA
• Eicosapentaenoic acid is a long chain unsaturated n-
3 fatty acid occurring naturally in fish oil, linseed
• The use of EPA in humans and dogs with
osteoarthritis results in the decrease of production
of pro-inflammatory cytokines which could prevent
from inflammatory cells activity
• Could also act on the level of gene expression
Omega-6:omega-3 fatty acid ratio vs prostaglandins production
Low n-6:n-3 ratio decreases inflammation in joint cartilage in dogs
PGE2 release form nuclear cells
Wander RC, et al. J Nutr 1997
0
50
100
150
200
250
300
350
400
450
500
31.0:1 5.4:1 1.4:1
Omega-6:Omega-3 Fatty Acid Ratio
PGE2
17
Total decrease of NSAIDs dosage
The study conducted showed the decreased of NSAIDs dosage need in dogs receiving the food enriched with omega-3 fatty acid
Fritsch DA, Allen TA, Dodd CE, Jewell DE, Sixby KA, Leventhal PS, Brejda J, Hahn KA. (2010) A multicenter study of the effect of dietary supplementation with fish oil omega-3 fatty acids on carprofen dosage in dogs with osteoarthritis.J Am Vet Med Assoc. 236(5):535-9.
Decreased of NSAIDS dosage
Activesubstances
Chondroprotective
- Glucosamine
- Chondroitin
- Hialuronic acid
- Keratan
- Collagen
Antinflammatory
- ASU
- Boswellia
- Harpagophytum
N-3 fatty acids
Vet Expert Dog MobilityThe support of joints metabolism in
case of osteoarthritis
• Regulation:• Unsaturated fatty acid content 3.5%
• EPA content – 3800 mg/kg
• Declaration of vitamin E content
• VetExpert Mobility dog :– Unsaturated fatty acid content 4,3%– EPA + DHA content– 5995 mg/kg– Vitamin E content E – 654 mg/kg
Vet Expert Dog Mobility – additional properties
• Glucosamine + chondroitin – 1000 mg/kg
• ASU (soy and avocado unsaponificables) – 1000 mg/kg
• L-carnitine – 170 mg/kg
• In humans – Piascledine
Mechanism of action
• In vitro exerts anabolic, anti-catabolic and anti-inflammatory
activity in chondrocytes.
• Increases collagen synthesis
• Inhibits interleukin-1beta - induced collagenase
• Increases aggrecan synthesis
• Inhibits IL1β-dependent activation do matrix metalloproteinase-3
(MMP)-3, IL-6, IL-8 and prostaglandin E2 (PGE2)
SOYA and AVOCADO UNSAPONIFICABLES (ASU)
• reduce the development of early osteoarthritic cartilage and
subchondral bone lesions in the anterior cruciate ligament dog model
of osteoarthritis.
• inhibition of inducible nitric oxide synthase and MMP-13, which are key
mediators of the structural changes that take place in osteoarthritis
• Registered by FDA for medium-term relief in osteoarthritis in humans
SOYA and AVOCADO UNSAPONIFICABLES
ASU in experimental osteoarthritis in dogs
Vet Expert Mobility Dog – features
• The only diet on the market with two mechanisms of antinflammatory action: n-3 fatty acids and ASU
• High content of protein, low in carbohydrates
• ADDITIONAL INDICATION: helps to support of alimentary tractfunction thanks to the content of FOS, MOS and Yucci Schidigeraextract
Vet Expert Mobility Dog
• Diet vs supplement (positioning)• Only diet could supply 3,5% of n-3 fatty acids
• Diet is one of the solutions in fighting with osteoarthritis
• Multimodal approach: supplements (three different) and diet from VetExpert
Properties Benefits
Fatty acids omega-3 Alleviate inflammation of the joints and have analgesic
properties.
Glucosamine
and chondroitin
Glucosamine and chondroitin are proteoglycans which are
the fundamental structural components of articular
cartilage.
L-carnitine Alleviates inflammation of the joints and has analgesic
properties.
ASU Unsaponifiable fractions of avocado and soya have anti-
inflammatory properties and the ability to inhibit the
enzymes degenerating articular cartilage.
Vet Expert Mobility Dog – features and benefits
Food allergy and intolerance
Food allergy and intolerance
Allergy is quite rare disease of dogs and cats – allergic
dermatitis is only 1% of all skin disorders, but food
allergy is a third cause of allergy after airborne allergy
and flea allergy.
It is a cause of 23% of all non-seasonal dermatitis
Main allergens of dogs and cats
DOGS
Beef
Milk products
Whey
Lamb
Eggs
Chicken
Soy
Corn
Food additives
CATS
Beef
Milk
products
Fish
Chicken
Food additives
68% of cases
25% of cases
89% of cases
Causes of food allergies
• Contact with antigen :
• The immunological response is probably induced by transient, repeated contact of the organism with antigen, not the constant presence of the allergen in the food!!!
