Homemade Diets Research Articles

Successful Long-Term Management of Canine Superficial Necrolytic Dermatitis With Amino Acid Infusions and Nutritionally Balanced Home-Made Diet Modification

A 10-year old, castrated male, Bichon Frise with a history of hyperadrenocorticism and intrahepatic portal vein hypoplasia was diagnosed with superficial necrolytic dermatitis (SND). The dog exhibited thick crusts on the chin, muzzle, prepuce, and paws. In addition, the dorsal surfaces of all paws were erythematous while the palmar/plantar surfaces were hyperkeratotic, hardened, and painful. The dog was treated with intravenous amino acid infusions (AAI), raw egg yolks, as well as zinc and omega-3 fatty acid oral supplements. The dog required AAI once every 2–3 weeks because this coincided with recrudescence of painful skin lesions. The dog was subsequently diagnosed with diabetes mellitus. A consult with the Nutrition Service was pursued 220 days after the original SND diagnosis because of concern for feeding raw eggs and for malnutrition since appetite was variable, muscle condition was reduced, and greater than 50% of ingested calories were from foods that were not nutritionally complete. There was also concern regarding the variability of the diet and the impact it would have on the management of diabetes mellitus. The diet was prepared by the dog owner according to a provided recipe and presented twice daily. The diet was rich in high quality protein and fat. All other treatments including medications, supplements, and bathing schedule remained unchanged at the time of diet modification. The dog was subclinical for SND associated clinical signs approximately 3 weeks after the diet modification, which also coincided with the last AAI. The AAI was postponed and was next administered 7 weeks later (i.e., 10 weeks from the previous infusion). The dog remained subclinical for SND related clinical signs and continued to receive AAI once every 10–12 weeks until he was euthanized 718 days later for complications related to severe multi-drug resistant, skin infections. In conclusion, this report highlights a novel role for nutritionally balanced home-made diets designed by a board-certified veterinary nutritionist could substantially increase time interval between AAI and outcome in dogs with SND.

Efficacy and Tolerance of Blended Diets in Children Receiving Gastrostomy Feeds.

To determine the prevalence of gastrointestinal (GI) symptoms in children receiving a blended diet via a gastrostomy tube. This is a single-center, retrospective study of children ages 1-18 years that received a blended diet. We reviewed demographics, anthropometrics, clinical characteristics, and rationale for switching to blended diet. Fixed-effects logistic regression analysis was used to evaluate the changes in patient symptoms over the 12-month follow-up period, and fixed-effects regression was employed to test for changes in anthropometrics. Twenty-three patients (8 female, 15 male) were identified, and data from 89 outpatient visits were analyzed. The most common underlying diagnosis was neurological disorder. Thirty-five percent of patients received commercial whole cow milk formulas, 30% received hydrolysate formulas, and 35% received amino acid-based formulas. After formula switches were made, 65% received homemade blended diets, 17.5% received commercial blended diets, and 17.5% received a combination of both. Median duration of time on a blended diet was 17 months. Ninety-five percent of patients who were previously experiencing upper GI symptoms improved within the first 3 months after blended diet initiation. Twenty-one percent of patients developed mild constipation on the diet, which was managed with increased water intake and/or polyethylene glycol. Only 2 patients discontinued the blended diet, because of inadequate weight gain and worsening of upper GI symptoms. In our study population, blended diets were well tolerated in gastrostomy-fed children and were associated with clinical improvement of upper GI symptoms.

Diagnosis of Feline Food Sensitivity and Intolerance Using Saliva: 1000 Cases.

