Page 995 - Small Animal Clinical Nutrition 5th Edition

1032 Small Animal Clinical Nutrition

ommended after GI obstruction has been ruled out (Table tamine (H )-receptor antagonists, cytoprotective drugs, PGE 2
2
VetBooks.ir 51-2). Rarely, some patients may require parenteral feeding analogs, antibiotics and anthelmintics (Table 51-2).
(Chapter 26).
The second approach, known as “feeding through vomiting,”
has been a successful alternative to NPO therapy in some vom- REASSESSMENT
iting patients. Pregnant women suffering hyperemesis reported
feeling less nausea and preferred the placement of a nasogastric Nutritional reassessment of patients with gastritis or gastroduo-
tube with slow frequent self feeding of small liquid meals to denal ulcers includes monitoring changes in body weight and
eating small regular meals or NPO therapy (MacBurney,1993). condition and determining the extent of vomiting. Daily food
This feeding method has also been used successfully in dogs dosage should be adjusted as indicated by changes in body
with parvoviral enteritis (Mohr et al, 2003). A possible expla- weight and condition.
nation for persistent vomiting is that the normal motility pat- If vomiting persists in the face of appropriate medical and
tern throughout the length of the bowel cannot be reestablished nutritional therapy, further diagnostics are warranted. Ad-
without strong intraluminal stimulation. In fact, vomiting and ditionally, different foods should be tried (Tables 52-3 and 52-
mucosal atrophy probably perpetuate bowel dysfunction. 4). If anemia was identified as a problem in pets with GI ulcers,
Feeding restarts normal patterns of motility beginning in the reassessment of the hemogram is recommended to ensure ade-
esophagus and food may reestablish motility patterns as it pass- quate repletion of iron and copper. In addition, frequent moni-
es down the bowel.The physical presence of food and nutrients toring of fecal occult blood loss is recommended.
serves as mechanical and chemical stimuli to normalize bowel
motility and function.
Simply refeeding dogs (orally) and cats (via nasoesophageal ENDNOTES
tube) has stopped protracted vomiting (i.e., lasting more than
c
seven days) successfully without using antiemetic drugs. Feed- a. Gastrografin. Squibb Diagnostics, New Brunswick, NJ,
ings are continued although the patient may vomit. Most cases USA.
of protracted vomiting cease within 24 hours of administering b. CLOtest, Ballard Medical Products, Draper, UT, USA.
liquid food. These patients then are offered small frequent c. Remillard RL. Personal observation. 1998.
meals of a highly digestible, moderate-fat food 24 hours after
the last episode of vomiting (Tables 52-3 and 52-4).
REFERENCES

CONCURRENT MEDICAL THERAPY The references for Chapter 52 can be found at
www.markmorris.org.
Nutritional management often is used in conjunction with other
therapeutic modalities including parenteral fluids, antacids, his-