Parenteral Nutrition

Perea, Sally

doi:10.1002/9781118785669.ch21

Cited by 8 publications

(5 citation statements)

References 49 publications

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“…Parenteral nutrition (infusing nutrients intravenously) can be used as an alternative in patients unable to tolerate enteral feeding; for example, those with intractable vomiting and diarrhoea, lack of gag reflex, presenting a high anaesthetic risk or recovering from severe gastric or intestinal disease and coagulopathy. Parenteral nutrition may be associated with a higher rate of complications than tube feeding, 74 is more expensive and limited in availability. For these reasons – as well as on a physiological level (see page 633) – enteral feeding remains preferable in the majority of cases.…”

Section: Nutritional Support Of the Hospitalised Cat: Feeding Tubesmentioning

confidence: 99%

2022 ISFM Consensus Guidelines on Management of the Inappetent Hospitalised Cat

Taylor¹,

Chan

Villaverde³

et al. 2022

Journal of Feline Medicine and Surgery

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Practical relevance: Inappetence may have many origins and, as a presenting sign or observation in the hospitalised patient, is common in feline practice. Nutritional assessment of every patient is encouraged, to identify the need for, and appropriate type of, intervention indicated. The impact of malnutrition may be significant on the feline patient, perpetuating illness, delaying recovery, slowing wound healing and negatively impacting gut health and immunity. Delayed intervention may result in the cat’s deterioration; hence prompt control of contributing factors such as the underlying illness, pain, nausea, ileus and stress is vital to optimise voluntary food intake. Management is multimodal, comprising reduction of stress, medications and assisted nutrition in the form of tube feeding or parenteral nutrition. Use of antiemetic, analgesic, prokinetic and appetite stimulant medications may restore appetite, but placement of feeding tubes should not be delayed. Feeding tubes are generally well tolerated and allow provision of food, water and medication with minimal stress, although clinicians must be aware of complications such as stoma site infections and refeeding syndrome. Clinical challenges: Cats are vulnerable to malnutrition owing to their unique metabolism and specific nutritional requirements. Moreover, their nature as a species means they are susceptible to stress in the hospital environment, which may result in reduced food intake; previous negative experiences may compound the problem. In particular, an inappropriate clinic environment and/or handling may cause or exacerbate inappetence in hospitalised patients, with negative impacts on recovery. Postponing interventions such as feeding tube placement to await improvement, owing to clinician or caregiver apprehension, may hinder recovery and worsen nutritional deficits. Evidence base: The 2022 ISFM Consensus Guidelines on Management of the Inappetent Hospitalised Cat have been created by a panel of experts brought together by the International Society of Feline Medicine (ISFM). Information is based on the available literature, expert opinion and the panel members’ experience.

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Section: Nutritional Support Of the Hospitalised Cat: Feeding Tubesmentioning

confidence: 99%

2022 ISFM Consensus Guidelines on Management of the Inappetent Hospitalised Cat

Taylor¹,

Chan

Villaverde³

et al. 2022

Journal of Feline Medicine and Surgery

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“…While there was no difference between the NE and NG groups in any of these factors, nor was an association found with outcome, larger randomized, prospective studies may reveal an association between energy intake and outcome. For example, overfeeding is now discouraged in both human and veterinary medicine and many veterinary nutritionists now recommend an initial daily calorie goal of RER . In the current study, 45 of the 46 dogs were fed at or below RER based on calories from tube feedings alone.…”

Section: Discussionmentioning

confidence: 99%

Comparison of complication rates in dogs with nasoesophageal versus nasogastric feeding tubes

Freeman

Heinze

et al. 2013

J Vet Emergen Crit Care

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“…In veterinary medicine, the premise that the gut plays an important role during critical illness and that EN is preferable to PN whenever possible is well established . Although studies prospectively evaluating tolerance of enteral feeding in dogs and cats with AP are limited, there is growing evidence supporting the benefits of EN in dogs and cats with AP.…”

Section: Clinicopathological Findingsmentioning

confidence: 99%

“…It is also possible that hyperglycemia may serve as a surrogate marker of disease severity and that the relationship to outcome may be independent of PN administration. Nevertheless, as there are no known advantages for hyperglycemia, it may be prudent to devise protocols to address the development of hyperglycemia including reduction of the PN administration rate, reduction of the dextrose content in PN solution and administration of insulin to reduce blood glucose . Intensive insulin therapy in hyperglycemic human patients receiving PN has been associated with a reduction in morbidity, however, this approach has not been applied to veterinary patients.…”

Section: Clinicopathological Findingsmentioning

confidence: 99%

“…The resting energy requirement (RER), also referred to as resting energy expenditure, “represents the energy requirement of a normal but fed animal at rest in a thermoneutral environment.” Although the precise amount of energy expenditure of animals with various diseases is unknown, the current convention is to use RER, as calculated by the Kleiber equation (RER = [body weight in kg] 0.75 × 70] as the initial starting point for initiating nutritional support in hospitalized animals . If patients have been anorexic for more than 3–5 days, it is recommended to feed only one third of the RER on day 1, and then gradually increase calories if tolerated, and reach full RER usually by day 3 .…”

Section: Clinicopathological Findingsmentioning

confidence: 99%

See 1 more Smart Citation

Nutritional management of acute pancreatitis in dogs and cats

Jensen

Chan

2014

J Vet Emergen Crit Care

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The nutritional management of veterinary patients with AP remains challenging. Based on clinical evidence in people, experimental animal studies, and preliminary studies in dogs and cats, the choice of EN over parenteral nutritional support during AP in dogs and cats appears to be beneficial and well tolerated. Optimization of nutritional therapies in dogs and cats including the use of immunonutrition during AP warrants further investigation.

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Parenteral Nutrition

Cited by 8 publications

References 49 publications

2022 ISFM Consensus Guidelines on Management of the Inappetent Hospitalised Cat

2022 ISFM Consensus Guidelines on Management of the Inappetent Hospitalised Cat

Comparison of complication rates in dogs with nasoesophageal versus nasogastric feeding tubes

Nutritional management of acute pancreatitis in dogs and cats

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