Simple SummaryThis study asked whether a novel saliva-based diagnostic test could predict food sensitivities and intolerances in cats. Clinical samples were obtained from 1000 cats proven or suspected to have adverse food reactions (AFR). Most were domestic shorthairs over 10 years old and weighed around 5 kg; they were equally distributed between spayed females and neutered males. Saliva was collected after at least an 8-h fast with a dental cotton rope, placed in a special saliva collection tube, and sent to the laboratory. Salivary reactions to 24 common foods were measured with immunological reagents. Low reacting foods were lamb, cow milk, pork, turkey, wheat (lowest) and white-colored fish, whereas high reacting foods were millet, white potato, rice (highest) and salmon. Thus, this novel salivary-based food sensitivity and intolerance test, described previously for dogs, also provided a reliable and clinically predictive alternative to other methods of measuring AFR in cats.This prospective study assessed the efficacy of a novel saliva-based immunoassay of IgA- and IgM-antibodies in predicting feline food sensitivities and intolerances. Clinical samples were obtained from 1000 cats proven or suspected to have food intolerances. Most were of domestic shorthair breed type, over 10 years of age, and weighed around 5 kg; they were equally distributed between spayed females and neutered males. Saliva was collected after at least an 8-h fast with a dental cotton rope, placed in a double-sleeved saliva collection tube, and sent to the laboratory. Salivary antibodies elicited by 24 common foods were measured with goat anti-canine IgA and IgM. Low reacting foods were lamb, cow milk, pork, turkey, wheat (lowest) and white-colored fish, whereas high reacting foods were millet, white potato, rice (highest) and salmon. Thus, the novel salivary-based food sensitivity and intolerance test, described previously for canines, also provided a reliable and clinically predictive alternative to food elimination trials, serum-based food allergy testing, and skin patch testing in cats. Manufacturers of commercial cat foods and treats, as well as those making homemade diets and treats for cats, should consider avoiding the more highly reactive foods as determined by the present study.

Remarkable frequency of a history of liver disease in dogs fed homemade diets with buckwheat.

In our nutrition consultation service we observed liver disease in 2 dogs of one owner who was feeding buckwheat. This led to the hypothesis that buckwheat may cause problems. The present retrospective study in a German and a Russian nutrition consultation service was carried out to see whether there is an increased incidence of liver disease in dogs fed buckwheat. A retrospective study was carried out on the nutrition consultation cases of the Chair of Animal Nutrition and Dietetics, LMU Munich and a Russian nutrition consultant. All cases of dogs with buckwheat in their nutritional history were evaluated and compared with randomly selected dogs that had not been fed buckwheat from the same case set. Two German and 1 Russian buckwheat samples were compared (appearance, nutrient content, starch gelatinization, flavonoids, fagopyrin) as well as cooking methods. In the years 2007-2017, 34 cases of dogs fed buckwheat were identified in Germany and 57 in Russia. Eighty-five control cases in Germany and 48 in Russia were evaluated. In Germany, the incidence of liver disease in dogs fed buckwheat was 32 %, while that of the control group was 3.5 %. However, in Russia there was no significant difference between dogs fed buckwheat and control dogs. The appearance of the German and Russian buckwheat differed, with smaller seeds and more greenish colour in the German specimens while the Russian buckwheat presented larger and more brownish seeds. There was no difference in the analyses of the 3 buckwheat samples in crude nutrient and rutin content. Quercetin, quercitrin and fagopyrin were not detectable in all three samples. The degree of starch gelatinization in the Russian sample was higher than in the German. In Russia it is recommended to remove the reddish scum during boiling whereas this is rarely mentioned in Germany. German buckwheat may represent a risk in canine diets. With the difference remaining unclear, it is recommended to refrain from feeding buckwheat to dogs. In dogs fed homemade diets and suffering from liver disease, buckwheat should be considered in the nutrition history.

Abnormal bone mineralization in a puppy fed an imbalanced raw meat homemade diet diagnosed and monitored using dual-energy X-ray absorptiometry.

A 4-month-old male Old English Sheepdog was presented for evaluation of a raw meat-based homemade diet after a 1-month history of progressive lameness. Marked dietary deficiencies were detected, which included calcium, phosphorus and vitamin D. Hypovitaminosis D and hypocalcaemia were diagnosed by serum analysis. Evidence of severe diffuse osteopenia was noted on survey radiographs. Dual-energy X-ray absorptiometry (DEXA) was used to quantify bone mineral content and density and compare to published reference ranges. The puppy's initial bone mineralization was markedly subnormal, with bone mineral density 66% lower than expected, and bone mineral content 40% lower than expected. Subsequent DEXA scans were performed at intervals during the puppy's recovery to document the rate of bone re-mineralization and guide therapeutic recommendations. Marked improvement was achieved within 4months through exercise control and feeding of a diet appropriately formulated for large breed puppy growth and development. This report reinforces the necessity of thorough dietary history and highlights the potential for malnutrition in pets fed homemade and raw meat-based diets. Use of DEXA has rarely been reported in clinical cases, yet can be a valuable tool for diagnosing and monitoring cases with abnormal bone mineralization. Further studies using DEXA to track bone mineralization in healthy puppies are encouraged to develop a more robust reference range of bone mineralization in growing dogs of varying sizes, weights and ages.

