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Technical Information

Product: Acute Care Paste and Powder
Acute Care Oral Paste and Supportive G.I. Powder were developed by Dr. Garry Pusillo. Dr. Pusillo is one of only a
handful of board certified animal nutritionists in North America.
Uniqueness, Applications and Uses:
Acute Care Paste and Supportive G.I. Powder are unique oral supplements suitable for dogs, cats, rabbits, puppies,
kittens as well as equine and large animals. They contain a prebiotic sugar called mannanoligosaccharide, probioitics,
fungal and bacterial derived digestive enzymes and the B vitamins. The main applications in veterinary medicine are for
acute, sub-acute and chronic or recurrent diarrheas resulting from stress, bacterial contamination, dietary indiscretions,
dysbiosis, as adjunct therapy in inflammatory bowel disease and general gut health. Many of these types of diarrheas
are associated with an overgrowth of unfriendly bacteria. The MOS (mannanoligosaccharides) in Acute Care help
decrease the levels of these unfriendly bacteria. This giant sugar molecule (that is not absorbed by the animal) has
lectin binding sites that are more attractive to the unfriendly bacteria than the lectin binding sites on the villi of the
intestinal tract. Once the unfriendly bacteria bind to the MOS, it cannot release and is flushed out of the intestine. MOS
also has been shown to help stimulate the immune system at the GI tract level. Acute Care Oral Paste is also useful as
a supplement for animals that are on or have been on antibiotic therapies. It can be given with or after the antibiotic
treatment is completed in order to help prevent a dysbiosis (an imbalance in gut flora) from occurring. Acute Care
Supportive G.I. Powder has the added benefit of the addition of N-acetyl glucosamine which is necessary in the
production of mucin, the glycoprotein that lines the intestinal tract. It is also used as the substrate in the formation of
proteoglycan ground substance that holds cells together. Thus the powder adds additional cellular support and GI
protective effect not available in the paste. Owners want the veterinarian to give them something for their pet to stop
the diarrhea. Instead of giving the owner a 5 day prescription for antibiotics or sending the owner to the drug store to
purchase Pepto-Bismol or Kaopectate, Vets now have a veterinary only product that will not just mask the symptoms,
but help treat the problem.

Ease of Administration and Owner Compliance:

Acute Care Oral Paste is readily accepted by dogs and tolerated by most cats. Most dogs will eat it out of the palm of
your hand. The smaller 15 cc dial-a-dose syringe is ideal for cats, puppies and other small animals. Owner compliance
is high because they want the problem solved immediately. Acute Care Paste is given 3 times per day. Most syringes
will last between 3 and 6 doses. Most acute diarrheas stop after one to three doses, but it is recommended that at least
3 doses are given to prevent the diarrhea from coming back. Any unused portion may be kept for administration at
another time.
Acute Care Supportive G.I. Powder is convenient and cost effective when therapy is required for several days or
weeks. When symptoms are present the recommended maintenance dose should be doubled and given twice daily
until symptoms resolve. For prevention or recurrent symptoms the maintenance dose can be given over a longer period
of time.
Efficacy and Communication of Benefits:
In the majority of acute diarrheas that are caused by stress, bacterial overload or imbalance, a fast and supplementation
with Acute Care Paste is all that is needed to resolve symptoms. When owners come into their vet clinics because their
pet has diarrhea, they want something that is going to work fast and be easy to give. Acute Care meets those criteria.
Acute Care can also be given with Flagyl (metronidazole) or Tylosin if the veterinarian so desires. Acute Care
Supportive G.I. Powder is used for animals with more protracted symptoms, G.I. recovery from surgery, pancreatitis,
viral or bacterial enteritis, and stress from boarding or traveling or for prevention.
Veterinarians often prescribe antibiotics for 5 or more days when these types of diarrheas occur. Acute Care Oral Paste is 1 to 1 ½ days of adjunctive therapy in most cases. Acute Care is a convenient form of supportive therapy for these types of diarrheas and does not have a direct competitor because it is so much more than just a probiotic. The competition has launched a product containing montmorillonite clay (an aluminum silicate). It is used to coat the intestinal mucosa and absorb bacteria, toxins and gas. It is comparable to the Kaolin Clays (Kaopectate). The company reports that when given twice a day for three days, 60% of the dogs demonstrated improvement in stool consistency. This product may be a couple of dollars per tube less than Acute Care but is not in the same class of treatment. Advantages of the Direct Fed Microbials in Acute Care:

