EmerAid® Sustain™ HDN™
or “Highly Digestible Nutrition” is a therapeutic diet scientifically designed to support felines that are recovering from critical illness, suffering from chronic medical conditions, or underweight. It is also designed to transition the debilitated cat from intensive care nutrition to normal feeding. As a recovery diet, it contains more whole nutrients than EmerAid Intensive Care HDN Feline. Developed by an expert panel, including critical care veterinarians and nutritionists, this therapeutic diet is easily absorbed and highly digestible.
- Available in 100-gram, 400-gram, and 2-kg pouches
- Powder is easily mixed with water to create a formula that can pass through tubes as small as 5-French
- Meets AAFCO nutritional requirements for all feline life stages
How to Administer EmerAid Feline Sustain
Indications & Contraindications
EmerAid® Sustain™ HDN Feline is indicated in patients recovering from a critical state but not ready for their normal diet. EmerAid® Sustain™ HDN Feline is also indicated for use in healthy patients requiring nutritional support during the pre- or post-operative period as well as patients requiring supplemental nutrition for low body weight.
- Convalescence
- Pre- or post-operative Nutritional
- Failure to thrive or gain weight
- Cachexia
- Anorexia/inappetance
- Neglect
- Hepatic lipidosis
- Severe parasitic infestations
- Infectious disease
- Autoimmune disease
- Anemia
- Peritonitis
Contraindications:
- Advanced stages of chronic kidney disease
- Hepatic encephalopathy
Features & Benefits
- High energy (2.35 kcal/ml ME)
- 1 month shelf life after opening
- Goes through tubes as small as 5 Fr without clogging
- Excellent for bolus tube feeding or syringe feeding
- Appropriate low levels of carbohydrates and high levels of protein for the true carnivore
- Purified fiber sources to maintain intestinal motility and commensal microflora
- Cellulose serves as a source of insoluble fiber and acts as a prebiotic
- Essential and conditionally essential amino acids to meet the needs of the metabolically stressed patient
- Promotes lean body mass and wound healing with L-carnitine, branched chain amino acids, and highly digestible proteins
- Hydrolyzed soy protein minimizes gastrointestinal hypersensitivity. These highly digestible macronutrients prevent and manage osmotic diarrhea, as is associated with completely elemental diets
- Balanced levels of omega 3:omega 6 polyunsaturated fatty acids
- Omega-3 fatty acids to modulate the inflammatory response and aid in tissue synthesis
- Synergistic antioxidants vitamin E, vitamin C, zinc and taurine to defend against oxidative stress
- Glutamine and arginine support immunity and antioxidant systems
- A-casozepine or dehydrated casein supports digestion of fats and tissue synthesis while providing anxiolytic properties
- L-tryptophan, a precursor for the synthesis of serotonin to reduce stress
- Dietary nucleotides provide RNA and DNA precursors to support the immune system, nourish the gastrointestinal tract, and assist in weight gain
- Balanced electrolytes
- Stabilized vitamins and chelated minerals
- Neutral pH
- Free of artificial colors and preservatives
- Naturally preserved with mixed tocopherols and citric acid
- Meets AAFCO nutritional requirements for all life stages
Storage, Handling & Expiration Date
Store EmerAid® Sustain™ HDN Feline in a cool, dry space. The shelf life of unopened EmerAid ® Sustain™ HDN Feline indicated by the “Best Before” date, which is 18 months from the manufacturing date. Refrigerate after opening, and use EmerAid® Sustain™ HDN Feline within 1 month of opening.
***WARNING*** EmerAid ® Sustain™ HDN Feline has been scientifically designed to be highly digestible. Avoid contamination by handling the product carefully. Keep the powder dry until ready to mix with water, and use a clean, dry scoop. Do not cross-contaminate with scoops using non-EmerAid foods as contamination can cause harmful bacterial growth.
Look for the “Best Before” label on the package.
Ingredients & Nutrient Profile
Cooked Chicken, Hydrolyzed Soy Protein, Dried Chicken Liver, Corn Oil, Canola Oil, Dicalcium Phosphate, Dried Hydrolyzed Casein, Dried Whole Egg, Defatted Wheat Germ, Glucose Syrup Solids, Cellulose, Potassium Chloride, Ground Limestone, Inulin, Magnesium Sulfate, Dextrose, Choline Chloride, Citric Acid, DL-Methionine, Taurine, L-Lysine, Vitamin E Supplement, Niacin Supplement, Copper Methionine Chelate, L-Carnitine, Ascorbic Acid, Zinc Oxide, Tocopherols, D-Calcium Pantothenate, Sodium Selenite, Vitamin A Supplement, Vitamin B12 Supplement, Thiamine Hydrochloride, Riboflavin Supplement, Pyridoxine Hydrochloride, Manganous Oxide, Biotin, Folic Acid, Vitamin D3 Supplement.