Dietary intervention for canine epilepsy: Two case reports.

SummaryEpilepsy is a common neurologic disorder in humans and domesticated canines. In both species the etiology is diverse and complex, and even with medication a significant portion of the population does not experience sufficient seizure control and/or has unacceptable side effects. Humans often try alternatives such as dietary therapy or brain surgery, but in dogs, brain surgery is rarely an option and, despite potential benefits, there are no standard recommendations for a dietary approach. Herein we describe 2 retrospective case studies detailing the effects of homemade diets prepared for dogs with uncontrolled epileptic seizures and/or toxic side effects of medication. Basic recipes are provided for each formula—a high‐fat “ketogenic” diet and a partial “whole food” diet. Carbohydrate content was reduced or controlled, and in one case this was proven to be essential for seizure control: ingesting carbohydrates would reverse the benefits of the diet and precipitate a seizure. Both dogs experienced fewer seizures and side effects when eating these modified diets compared to when they were administered antiepileptic drugs, including complete cessation of seizures for extended periods. Practical advantages and success of these homemade dietary interventions highlight the potential for diet‐based metabolic therapy as a treatment option for seizures not only in humans but also in dogs.

Development of enteral homemade diets for elderly persons receiving home care and analysis of macro and micronutrient composition

Abstract Objective: the development and analysis of the macro and micronutrient composition of homemade enteral diets. Method: A standard homemade enteral diet was developed at three caloric concentrations - 1500, 1800 and 2100 Kcal. After preparation and testing of viscosity, stability, odor and color, plus evaluation of cost, the chemical composition of the nutrients of the diets were analytically determined. Folic acid, vitamin D and vitamin B12 values were calculated using chemical composition tables. The results were compared with recommended nutritional standards for the elderly. Result: The diets exhibited normal macronutrient distribution. The 1500 caloric level presented some mineral and vitamin deficiencies. Suitable values were obtained at the other caloric levels for all minerals except magnesium. There were appropriate levels of all the vitamins in the 2100 Kcal diet, while vitamin E, D and B6 levels were below the recommended dietary allowances in the 1800 Kcal diet. Conclusion: The standard homemade enteral diets studied can contribute to the food and nutritional safety of elderly persons undergoing home care, if all are supplemented with magnesium and the 1800 Kcal diet is supplemented with vitamin E, D and B6. The 1500 Kcal diet was not nutritionally safe in terms of micronutrients.

Nutritional and microbiological quality of commercial and homemade blenderized whole food enteral diets for home-based enteral nutritional therapy in adults

Serious nutritional and contamination risks may be involved in the preparation of blenderized tube-feeding diets and in the handling of commercial diets. Their nutritional and microbiological quality in home settings is unknown. The objective of this study was to assess the nutritional and microbiological quality of commercial enteral and homemade blenderized whole foods diets intended to adult patients in home nutritional therapy. In a cross sectional study, 66 samples of commercial (CD) and noncommercial (NCD) enteral diets were collected at the homes of patients in home enteral nutritional therapy, 33 of each type. Commercial diets were either powder (PCD; n=13) or liquid (LCD; n=20). The samples were analyzed in laboratory to assess their nutritional and microbiological quality. Anthropometric data of mid upper arm circumference (MUAC) and triceps skinfold (TST) thickness were obtained from the patients' medical records. NCD presented significantly lower values for protein, fat, fiber, carbohydrate and energy while water content was significantly higher. PCD and LCD did not show any statistically significant differences between them. In the NCD, the values measured for macronutrients and energy corresponded to less than 50% of the prescribed values (except for fat). In CD, protein value was about 20% more than the prescribed value; fat and energy values corresponded to approximately 100% of the prescription, while carbohydrate corresponded to 92%. Regardless the type of the diet, prevalence of undernutrition was high in both groups though patients of the NCD presented a higher percentage. Samples of NCD complied significantly less with the microbiological standards; only 6.0% complied with the standard for coliform bacteria. Escherichia coli was detected in 10, 2, and 2 samples of NCD, PCD and LCD, respectively. Homemade blenderized enteral diets showed low values of energy and macronutrients, delivered less than 50% of the prescribed values and had high levels of bacterial contamination.

