{"id":989,"date":"2014-07-01T23:33:06","date_gmt":"2014-07-01T23:33:06","guid":{"rendered":"http:\/\/phosdev.com\/todaysveterinarypractice\/?p=989"},"modified":"2022-02-16T15:46:56","modified_gmt":"2022-02-16T15:46:56","slug":"in-clinic-form-step-by-step-feeding-the-pet-with-cancer","status":"publish","type":"post","link":"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/nutrition\/in-clinic-form-step-by-step-feeding-the-pet-with-cancer\/","title":{"rendered":"Step by Step: Feeding the Pet with Cancer"},"content":{"rendered":"<p><a href=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2016\/06\/T1407C05.pdf\"><img decoding=\"async\" class=\"alignnone size-full wp-image-9886\" src=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2011\/07\/pdf_button.png\" alt=\"pdf_button\" width=\"110\" height=\"27\" \/><\/a><\/p>\n<hr \/>\n<p><i>Korinn E. Saker, MS, DVM, PhD, Diplomate ACVN North Carolina State University<a href=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2014\/07\/Screen-Shot-2015-06-16-at-11.36.57-AM.png\"><img decoding=\"async\" class=\" wp-image-4348 alignleft\" src=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2014\/07\/Screen-Shot-2015-06-16-at-11.36.57-AM.png\" alt=\"Screen Shot 2015-06-16 at 11.36.57 AM\" width=\"169\" height=\"274\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2014\/07\/Screen-Shot-2015-06-16-at-11.36.57-AM.png 270w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2014\/07\/Screen-Shot-2015-06-16-at-11.36.57-AM-185x300.png 185w\" sizes=\"(max-width: 169px) 100vw, 169px\" \/><\/a><\/i><\/p>\n<p><span class=\"helvetica-9-pt\">~Read <a href=\"https:\/\/todaysveterinarypractice.com\/acvn-nutrition-notes-practical-approaches-to-feeding-the-cancer-patient\/\" target=\"_blank\" rel=\"noopener noreferrer\">Practical Approaches to Feeding the Cancer Patient<\/a> for further information on feeding dogs and cats with cancer. Visit tvpjournal.com\/resources.asp#resources for the table, Feeding Guidelines Based on Nutritional Status for Dogs &amp; Cats with Cancer, which provides detailed information on:<\/span><\/p>\n<p><span class=\"tabs-and-bullets\">Clinical assessment (Step 1)<\/span><\/p>\n<ul>\n<li><span class=\"tabs-and-bullets\">Specific feeding guidelines (Steps 2\u20134, 6, 7)<\/span><\/li>\n<li><span class=\"tabs-and-bullets\">Suggested feeding approaches (Step 5)<\/span><\/li>\n<li><span class=\"tabs-and-bullets\">Practical recommendations (Step 7).<\/span><\/li>\n<li><\/li>\n<\/ul>\n<p class=\"tabs-and-bullets\"><span class=\"helvetica-9-pt\">1. Assess the pet to determine nutritional status: Well-nourished, borderline malnourished, or significantly malnourished.<\/span><\/p>\n<p class=\"tabs-and-bullets\"><span class=\"helvetica-9-pt\">2. Determine current caloric intake and daily calorie needs of pet based on nutritional status:<\/span><\/p>\n<ul>\n<li><span class=\"tabs-and-bullets\">Assess current daily calorie intake: Using the reported caloric density (kcal\/can, kcal\/8-ounce cup, kcal\/gram of diet) of the commercial diet being offered, calculate the actual daily calorie intake based on amount (cans, cups, grams) of diet consumed each day.