Homework Session 13: Neoplasia, Recovery and Critical Care …



Week 13 Written Assignment

Case #1: Megie is a Labrador mixed breed, neutered female dog approximately 10-years old. She recently had oral surgery for a tumor and is reluctant to eat. She has a BCS 3/5 and weighs 75 pounds. She has no other detected disease conditions and the objective is to provide her normal caloric intake for the next 10 days. Use the link below for product information.



|BW | 75# |

|Target BW | 75# = 34kg to maintain her body weight during recovery |

|RER |70 x (34kg)0.75 |

| |70 x 14.0=985 |

| |985-998 |

|DER factor | 1.6 |

|DER | 1576-1596.5 |

|Prescription Diet® a/d® Canine | 183 kcal/can |

|kcal/can | |

|Amount | 7-8 cans/day |

1. Why did the veterinarian recommend canned food for Megie? This diet is palpable in order to stimulate the inappetent pet along with encouraging the pet to eat. It is smooth, soft, and has a moist consistency to assist in syringe, hand and spoon feedings. It also has high glutamine to assist in fighting complications, infections, helps maintain GI health, and boost cell-mediated immunity.

2. How can the owners increase Megie’s interest in food? The owners can warm the food to body temperature which can enhance the aroma, add water for texture to easily ingest due to recent oral surgery.

3. When will you call to check up on Megie? A recommended follow-up with the owners and pet would be the next day.

4. What food would you recommend when Megie returns for her suture removal and recheck? Based on the re-check exam and assuming the surgery site is healing properly, a recommendation of weaning the pet off the prescription diet would be ideal. The owners can consider a maintenance diet that is reduced in carbohydrates, high quality proteins and amino acids (arginine and glutamine), high fats and Omega-3 fatty acids. Hills offers a prescription diet specifically for pet who have been diagnosed with cancer or undergoing treatment. Hill’s n/d is a diet which consist of all the needs for the cancer patient while starving the cancer cells. Unfortunately, this diet only comes in canned form and can be costly.

Case # 2: Tigger, a neutered male cat has acute hepatic lipidosis. He was very overweight at 17 pounds and BCS 5/5 when he stopped eating. After one week, his weight was 14 pounds and he was icteric. The veterinarian has placed a stomach tube to facilitate feeding for Tigger and recommended

Royal Canin Veterinary Diet® Recovery RS™ Canine/Feline. The objective is to stop the weight loss and maintain Tigger until he begins to eat again. Use the link below for product information.



|BW | 17# |

|Target BW | 14#=6.3kg |

|RER |70 x (6.3kg)0.75 |

| |70 x 3.97=278 |

| |278-280 |

|DER factor | 1.2 |

|DER |333.6-336 |

|Royal Canin Veterinary Diet® Recovery| 183 kcal/5.8 oz can |

|RS™ Canine/Feline canned kcal/can | |

|Amount per day | 1 1/3-1 ½ can/day |

|Amount per feeding |Day 4 at 100% of 280 kcal |

| |93ml-46ml |

|Number of feedings |3-6 feedings/day |

| |(Feeding 1-2 times a day is not tolerated due to volume |

| |overload) |

1. Write out your directions for feeding Tigger including the amount at each feeding and the number of feedings.

Make sure the food is warmed to body temperature by a warm water bath and stir to avoid hot spots within the food. Remove the cap of the tube and draw back on the syringe to observe any food or liquid. If a large amount of fluid is removed or observed from the tube, do not feed. Administer 5-10ml of water to ensure the tube is patent, infuse the amount of food needed slowly over a few minutes. Once the feeding is completed, administer another 5-10 ml of water to flush the tube.

Day 1: 25% = 70 kcal = 23ml if given 3 times a day or 11mls if given 6 times a day

Day 2: 50% = 140 kcal = 46ml if given 3 times a day or 23mls if given 6 times a day

Day 3: 75% = 210 kcal = 70ml if given 3 times a day or 35mls if given 6 times a day

Day 4: 100% = 280 kcal = 33ml if given 3 times a day or 16mls if given 6 times a day

2. Why should you not give Tigger all his food at one time? Overfeeding or rapid reintroduction of nutrition may lead to vomiting, diarrhea, and/or discomfort. If there is a history of anorexia or hepatic lipidosis, refeeding syndrome is a risk.

3. Can Tigger also eat and drink while he has a stomach tube? Yes, he can eat and drink but his intake must be calculated/ measured in order to alter the feeding schedule and amounts given.

4. How will you explain the advantages of Royal Canin Veterinary Diet ® Recovery RS™ Canine/Feline to the owner? This diet is highly digestible and palatable which supports the nutritional needs for Tigger condition. It has a special texture designed to facilitate syringe and tube feeding without the need to dilute in comparison to other recovery diets.

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