Ghiringhelli / Bontempo

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Ghiringhelli

Matteo Ghiringhelli has a Master’s degree in Veterinary Medicine from the University of Milan (2013), graduating with a master thesis on the surgical anatomy of the cisterna chyli and the thoracic duct. From 2013 he worked as small animals private practitioner in collaboration with different private veterinary clinics (emergency medicine and surgery). He collaborates as experimental surgeon on differents research projects at the Department of Health, Animal Science and Food Safety, University of Milan. He is now working at the Division of Veterinary Nutrition of the Faculty of Milan where he started a PhD program in 2014. He is interested in Surgery and Nutrition.


Bontempo

Valentino Bontempo got the doctorate in Zootechnical Science at the University of Naples (Italy) in 1992. From 1992 to 1998 he was researcher at the Department of Animals, Vegetables and Environment Sciences, Agriculture Faculty, University of Molise. From 1998 to 2001 he was associate Professor of Animals Nutrition and Feeding at the same department. In 2001 he became full Professor of Animal Nutrition and Feeding at the Department of Veterinary Science and Technologies for Food Safety at the Faculty of Veterinary Medicine, University of Milan. Coordinator of the Doctorate in Animal Feeding and Feed Safety from 2006 to 2012. Member of the EAEVE commission.


Research Project

Evaluation of parenteral nutrition in malnourished dogs

Sick and injured animals undergo metabolic changes that put them at high risk of malnutrition and related complications. In healthy animals which do not receive enough calories to meet their requirements, the body compensates the caloric deficit by reducing metabolism, releasing catecholamines and stress hormones, activating liver glycogenolysis, and, finally, by mobilizing amino acids from skeletal muscles.

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Parenteral nutrition (PN) can sustain life when patients are unable to take sufficient nourishment via the gastrointestinal tract for prolonged periods. However, PN is also associated with significant risks and complications so that alternative methods of nourishing patients should be considered in every case.

Figure 1: Taurine (2-aminoethanesulfonic acid)

When possible, oral or enteral nutrition are preferred options. PN use should be considered when normal oral intake or enteral nutrition cannot be started before a period of three/five days. Short-term parenteral nutrition is appropriate in malnourished and/or severely catabolic patients unable to be adequately nourished enterally. In this patient group, the risks of complications of nutrition depletion are greater and parenteral nutrition should be started earlier. As this method is an invasive therapy, it must be used in a manner which limits the risk of sepsis, catheter insertion complications and metabolic complications. The progress in the nutrients formulation and administration techniques, a careful selection of cases and a scrupulous monitoring of the patients by properly trained staff makes its use simple and effective in small animal clinic.
This project follows the human medicine base evidence enhancing that a target PN for every single pathology could be the correct way to contrast the malnutrition. The purpose of this study will be to evaluate the use of total or partial parenteral nutrition in dogs. We will select different pathologic conditions wherein the patients are malnourished or they lose weight fast.

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We will consider 3 categories of pathologies: cancer, gastroenteric disease (i.e IBD, megaesophagus, infection/infiammation) and liver and pancreas pathologies (this group represents the exocrine glands affection). These pathological conditions are the hardest disease where the malnutrition and cachexia evolve fast and the oxidative stress produces a heavy alteration of the intestinal absorption. Particular care is provide for gastroenteric affections because they represent the first causes of the protein losing pathology and disabsorption.

Sixty dogs will be divided into 2 groups: Group 1 will be healthy dogs with normal Body Condition Score (BCS =3), Group 2 will be dogs affected with cancer or gastroenteric disease and liver and pancreas pathologies. Blood biochemistry test (electrolytes, kidney function, liver function, glucose, hemoglobin, iron, albumin and C-reactive protein),oxidative markers (TBARS and carbonyl proteins) and intestinal absorption (citrulline plasma) will be evaluated in both groups.

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Blood analysis of dogs will be need to define the differences between pathology and healthy status. In a second step of the study the unhealthy dogs will be divided into 2 groups: Group 1 will be treated with standard parenteral nutrition, while Group 2 will be fed with a parenteral nutrition personalized for every single patient based on the deficiencies of the lipids, amino acids, glucose, minerals and antioxidants compounds for each case. During the third step (final step) all collected data will be processed to achieve a PN software to define a specific diet for every single pathology considered.