The effect of diet on serum 25-hydroxyvitamin D concentrations in dogs.

BackgroundVitamin D (vitD) deficiency is linked to many disease states including rickets and cancer, and vitD supplementation to improve response to cancer therapy has been explored. Supplementation may be most appropriate for dogs with suboptimal vitD concentrations. In dogs, the primary source of vitD is diet (predominantly via commercial dog food). Our goal was to determine how food source and supplements affect 25(OH)D concentrations, the storage form of vitD. Serum was collected from clinically healthy dogs, and pet owners were surveyed about food source and supplements. Serum 25(OH)D concentration was measured using a quantitative chemiluminescent assay (LIASON, DiaSorin, Stillwater, MN).ResultsDogs (n = 320) were tested for serum 25(OH)D concentrations (range 9.5–249.2 ng/mL). Dogs were fed commercial diets from forty different manufactures (n = 292); additionally some dogs were fed homemade diets (n = 18) or a combination of commercial and homemade diets (n = 10). Median serum 25(OH)D concentrations in dogs fed commercial foods ranged from 47.4 to 100.1 ng/mL with an overall median of 67.9 ng/ml (CV 29 %). Analysis for differences among manufacturers was significant (P = 0.0006). Serum 25(OH)D concentrations amongst dogs fed homemade diets had the largest range (9.5–129 ng/mL) and the lowest value (9.5 ng/mL). Dogs receiving salmon oil as a supplement (n = 22) had significantly higher serum 25(OH)D (on average a 19.6 ng/mL increase) than those not receiving a supplement (P = 0.007).ConclusionsSerum 25(OH)D concentrations in dogs vary widely which likely reflects varying dietary vitD content. Notable differences exist among manufacturers and brands and may reflect differences in proprietary formulations. Given the variability of measured serum 25(OH)D concentrations in dogs and the importance vitD appears to have on health status, dietary vitD content should be optimized.Electronic supplementary materialThe online version of this article (doi:10.1186/s13104-015-1360-0) contains supplementary material, which is available to authorized users.

Physicochemical and nutritional characteristics of handmade enteral diets.

There is an increasing use of enteral therapy at home, which reduces costs and improves patients' quality of life. Homemade food diets are being commonly used in the households of undeveloped countries, but those diets vary in composition and characteristics depending on the ingredients and preparation procedures adopted in its preparation, which influences the quality of the diet to satisfy the nutritional needs of patients. This study aimed to formulate and determine the quality of homemade enteral diets. An enteral diet plan was prepared by using conventional food, consisting of 6 meals, totalizing 2 liters per day, and it was adopted a proportion of 25% of solid food. The diets were analyzed for stability, viscosity, flow, pH, chemical and nutritional composition. The enteral diet plan was adequate in its physical-chemical aspects, however, it presented low percentages of adequacy, 20-53%, between the estimated and real content of macronutrients in the soup, formula used for lunch and dinner, which impaired the nutritional quality of the enteral diet plan. The results showed the difficulty of establishing the nutritional content of these diets, especially when made of meat and vegetables. Therefore, it is suggested a mixed enteral therapy by using commercial diets to achieve part of the nutritional needs of the patient together with enteral diets of homemade food to supplement it and also to redeem the psychosocial values of the feeding process.

Variability in content of homemade diets for canine chronic kidney disease

Veterinary RecordVolume 174, Issue 14 p. 352-352 Research Variability in content of homemade diets for canine chronic kidney disease M. Davies B VetMed CertVR CertSAO FRCVS, Corresponding Author M. Davies...

Evaluation of the owner's perception in the use of homemade diets for the nutritional management of dogs

Many dog owners see homemade diets as a way of increasing the bond with their pets, even though they may not have the convenience of commercial diets. Modifications of ingredients, quality and proportion might change the nutritional composition of the diet, generating nutritional imbalances. The present study evaluated how dog owners use and adhere to homemade diets prescribed by veterinary nutritionists over an extended period of time. Forty-six owners of dogs fed a homemade diet for at least 6 months were selected for the present study. Owners were invited to answer questions by first reading all possible answers and then selecting the one that best indicated their opinion. The results were evaluated through descriptive statistics. Thirty-five owners (76·1%) found that the diets are easy to prepare. Fourteen owners (30·4%) admitted to modifying the diets, 40% did not adequately control the amount of provided ingredients, 73·9% did not use the recommended amounts of soyabean oil and salt, and 34·8% did not correctly use the vitamin, mineral or amino acid supplements. Twenty-six owners (56·5%) reported that their dogs refused to eat at least one food item. All of these alterations make the nutritional composition of the diets unpredictable and likely nutritionally imbalanced. Although homemade diets could be a useful tool for the nutritional management of dogs with certain diseases, not all owners are able to appropriately use this type of diet and adhere to it for an extended period of time and this limitation needs to be considered when recommending the use of homemade diets.

