PMC:5423899 / 2379-5618 JSONTXT

{"project":"2_test","denotations":[{"id":"28540291-16032342-43169036","span":{"begin":210,"end":211},"obj":"16032342"},{"id":"28540291-23403690-43169036","span":{"begin":210,"end":211},"obj":"23403690"},{"id":"28540291-22736679-43169036","span":{"begin":210,"end":211},"obj":"22736679"},{"id":"28540291-11215916-43169037","span":{"begin":1195,"end":1196},"obj":"11215916"},{"id":"28540291-20939411-43169037","span":{"begin":1195,"end":1196},"obj":"20939411"},{"id":"28540291-22577048-43169037","span":{"begin":1195,"end":1196},"obj":"22577048"},{"id":"28540291-11215916-43169038","span":{"begin":1439,"end":1440},"obj":"11215916"},{"id":"28540291-20939411-43169039","span":{"begin":1627,"end":1628},"obj":"20939411"},{"id":"28540291-22577048-43169040","span":{"begin":2070,"end":2071},"obj":"22577048"},{"id":"28540291-11215916-43169041","span":{"begin":2297,"end":2298},"obj":"11215916"},{"id":"28540291-24171376-43169042","span":{"begin":2303,"end":2304},"obj":"24171376"},{"id":"28540291-11215916-43169043","span":{"begin":2430,"end":2431},"obj":"11215916"},{"id":"28540291-24171376-43169044","span":{"begin":2892,"end":2893},"obj":"24171376"},{"id":"28540291-11215916-43169045","span":{"begin":2999,"end":3000},"obj":"11215916"},{"id":"28540291-20939411-43169046","span":{"begin":3002,"end":3003},"obj":"20939411"}],"text":"Introduction\nDietary recommendation for the management of chronic gastroenteropathy in cats has included the use of both veterinary therapeutic elimination and veterinary therapeutic gastrointestinal formulas (1–3). Veterinary elimination diets are designed to limit dietary antigens by incorporating uncommon or hydrolyzed protein ingredients and are utilized to diagnose and manage gastrointestinal and/or dermatologic conditions with an underlying food intolerance or food allergy. Veterinary gastrointestinal formulas differ in that they do not necessarily utilize unique or hydrolyzed protein sources but are designed with highly digestible ingredients to facilitate digestion and absorption of nutrients within a compromised gastrointestinal tract. Veterinary gastrointestinal formulas may also incorporate other dietary modifications such as adjustment of macronutrient distribution, fatty acid composition, and inclusion of dietary fibers and prebiotics.\nWhile nutritional intervention is commonly utilized to manage chronic gastroenteropathy in cats, there have only been a handful of reported studies evaluating the efficacy of nutritional intervention in naturally occurring disease (4–7). Guilford et al. showed that 49% of 55 cats with chronic gastrointestinal disease were responsive to dietary change, and 29% of the 55 demonstrated a food allergy or sensitivity with recrudescence of clinical signs upon diet re-challenge (4). In another study, eight cats with chronic diarrhea and/or vomiting responded to dietary therapy with a hydrolyzed diet after other medical and dietary interventions were unsuccessful (5). Laflamme et al. demonstrated improvement in fecal score in 78.2% of 55 cats with chronic diarrhea fed either a low-fat (23% ME) or high-fat (45.1% ME) dry diet containing common ingredients (6). Additionally, two canned therapeutic gastrointestinal formulas containing common ingredients were evaluated for the management of naturally occurring chronic diarrhea, demonstrating resolution to a normal fecal score in up to 46.7% of 15 cats (7).\nWhile recent studies have focused on chronic diarrhea, less is known regarding dietary intervention with chronic vomiting. Vomiting is the primary clinical sign recognized in feline patients with chronic gastroenteropathy (4, 8, 9). In the Guilford’s study, vomiting was present in 51.4% of the cats, diarrhea in 31.4%, and vomiting and diarrhea in 17.1% (4). Of patient visits to Banfield Pet Hospital® between 2008 and 2012, 1.4% of total feline visits per annum presented with chronic vomiting alone, 0.4% with chronic diarrhea alone, and 0.1% with both chronic vomiting and chronic diarrhea (8). An evaluation of 100 feline cases of chronic small bowel disease suggested that diagnostic evaluation and implementation of dietary management is indicated in cats with vomiting as infrequently as two times per month (9). While the use of elimination diets containing novel and hydrolyzed protein sources has been evaluated (4, 5), to the authors’ knowledge, no studies to date have evaluated the efficacy of feeding a non-specific gastrointestinal therapeutic diet to cats with chronic gastroenteropathy with vomiting included as one of the primary clinical signs."}