Article Outline:

• Indications
• Megaesophagus and PEG or PEG-J Tubes
• Advantages of PEG Tubes
• Disadvantages of PEG Tubes
• Advantages of PEG-J Tubes
• Disadvantages of PEG-J Tubes
• Advantages and Disadvantages of Nasojejunostomy Tubes
• Contraindications
• Equipment
• Gastrostomy Tubes
• Construction Materials
• Placement Style
• Anatomy
• Sizes
• Additional Materials
• Low-Profile Gastrostomy Tubes
• One-Step Gastrostomy Tubes
• Replacement PEG-B Tubes
• Jejunostomy Tubes
• Techniques for Tube Placement
• Preparation
• PEG Tube Placement
  • Gastrostomy Tube Removal and Replacement
  • Gastrostomy Tube Removal
  • Gastrostomy Tube Replacement
  • Gastrostomy Gastrogram
  • PEG-J Tube Placement
  • Retrograde Guidewire Technique
  • Antegrade Guidewire Technique
  • Antegrade Wire-Free Technique
  • Repositioning Jejunostomy Tubes
  • Jejunostomy Tube Removal
  • Nasojejunostomy Tube Placement
  • Antegrade Technique
  • Retrograde Guidewire Technique
  • Tube Maintenance and Use
  • Maintenance
  • Feeding and Other Use
  • Gastrostomy Tube Feeding
  • Gastrojejunostomy Tube Feeding
  • Nasojejunostomy Tube Feeding
  • Complications
  • PEG Tubes
  • PEG-J Tubes
  • Nasojejunostomy Tubes
  • Conclusion
  • References

Chapter Outline

Nutritionally Responsive Gastrointestinal Disease

• SIBO and ARD
• Pathogen Overgrowth
• Pancreatitis and Exocrine-Pancreatic Insufficiency
• Inflammatory Bowel Disorders
• Nonspecific Acute Diarrhea
• Gastric Dilatation-Volvulus

Dietary Management of Intestinal Disease

• Managing Acute Disease
• Long-Term Management - Diet Composition
• Diet Digestibility

References

• CANCER CACHEXIA
• • Phases of Cachexia
  • Alterations in Carbohydrate Metabolism
  • Alterations in Protein Metabolism
  • Alterations in Lipid Metabolism
  • Changes in Energy Requirements
• DIETARY MANAGEMENT OF CANCER PATIENTS
• • Diet Characteristics
  • Calculating Energy Needs
• METHODS OF FEEDING
• CONCLUSION
• References

Aging is associated with a wide variety of physiological changes that compromise the ability of the body to respond to stress or change, and ultimately contribute to morbidity and mortality.  Much research has been done on the aging process in humans and experimental animals, and the impact of diet, but there is relatively little data from companion animal studies.  However, although many of the aging changes are likely to be similar between different mammals, it is known that there are some differences with cats. 

In contrast to dogs and humans, elderly cats experience an increase in their maintenance energy requirements rather than a continued decline, which may be mediated partly through a better-maintained basal metabolic rate but also through progressive compromise in fat and protein digestion.  Old age is also associated with a progressive loss of lean body mass that may be mitigated in part by feeding higher protein levels.  Diets designed for healthy elderly cats should therefore concentrate on being energy dense, highly digestible and with an increase in the proportion of protein calories, and being fed with the aim of supporting optimal body weight.  There is also strong evidence emerging that dietary manipulation in cats may be able to modify aspects of the aging process, with a long-term longitudinal study of cats demonstrating both survival and health benefits from feeding a diet supplemented with antioxidants, fatty acids, and a prebiotic source.

The American College of Veterinary Nutrition recommends a three-step approach to patient assessment that includes assessment of patient factors, dietary factors, and feeding factors.  After the assessment phase, a nutritional treatment plan is developed and instituted, and serial monitoring and adjustment ensue (an iterative process).

This chapter focuses on the nutritional management of feline disorders.

Cardiovascular Diseases
Dental and Oral Diseases

Skin Disorders

Gastrointestinal Diseases

Hepatic Diseases

Endocrinologic Diseases - Obesity, Diabetes Mellitus, Hyperthyroidism

Musculoskeletal Diseases - Osteoarthritis

Oncology

Ophthalmologic Diseases - Herpesvirus Infection

Pulmonary and Thoracic Medicine:  Chylothorax

Toxicology

Critical Care

Urinary Tract Disorders:  Chronic Renal Failure, Urolithiasis, Idiopathic Cystitis