<\/span><\/li>\n<li><span class=\"tabs-and-bullets\">Calculate resting energy requirement (RER) based on pet\u2019s current or optimal body weight (BW):<\/span><\/li>\n<\/ul>\n<blockquote>\n<p class=\"tabs-and-bullets\"><span class=\"helvetica-9-pt\">RER (kcal ME\/day) = (BWkg)0.75 \u00d7 70<\/span><\/p>\n<\/blockquote>\n<ul>\n<li><span class=\"tabs-and-bullets\">Calculate daily energy requirement (DER, a mathematical equation with variables based on nutritional status):<\/span><\/li>\n<\/ul>\n<blockquote>\n<p class=\"tabs-and-bullets\"><span class=\"helvetica-9-pt\">DER (kcal ME\/day) = RER \u00d7 predetermined numerical factor (<strong>Table<\/strong>).<\/span><\/p>\n<\/blockquote>\n<ul>\n<li><span class=\"tabs-and-bullets\">Compare actual daily caloric intake to daily calories required (DER).<\/span><\/li>\n<\/ul>\n<table id=\"table-5\" border=\"1\" cellspacing=\"1\" cellpadding=\"3\">\n<tbody>\n<tr>\n<td colspan=\"3\" align=\"center\">\n<p class=\"brown\"><strong>Table. Predetermined Numerical Factors for Calculating DER<\/strong><\/p>\n<\/td>\n<\/tr>\n<tr>\n<td rowspan=\"2\" bgcolor=\"#f9dea8\">NUTRITIONAL STATUS<\/td>\n<td colspan=\"2\" align=\"center\" bgcolor=\"#cfe7b8\">NUMERICAL FACTOR<sup>a<\/sup><\/td>\n<\/tr>\n<tr>\n<td align=\"center\" bgcolor=\"#cfe7b8\"><strong>Canine<\/strong><\/td>\n<td align=\"center\" bgcolor=\"#f9dea8\"><strong>Feline<\/strong><\/td>\n<\/tr>\n<tr>\n<td valign=\"bottom\" bgcolor=\"#faedcf\"><strong>Well Nourished<\/strong><br \/>\nBCS 4\u20136 (current BW)<sup>b<\/sup><br \/>\nBCS &gt; 6 (ideal BW)<sup>c<\/sup><\/td>\n<td align=\"center\" valign=\"bottom\" bgcolor=\"#ecf5e2\">1.6<br \/>\n1\u20131.2<\/td>\n<td align=\"center\" valign=\"bottom\" bgcolor=\"#faedcf\">1.2<br \/>\n0.8\u20131<\/td>\n<\/tr>\n<tr>\n<td bgcolor=\"#faedcf\"><strong>Borderline Malnourished<\/strong><\/td>\n<td align=\"center\" bgcolor=\"#ecf5e2\">1.6\u20132.5<\/td>\n<td align=\"center\" bgcolor=\"#faedcf\">1.2\u20132<\/td>\n<\/tr>\n<tr>\n<td bgcolor=\"#faedcf\"><strong>Significantly Malnourished<\/strong><\/td>\n<td align=\"center\" bgcolor=\"#ecf5e2\">1.6\u20133<\/td>\n<td align=\"center\" bgcolor=\"#faedcf\">1.3\u20132.5<\/td>\n<\/tr>\n<tr>\n<td colspan=\"3\">\n<p class=\"references\">a. Numerical factor varies depending on nutritional status and signalment (adult life stage)<br \/>\nb. Calculate based on current BW<br \/>\nc. Calculate based on ideal BW<\/p>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p class=\"tabs-and-bullets\"><span class=\"helvetica-9-pt\">3. Determine dietary fat and protein levels (low, moderate, high; see <strong>Table 4<\/strong>, <a href=\"https:\/\/todaysveterinarypractice.com\/acvn-nutrition-notes-practical-approaches-to-feeding-the-cancer-patient\/\" target=\"_blank\" rel=\"noopener noreferrer\"><u><span style=\"color: #0066cc\">Practical Approaches to Feeding the Cancer Patient<\/span><\/u><\/a>) based on current or planned treatment regime and comorbidities, such as renal, hepatic, or pancreatic disease.<\/span><\/p>\n<p class=\"tabs-and-bullets\"><span class=\"helvetica-9-pt\">4. Determine required supplemental nutrients based on anticancer therapy.<\/span><\/p>\n<ul>\n<li><span class=\"tabs-and-bullets\">No treatment: Consider immediate dietary supplementation of omega-3 fatty acids and antioxidants (AOX).