Learning

Macahl Animal health,
Where pet health is our priority

CPD webinar – Sign up now for our next webinar by Kristine Jensen,
DVM, MVetMed, DACVIM (Small Animal Internal Medicine) and we will
email you with further details.

Macahal Animal Health

Learning

Macahl Animal health,
Where pet health is our priority

CPD webinar – Sign up now for our next webinar by Kristine Jensen,
DVM, MVetMed, DACVIM (Small Animal Internal Medicine) and we will
email you with further details.

Webinars

  • An Introduction to Microenteral nutrition and Effective hydration (Part 2)

  • An Introduction to Microenteral nutrition and Effective hydration (Part 1)

  • Dan Chan – Part 1

  • Dan Chan – Part 2

Articles

  • Macahl Animal Health Steiner Clinical Update

    Early nutritional support is essential for a successful outcome in many acute gastrointestinal diseases

  • Oral Rehydration Therapy

    Oral rehydration therapy (ORT) is simply the administration of basic nutrients and water, given by mouth.

  • Early Enteral Nutrition principles & practice

    In simplest terms, the major function of the gastrointestinal tract (GIT) is to transform ingested food into simple molecules that can be used for energy and metabolic function by all of the other cells in the body.

Microenteral Nutrition

What happens when an animal doesn’t eat?

Enterocytes are the cells that line the small intestine absorbing all the bodies nutrients and fluids and protecting against pathogenic bacteria, helping maintain the immune function of the gastrointestinal tract. Without direct nutrition enterocytes atrophy within as little as 90minutes, and so 24hrs to 72hrs fasting can have a devastating effect to the integrity and motility of the GI barrier.

Know the cells of the Gastrointestinal tract:

  • The intestinal epithelium is made up of four major types of cells – enterocytes, mucous cells, enteroendocrine cells and Paneth cells. These four cell types all originate from stem cells located in the ‘valleys at the bottom of the villi, named the crypts of Lieberkuhm.
  • Secondary digestion and absorption of nutrient molecules takes place in the small intestine through a layer of finger-like villi.
  • Enterocytes are simple, column-shaped epithelial cells found in the small intestine and also the colon. they are also known as ‘surface absorptive cells’ and are the workhouses of the intestine. Enterocytes are coontinuously formed and replenished from the stem cells that are located in the crypts between the villi. Enterocytes are ‘born’ at the bottom of the villus and take 2-5 days to slowly migrate up to the apex of the villus. Once they reach the apex, they are programmed to die. In contrast, red blood cells live for about 3 months in the circulation.
  • Enterocytes are responsible for absorbing sugars, amino acids, water and electrolytes. They adhere tightly to eachother and therefore also serve as a physical barrier that prevents food and bacteria in the intestinal lumen from migrating freely into the systematic circulation.
  • Each enterocyte also forms numerous tiny folded extensions of its cell membrane, about 1 micrometer long, that are termed microvilli or ‘striated border’. These folds increase the surface area for absorption. Enzymes located in these microvilli break down sugars and proteins into their final forms, ready for absorption and transport through the enterocyte.
  • Mucous cells release mucin that acts as a protective barrier for the villi.
  • Enteroendocrine cells are scatter throughout the stomach, pancreas and small intestine. They are responsible for producing various hormones that control gastroinintestinal functions, such as gastrin, chloecystokinin, insulin and glycagon.
  • Paneth cells are the guardians for the stem cells. They can release substances that causelysis of bacteria. Paneth cells actually live for about 3 weeks and are located in the crypts.

 

Did you know? The gi tract weighs 5% of total body weight and uses up to 20% of the oxygen supply. It’s a hardworking organ and has to work even harder during illness as metabolism actually increases. #feeddontfast. Early enteral nutrition EEN helps speed recovery, reduce hospitalization time and can make the difference in reducing mortality with acute GI patients. Classic advise was to fast critically ill patients for up to 48 to 72hrs, but this led to complications where the gi barrier started to breakdown causing a leaky gut – bacterial translocation would lead to potential problems of sirs, sepsis or mods.