Food allergy – treatment
The strategies of nutritional management –
• Elimination diet : new protein and
carbohydrates which animal were not eating
previously
• Protein hydrolysis
• Diet without animal protein
Food allergy – treatment
Elimination diet – the use of food with new protein and
carbohydrate sources or with hydrolysed protein
The basis for the success is good compliance of the owner – no
treats, noadditional foods (no vitamin supplements)
16% of animals react negatively to the foods offered as
elimination ones!!!!!!
Food allergy – treatment
• The most frequently used sources of protein and carbohydrates in pet foods: chicken, beef, eggs, soy, milk, corn, rice and wheat
• Less frequently used sources of protein in pet foods:lamb, fish, turkey, oat, barley, potato, linseed
• Rarely used sources of protein and carbohydrates in pet foods: sorghum, rabbit meat, veal, rye, tapioca
Elimination diet
•But:•Cross-sensitivity exist :
• Beef and milk casein (dogs)• Lamb and beef (dogs)• Potato and dust (humans)
Food allergy – treatment
• The decrease of pruritus by a half proves hypersensitivity
• Return to previous diet in order to prove food hypersensitivity
• The identification of ingredient responsible for allergy
• BUT: sometimes owners do not want to look for the reason – they just select new food.
Elimination diet should be used as a only source of food, first symptoms of improvement could be seen after 2-3 weeks of treatment, but sometimes requires 10 weeks
Vet Expert Dermatosis Dog – law requirementsSupport of skin function in the case of dermatosis and excessive
loss of hair
• Regulation :• High level of essential fatty acids
• VetExpert Dermatosis Dog Salmon:
– Essential fatty acids – 4,3%
– EPA + DHA 5000 mg/kg
Vet Expert Dermatosis Dog - law requirementsReduction of ingredient and nutrient intolerances
• Regulation :• Selected protein source(s); and/or
• Selected carbohydrate source(s)
• VetExpert Dermatosis Dog SALMON:– Protein source – salmon
– Carbohydrate sources – potatoes and rice
Vet Expert Dermatosis Dog – additional properties
• Prebiotics – modifying alimentary tract microflora in case of food intolerances
• Ginger – modifying alimentary tract peristalsis, soothing properties
Properties Benefits
Protein The food contains one source of protein, salmon, which helps prevent the presence in food of
other protein allergens, which could cause the symptoms.
Omega-6 fatty acids Increased content supports the functions of the skin and improves the quality of fur by
supporting the skin barrier and it protects from the filtering through of environmental
allergens into the body.
Omega-3 fatty acids Protect from the negative effects of inflammatory conditions of the skin.
Fructo oligosaccharides
(FOS), mannan -
oligosaccharides (MOS)
Prebiotics used by the bacteria of the gastrointestinal tract. They ensure the stability of the
intestinal microflora, provide cells of the colon with energy and stimulate the immunological
mechanisms in the gastrointestinal tract.
Yucca Schidigera Extract of Yucca Schidigera has the ability to absorb metabolites in the lumen of the
gastrointestinal tract.
Ginger The addition of ginger stimulates the peristalsis of the gastrointestinal tract and has protective
and anti-inflammatory effects.
Vet Expert Dermatosis Dog – features and benefits
Vet Expert Dermatosis Dog - law requirementsReduction of ingredient and nutrient intolerances
• Regulation :• Selected protein source(s); and/or
• Selected carbohydrate source(s)
• VetExpert Dermatosis Dog RABBIT:
– Protein source – rabbit
– Carbohydrate sources – potatoes
Vet Expert Dermatosis Dog – features
• High amount of total n-3 + n-6 fatty acids• Unsaturated fatty acids– 4,3% • EPA + DHA 5000 mg/kg
• High protein content – paplatbility
• ADDITIONAL INDICATION: • Improves functioning of the skin thanks to high level of n-6 fatty acids• Improves the function of alimentary tract thank to the content of MOS, FOS,
ginger, Yucci Schidigera and glutamine
Vet Expert Hypoallergenic Dog - law requirementsReduction of ingredient and nutrient intolerances
• Regulation :• Selected protein source(s); and/or
• Selected carbohydrate source(s)
• VetExpert Hypoallergenic Insect:
– Protein source – insect Hermetia illucens
– Carbohydrate sources – potatoes
Vet Expert Hypoallergenic Dog
• Hypoallergic diet with single source of protein• Insect protein isolated from HERMETIA ILLUCENS larvae• Potential allergenicity of insect protein in dogs is close to
zero
• Diet with single source of carbohydrates• Potato
• Grain-free• Hydrolysed chicken liver as digest• Flaxseed and fish oil as source of omega-3 fatty
acids
Hermetia illucens – why?
• First commercially produced larvae of insects
• Insects are invertebrates• Small possibility of allergy to invertebrates in mammals
• High fat contents – especially lauric acid• Saturated fatty acid supporting immunity
• Antibacterial, antiviral and antifungal action
• Up to now its main source was coconut oil
Hermetia illucens – why?
Hermetia illucens – why?
Vet Expert Veterinary Diet Dermatosisdog salmon & potato
400 g
Feeding instruction: The recommended period of administration in case of reducing the occurrence of feed intolerance is from 3 to 8 weeks. If the symptoms of intolerance subside, the feed may be given for an indenite period of time. In case of maintaining the normal functions of the skin in dermatoses and in case of excessive fur loss the feed should be given up to 2 months.