- Microencapsulated micro-organisms- all the beneficial bacteria are encapsulated with a hydrophobic coating
to keep moisture and oxygen out. This process provides maximum stability when mixed with food. Isomalto-oligo saccharides are microencapsulated with the micro-organisms to assure that the food (sugar) necessary for them to grow is available when they are activated. - Compatible with the digestive environment - a major requirement for any direct fed microbial is that it must
be adapted to grow and multiply in the gut environment. This includes the ability to survive in gastric juice at low pH and in bile salts that are present in the intestinal tract. Compatible with Antibiotics- each strain of micro-organisms used, has been tested to evaluate its ability to
survive and grow in the presence of over 40 antibiotics. Antibiotics do not affect the mycotoxin, bacterial, mold,
and other binding properties of Acute Care.
Digestive Enzymes in Acute Care:

The enzymes in Acute Care have been derived from both fungal and bacterial origin and originate from organisms
classified as GRAS-listed organisms. A mixture of enzymes from both fungal and bacterial sources was chosen to
ensure activity over as broad a pH range as possible.
The enzymes in Acute Care are specifically designed to have maximum activity at temperatures and pH that are near
those encountered in the digestive tract.
Briefly to touch on two main microbials and their fermentation extracts that is contained in Acute Care Paste: Bacillus Subtillus is one of the most beneficial bacteria. It is a “natural enzyme factory". It produces two main
enzyme systems, the amylactic and the proteolytic. These systems are not as specific as those associated with
A. Oryzae, but they are equally important to efficient animal digestion.
Aspergillus Oryzae synthesizes at least eight enzymes that have currently been isolated, each of which is
specific to the breakdown of particular compounds into chemically, simpler nutrients.
1. Maltase breaks down malt sugar to glucose 2. Lactase breaks down milk sugar to glucose and galactose 3. Alpha glycosidase breaks down alpha glycosidase to fructose 4. Beta glycosidase breaks down cellobiose to glucose, and beta glycosidase to glucose and alcohol 5. Lipase breaks down fats into glycerol and higher fatty acids 6. Cellulase breaks down cellulose 7. Protease breaks down proteins to amino acids and nitrogen 8. Glycerophosphorase breaks down glycerophosphoric acid to glycerin and phosphoric acid. Each of the end products facilitated by A. Oryzae is used by the animal. Many, including glucose, galactose and alcohol, provide energy. Others, such as amino acids, provide body building materials. Still others, such as phosphoric acid, provide regulatory functions within the animal; in this case, the maintenance of stable blood pH. Combining enzymes from various sources as found in the Acute Care Paste, results in a wider range of optimal pH,
synergism of the combined enzymes, increased percentage of absorption, increased level of effectiveness, and broader
range of application.

Mannanoligosaccharides (MOS):
is derived from the cell wall of the yeast Saccharomyces cerevisaiae. This complex sugar has three main
1. Binds pathogenic bacteria
2. Helps immune system resist infections
3. Helps maintain GIT integrity
Mannan is a sugar recognized by certain bacteria, including many strains of E. coli and salmonella. In the oligosaccharide form however, the mannan is not available for the pathogen to grow. When MOS is ingested by animals, lectins of these pathogens are tricked into attaching to the mannan sugar instead of the carbohydrates attached to the intestinal villi. These lectins are then flushed out without being able to metabolize the sugar, resulting in a "cleansing" effect of the intestinal wall and preventing permanent damage to the villi (finger-like protrusions on the intestinal wall containing sights for nutrient absorption). MOS has also been shown to bind mycotoxins such as alflatoxin produced by certain molds.
Mannan oligosaccharides benefit digestive function and intestinal health through interactions with gut bacteria and
modulating immune response to promote disease resistance. MOS lessens the impact of pathogens and mycotoxins in
the gut.
N-acetyl glucosamine (in Acute Care Powder only):
N-acetyl glucosamine is necessary in the manufacture of mucin, the glycoprotein that lines the intestinal tract. There is
an increase uptake of N-acetyl glucosamine by the intestinal mucosa in patients with inflammatory bowel disease. This
glucosaminoglycan is also used as a substrate in the formation of the proteoglycan ground substance that holds cells
together. This ground substance is weakened by the inflammatory process. Thus patients with chronic inflammatory
conditions can benefit form the introduction of N acetyl glucosamine to their diets.



The Journal of Clinical Endocrinology & MetabolismCopyright © 2000 by The Endocrine Society CLINICAL CASE SEMINAR Metastatic Congenital Adrenocortical Carcinoma: A Case Report with Tumor Remission at 31⁄2 Years MUSHTAQ A. GODIL, MARK P. ATLAS, ROBERT I. PARKER, CEDRIC J. PRIEBE,MICHELLE M. ZERAH, PHILIP KANE, JAMES TSUNG, AND THOMAS A. WILSON Departments of Pediatrics (M.A.G., M.P.A

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