Thiamine deficiency in dogs and cats

Vet Med Today: Timely Topics in Nutrition 649 I past years, nutritional deficiencies were considered to be an important problem in dogs and cats. Currently, most pet owners in many countries, such as the United States and Canada, feed nutritionally balanced commercial pet foods. As a result, nutritional deficiencies have become uncommon because reputable pet food manufacturers regularly test their products to ensure that they contain adequate amounts of all nutrients. Anecdotally, most reported deficiencies currently arise from animals eating incomplete or unbalanced homemade, vegetarian, or raw meat diets. Therefore, veterinarians may not consider deficiencies as differential diagnoses in animals eating traditional commercial diets. However, thiamine (vitamin B 1 ) deficiency is of clinical concern even today. Since 2009, there have been 5 major voluntary pet food recalls involving thiaminedeficient pet foods in the United States that ultimately involved 9 brands of cat foods and at least 23 clinically affected cats. Most of these recalls were instituted in response to a report from a consumer or veterinarian after treating a cat that had clinical signs consistent with thiamine deficiency. In addition to the possibility of a deficiency in commercial pet foods, there are a variety of situations in which a deficiency may arise in dogs or cats with medical conditions. Clinical manifestations of a deficiency of thiamine are variable, and the disease is likely underreported because of the wide array of clinical signs in combination with a lack of specific clinicopathologic changes detected via laboratory analysis. Thiamine has received much attention as a vitamin deficiency that is common in ruminants, primarily as a result of rumen bacterial inactivation of the vitamin, which results in characteristic cerebrocortical necrosis and neurologic signs. Dogs and cats can also be affected by deficiency of this vitamin because of an inability to endogenously synthesize large quantities of thiamine. Therefore, both cats and dogs need to have a consistent dietary supply of thiamine. As with all B vitamins, thiamine is water soluble, stored in the body in small amounts, and subject to urinary losses. Thiamine is also particularly labile and easily destroyed by typical foodprocessing techniques. In fact, many early experiments Thiamine deficiency in dogs and cats

Productive and Blood Indices of Dwarf Rams Fed a Mixture of Rice Straw and Groundnut Haulms Alone or Supplemented with Concentrates Containing Different Levels of Shea Nut Cake

3 Abstract: Six juvenile West African dwarf rams were used for three periods in a double 3 x 3 Latin square design to test the nutritional value of three home-made diets meant for use as dry season sheep feed in the Tolong-Kumbungu district of the Northern region of Ghana. The three dietary treatments were: mixture of 625 g/kg DM rice straw and 375 g/kg DM groundnut haulms (T1), T1 + concentrate feed containing 115 g/kg DM shea nut cake (T2) and T1 + concentrate feed containing 230 g/kg DM shea nut cake (T3). Each period consisted of 14 days of adaptation to the feed and 14 days in which data were collected. Total DMI was significantly low (p<0.05) when the rams were on T1 (453.4 g/d) compared to when on T2 (612.0 g/d) and T3 (627.6 g/d). Daily weight gain values obtained when rams were on T1 and T3 differed (p<0.05), but the value obtained when on T2 was similar to T1 and T3; the values being 20.3 g, 31.2 g and 39.3 g for T1, T2 and T3, respectively. Concentrate supplementation improved DM and CP digestibility with values being significantly higher on T2. Supplementation did not affect the haematological and serum biochemical indices of the rams except total protein and albumin, which two values were significantly high on T3. It was observed that supplementation increased DMI, daily weight gain and serum total protein and albumin due to the high crude protein and energy contents of the supplemental concentrate. It was concluded that all three test diets were suitable for dry season sheep feeding in the test area and that shea nut cake could be included in sheep diets up to 230 g/kg DM without any harmful effect on their haematological and serum biochemical profile.