Todays approach is to recommend enteral nutrition as soon as the patient is able to tolerate a prescribed diet. These diets are usually high in fat and protein, designed to provide full RER resting energy requirments unti the patient is able to eat normal food again. Within the first 24hrs of acute GI patients their gut is not able to tolerate these diets as it is in an impaired state and not able to breakdown complex fats and proteins. Microenteral nutrition is a safe and simple solution to begin enteral feeding within as little as 2hrs of patient arriving. Once vomiting has been stabilized, offering a small volume of microenteral nutrition often by tube feed or syringe, trickle feeds the gi tract and directly nourishes the Enterocytes to stop

Atrophy and begin recovery. Starting at 0.5ml per kg every 2hrs and increasing by 50% every 4 -8hrs nourishes the wall of the small intestine, helping rebuild the barrier and strengthen the enterocytes to tolerate more complex proteins and sugars. This small amount of specially formulated nutrients enables the clinician to treat the organ and not just the symptoms and the earlier enteral nutrition is begun, the faster the patient recovers. Oralade is the first ready to use microenteral nutrition product developed for animals, to provide exactly the nutrients enterocytes require to stop atrophy and begin recovery.

Containing zero fat and only 1% protein it requires no digestion and is instantly absorbed. The isotonic balance of fluids, electolytes, glucose and simple amino acids provides the nutrition needed to feed the GI tract. Upon patient showing tolerance for higher calorie enteral diets, Oralade makes a perfect complement to any prescription diet as it has no contraindications and is also hypoallergenic. Rather than blending diets in water, adding Oralade increases absorption, provides rehydration and increases palatability.

Signs of dehydration

The body fluids of a dog or cat are over 60% of total body mass.

A slight dip in the balance of water, electrolytes and glucose can have an immediate physiological effect on how the body and organs function. Dehydration can occur for several reasons and is more common with sick patients. Oral rehydration therapy (ORT) and Intravenous fluid therapy (IV) are the two main strategies to manage dehydration and help patient recovery.

Signs of Dehydration

Dehydration is the imbalance of fluids and electrolytes in the body, caused by reduced fluid intake or increased fluid loss through vomiting and/or diarrhoea. If left untreated severe dehydration  can be fatal, so it’s important to act fast. Rehydration requires more than plain water, as body fluids contain, electrolytes, glucose, water and nutrients. Beware of the signs of dehydration with dogs and cats as often its less obvious than in humans, since dogs and cats don’t sweat!.

Some of the main symptoms are:

  1. Sunken eyes
  2. Dry gums
  3. Lethargy
  4. Weakness
  5. Collapse
  6. Loss of skin elasticity

Causes of Dehydration

Increased fluid loss can occur through;Gastroenteritis; vomiting, diarrhoea and blood loss.

Increased Urination often from problems with renal failure, diabetes or other causes can also lead to dehydration if the patient is not drinking enough fluids to compensate.

Reduced water intake – a dog or cat may have an underlying problem causing them to drink and eat less due to discomfort or not feeling well.

Other; Viral, Heat stroke, Travel sickness, Whelping,

Over 34% of dogs visiting the veterinary clinic are diagnosed with symptoms of gastroenteritis.

Why are electrolytes important?

Electrolytes are minerals that conduct the electrical signals maintaining normal body function. They promote health blood flow, muscle actions, nerves and organ function and much more. The body needs to maintain a balance and so with losses of both fluids and electrolytes and nutrients, animals and humans eat and drink fluids to replenish this balance. When an animal is sick and unwilling or unable to properly rehydrate, the body actually needs these nutrients more than every to help recovery.

ORT solutions often contain an isotonically balanced level of fluids, electrolytes and carbohydrates for energy. As body fluids have an osmolarity of around 300msOml, isotonic solutions have a very similar pressure and balance of these elements, enabling fast absorption and rehydration. Hypotonic solutions have a lower level of minerals and Hypertonic have an increased level of Carbohydrates. Examples of a hypotonic solution could be simply tap water – as it contains trace minerals or a Hypertonic solution could be sea water – as it contains a high level of sodium.