Fresh drinking water should always be available.
Serve at room temperature.
Once opened, store in the refrigerator up to 3 days.
Shelf life: 2 years.
Vet Expert Veterinary Diet Dermatosis
Nutritional characteristics Benefits
One source of protein – salmon
One source of carbohydrates -
potatoes
help avoid the presence in food
allergens, which may be the cause
of the symptoms occurring in the
animal
Fatty acids n-6 & n-3 High content has anti-inflammatory
and supports the function of the skin
Grain free
It does not contain grains that could
be a source of potential allergens
and mycotoxins
Alimentary tract disorders responding to dietetic treatment
• Gastric regurgitation
• Gastritis
• Stomach motility disorders
• Enteritis (acute and chronic)
• Protein-loosing enteropathy
• Short bowel syndrome
• Colitis (acute and chronic)
• Antibiotic-responsive enteropathy
Alimentary tract disorders
• Main objective of the therapy:
• Fulfilling the requirements
• Preventing from deficiencies and under nutrition.
• In long-term view
• Improvement of alimentary tract restoration,
• Restoration of proper microflora,
• Normal motility stimulation
• Inhibition of inflammatory processes in intestine
• Proper digestion and absorption
Alimentary tract diseases
• Basic management in acute conditions – fasting for 12-48 h and then administration of highly digestible diet for al least several days
• Recent studies show that the composition of diet and is much more important than feed withdrawal after first signos of the disease
Alimentary tract diseases – protein
• GIT diseases negatively influence digestion and absorption of protein. Its deficiency causes disorders of alimentary tract removal and of local intestinal immunity (protein-losing enteropathy)
• Incompletely digested protein from small intestine is transported to colon where it is digested by microflora and significant amounts of gases and ammonia are produced. This could lead to diarrhoea, colitis and could lead to local immunity disorders and allergy to specific nutrients
Alimentary tract diseases – carbohydrate
• Diet should contain carbohydrates from plant origin, which does not contain gluten. • White rice is good solution since it does not contain gluten and has low
antigenicity;
• Corn and potato are also good solution but they are less digestible than rice, and corn could induce hypersensitivity
• Wheat, oat and barley should be avoided.
Prebiotics – definition
Not digested diet component which exerts beneficial action of host by stimulating growth and/or activity of one or several probiotic bacteria in the colon.
Main probiotics• Fructooligosaccharides• Mannooligosaccharides• Galactooligosascharides• Transgalactooligosaccharides• Lactose
Fructooligosaccharides - FOS
Fructooligosaccharides (FOS) are prebiotics being a natural nutrient for probiotic bacteria and they can not be used by harmful bacteria.
The molecule of FOS contains fructose and glucose (short chains of fructose with glucose molecule at the end)
Prebiotics by decreasing feces pH stimulate the growth of beneficial bacteria and inhibit the growth of harmful bacteria, such as Clostridium perfringens.
Action• Prebiotics improve the feces consistency without increasing its volume (prevent
constipation)• inhibit production of endotoxins and decrease the level of putrescent
substances within gut.• Increase the number of beneficial bacteria i.e. Bifidobacterium• Majority of Bifidobacterium, Lactobacillus, Bacteroides bacteria uses FOS as
glucose whereas Salmonella, Clostridium is not metabolising FOS at all or in small amount
Mannooligosaccharides - MOS
Mannooligosaccharides (MOS) due to its adhesive properties block the sites of adhesion of harmful bacteria with alimentary tract endothelium what unables the colonization of intestines by pathogenic bacteria.
MOS increases the level of IgA antibodies in colon what stimulates the non-specific immunity of alimentary tract.
MOS molecule contains mannose and glucose
Not hydrolysed by digestive enzymes but only by Lactobacillus and Bifidobacterium bacteria; not fermented on the level similar to FOS
Main role:
• Immunomodulation
Vet Expert Intestinal Dog – law requirementsCompensation for maldigestion
• Regulation :• Highly digestible ingredients
and low level of fat
• VetExpert Intestinal Dog:
– Digestibility - >90%
– Fat content – 10%
Vet Expert Intestinal DogReduction of acute intestinal absorptive
disorders• Regulation:
• Increased level of electrolytes and highly digestible ingredients
• VetExpert Intestinal Dog:– Digestibility > 90%
– Content of sodium and potassium given
Vet Expert Intestinal Dog – additional properties
• Low fiber content – increases digestibility
• Inulin added (FOS) – prebiotic modifying
alimentary tract microflora
• Ginger (1000 mg/kg) – extract modifying
alimentary tract peristalsis; sooths
alimentary tract mucosa
• ADDITIONAL INDICATION: improves joint
function thanks to the glucosamine and
chondroitin content
Properties Benefits
Digestibility High digestibility increases the number of nutrients used by the body of the animal.
Crude fibre Reduced amount improves the digestibility of the food and reduces the volume of
stools
Fat A reduced amount inhibits the stimulation of the pancreas of the animals with
exocrine pancreatic failure.