Oral administration of bovine lactoferrin inhibits bacterial infection in tilapia and elevates survival after bacterial infection: an examination of its immune-modulating properties

It was previously reported that the oral administration of lactoferrin (LF) provides antimicrobial activity in animals against bacterial and viral infections and is involved in immunomodulatory properties. In this report, a hybrid strain of Oreochromis nilotica (male) × O. mossambicus (female) was fed homemade diets with or without supplementation with 10, 50, 100, and 150 mg bovine LF g−1 feed for 60 days. After dietary treatment, the experimental fish were infected with Streptococcus agalactiae. LF supplementation resulted in a significantly higher survival rate and suppression of bacterial growth at 24–96 h in the liver, spleen, kidneys, eyes, and gills. A reduction in peroxidase activity was followed by a similar reduction in the peroxidase content of leukocytes at 24 h as analyzed by spectrophotometry. Respiratory burst (RB) activity was detected regardless of the time at which LF was administered to fish in relation to the bacterial infection. A beneficial effect of LF on RBs was also detected before bacterial challenge (with 100 mg LF/g) and 24 h after bacterial challenge with 150 mg/g. The results obtained validate LF’s beneficial effects on RBs by phagocytes in tilapia, which was only shown at 48 h after supplementation with 100 mg bovine LF g−1 feed after the bacterial infection. Moreover, after oral administration of LF, it was detected in the mucosa of the small intestines of tilapia. In conclusion, we demonstrate a reduction in fish mortality after the oral administration of LF, and we examined its immunomodulatory properties in tilapia.

Digestibilidade aparente de ingredientes do Semi-Árido Nordestino para tilápia do Nilo

O experimento avaliou o coeficiente de digestibilidade aparente (CDA) da matéria seca (MS), energia bruta (EB), extrato etéreo (EE) e proteína bruta (PB) de ingredientes do Semi-Árido Nordestino: farinhas do feno de maniçoba (FM), do feno de leucena (FL) e do feno da folha de mandioca (FFM), raspa de mandioca (RM) e resíduos de vitivinícola (RV) para tilápia do Nilo (Oreochromis niloticus). Os CDA para a MS, EB, EE e PB foram de 20,74%, 30,30%, 48,36% e 71,72% para FL; 19,34%, 17,08%, 30,03% e 44,88% para FM; 30,32%, 23,04%, 4,43% e 21,07% para FFM; 72,85%, 70,62%, 81,78% e 84,51% para RM e de 33,38%, 50,80%, 79,39% e 67,25% para RV. O feno de leucena, a raspa de mandioca e os resíduos de vitivinícola são promissores para a formulação de rações. A utilização dos ingredientes testados na composição de rações artesanais ou comercias para a tilápia do Nilo, bem como os níveis seguros para a inclusão destes devem ser testados.

Commercial Enteral Formulas and Nutrition Support Teams Improve the Outcome of Home Enteral Tube Feeding

The benefits of home enteral tube feeding (HETF) provided by nutrition support teams (NSTs) have been questioned recently, given the growing costs to the healthcare system. This study examined the effect of a specialized home enteral nutrition program on clinical outcome variables in HETF patients. The observational study included 203 patients (103 women, 100 men; mean age 52.5 years) receiving HETF with homemade diets for at least 12 months before starting a specialized home nutrition program for another 12 months consisting of provision of commercial enteral formulas and the guidance of an NST. Both study periods were compared regarding the number of hospital admissions, length of hospital and intensive care unit (ICU) stay, and costs of hospitalization. A specialized HETF program significantly reduced the number of hospital admissions and the duration of hospital and ICU stays. The need for hospitalization and ICU admission was significantly reduced, with odds ratios of 0.083 (95% confidence interval, 0.051-0.133, P < .001) and 0.259 (95% confidence interval, 0.124-0.539, P < .001), respectively. Specialized HETF was associated with a significant decrease in the prevalence of pneumonia (24.1% vs 14.2%), respiratory failure (7.3% vs 1.9%), urinary tract infection (11.3% vs 4.9%), and anemia (3.9% vs 0%) requiring hospitalization. The average yearly cost of hospital treatment decreased from $764.65 per patient to $142.66 per year per patient. The specialized HETF care program reduces morbidity and costs related to long-term enteral feeding at home.

