Critical Cases Benefit from Nutrition

by Kara M. Burns, MS, MEd, LVT, VTS (Nutrition)

critical care for cats

Malnutrition in veterinary patients leads to increased morbidity and mortality. In the GI tract, transit times increase, absorptive capabilities decrease, villous atrophy, and there is an increased risk of bacterial translocation. Malnutrition has been documented to decrease humoral immunity and barrier function, inflammatory response, leukocyte motility, and bactericidal activity.
Protein malnutrition may modify the normal or expected metabolism of certain drugs, which may alter their therapeutic effect, even when given at recommended dosages.

cat illustration Additionally, evidence suggests that nutritional support should begin as soon as possible in the critical or hospitalized patient. The risk factors to consider are: history of inadequate nutritional intake; serious underlying disease (e.g., severe trauma, peritonitis, acute pancreatitis, major gastrointestinal surgery); and large protein losses (e.g., protracted vomiting, diarrhea, protein-losing nephropathies, burns, etc.). Patients with these risk factors are candidates for nutritional support and this nutritional support should begin as soon as possible.

How does critical care nutrition help cats with Hepatic Lipidosis?

Hepatic lipidosis in cats is a potentially deadly intrahepatic cholestatic syndrome which develops in cats with anorexia (~ 2+ days’ duration) and a state of negative energy balance. Hepatic lipidosis may be a result of another disease process or be a primary, idiopathic disease.3 Anorexia is usually the predisposing factor. Cats are susceptible to stress, which can precipitate appetite loss. Additionally, anorexia may result from a major disease condition such as heart disease, kidney disease, and pancreatitis, to name a few.

cat with feeding tube

Clinical signs upon presentation are inappetence, vomiting, lethargy, and diarrhea. Providing critical nutrition to felines affected by hepatic lipidosis is key to their recovery. EmerAid® HDN™ Feline semi-elemental formulas provide nutrients made up from the building blocks of proteins, carbohydrates, and fats. Semi-elemental nutrition provides easier digestion and rapid absorption of nutrients, designed to support the critical systems of the body.

EmerAid® HDN™ formulas are species specific, semi-elemental diets. They provide easy to digest nutrients while minimizing the risk of diarrhea. EmerAid® HDN™ can be reconstituted as needed to be fed through a feeding tube, syringe, or as a calorically dense bite of nutrition.EmerAid is also energy dense, which is extremely beneficial to critical patients and the GI tract. Energy dense foods provide higher energy delivered in smaller amounts of food. Thus, patients receive the nutrition they need in the proper amounts through multiple small ‘meals’. Smaller amounts put less strain on the gut while providing needed energy for healing.

Willow is an 8 year old spayed female DSH. She presents with inappetence of 2 days duration and vomiting. Upon examination, Willow is found to be icteric, moderately dehydrated, with an unkempt coat and a BCS 4/5. Last week, the owner reportedly purchased new living room furniture, which has acted as a stressor for Willow. Her CBC findings show a nonregenerative anemia and a stress leukogram. Serum chemistry profile findings show cholestasis. Correcting fluid, electrolyte, and metabolic deficits and initiating nutrition are the goals of management of hepatic lipidosis.

parovirus

Nutritional management is the foundation for managing hepatic lipidosis. A feeding tube is the best alternative to get nutrients into Willow. A nasoesophageal tube is placed as enteral nutrition should begin as soon as possible. Anti-emetics can be given if patient is still vomiting. EmerAid Intensive Care HDN Feline is highly digestible and easily absorbed, thus the formula for nutritional support of hepatic lipidosis.

Willow’s dehydration status was corrected, and a feeding tube placed. She tolerated the feeding tube and bolus feedings of energy dense EmerAid Intensive Care HDN Feline (small amounts, multiple times a day) and after the second day, began to show signs of improvement – more alert and active, no diarrhea, etc. On the third day, she began to eat on her own, although the tube was not removed until day 5. At this time, Willow was eating her total RER on her own, thus no longer needing the feeding tube. Her food in hospital as well as when she returned home was mixed with EmerAid IC HDN, to ensure her caloric needs were being met. After two days at home, the EmerAid was discontinued. Willow has adjusted to the new furniture in the house and is said to be resting comfortably on the back of the new couch.

Highest kcal/ml critical care diet

Highly digestible nutrition for maximum absorption

No diarrhea

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