Soluble carbohydrates
(inulin)
Are a source of Fructo oligosaccharides used by the bacteria of the gastrointestinal
tract. Ensure the stability of the intestinal microflora and provide the bacteria of the
colon with energy.
Electrolytes An increased content allows compensation of the losses caused by vomiting and
diarrhoea.
Ginger The addition of ginger stimulates the peristalsis of the gastrointestinal tract and has
protective and anti-inflammatory properties.
Vet Expert Intestinal Dog – features and benefits
Vet Expert Intestinal Elimination Dog
First on the market diet being combination of intestinal diet and hypoallergenic diet
INTESTINAL DIET
High protein level
Low fat level
Low fibre level
FOS + MOS
Ginger
ELIMINATION (Hypoallergenic) DIET
Single source of animal protein
No gluten
Rice and potatoe as carbohydrate source
Vet Expert Intestinal Elimination Dog
1. Food allergies often have clinical signs from alimentary tract (diarrhoea)• Hypoallergenic diet w one source of animal protein but of high palatability
and absorption is necessary
2. Malabsorption / maldigestion often requires simple diet – based on single ingredients• High-protein and easy-digestible diet jest necessary since GIT damage
increases the risk of potential allergies – the best is diet without potential allergens (grain gluten) and based on single source of protein)
Vet Expert Intestinal Elimination Dog
Features
• Diet for dogs with digestion and absorption disorders
• Low amount of fat fulfils requirements of dogs in case of exocrine pancreas insufficiency
• Contains ingredients supporting digestion in alimentary tract (Fructooligosaccharides and mannooligosaccharides) or supporting its function (ginger)
• Moderately decreased fibre level ensures proper peristalsis of GIT without increase of faeces volume
• Could be given to puppies
• ADDITIONAL INDICATION: diet formulated on the basis of single animal protein and potato and brown rice – diet could be used as elimination diet in dogs with dietary allergy / intolerance suspicion
Vet Expert Intestinal Elimination Dog
Key nutritional factors content
Ingredient Amount Function
Protein 30% Single source of animal protein (turkey); increased level
Fat 9% Reduced amount of fat enable use of the diet in animals with exocrine pancreas insufficiency (acute pancreatitis)
Fibre 3% Reduced amount increases diet digestibility about is sufficient for proper peristalsis of GIT
FOS 1000 mg/kg
Fructooligosaccharides are main source of energy for probiotic bacteria
MOS 1000 mg/kg
Mannanooligosacharydy stimulates natural mechanisms of local immunity in alimentary tract
Ginger 800 mg/kg
Soothes intestine wall
Gluten-free Helps to avoid hypersensitivity to proteins from grains
Vet Expert Intestinal Elimination Dog
Vet Expert Intestinal Dog
400 g
Feeding instruction: The recommended period of administration in case of acute diarrheas and during convalescence is 1 to 2 weeks. The balancing of deciencies caused by malabsorption: 3 to 12 weeks. In the case of chronic pancreatic insuciency the product should be used until the death of the animal.
Fresh drinking water should always be available.
Serve at room temperature.
Once opened, store in the refrigerator up to 3 days.
Shelf life: 2 years.
Vet Expert Intestinal Dog
Nutritional characteristics Benefits
A high protein content
A high protein facilitates supply of
nutrients in animals with impaired
digestion and absorption
FOSStabilizes the intestinal microflora and
provide energy for the colon cells
MOS Stimulates the immune processes in gut
Fiber Low content improving digestibility
Increasing incidence of obesity
- Estimated 25-40% pets are overweight or obese
- Owners and veterinarians tend to underestimate incidence of obesity
- Body condition scoring is useful tool for recognition of obesity
Incidence
Owner evaluation of pet weight
Under 2%
Over 18%
Average 80%
Dog Cat
Under 4%
Over 19%
Average 77%
1992 AAHA Survey
- Associated with or exacerbates specific diseases
- May make pets less tolerant of metabolic stress
- Can complicate therapeutic and diagnostic procedures
Health risks of obesity
Obesity issues
Metabolic Functional Disease risks
Hyperlipidemia Joint stress Dermatoses
Hyperinsulinemia Dyspnea Reproduction
Glucose intolerance Hypertension Immunocompromise
Diabetes mellitus Tumors
DOD/osteoarthritis
Treating obesity
Nutritional technology for weight loss:- Calorie Control – reduce caloric density
- Intake Control - Reduce internal drive to eat – satiety via fiber, water, AA’s
- Metabolic Control- Shift metabolism from storage to usage
- Carnitine
Treatment Options
Reducing diet characteristics– Moderate kcal restriction
(20-50%)
– Non-energy nutrients balanced to dry matter intake
– Low fat
– High fiber for satiety and kcal
– Protein and micronutrients
– Profile suitable for dogs and cats
Treating obesity
Key nutritional factors for weight loss (DMB):
- Energy canine < 3.1 kcal ME/g
- Energy feline < 3.5 kcal ME/g
- Fat 5-12% for dogs, 7-14% cats
- Fiber 10-30% crude fiber
- Protein >25% for dogs, >35% for cats
Vet Expert Obesity DogReduction of excessive body weight
• Regulation :• Low energy density
• Vet Expert Obesity Dog:
– Metabolizable energy 3080 kcal/kg as fed diet
Vet Expert 4T Obesity Dog– additional properties
• Resistant starch added
• Increased protein content -30%
• Increased fibre content – 10%
• L-carnitine – 2500 mg/kg
Vet Expert Obesity Dog – features
• High L-carnitine content
• Relatively low fiber content – lower amount of faeces produced, better palatability
• Resistant starch is not digested – not a source of energy
• ADDITIONAL INDICATION: improves joint function thanks to the glucosamine and chondroitin content
Properties Benefits
Energy, Fat Reduced quantity allows a reduction in weight gain and stimulates the burning of fat
tissue in the body.