Download the Feline EmerAid HDN Nutrient Profile PDF (80.4 KB)
| Nutrient | Dry Matter | Units | Per 100 kcal |
|---|---|---|---|
| ME | 5025.00 | kcal/kg | |
| Protein | 40.10 | % | 7.98 g/100 kcal |
| Fat | 35.60 | % | 7.08 g/100 kcal |
| Fiber | 3.00 | % | 0.60 g/100 kcal |
| Moisture | 5.60 | % | 1.11 g/100 kcal |
| Calcium | 1.35 | % | 0.27 g/100 kcal |
| Phosphorus | 1.05 | % | 0.21 g/100 kcal |
| Potassium | 0.90 | % | 0.18 g/100 kcal |
| Chloride | 0.79 | % | 0.16 g/100 kcal |
| Magnesium | 0.15 | % | 0.03 g/100 kcal |
| Sodium | 0.33 | % | 0.07 g/100 kcal |
| Iron | 368.58 | mg/kg | 7.33 mg/100 kcal |
| Manganese | 15.00 | mg/kg | 0.30 mg/100 kcal |
| Copper | 20.00 | mg/kg | 0.40 mg/100 kcal |
| Zinc | 100.00 | mg/kg | 1.99 mg/100 kcal |
| Vitamin A | 10163.41 | IU/kg | 202 IU/100 kcal |
| Vitamin D3 | 950.13 | IU/kg | 19 IU/100 kcal |
| Vitamin E | 82.80 | IU/kg | 2 IU/100 kcal |
| Vitamin K | 49.80 | IU/kg | 1 IU/100 kcal |
| Biotin | 0.36 | mg/kg | 0.01 mg/100 kcal |
| Choline | 3150.03 | mg/kg | 62.67 mg/100 kcal |
| Folic Acid | 60.83 | mg/kg | 1.21 mg/100 kcal |
| Niacin | 178.22 | mg/kg | 3.55 mg/100 kcal |
| Panto Acid | 48.92 | mg/kg | 0.97 mg/100 kcal |
| Pyridoxine | 12.58 | mg/kg | 0.25 mg/100 kcal |
| Riboflavin | 16.16 | mg/kg | 0.32 mg/100 kcal |
| Thiamin | 8.00 | mg/kg | 0.16 mg/100 kcal |
| Vitamin B12 | 2.10 | mg/kg | 0.04 mg/100 kcal |
| Vitamin C | 117.76 | mg/kg | 2.34 mg/100 kcal |
| Lysine | 3.51 | % | 0.70 g/100 kcal |
| Methionine | 1.18 | % | 0.23 g/100 kcal |
| Taurine | 0.20 | % | 0.04 g/100 kcal |
| Linoleic, n-6 | 9.06 | % | 1.80 g/100 kcal |
| Linolenic, alpha n-3 | 0.60 | % | 0.12 g/100 kcal |
| 20:4 arachidonic | 0.25 | % | 0.05 g/100 kcal |
Mixing Directions
Use a syringe to draw up the mixture. When finished, flush and clean the feeding syringe. Make fresh for each feeding. Discard remaining food after each feeding.
For your convenience and your patient’s benefit, standard mixing directions have been updated in 2016:
| Feeding Style | EmerAid® Sustain™ HDN Powder (parts)* | Water** (parts) | ME*** (kcal/ml) |
|---|---|---|---|
| Syringe | 3.5 | 2 | 2.54 |
| Tube (10Fr or larger) | 2 | 2 | 1.84 |
| Tube (5Fr-8Fr) | 1.5 | 2 | 1.53 |
| * “Parts” indicate the proportions needed. To mix EmerAid, you can use the scoop provided, a syringe cap, any measuring implement of your choice as long as the proportions described above remain consistent ** Mix with hot water measuring 122°F (50°C) *** Metabolizable energy when made as directed |
|||
| EmerAid Sustain HDN pouch (g) | Number of tablespoons a per container b |
|---|---|
| 100 | 12.5 |
| 400 | 50.0 |
| 2000 | 250.0 |
a 1 scoop = 1 tablespoon (tbsp)
b 1 tbsp of EmerAid Sustain HDN Canine weighs 8 (7.5) grams
| How many kcal per scoop of EmerAid Sustain Feline? | |||
|---|---|---|---|
| 1 scoop*= 7.5 grams | 5025.81 kcal/kg | 5.026 kcal/g x 7.5 g | 37.70 kcal/scoop |
| *1 scoop = 1 TBSP | |||
Feeding Recommendations
Adult Cat Feeding Recommendations
See our Basic Use Guide.
EmerAid® Sustain™ HDN Feline is a therapeutic product to be used under the supervision of a veterinarian. Begin with 25% to 30% of daily 
caloric requirements and gradually adjust the volume and number of feedings based on patient condition. A volume of 5-10 ml/kg/feeding is generally well tolerated via esophagostomy or gastric tube. The following equation can be used to calculate resting energy requirement: RER = [70 x BW(kg)0.75] .
