Page 457 - Small Animal Clinical Nutrition 5th Edition

Enteral-Assisted Feeding 471

Table 25-11. Recipes for blending selected commercial moist veterinary therapeutic foods in Tables 25-8 and 25-9 for use
VetBooks.ir Feeding tube size 20 Fr. 18 Fr. 16 Fr. 14 Fr.
with feeding tubes.

Water
Water
Water
density
density
density
added
density
Can size No. of Water Energy added Energy added Energy added Energy
Moist veterinary foods (oz.) cans (ml) (kcal/ml)* (ml) (kcal/ml)* (ml) (kcal/ml)* (ml) (kcal/ml)*
Hill’s Prescription Diet
a/d Canine/Feline 5.5 2 30 1.00 40 0.97 45 0.96 50 0.95
Hill’s Prescription Diet
n/d Canine 12.7 1 95 1.20 100 1.18 110 1.16 120 1.14
Iams Veterinary Formula
Maximum-Calorie Canine 6 2 30 1.74 35 1.72 40 1.70 45 1.68
& Feline
Purina Veterinary Diets
Feline CV 5.5 2 100 1.04 105 1.03 110 1.01 120 0.99
Purina Veterinary Diets
Feline DM 5.5 2 55 1.01 60 1.00 70 0.97 75 0.96
Royal Canin Veterinary Diet
Feline and Canine 6 2 30 0.88 32.5 0.88 35 0.87 37.5 0.87
Recovery RS
*Predicted as fed energy density of blended mixture.
offered for several more days before proceeding with the food calculated RER, realizing their actual energy requirement is
change. Most pets undergo food changes with few or no likely to change over the course of the disease process through
detectable GI disturbances. the recovery period.
• Nutritional support by an enteral, parenteral or a combination
SUMMARY method should initially deliver sufficient calories to meet the
patient’s RER at its current weight, adjusted for protein and
• The major consequences of malnutrition in all patients are body condition.To begin feeding patients at RER is a ration-
decreased immunocompetence, decreased tissue synthesis and al and safe estimate that decreases the probability of metabol-
repair and altered drug metabolism. ic complications.
• A nutritional assessment includes a patient history, a diet his-
tory,a physical examination with special attention given to cer- ACKNOWLEDGMENTS
tain risk factors, body condition scoring and laboratory tests.
• Patients with a history of nausea, vomiting and diarrhea are at The authors and editors acknowledge the contributions of Drs.
increased risk for malnutrition because nutrient intake and/or P. Jane Armstrong and Deborah J. Davenport in the previous
usage has been suboptimal for some time before admission. edition of Small Animal Clinical Nutrition.
• Animals use body carbohydrate, fat and protein stores to
maintain blood glucose concentrations throughout the course ENDNOTES
of food deprivation, trying to maintain vital functions for as
long as possible. The proportion of each stored component a. Impact, Novartis, Minneapolis, MN, USA.
used varies over the course of food deprivation. b. Sovereign Feeding Tube. Sherwood Medical, St. Louis, MO,
• The adaptation from the fed to the fasting state is one in which USA.
fuel use by the patient shifts from primarily a mixture of fuels c. Kangaroo Enteral Feeding Tube. Sherwood Medical, St.
to one in which the primary fuels are glycerol and fatty acids Louis, MO, USA. KeoFeed II Feeding Tube. IVAC Corp.,
(fat). San Diego, CA, USA.
• An understanding of the metabolic changes that occur dur- d. Feeding Tube. Cook Veterinary Products, Bloomington, IN,
ing simple starvation is essential to understanding the under- USA.
lying metabolic alterations present during anorexia with con- e. Pezzar Model Catheter, C.R. Bard, Inc., Covington, GA,
current illness. USA.
• Major electrolyte and acid-base abnormalities and blood glu- f. Gastrostomy Tube Introduction Set. Cook Veterinary
cose levels should be corrected or near normal before institut- Products, Bloomington, IN, USA.
ing either enteral or parenteral nutritional support. g. CliniCare. Abbott Laboratories, North Chicago, IL, USA.
• A practical goal is to begin nutritional support within 24 h. Formula V EnteralCare, PetAg, Hampshire,IL, USA.
hours of hospitalization for the injury or illness.
• Patients with a suspected or documented food intake less than REFERENCES
their calculated daily RER for more than three days are can-
didates for assisted feeding. The references for Chapter 25 can be found at
• The optimal target feeding for hospitalized patients is their www.markmorris.org.