Crude fibre Fibre has the capacity to absorb water and therefore its increased content in the food
increases the volume of food in the gastrointestinal tract. This, in turn, boosts the
signal of satiety and stabilizes the level of glucose in the blood, which is important in
diabetes. It also stimulates the peristalsis of the gastrointestinal tract (constipation).
L-carnitine Crucial in the process of accelerating the pace of burning of fatty acids in cells. Its
increased content supports the mobilisation of fatty acids.
Resistant starch A special type of starch which is resistant to digestion and absorption in the small
intestine which means it is not a source of additional calories for the body.
Vet Expert Obesity Dog – features and benefits
Vet Expert Obesity Dog
400 g
Feeding instruction: Recommended time of administration until the target body weight is achieved (maximum weight loss of 1-2% of body weight per week). In order to control the glucose level use initiallyto 6 months.
Fresh drinking water should always be available.
Serve at room temperature.
Once opened, store in the refrigerator up to 3 days.
Shelf life: 2 years.
Vet Expert Obesity Dog
Nutritional characteristics Benefits
Fat & energyLower levels helps to reduce body weight
gain and body fat stimulate
Increased dietary fiber
content
Iincreased content stabilizes blood sugar
and stimulates the feeling of satiety and
gastrointestinal peristalsis
L-carnitin Helps fat burn
Kidney failure in dogs and cats
Chronic renal failure (CRF)
• Occurs when compensatory mechanisms of the diseased kidneys are no longer able to maintain the EXCRETORY, REGULATORY, and ENDOCRINE functions of the kidneys
• Resultant retention of nitrogenous solutes, derangements of fluid, electrolyte and acid-base balance, and failure of hormone production constitute CRF
Progression of renal disease: Diet
• Protein
• Phosphorus
• Calories
• Lipids
Diet and progression of renal disease: Protein restriction
• Role of low protein diet in slowing progression of renal disease is controversial
• Prevention of hyperfiltration by low protein diet may not be feasible in dogs without inducing malnutrition
• Low protein diets may have other beneficial effects (limitation of proteinuria)
Diet and progression of renal disease: Phosphorus restriction
• Slows progression of renal disease
•Prevents or reverses renal secondary hyperparathyroidism
• Limits renal interstitial mineralization, inflammation and fibrosis
Diet and progression of renal disease: Caloric restriction
• Extremely low protein diets are unpalatable and experimental rats with remnant kidney consumed less food
•One study showed improvement in proteinuria and renal morphologic changes when calories (but not protein) were restricted
Diet and progression of renal disease: Lipids
• n-6 PUFA may hasten progression of renal disease whereas n-3 PUFA are renoprotective
• n-3 PUFA promote production of “good” prostaglandins and limit production of “bad” prostaglandins
Commercial diets for CRF management (dry matter basis)
0.2-0.3%0.2-0.3%Sodium
0.5-0.6%0.2-0.3%Phosphorus
25-28%15-17%Protein
CatDog
Conservative medical management of CRF: Phosphorus restriction
• Reversal or blunting of renal secondary hyperparathyroidism
• Prevention of soft tissue mineralization (including kidneys)
• Improvement in renal tubulointerstitial lesions
• Improvement in renal function (rats)
Conservative medical management of CRF: Phosphorus restriction
• Modified-protein diets for dogs and cats with CRF also are low in phosphorus
• Initially try dietary phosphorus restriction alone
• If inadequate, add phosphorus binders
Decrease of phosphorus content in the diet from 1.4% to 0.4% results in increase of two-years survival rate of dogs with chronic kidney failure from z 8% to 15% (two-times)
The influence od phosphorus content in the diet on
survival rate of dogs with chronic kidney insufficiency
0
5
10
15
20
25
0 2 4 6 8 10 12 14 16 18 20 22 24
Time (months)
Su
rviv
al
rate
0.4% P
1.4% P
Vet Expert Renal DogSupport of renal function in the case of
chronic renal insufficiency
• Regulation :• Low level of phosphorus and
restricted level of protein but of high quality
• VetExpert Renal Dog:
– Phosphorus content - 0.5%
– Protein content – 17,5%
Vet Expert Renal Dog – additional properties
• Increased n-3 fatty acid content–
1.25%
• Limited sodium content– 0.18%
• L-carnitine – 2500 mg/kg – supports
the production of energy from fat
BUT:
• Early Renal type of diet
Vet Expert Renal Dog – features
• Early Renal type of diet – three first phases accordingto IRIS
• Anti-hypertensive – very low sodium content and high n-3 fatty acids content
• ADDITIONAL INDICATION - helps to supportalimentary tract function thanks to inulin content
Properties Benefits
Phosphorus Reduced content helps to reduce the pace of the renal disease.
Protein A reduced amount of high quality protein helps reduce the advancement of renal disease, while
ensuring its optimal digestion and absorption in the gastrointestinal tract.
Omega-3 fatty
acids
Increased content may reduce pressure inside the glomerulus and therefore reduce the pace of the
advancement of the lesions.
Sodium A reduced amount decelerates the advancement of the renal disease and protects from hypernatremia
in the case of myocardial disease.
Alpha lipoic acid Addition supports the neutralisation of free radicals formed in the course of a renal disease.
L-carnitine and fat Addition of L-carnitine supports the process of burning fatty acids and the production of energy from fat,
in the result of which the body does not use protein for energy purposes and does not strain the kidneys
with the product of its metabolism.
Vet Expert Renal Dog – features and benefits
Hepatic diet - what to consider
• Dogs with liver disease are usually catabolic and require ENERGY
Protein - increase or decrease?
Lipid metabolism?
Vitamins and micronutrients
Dietary management for various liver diseases
• Acute liver failure (poisoning) - protection from malnutrition• Fluid therapy for stabilization
• Intuitively, if the dog has no appetite for 4-5 days
• Oral nutrition - start from 50% of the daily requirement;
• Standard amount of protein (preferably milk);
• Increased energy level;
• Increased levels of antioxidants (vit E, C)
Dietary management for various liver diseases
• Chronic liver failure (inflammation) - Maintaining proper body condition• A few meals a day (3 to 6)
• Protein - do not reduce, limit the amount of protein of animal origin
• Controlled fiber - normalization of food passage time
• Increased zinc and antioxidants
Dietary management for various liver diseases
• Copper poisoning - Bedlington terrier• Reduce copper (beef, cheese, eggs)
• Increasing the amount of zinc in the diet for the rest of the animal's life (suppressing the absorption of copper in the intestines)
Dietary management for various liver diseases
• Hepatic encephalopathy - maintenance of muscle mass• Protein restriction (15%)
• Soluble fiber
Dietary management for various liver diseases - is there a universal diet?
• Protein• Never below 14%, preferably 20%; High quality and digestibility
• Fiber• Moderate amount (best soluble)
• Additional vitamins and minerals• Zinc, vit. E, wit. C, antioxidants
• Reduction of copper, sodium
Vet Expert Hepatic DogSupport of liver function in the case of
chronic liver insufficiency
• Regulation :• High quality protein, moderate
level of protein, high level of essential fatty acids and high level of highly digestible carbohydrates
• VetExpert Hepatic Dog:– Protein level – 17,5%
– Essential fatty acids (total) – 3,62%
– Carbohydrates – 54,5%
Vet Expert Hepatic Dogfeatures and benefits
Ingredient Content Function
protein 17,5% The reduced content protects against the effects of toxic poisoning by the products of protein metabolism
copper 6 mg/kg Minimal content protects against the potential effects of copper accumulation in the liver
zinc 220 mg/kg The maximally elevated content has an antioxidant effect and limits copper absorption
artichoke 2 g/kg Bile release stimulation
phospholipids 1,5 g/kg Helps regenerate liver cells
taurine 1 g/ kg antioxidant
Vet Expert Hepatic Dog
400 g
Feeding instruction: The diet should be administered in accordance with the nutritional recommendations as the only food of animal according to its age, breed and activity level. Recommended time of administration, initially to6 months.
Contraindications: Dogs with hyperlipidemia or pancreatitis, and dogs that have suffered or are at risk of pancreatitis. Not recommended for females during pregnancy and lactation and for puppies.
Fresh drinking water should always be available.
Serve at room temperature.
Once opened, store in the refrigerator up to 3 days.
Shelf life: 2 years.
Vet Expert Hepatic Dog
Nutritional characteristics Benefits
ProteinsLower levels helps reduce protein as a source of
toxic ammonia
CopperLower levels protect by the toxic effects of copper
with storage
L-carnitine Support liver function
Vet Expert Recovery Dog
400 g
Feeding instruction: Recommended time of administration achievements to return to normal.
Fresh drinking water should always be available.
Serve at room temperature.
Once opened, store in the refrigerator up to 3 days.
Shelf life: 2 years.
Vet Expert Recovery Dog
Nutritional characteristics Benefits
Energy
A high energy value is necessary to meet the
increased demand animal during
convalescence
Fiber Low content improving digestibility
ConsistencySemi simplify administration by gavage feeds
High protein contentA high protein simplify nutrients supply in
animals with impaired digestion and absorption
Vet Expert Intestinal CatCompensation for maldigestion
• Regulation :• Highly digestible
ingredients and low level of fat
• Vet Expert Intestinal Cat:
– Digestibility - >90%
– Fat content – 20%
Vet Expert Intestinal CatReduction of acute intestinal absorptive
disorders• Regulation:
• Increased level of electrolytes and highly digestible ingredients
• Vet Expert Intestinal Cat:– Digestibility > 90%
– Content of sodium and potassium given
Vet Expert Intestinal Cat – additional properties
• Low fiber content – increases digestibility
• Inulin added (FOS) – prebiotic modifying alimentary tract microflora
• Ginger - extract modifying alimentary tract peristalsis; sooths alimentary tract mucosa
Properties Benefits
Digestibility High digestibility increases the number of nutrients used by the
body.
Fat Reduced amount inhibits the stimulation of the pancreas in animals
with exocrine pancreatic failure.
Soluble
carbohydrates
(inulin)
Are a source of fructo oligosaccharides used by the bacteria of the
gastrointestinal tract. This ensures the stability of the intestinal
microflora and provides energy for the cells of the colon.
Electrolytes Their increased content compensates the imbalance caused by
vomiting or diarrhoea.
Vet Expert Intestinal Cat – features and benefits
Vet Expert Intestinal Cat canNew intestinal cat
• meat and meat by-product (34% chicken; 34% turkey),
• vegetables (2% potato), minerals (1%);
• oils and fats (0,2% salmon oil), brewer yeast (0,1%),
• FOS (0,1%), • MOS (0,1%)• Taurine 1500mg
Intestinal Vetexpert vs Intestinal Royal Canin
Intestinal Vetexpert Intestinal Royal Canin
Composition Broth, chicken (34%), turkey (34%), potato (2%), salmonoil (0,2%), MOS (0,1%), FOS (0,1%), yeast (0,1%)
Meat and meat by product, cereals, oils and fats, minerals,sugar, yeast
Chemical Analysis Protein: 10,3% (36,05)Fat: 5,4% (45,9)Ash: 2,5%Fibre: 0,5%Water: 80%EM: 92,21kcal/100gNFE: 0,3% (1,05)
Protein: 7,6% (26,6)Fat: 5,6% (47,6)Ash: 1,6%Fibre: 0,8%Water: 80%EM: 94kcal/100gNFE: mathematical calculation: 4,4% (15,4)
Additives Omega 6 and Omega 3 (EPA+DHA): Omega 6 and Omega 3 (EPA+DHA): 0,1%
Picture
Intestinal Vetexpert vs Hill`s i/d
Intestinal Vetexpert i/d Hill`sComposition Broth, chicken(34%), turkey (34%), potato (2%),
salmon oil (0,2%), MOS (0,1%), FOS (0,1%), yeast (0,1%)
Meat and meat by product, cerels, plant protein extracts, fats and oils, minerals.Easly digestible: pork liver, chicken, rice flour
Chemical analysis Protein: 10,3% (36,05)Fat: 5,4% (45,9)Ash: 2,5%Fibre: 0,5%Water: 80%EM: 92,21kcal/100gNFE: 0,3% (1,05)
Protein: 9,9% (34,65)Fat: 6,1% (51,85) Ash: 1,8%Fibre: 0,7%Water: 75,5%EM: 107,5kcal/100gNFE: mathematical calculation: 6% (21)
Additives Omega 6 and Omega 3 (EPA+DHA) Omega 6 and Omega 3 (EPA+DHA)
Picture
Vet Expert Intestinal Cat can – fetures and benefits
Urinaryproblems
Dogs
Infections
Cats
Uroliths
FIC
DysuriaDifficulty while urinating
PollakiuriaFrequent urination in small quantities
AnuriaLack of urination
StranguriaPain while urinating
HaematuriaBlood in urine
All conditions show similar signs
The “Urias”
PeriuriaUrination in inappropriate places
Upper
Urinary Tract
Lower
Urinary Tract
Urinary Tract
Feline Lower Urinary Tract Disease FLUTD
• Idiopathic LUTD• Feline Idiopathic cystitis (FIC)
• Urolithiasis• Calcium oxalate
• Struvite
• Anatomical defects
• Behaviour
• Bacterial infection
• Neoplasm
• Iatrogenic
Feline Idiopathic Cystitis (FIC)
• Inflammation of the bladder wall
• No obvious reason • Stress?
• Irritation?
• Abnormalities in nervous system of the bladder?
Effect of stress in FIC
Adapted from: Buffington CAT, Chew DJ, Woodworth BE. Feline Interstitial Cystitis. JAVMA 1999; 215 ( 5)9
Urolithiasis
• Stone formation depends on: • Concentration of building blocks
• Promoters and inhibitors
• Urinary pH
All these can be influenced by diet!
The prevalence of different urolith types according to Canadian
Veterinary Urolith Center (1998-2007)
(Huston i Moore, 2009)
0
100
200
300
400
500
600
700
1998a 1999 2000 2001 2002 2003 2004 2005 2006 2007
Szczawian
Struwit
Moczan
Fosforan wapnia
DSBC
Ksantyna
Krzemian
Cystyna
Pirofosforan sodu
Maybe one solution for both uroliths?
Increased water intake!!!!
