Dechra Brand Guidelines

Diet Information Sheet

Nutritional management as an adjunct to medical treatment of hyperadrenocorticism in dogs

Justasmedical treatmentcanunmaskallergicdermatitis, itmayalsounmaskor intensify symptomsofosteoarthritis. Adietwith increased levelsofomega-3 fattyacidscan supporthealthy jointsandmobility 5 . Bloodglucose levels indogswithhyperadrenocorticismare often in thehighendof the reference rangeandabout10% of thedogswithhyperadrenocorticismdevelopovertdiabetes mellitus 6 .Poorcontrolofbloodglucose iscausedby antagonismof insulinby thegluconeogeniceffectsofexcess glucocorticoids.Althoughmedical treatmentof hyperadrenocorticism significantly reducesplasma levelsof cortisol, thiseffectmaynot last throughout thewholeday, whichmayexplain the lackofcontrolofbloodglucose in somedogs. Nutritionalmanagementcanplayan important role in themanagementofhyperglycemia.High-fibrediets withcomplexcarbohydratescan reducepost-prandial glucose levels 7 andhigh levelsofomega-3 fattyacidscan improve insulin sensitivity in insulin resistantdogs 8 . Although increased levelsofblood lipidsare reducedby Vetoryl ® treatment,blood lipid levelscan remain increased. Hypertension isanotherdisease thatmaynotbecompletely prevented inalldogswithhyperadrenocorticism treatedwith Vetoryl.High intakeofomega-3 fattyacidscanhelp to regulatehyperlipidemia 9 and supportmaintenanceofnormal bloodpressure. Hyperadrenocorticism ismainlydiagnosed inelderlydogs. Inelderlydogshealthproblems likeobesity, reducedheart andkidney functionand reduced immune statusaremore prevalentand theseanimalscouldbenefit fromadditional nutritionalmanagementwithadietwithamoderateenergy density,moderate levelsofphosphorusand sodiumand added taurine,L-carnitine,omega-3 fattyacidsand beta-glucans. Appropriatedietaryadvice shouldbegivenaccording to theconditionof thedogwithhyperadrenocorticismand thepresenceof intercurrentdisease. It is recommended tocontinuemonitoring thenutritional statusof thedogand presenceofpotentialconcurrentcomplicationsand to adapt thenutritionalmanagement foreach individualdog asneeded.

1.WSAVANutritionalAssessmentGuidelinesTaskForce Members (2011)WSAVANutritionalAssessmentGuidelines. Journalof SmallAnimalPractice 52: 385-396.

CEDENDOCRINESUPPORT

2.HenselP (2010)Nutritionand skindiseases in veterinary medicine. ClinicalDermatology 28: 686-693.

Medical treatment is thecornerstoneofendocrine disordermanagement,butoptimalnutritional support canbean importantadjunct in today’s veterinaryclinic. Endocrinedisorders suchashyperadrenocorticism, hypothyroidismanddiabetesmellitus impactmany organsandbody functionsandareoftenaccompaniedby complications suchaspoor skinconditions,poorglucose control, recurrent infections,hyperlipidemia,hypertension oroverweight.SPECIFIC TM CEDEndocrineSupporthas been specially formulated toprovideadditionalnutritional support tomedical treatmentofendocrinedisorders.

3.LiJ etal . (2006)Effectsofbeta-glucanextracted from Saccharomycescerevisiaeongrowthperformance,and immunologicaland somatotrophic responsesofpigs challengedwithEscheriacoli lipopolysaccharide. Journalof AnimalScience 84 :2374-2381. 4.Baddaky-TaugbølB etal . (2005)A randomised,controlled, double-blinded,multicentre studyon theefficacyofadiet rich infishoilandborageoil in thecontrolofcanineatopic dermatitis. InAdvances inVeterinaryDermatology,Vol. 5. Eds AHillier,APFoster,KWKwochka.Oxford,UK,Blackwell Publishing.pp173-187. 5.RoushJK etal . (2010)Multicenter veterinarypractice assessmentof theeffectsofomega-3 fattyacids in osteoarthritis indogs. Journalof theAmericanVeterinary MedicalAssociation 236: 59-66. 6.HerrtageME&Ramsey IK (2012)Canine hyperadrenocorticism. InBSAVAManualofCanineandFeline Endocrinology.4thedn.EdsCTMooneyandMEPeterson. BritishSmallAnimalVeterinaryAssociation.pp167-189. 7.GrahamPA etal . (1994)Cannedhighfiberdietand postprandialglycemia indogswithnaturallyoccurring diabetesmellitus.JournalofNutrition 124: 2712S-2715S. 8.LeBloc’hJ etal . (2010)Omega-3 fattyacids supplementation improves insulin sensitivityand increases EPAandDHA tissuecontent inobese insulin resistantdogs. InTheWaltham InternationalNutritionalSciencesSymposium PetNutrition-ArtorScience?Cambridge,UK,September 16-18,2010,pp38. 9.BaysHE etal . (2008)Prescriptionofomega-3 fattyacids and their lipideffects:physiologicmechanismsofactionand clinical implications. ExpertReviewofCardiovascularTherapy 6: 391-409.