Table 1. EmerAid® Sustain™ HDN Feline feeding recommendations based on predicted resting energy requirements (RER)a in adult cats
| BW (kg) | BW (lb) | RER (kcal/day) | Feed (G/day)b | Feed (ml/day)c |
|---|---|---|---|---|
| 1 | 2.2 | 70 | 14 | 28 |
| 2 | 4.4 | 118 | 23 | 46 |
| 3 | 6.6 | 160 | 32 | 63 |
| 4 | 8.8 | 198 | 39.4 | 86 |
| 6 | 13.2 | 268 | 53.3 | 115 |
| 8 | 17.6 | 333 | 66.3 | 143 |
| 9 | 19.8 | 364 | 72.4 | 155 |
| 10 | 22.0 | 394 | 78.4 | 169 |
| 12 | 26 | 451 | 89.7 | 178 |
| 14 | 31 | 507 | 100.9 | 199 |
a From Ramsey JJ. Determining energy requirements. In: Fascetti AJ, Delaney SJ (eds). Applied Veterinary Clinical Nutrition. Wiley-Blackwell: Ames, Iowa, 2012. Pp. 33-36 and and Thatcher CD, et al. Small Animal Clinical Nutrition: An Iterative Process. In Hand MS, Thatcher CD, Remillard RL, Roudebush P, and Novotny BJ (eds). Small Animal Clinical Nutrition 5. MMI, Topkea, KS, 2010.
b EmerAid Sustain HDN Feline contains 5.026 kcal/grams (1 scoop = 1 tbsp = 7.5g)
c Recommendations based on 3.5:2 mixing ratio and RER. See our Feeding Example below.
When transitioning from EmerAid® Sustain™ HDN Feline, mix Sustain with Intensive Care diet in increasing proportions over time until the patient is eating only EmerAid Sustain.
Kitten Feeding Recommendations
Kittens have relatively high energy requirements when compared to adult cats. EmerAid® Sustain™ HDN Feline meets or exceeds requirements for all life stages.
Table 2. EmerAid® Sustain™ HDN Feline feeding recommendations based on predicted daily energy requirements (DER) in the average kitten.
| BW (kg) | BW (lb) | Est DER (kcal/day)d | Max Fed (G/day)e | Max Fed (ml/day)f |
|---|---|---|---|---|
| 0.05 | 0.11 | 22.21 | 4 | 9 |
| 0.1 | 0.25 | 37.34 | 7 | 15 |
| 0.2 | 0.44 | 62.80 | 12 | 25 |
| 0.4 | 0.90 | 105.62 | 20 | 42 |
| 0.6 | 1.3 | 143.16 | 25 | 56 |
| 0.8 | 1.8 | 177.64 | 35 | 70 |
| 1.0 | 2.2 | 210.00 | 40 | 83 |
| 1.8 | 4 | 328.24 | 60 | 129 |
| 2.7 | 6 | 444.78 | 85 | 175 |
| 3.6 | 8 | 552.04 | 105 | 217 |
d Daily energy requirements for kittens less than 4 months of age were calculated as 3 x RER where RER = 70 x BW(kg)0.75
e EmerAid Sustain HDN Feline contains 5.026 kcal/grams (1 scoop = 7.5 g). Powder can be mixed with the regular diet (wet food) as a supplement or when transitioning your patient to the regular diet.
f Recommendations based on 3.5:2 mixing ratio and RER. See our Feeding Example below.
Feeding Example
Six-year-old domestic shorthair cat that has recovered from critical illness, but exhibits failure to gain weight. Body weight is 5 kg (11 lb), BCS 2/5.
Photo courtesy of Ann Wortinger, BIS, LVT, VTS (ECC, SAIM, Nutrition)
| BW (kg) | BW (lb) | RER (kcal/day) | Feed (G/day) | Feed (ml/day) |
|---|---|---|---|---|
| 4 | 8.8 | 198 | 39.4 | 86 |
| 6 | 13.2 | 268 | 53.3 | 115 |
Patient body weight falls midway between the guidelines listed above. Therefore the recommended volume to be fed falls between 86 ml and 115 ml. The median value is 100.5 ml and this number represents the maximum estimated volume to be fed daily. Feedings are cautiously planned for every 4 to 6 hours in this patient, so dividing 101.5 ml by 4 gives us approximately 25 ml per feeding.
Unless the patient has been previously syringe fed or tube fed, begin cautiously with 30% to 50% of this estimated volume for the first feeding: ~8 ml to 12 ml.
Evaluate the Patient’s Feeding Response
Did the patient accept this feeding well? Does the food appear to be tolerated by the patient’s GI tract?
If yes, increase the volume fed gradually over the course of two to three feedings. Frequency and volume should be adjusted based upon patient response, but a cautious plan could be:
| First meal: | 1/3 of calculated energy requirements | ~ 8 ml |
| Second meal: | 2/3 of calculated energy requirements | ~ 15 ml |
| Third meal: | 3/3 of calculated energy requirements | ~ 25 ml |
| If patient tolerates increase in frequency and in volume of EmerAid® Sustain HDN™ Feline, continue feeding per below: | ||
| Daily meals: | 25 ml four times/day | |
Long-Term Feeding
Under the direct supervision of a veterinarian, feline patients may be fed EmerAid® Sustain™ HDN™ long term. When the patient has fully recovered, they may transition to their regular diet as recommended by their veterinarian.