The 3 most common electrolytes used in ORT solutions are Sodium NA+, Potassium K+, Chloride CL-.

Oralade is designed to be Isotonic, with an osmolarity of approx. 300msOml containing a similar level of sodium, potassium and chloride to body fluids of both cats and dogs. It contains just 12kcal per 100ml, which means its low calorie and also zero fat, enabling fast absorption and rehydration.

Taste Matters

Several studies with humans by leading sports drink brands have proven that taste plays a key role in optimum fluid intake. Flavour and also sodium stimulate thirst encouraging greater fluid intake, whereas plain water causes bloating and shuts the thirst mechanism down early. Equally an unpalatable taste will deter sufficient fluid intake for rehydration and in cases of moderate to severe dehydration Intravenous IV fluids are essential. All patients that receive IV fluids must begin voluntary drinking and eating and they can often be nauseous, so again taste is important. Dogs and cats love certain tastes and smells, but equally hate others.

Love: meaty, sweet, slightly salty – natural meaty flavours similar to their favourite food, slightly sweet  – slightly salty increases saliva and appetite and thirst

Hate; citrus, bitter, chlorine, – tap water often contains chlorinated water, citric acid is common in ORT powder products and human electrolyte drinks, vitamins and other additives can carry bitter tastes.

Oralade #wheretastecomesfirst – carefully designed to include only what they love and exclude anything that they hate. Afterall we are looking to encourage sick and nauseous animals to voluntarily drink and so a palatable taste and appealing aroma are essential ingredients for good hydration intake. In several independent feeding tests to monitor fluid intake by both healthy and sick pets, we tested Oralade against, plain water, powder ORT soluitons

First choice: 97% Oralade vs 3% ORT powder

Total consumption 86% vs Plain water

In fact we are so confident of both owner compliance and patient acceptance that we provide a satisfaction guarantee on all products and if you are not 100% happy with your purchase we will offer a replacement or refund.

For a highly palatable and ready to use Oral Rehydration Solution, choose Oralade.

Trusted by Vets Loved by Pets

Webinars

  • An Introduction to Microenteral nutrition and Effective hydration (Part 2)

  • An Introduction to Microenteral nutrition and Effective hydration (Part 1)

  • Dan Chan – Part 1

  • Dan Chan – Part 2

Articles

  • Macahl Animal Health Steiner Clinical Update

    Early nutritional support is essential for a successful outcome in many acute gastrointestinal diseases

  • Oral Rehydration Therapy

    Oral rehydration therapy (ORT) is simply the administration of basic nutrients and water, given by mouth.

  • Early Enteral Nutrition principles & practice

    In simplest terms, the major function of the gastrointestinal tract (GIT) is to transform ingested food into simple molecules that can be used for energy and metabolic function by all of the other cells in the body.

Microenteral Nutrition

Microenteral Nutrition

What happens when an animal doesn’t eat?

Enterocytes are the cells that line the small intestine absorbing all the bodies nutrients and fluids and protecting against pathogenic bacteria, helping maintain the immune function of the gastrointestinal tract. Without direct nutrition enterocytes atrophy within as little as 90minutes, and so 24hrs to 72hrs fasting can have a devastating effect to the integrity and motility of the GI barrier.

