Nutritional support for the dysphagic adult horse

Abstract

Summary The dysphagic horse will frequently require nutritional support due to a failure to ingest either sufficient or any feed at all to meet its daily energy and protein requirements. There are a variety of means by which this nutritional support can be provided, the choice of which is largely dependent on the cause of the dysphagia, anticipated duration of the dysphagia, metabolic demands of the underlying disease/disorder associated with the dysphagia, any financial restraints and facilities available. This manuscript provides an overview of the various means by which nutritional support can be provided and highlights some of the advantages and disadvantages of each which may be considered when choosing the most appropriate approach.

Equine Dysautonomia

“…At the authors' institute, newly hospitalized chronic cases receive 2 hourly small feeds, reducing to 4 hourly feeds after approximately 1 week of hospitalization. Both continuous flow enteral feeding and total and partial parenteral nutrition has been used in selected cases, with little evidence of a positive influence on case outcome [66]. However, via a reduction in the initial rate of weight loss, their use may extend the period of time available for a spontaneous improvement in appetite to occur.…”

“…Fulminant diarrhea: Severe diarrhea has been recognized in a proportion of chronic ED cases, usually those receiving supplementary liquid enteral feeding via a nasogastric tube [66]. This is a recognized complication of enteral feeding in horses, thought to partly reflect the low fiber content of commercially available liquid feeds [70].…”

When Changing the Hay Makes a Difference: A Series of Case Reports

“…However, these case reports do not give adequate information about the nutritional management of the horses affected by dysphagia, and are primarily focused on parenteral nutrition or enteral nutrition via a nasogastric tube. Instead, in such cases it is important to receive the appropriate nutritional support, especially in long-standing disease processes [14] . In particular, it is important to identify the site where the dysphagia originates-specifically, whether it is pre-pharyngeal, pharyngeal, or post-pharyngeal [12] -as this can affect voluntary feeding.…”

“…Even if the causes of dysphagia and the subsequent medical therapies vary, the nutritional approach can be standardized in cases in which voluntary feeding is possible. A number of options are available, such as pelleted feeds made into a slurry consistency, custom-made diets, or commercial human and equine liquid diets, and each one should be tailored to the horse's condition [14] .…”