Undersaturated solution – 1 spoon of sugar dissolves completely
Metastable solution – 3 spoons of sugar dissolve
completely; any additional sugar will result in precipitation of crystals
Supersaturated solution
5 spoons of sugar do not dissolve completely, resulting in precipitation of crystals initially, then uroliths
Saturation of a Liquid
Increase of water intake
• Additional water in food
• Increased number of water bowls
• Wet food (pouch, can)
• Increased urination (i.e. increased physical activity)
• „Alternative” sources of water
• Increased thirst
Food and water
Stimulation of water intake
Bullions
„Fountains”
Freshness• Every day fresh water
• Regular bowls cleaning
Salt?
Look further
Cat number Age (in
years)
BOWL, average
water intake
(ml/kg/day)
Bowl, urine
gravity
Fountain, average
water intake
(ml/kg/day)
Fountain, urine
gravity
5 0,5 41,6 1,058 41,6 >1,060
10 0,5 38,0 1,054 50,8 >1,06
11 0,5 32,3 >1,060 28,7 >1,06
7 4 9,5 1,060 16,2 >1,060
1 5 20,9 1,051 18,1 1,044
3 5 21,3 1,056 31,5 >1,060
8 6 23,7 1,051 44,1 1,051
4 7 11,3 >1,060 25,4 >1,060
2 7 14,7 >1,060 52,3 1,054
6 8 15,8 1,053 37,0 1,054
12 8 26,9 1,052 18,2 >1,060
9 10 18,8 1,046 14,8 1,057
AVERAGE 22,9 ± 10,2 33,1 ±13,1
The influence of water source on its amount drinked by cats (Grant, 2010)
Factors influencing amount of urine produced by cats
• Salt
0
5
10
15
20
25
0,4 0,8 1,2
Uri
ne
am
ou
nt (m
l/kg/d
)
% diatery Na (in d.m.)
The influence of dietary Na on the amount of urine produced by cats
Vet Expert Urinary CatReduction of struvite stone recurrence
• Regulation:• Urine acidifying properties and
moderate level of magnesium
• Vet Expert Urinary Cat:– Urine acidifier – DL-methionine
1000 mg/kg – Magnesium – 0,09%– Protein contents – 34%
Vet Expert Urinary Cat– additional properties
• Moderately increased sodium content – 0.7% - increases thirst
• Glucosamine – potentially improves mucopolysaccharideslayer in urinary bladder
• ADDITIONAL INDICATION: improves joint function thanks to the glucosamine and chondroitincontent
Properties Benefits
Sodium,
chlorides
Its increased content makes cats drink water which increases the volume of
urine and protects from the precipitation of crystals and struvites and oxalates
in urine.
DL-
methionine
Reduces the pH of urine which causes the dissolution of crystals and struvite
stones and protects from re-occurrence.
Glucosamine Increased content supports the functions of the mucopolysaccharide barrier
in the wall of the bladder, which reduces the bacteria’s ability to filter through
into other organs and systems of the body.
Vet Expert Urinary Cat – features and benefits
Vet Expert Urinary Cat pouch
• Urinary tract
• Great palatability
• Acidic urine
• Decreased magnesium
• Moderate sodium
Vet Expert Urinary Cat pouch
Nutritional characteristics Benefits
Controlled the content of micro-
and macronutrientsControlled level of urinary stones
components
DL-methionine addedAcidic pH of urine, which facilitates
the dissolution of struvite stones
Antioxidants, vitamin E Counteracts oxidative stress
Moderately increased sodium
content
Increases water intake and urine
output
Wet food
Contains 82 g of water every 100 g of
feed - to the demand for water cats
and prevents precipitation of urinary
Palatability VetExpert URINARY CAT
PREFERENCE 1 day 2 day AVARAGE
RC Urinary 27,3% 45,5% 36,4%
4T Urinary 72,7% 54,5% 63,6%
First Choice SMELL 1 day 2 day AVARAGE
RC Urinary 29,0% 25,0% 27,0%
4T Urinary 71,0% 75,0% 73,0%
First Choice EATEN
1 day 2 day AVARAGE
RC Urinary 29,0% 25,0% 27,0%
4T Urinary 71,0% 75,0% 73,0%
First ChoiceEATEN
First ChoiceSMELL
PREFERENCE
In this case more favorable result was obtained for the product 4T Urinary by far and repeating better than in the case of the RC Urinary
VetExpert Obesity & Diabetes Cat( high protein & low carbohydrates)
• meat and meat by product (67% turkey),
• vegetables (3% potatoes), • fibre (1%), • minerals (1%)• Taurine 1500mg)
Vet Expert Obesity & Diabetes Cat can – fetures and benefits
Vet Expert Renal Cat pouch
Dog Diets
Dog
Dry
Wet Can
Intestinal Renal
Hepatic ObesityDermatosisIntestinal
Hepatic Dermatosis Obesity Hypoallergenic Mobility
Recovery
Cat Diets
Cat
Dry
Wet Pouch
Intestinal
Renal Urinary
Intestinal
Urinary
Wet CanObesity
& Diabetes