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51 ACVN NutritioN Notes Peer reviewed July/August 2014 today's Veterinary Practice tvpjournal.com O ne of the most significant nutritional issues that can arise during cancer treatment in companion animals is malnutrition. 1 Malnutrition is characterized by various clinical signs, including: • Poor wound healing with altered immune response • Fluid and electrolyte imbalances • Body weight changes characteristically associated with a cachectic state. In general, malnutrition of the cancer patient—both human and animal: • Significantly decreases response to treatment proto- cols and time of remission • Increases mortality and morbidity • Has an overall detrimental effect on quality of life. Pets with cancer—similar to human cancer patients— experience side effects when undergoing common on- cologic therapies. The continuum of cancer survival, treatment, recovery, and living with advanced cancer re- quires an integrated approach to patient care. Appropri- ate and timely nutritional support is a key component in caring for these pets. FACTORS THAT AFFECT NUTRITIONAL STATUS Numerous factors impact—both directly and indirect- ly—the nutritional status of cancer patients, including: 2,3 • Ongoing tumor–host competition for dietary energy substrates, which results in chronic malnourishment for the host (pet) • The disease process itself (eg, neoplasms that cause vomiting) • Use of antineoplastic therapies • Pets' health status prior to initiation of treatment. Cachexia is a complex syndrome characterized by se- vere, chronic, undesired, and progressive weight loss and muscle wasting, with or without loss of fat mass. 4 This Practical Approaches to Feeding the CanCer Patient Korinn E. Saker, MS, DVM, PhD, Diplomate ACVN North Carolina State University the American College of Veterinary Nutrition (acvn.org) and Today's Veterinary Practice (tvpjournal.com) are delighted to bring you the Nutrition Notes column, which provides the highest quality, cutting-edge information on companion animal nutrition, provided by the ACVN's foremost nutrition specialists. the primary objectives of the ACVN are to: • Advance the specialty area of veterinary nutrition • increase the competence of those practicing in this field • establish requirements for certification in veterinary nutrition • encourage continuing education for both specialists and general practitioners • Promote evidence-based research • enhance dissemination of the latest veterinary nutrition knowledge. the ACVN achieves these objectives in many ways, including designating specialists in animal nutrition, providing continuing education through several media, supporting veterinary nutrition residency programs, and offering a wide array of resources related to veterinary nutrition, such as this column. Nutritional Goals for Veterinary Cancer Patients Nutritional support goals for veterinary cancer patients can range from simple to complex, but most impor- tant, they need to be defined and agreed upon by the pet caregiver and veterinarian at time of diagnosis. there is no published benefit to delaying nutrition as- sessment and support for the cancer patient. each nutrition support plan should be developed with defined goals in mind, and these goals should be individually defined for each pet. However, universal concerns for any pet with cancer include: • Preserving lean muscle • Minimizing metabolic and gastrointestinal (Gi) intol- erance to food • optimizing the pets' quality of life.