Internal Medicine and Nutrition
This domain tests how you monitor and support common chronic and acute medical conditions, and how you turn a calorie calculation into a feeding plan a client can follow.
Core rules
- Resting energy requirement: RER = 70 x (body weight in kg)^0.75. Multiply by a life-stage and body-condition factor for maintenance energy.
- Use ideal body weight for obese patients; use current weight for critically ill patients until rehydration is complete.
- Chronic kidney disease is staged by IRIS using creatinine or SDMA plus proteinuria; management includes phosphate control, adequate but restricted protein, potassium, omega-3 fatty acids and blood pressure monitoring.
- Diabetes management pairs insulin every 12 hours with a glucose curve, consistent diet and timing, and owner education on hypoglycemia signs.
- Feline hyperthyroidism presents with weight loss despite a ravenous appetite and tachycardia; treatment options are methimazole, radioiodine or a prescription diet.
- Congestive heart failure commonly uses furosemide, pimobendan and an ACE inhibitor, with sodium restriction.
- Pancreatitis calls for fluid support, antiemetics, analgesia and low-fat feeding once the patient will eat.
Worked example
A 10 kg neutered indoor dog needs a maintenance estimate. 10^0.75 is about 5.62, so RER = 70 x 5.62 = 394 kcal/day. Multiply by roughly 1.6 for a neutered adult, giving about 630 kcal/day. If the diet is 350 kcal per cup, that is about 1.8 cups divided into two meals, adjusted at recheck by body condition score.
Traps that cost marks
Feeding full maintenance calories to an obese patient, free-feeding a multi-cat household when one cat is on a prescription diet, changing diets abruptly, and assuming every senior diet is appropriate for kidney disease.