Therapeutic Nutrition IV: Renal Disease, Cancer, &

Cognitive Dysfunction Syndrome

Renal Disease

Beck; 10-month old, Male, Brittany Beck; 10-month old, Male, Brittany SpanielSpaniel

What Do The Kidneys Do?

Filtration Maintain HomeostasisRelease erythropoeitinToxin excretionRegulate Acid/Base balanceConversion of Vitamin D

Renal DiseaseKidneys are unable to excrete

adequate urea and other toxins which accumulate as internal poisons

Kidneys are unable to perform other metabolic functions

Can be acute or chronic

Hill’s Pet Nutrition, Inc.Clinical Atlas of Anatomy

What Can CauseWhat Can Cause Renal Failure? Renal Failure?

Acute Chronic

1-2 yrs(2%)

2-4 yrs(4%)

4 -7 yrs(11%)

7-10 yrs(14%)

10-15 yrs(33%)

> 15 yrs(36%)

Veterinary Medical Database http://www.vmdb.org

Chronic Kidney Disease in Cats (1990-2000)

Stages of Renal Disease

*SACN, 4th Edition, Hand, Thatcher, Remillard, Roudebush

Chronic Renal Disease is Progressive and Chronic Renal Disease is Progressive and IrreversibleIrreversible

Normal RenalFunction

Loss of Renal Reserve

Renal Insufficiency

Azotemia Uremia Death

Renal Disease GoalsSlow the disease progression by:

Reducing workload of kidneysMaintaining hydrationReducing clinical symptoms

Renal Disease KNF1. Water

2. Restricted protein <15% Dogs <30% Cats

3. Reduced dietary phosphorus

4. Reduced dietary sodium

Renal Disease ProductsNF Kidney Function®

Multi-Stage Renal Feline Dry & Canned Early Stage Canine Dry Formula

Prescription Diet® k/d; Prescription Diet® u/d

Prescription Diet® g/d

Renal LP 11Renal LP 21Renal MP 14

Cognitive Dysfunction Syndrome

Disorientation Interaction Sleep Patterns Housesoiling

D.I.S.H.

Cognitive Dysfunction Syndrome

ANIPRYL (Pfizer Animal Health)

What Clues Might You Have to Indicate a Dog has CDS?

Clinical Signs Checklist

What’s the Deal with Mitochondria?Energy production generates

free radicals as a by-product

Free radicals attack mitochondria, DNA and cellular membranes

Damaged mitochondria become less efficient and product even more free radicals

Body’s natural antioxidant defenses overwhelmed

Cognitive Dysfunction Syndrome

High fat content is susceptible to oxidative damage

Naturally low levels of protective antioxidants

High metabolic activityMagnetic

ResonanceImages

Healthy Older Brain

Older Brain with Damage

The BrainThe Brain

Cognitive Dysfunction Syndrome Studies

Measured problem-solving ability (cognitive function)

Study Design6 months of baseline testingSplit into equal “IQ” groups based on

preliminary tests6 month feeding period

Hill’s Pet Nutrition, Inc. - Clinical Study Supporting Canine b/d®

A Test for the Dogs

Cognitive Dysfunction SyndromeDoes Aging Affect Cognitive Ability?

YoungYoung OldOld

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5050

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UnsuccessfulUnsuccessfulAgersAgers

Successful Successful AgersAgers

How CDS is DiagnosedLarge/Giant Breed Dogs ≥ 5 yearsOther Breeds ≥ 7

One or more signs of DISH• Disorientation• Interaction Changes• Sleep/Activity Changes• Housetraining Forgotten

Rule Out Other Disease Conditions

Cognitive Dysfunction Products

Prescription Diet® b/d

Cancer

What Might Some Characteristics of A Pet Food For a Cancer Patient Be?

Cancer DefinitionsNeoplasia –

new and abnormal growth; any benign or malignant tumor

Cancer cachexia – severe malnutrition and body wasting that occurs in patients with cancer

Cancer in Dogs and Cats

Metabolic changes result in accelerated starvation (cancer cachexia)

Side effects of chemotherapy and radiation therapy may deplete nutritional stores

Nutritional ChangesAltered Carbohydrate Metabolism

Tumors preferentially use glucose for energy

Elevated insulin and lactate levels

Altered Protein MetabolismTumor competes for amino acids and

energy

Altered Fat MetabolismDog uses fat for energy

Cancer - Goals

Increase remission Increase survival time Improve quality of life

Cancer KNF

High levels of fat and protein for energy Low level of carbohydrates Therapeutic levels arginine Provide n-3 fatty acids

Cancer/Neoplasia Products

Prescription Diet® n/d

Prescription Diet® a/d

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COMMON TOXICITIES