Energy-intake and activity risk factors for owner-perceived obesity in a defined population of Swedish dogs

Our main objective was to obtain baseline data on daily metabolisable energy (ME) intake, activity, and risk factors for obesity in a population of 460 privately owned Swedish dogs in 1999. A previously validated mail-and-telephone questionnaire was used ( Sallander et al., 2001a). The dogs were of 124 breeds, 1–3 years old, and had body weights (BW) between 1 and 75 kg. The ME intakes of this population could be described with the equation ME intake (kilojoules, kJ/d) = 554BW 0.66 ( r sp = 0.73, P = 0.0001). The energy intake originating from commercial foods was 79% (median, range 45–97). Table foods generally had a higher fat content (median 13 g/megajoule, MJ, range 1–122) than commercial foods (median 8 g/MJ, range 2–18; P = 0.0001). The median energy density was 1603 kJ/100 g (median; range 1106–2105). Almost all (97%) dogs were taken for walks, and there was a significant difference between the duration of the walks during weekdays and weekends (medians 60 and 90 min/d, respectively, P = 0.006). Sixty percent of all dogs were trained in activities such as obedience (31%), hunting (27%) or tracking (18%) for a median of 35 min/d (range 1–146). The final regression model for obesity included the factors sex, appetite and feeding a home-made diet/table foods. Dogs that were perceived to have good or very good appetite had 3.42-fold greater odds for obesity than individuals with bad or very bad appetite (95% CI 1.19–9.80; P = 0.022). Females had 2.17-fold greater odds of being obese than males did (95% CI 1.30–3.70; P = 0.003). Also, dogs fed table foods or home-made diets had 2.06-fold greater odds of obesity than those that were not given these food items (95% CI 0.97–4.35; P = 0.050).

The glucose and insulin response to isoenergetic reduction of dietary energy sources in a true carnivore: the domestic cat (Felis catus)

The present study assessed the effect of separate reduction of each energy-delivering nutrient - protein, fat and carbohydrate - on glucose tolerance and insulin response in a strict carnivore: the domestic cat (Felis catus). Three isoenergetic, home-made diets with the following energetic distribution, low protein (LP): protein 28 % of metabolisable energy; fat 43 %; nitrogen-free extract 29 %; low fat: 47, 27 and 25 %; low carbohydrate (LC): 45, 48 and 7 %, were tested in a 3 x 3 Latin square design. Nine healthy normal-weight cats were randomly assigned to each of the diets in a random order at intervals of 3 weeks. At the end of each testing period, intravenous glucose tolerance tests were performed. Plasma glucose concentrations and area under the glucose curve showed no differences. Area under the insulin curve was lower when cats were fed the LP diet, and the second insulin peak tended to be delayed when the LC diet was fed. In contrast to other studies, in which energy sources were elevated instead of being reduced, the present trial contradicts the often suggested negative impact of carbohydrates on insulin sensitivity in carnivores, and shows that reducing the dietary carbohydrate content below common amounts for commercial foods evokes an insulin-resistant state, which can be explained by the cats' strict carnivorous nature. It even points to a negative effect of protein on insulin sensitivity, a finding that corresponds with the highly gluconeogenic nature of amino acids in strict carnivores.

Nutritional Quality and Osmolality of Home-made Enteral Diets, and Follow-up of Growth of Severely Disabled Children Receiving Home Enteral Nutrition Therapy

This study evaluated the nutritional quality of home-made enteral diets and their effect on growth parameters. Thirty pediatric patients receiving only homemade enteral diets were enrolled. Samples of milk-based (MB) and soup-based (SP) feeds were taken for chemical analyses. The children's anthropometric indexes were assessed. In the MB, the measured values for the macronutrients and energy corresponded to approximately 70% of the prescribed values. Conversely, the SP measured values corresponded to less than 50% of the prescribed values, except for carbohydrate. The prevalence of underweight was 30% (9/30) at the time of entry into home nutritional therapy and declined to 20% (6/30) at the time of the study (p = 0.007). Stunting increased throughout the follow up, from 30% (9/30) to 53% (16/30; p = 0.511). Obesity prevalence fell from 17% (4/23) to 9% (2/23; p < 0.001). Despite their inconsistent levels of macronutrients and energy, home-made enteral diets had no negative effect on the patients' weights.