EmerAid® Intensive Care™ HDN™ Canine
or “Highly Digestible Nutrition” is a semi-elemental therapeutic diet scientifically designed for the critically ill dog. 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
- When fed to growing or lactating animals, supplement the diet daily with 1% fish oil on a dry matter basis to ensure proper docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) levels
- Meets AAFCO nutritional requirements for adult maintenance
How to Administer EmerAid Canine HDN
Indications & Contraindications
Use EmerAid® Intensive Care HDN™ Canine for nutritional support during:
- Critical illness
- Post-operative period in debilitated patients
- Malabsorption/maldigestion
- Poor weight gain
- Cachexia
- Anorexia, inappetance
- Acute renal disease
- Infectious disease
- Peritonitis
- Autoimmune disease
- Anemia
- Convalescence
Contraindications include:
- Chronic renal disease
- Hepatic encephalopathy
Features & Benefits
- High energy (2.26-1.36 kcal/ml ME)
- One month shelf life after opening
- Goes through tubes as small as 5 Fr without clogging
- Excellent for bolus tube feeding or syringe feeding (not recommended for CRI pumps)
- Species-specific nutritional formulation
- Essential and conditionally essential amino acids to meet the needs of the metabolically stressed patient
- Lean body mass and wound healing promoted with high quality, easily digestible protein plus omega-3 fatty acids to aid in tissue synthesis
- Enriched in branched chain amino acids to benefit muscle synthesis and repair
- Hydrolyzed soy protein minimizes gastrointestinal hypersensitivity. These highly digestible macronutrients prevent and manage osmotic diarrhea, as is associated with completely elemental diets
- Purified fiber sources to maintain intestinal motility and commensal microflora
- Cellulose serves as a source of insoluble fiber and acts as a prebiotic
- Higher fiber plus highly digestible soy protein means the incidence of diarrhea is lower than with other critical care formulas
- Glutamine and arginine support immunity and antioxidant systems
- Enterocyte health maintained and supported allowing for the maximum absorbable nutrition in the gastrointestinal tract
- Synergistic antioxidants vitamin E, vitamin C, zinc and taurine to defend against oxidative stress
- 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
- Hydrolyzed starch supplies glucose, disaccharides, and oligosaccharides, which avoids the osmotic problems associated with feeding only glucose. Vital for the acute carbohydrate needs associated with debilitation.
- Balanced electrolytes
- Stabilized vitamins and chelated minerals
- Free of artificial colors and preservatives
- Naturally preserved with mixed tocopherols and citric acid
- Meets AAFCO nutritional requirements for adult maintenance
Storage, Handling & Expiration Date
Store EmerAid® Intensive Care HDN™ Canine in a cool, dry space. The shelf life of unopened EmerAid® Intensive Care HDN™ Canine is approximately 18 months from the date of manufacturing (see the “Best Before” label). