b'ARTICLEMCTs are more easily digested and more rapidly absorbed in the small intestinal lumen without stimulating cholecystokinin secretion or relying on pancreatic lipase and bile acids for absorption. 6,7 MCT can serve as an easily digestible source of energy in diets where long-chain fatty acids (LCFAs) need to be restricted. 3We shall now discuss fat-sensitive conditions in the dog. A summary table is provided, Table 1, over the page.Acute vomiting or diarrhoeaAnimals experiencing acute vomiting and/or diarrhoea should be fed a fat limited diet whilst they are unwell. Fat slows gastric transit time, which may exacerbate vomiting and increase theFigure 1.Digestion and absorption of MCTs & LCTs. 3 Courtesy of Purina Institute.risk of aspiration. Maldigestion of fat can exacerbate diarrhoea. gastrointestinal tract. This results in Protein-losing enteropathy (PLE) leakage of the lymphatic contents PLE is a disease syndrome characterisedinto the intestinal submucosa, lamina by excessive loss of plasma proteins,propria, and lumen. 10particularly albumin, into theLymphangiectasia has primary gastrointestinal tract. Patients haveand secondary causes. Primary a severe negative protein and energylymphangiectasia may be congenital, balance. Diseases most commonlybut is generally idiopathic. More associated with PLE include intestinalcommonly, lymphangiectasia manifests lymphangiectasia, severe chronicas a secondary disorder to another enteropathy and intestinal lymphoma. 8 disease. Inflammation, infection, Dietary goals for managing theand neoplasia may cause lymphatic patient with PLE are fat restriction,obstruction. 11whilst providing sufficient energy andManagement of PLE includes protein for essential nutritional support.immunosuppressive drugs, low-fat or Fat should be restricted to 20% MEhypoallergenic therapeutic diets, oncotic regardless of underlying cause. Limitingsupport, and nutritional supplementation dietary fat will decrease lymph flow,of deficient vitamins and minerals, reduce lymphatic vessel distension andespecially cobalamin, calcium and minimise protein loss. magnesium. 12Dogs with PLE may be cachectic. SinceDietary interventions include primarily low-fat diets are lower in calories,highly digestible, fat restricted diets. 13 dogs experiencing severe weight lossLow-fat to ultra-low fat diets reduce may benefit from a diet containingintestinal lymph flow, decrease lacteal medium-chain fatty acids (MCFAs)distention, and thereby minimise protein as an alternative energy source. 6,7Itloss. MCFAs can provide an alternative is important to limit the quantity ofenergy source less likely to contribute to long-chain triglycerides (LCTs) as theylymphatic congestion. contribute to increased lymph flow andHyperlipidaemia 20%subsequent protein loss. 9 Hyperlipidaemia occurs as a disturbance Lymphangiectasia of lipid metabolism that results in Intestinal lymphangiectasia is aelevated blood lipids, particularly type of protein-losing enteropathytriglycerides, cholesterol or both. Max fat (ME) forcharacterised by dilatation of thePrimary hyperlipidaemia can be familialdogs with PLEintestinal lymphatic vessels in thein predisposed breeds such as Miniature www.inspiredvet.co.uk29'