Hyperadrenocorticism requiresmedicalor surgical intervention to treat thecondition.However, someof thecommoncomplicationsof thediseasemaybenefit from supportivemeasures suchasnutritional management.Nutritionalassessment isan important aspectofpatientcare, sinceoptimalnutritioncan enhancequalityof lifeand lifeexpectancy. It is therefore recommended to includenutritional assessmentas the5th vital sign in the standard physicalexaminationofeachpet 1 .Fordogs diagnosedandmedically treated for hyperadrenocorticismnutritionalassessment should be includedduring routinemonitoringof thedog. Basedon theoutcomeof thenutritionalassessment – includingassessmentof thedog’sage,body condition score,musclecondition scoreandpresence ofconcurrentclinicalconditions suchas dermatologicalproblems,poorbloodglucosecontrol, hypertension,hyperlipidaemia, reduced immune status, renalorcardiac failureandpoormobility –a recommendation foroptimalnutritional support should bemade foreach individualdog.

Mostdogswithhyperadrenocorticismpresentwith dermatologicalabnormalities suchasalopecia, thinningof the skin,hyperpigmentation and recurrent skin infections. Restorationof thepoor skincondition indogswithhyperadrenocorticism requires sufficient supplyof skin-supportivenutrients.Adietwith increased levelsof fattyacidsandessential skin- supportivenutrients suchas vitaminA,EandB complex,protein, zincand seleniumcan support restorationofcompromised skinandmaintenanceof healthy skinandcoat 2 . Intakeofomega-3 fattyacids andbeta-glucanscanalter theproductionof eicosanoidsandcytokinesand support the immune response 3 . Although skinandcoatconditionusually improves aftermedical treatment, somedogsmay start to show clinical signsofallergicdermatitis. In thesedogs, the high levelsofendogenouscortisoldampens inflammatory skin reactionsandpruritus.Asa resultof the reductionofplasmacortisol levelspost treatment, allergicdermatitis in thesedogsmaybeunmasked. Dogswithallergicdermatitiscanbenefit fromhigh dietary levelsofomega-3 fattyacidswhichhave shown to support skincondition inatopicdogs 4 .

Cerealswitha reducedglycemic index (wholewheatandoats)anda high leveloffibre topromotegradual releaseofglucose from thediet to reducepostprandialhyperglycemia for supportofpatientswithdiabetes mellitusorpoorbloodglucosecontrol.

Fibre

Diabetes mellitus

Glycemic index

Uniquelyhigh levelsofomega-3 fattyacidsEPAandDHA fromfishoil andomega-6 fattyacidGLA fromborageoil. High intakeofomega-3 fattyacidshas shown to regulateblood lipids incaseofhyperlipidemia,helpmaintainnormalblood pressureand increase insulin sensitivity.These fattyacidscanaffect the immune response andalter theproductionofeicosanoidswhichhaveeffectsondifferentprocesses in thebody.

Immune support, regulation blood lipids

EPA DHA

GLA

Contains ß-1,3/1,6-glucans from yeast,and increased levelsof zinc, seleniumandomega-3 fattyacids to support the immune status. Beta-glucanscanbind tomacrophagesandalert the immune system, thereby supporting the immune responseandalteringcytokineproduction.

Immune support

Acomplete,balanceddietwith verymoderateenergydensity for supportofoptimalweightmanagement.The controlled levelsofminerals likephosphorusand sodium reduce theworkloadof thekidneysand support renal function in seniordogs.

Moderate energy, balanced minerals

Contain EPAandDHA fromfishoil for supportofhealthy joints, skinandcoat.

Joint, skin & coat support

euticalsPLC

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