Know the cells of the Gastrointestinal tract:

  • The intestinal epithelium is made up of four major types of cells – enterocytes, mucous cells, enteroendocrine cells and Paneth cells. These four cell types all originate from stem cells located in the ‘valleys at the bottom of the villi, named the crypts of Lieberkuhm.
  • Secondary digestion and absorption of nutrient molecules takes place in the small intestine through a layer of finger-like villi.
  • Enterocytes are simple, column-shaped epithelial cells found in the small intestine and also the colon. they are also known as ‘surface absorptive cells’ and are the workhouses of the intestine. Enterocytes are coontinuously formed and replenished from the stem cells that are located in the crypts between the villi. Enterocytes are ‘born’ at the bottom of the villus and take 2-5 days to slowly migrate up to the apex of the villus. Once they reach the apex, they are programmed to die. In contrast, red blood cells live for about 3 months in the circulation.
  • Enterocytes are responsible for absorbing sugars, amino acids, water and electrolytes. They adhere tightly to eachother and therefore also serve as a physical barrier that prevents food and bacteria in the intestinal lumen from migrating freely into the systematic circulation.
  • Each enterocyte also forms numerous tiny folded extensions of its cell membrane, about 1 micrometer long, that are termed microvilli or ‘striated border’. These folds increase the surface area for absorption. Enzymes located in these microvilli break down sugars and proteins into their final forms, ready for absorption and transport through the enterocyte.
  • Mucous cells release mucin that acts as a protective barrier for the villi.
  • Enteroendocrine cells are scatter throughout the stomach, pancreas and small intestine. They are responsible for producing various hormones that control gastroinintestinal functions, such as gastrin, chloecystokinin, insulin and glycagon.
  • Paneth cells are the guardians for the stem cells. They can release substances that causelysis of bacteria. Paneth cells actually live for about 3 weeks and are located in the crypts.

 

Did you know? The gi tract weighs 5% of total body weight and uses up to 20% of the oxygen supply. It’s a hardworking organ and has to work even harder during illness as metabolism actually increases. #feeddontfast. Early enteral nutrition EEN helps speed recovery, reduce hospitalization time and can make the difference in reducing mortality with acute GI patients. Classic advise was to fast critically ill patients for up to 48 to 72hrs, but this led to complications where the gi barrier started to breakdown causing a leaky gut – bacterial translocation would lead to potential problems of sirs, sepsis or mods.

Todays approach is to recommend enteral nutrition as soon as the patient is able to tolerate a prescribed diet. These diets are usually high in fat and protein, designed to provide full RER resting energy requirments unti the patient is able to eat normal food again. Within the first 24hrs of acute GI patients their gut is not able to tolerate these diets as it is in an impaired state and not able to breakdown complex fats and proteins. Microenteral nutrition is a safe and simple solution to begin enteral feeding within as little as 2hrs of patient arriving. Once vomiting has been stabilized, offering a small volume of microenteral nutrition often by tube feed or syringe, trickle feeds the gi tract and directly nourishes the Enterocytes to stop

Atrophy and begin recovery. Starting at 0.5ml per kg every 2hrs and increasing by 50% every 4 -8hrs nourishes the wall of the small intestine, helping rebuild the barrier and strengthen the enterocytes to tolerate more complex proteins and sugars. This small amount of specially formulated nutrients enables the clinician to treat the organ and not just the symptoms and the earlier enteral nutrition is begun, the faster the patient recovers. Oralade is the first ready to use microenteral nutrition product developed for animals, to provide exactly the nutrients enterocytes require to stop atrophy and begin recovery.

Containing zero fat and only 1% protein it requires no digestion and is instantly absorbed. The isotonic balance of fluids, electolytes, glucose and simple amino acids provides the nutrition needed to feed the GI tract. Upon patient showing tolerance for higher calorie enteral diets, Oralade makes a perfect complement to any prescription diet as it has no contraindications and is also hypoallergenic. Rather than blending diets in water, adding Oralade increases absorption, provides rehydration and increases palatability.

Signs of dehydration

Signs of dehydration

The body fluids of a dog or cat are over 60% of total body mass.

A slight dip in the balance of water, electrolytes and glucose can have an immediate physiological effect on how the body and organs function. Dehydration can occur for several reasons and is more common with sick patients. Oral rehydration therapy (ORT) and Intravenous fluid therapy (IV) are the two main strategies to manage dehydration and help patient recovery.