<\/span><\/li>\n<li><span class=\"tabs-and-bullets\">Surgery: If intestinal surgery, consider immediate glutamine supplementation; following any surgery, delay omega-3 fatty acid supplementation for 3 to 4 days.<sup>1,2<\/sup><\/span><\/li>\n<li><span class=\"tabs-and-bullets\">Chemotherapy: Prior to therapy, consider probiotic supplementation; during therapy, appetite stimulants and omega-3 fatty acid supplementation. Do not supplement with AOX until chemotherapy regime is completed.<\/span><\/li>\n<li><span class=\"tabs-and-bullets\">Radiation: Same as chemotherapy.<\/span><\/li>\n<\/ul>\n<p class=\"tabs-and-bullets\"><span class=\"helvetica-9-pt\">5. Identify appropriate feeding method to ensure adequate RER\/DER intake:<\/span><\/p>\n<ul>\n<li><span class=\"tabs-and-bullets\">Voluntary only<\/span><\/li>\n<li><span class=\"tabs-and-bullets\">Voluntary + enteric assisted<\/span><\/li>\n<li><span class=\"tabs-and-bullets\">Enteric assisted only<\/span><\/li>\n<li><span class=\"tabs-and-bullets\">Parenteral \u00b1 enteric assisted.<\/span><\/li>\n<\/ul>\n<p class=\"tabs-and-bullets\"><span class=\"helvetica-9-pt\">6. Choose appropriate diet based on appropriate nutrient levels, supplemental nutrients, and feeding method.<\/span><\/p>\n<p class=\"tabs-and-bullets\"><span class=\"helvetica-9-pt\">7. Discuss feeding plan with pet caregiver:<\/span><\/p>\n<ul>\n<li><span class=\"tabs-and-bullets\">Identify food choices or options.<\/span><\/li>\n<li><span class=\"tabs-and-bullets\">Calculate daily feeding dose based on daily caloric goal (RER to DER at current or optimal BW).<\/span><\/li>\n<li><span class=\"tabs-and-bullets\">Determine feeding frequency.<\/span><\/li>\n<li><span class=\"tabs-and-bullets\">Set monitoring parameters and follow-up schedule.<\/span><\/li>\n<\/ul>\n<p class=\"tabs-and-bullets\"><span class=\"helvetica-9-pt\">AOX = antioxidants; BCS = body condition score; BW = body weight; BWkg = body weight in kilograms; DER = daily energy requirement; ME = metabolizable energy; RER = resting energy requirement<\/span><\/p>\n<h3 class=\"tabs-and-bullets\"><strong><span class=\"references\">References<\/span><\/strong><\/h3>\n<ol>\n<li class=\"references\">Mooney MA, Vaughn DM, Reinhart GA, et al. Evaluation of the effects of omega-3 fatty acid-containing diets on the inflammatory stage of wound healing in dogs. <em>Am J Vet Res<\/em> 1998; 59(7):859-863.<\/li>\n<li class=\"references\">Harris WS. Expert opinion: Omega-3 fatty acids and bleeding\u2014cause for concern? <em>Am J Cardiol<\/em> 2007; 99:44C-46C.<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"<p>Korinn E.<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"iawp_total_views":165,"footnotes":""},"categories":[367],"tags":[],"class_list":["post-989","post","type-post","status-publish","format-standard","hentry","category-july-august-2014","clinical_topics-nutrition","clinical_topics-oncology"],"acf":{"hide_sidebar":false,"hide_sidebar_ad":false,"hide_all_ads":false},"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v24.7 (Yoast SEO v27.3) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Step by Step: Feeding the Pet with Cancer | Today&#039;s Veterinary Practice<\/title>\n<meta name=\"robots\" content=\"noindex, follow, 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