Signs of Dehydration

Dehydration is the imbalance of fluids and electrolytes in the body, caused by reduced fluid intake or increased fluid loss through vomiting and/or diarrhoea. If left untreated severe dehydration  can be fatal, so it’s important to act fast. Rehydration requires more than plain water, as body fluids contain, electrolytes, glucose, water and nutrients. Beware of the signs of dehydration with dogs and cats as often its less obvious than in humans, since dogs and cats don’t sweat!.

Some of the main symptoms are:

  1. Sunken eyes
  2. Dry gums
  3. Lethargy
  4. Weakness
  5. Collapse
  6. Loss of skin elasticity

Causes of Dehydration

Increased fluid loss can occur through;Gastroenteritis; vomiting, diarrhoea and blood loss.

Increased Urination often from problems with renal failure, diabetes or other causes can also lead to dehydration if the patient is not drinking enough fluids to compensate.

Reduced water intake – a dog or cat may have an underlying problem causing them to drink and eat less due to discomfort or not feeling well.

Other; Viral, Heat stroke, Travel sickness, Whelping,

Over 34% of dogs visiting the veterinary clinic are diagnosed with symptoms of gastroenteritis.

Why are electrolytes important?

Electrolytes are minerals that conduct the electrical signals maintaining normal body function. They promote health blood flow, muscle actions, nerves and organ function and much more. The body needs to maintain a balance and so with losses of both fluids and electrolytes and nutrients, animals and humans eat and drink fluids to replenish this balance. When an animal is sick and unwilling or unable to properly rehydrate, the body actually needs these nutrients more than every to help recovery.

ORT solutions often contain an isotonically balanced level of fluids, electrolytes and carbohydrates for energy. As body fluids have an osmolarity of around 300msOml, isotonic solutions have a very similar pressure and balance of these elements, enabling fast absorption and rehydration. Hypotonic solutions have a lower level of minerals and Hypertonic have an increased level of Carbohydrates. Examples of a hypotonic solution could be simply tap water – as it contains trace minerals or a Hypertonic solution could be sea water – as it contains a high level of sodium.

The 3 most common electrolytes used in ORT solutions are Sodium NA+, Potassium K+, Chloride CL-.

Oralade is designed to be Isotonic, with an osmolarity of approx. 300msOml containing a similar level of sodium, potassium and chloride to body fluids of both cats and dogs. It contains just 12kcal per 100ml, which means its low calorie and also zero fat, enabling fast absorption and rehydration.

Taste Matters

Several studies with humans by leading sports drink brands have proven that taste plays a key role in optimum fluid intake. Flavour and also sodium stimulate thirst encouraging greater fluid intake, whereas plain water causes bloating and shuts the thirst mechanism down early. Equally an unpalatable taste will deter sufficient fluid intake for rehydration and in cases of moderate to severe dehydration Intravenous IV fluids are essential. All patients that receive IV fluids must begin voluntary drinking and eating and they can often be nauseous, so again taste is important. Dogs and cats love certain tastes and smells, but equally hate others.

Love: meaty, sweet, slightly salty – natural meaty flavours similar to their favourite food, slightly sweet  – slightly salty increases saliva and appetite and thirst

Hate; citrus, bitter, chlorine, – tap water often contains chlorinated water, citric acid is common in ORT powder products and human electrolyte drinks, vitamins and other additives can carry bitter tastes.

Oralade #wheretastecomesfirst – carefully designed to include only what they love and exclude anything that they hate. Afterall we are looking to encourage sick and nauseous animals to voluntarily drink and so a palatable taste and appealing aroma are essential ingredients for good hydration intake. In several independent feeding tests to monitor fluid intake by both healthy and sick pets, we tested Oralade against, plain water, powder ORT soluitons

First choice: 97% Oralade vs 3% ORT powder

Total consumption 86% vs Plain water

In fact we are so confident of both owner compliance and patient acceptance that we provide a satisfaction guarantee on all products and if you are not 100% happy with your purchase we will offer a replacement or refund.

For a highly palatable and ready to use Oral Rehydration Solution, choose Oralade.

Trusted by Vets Loved by Pets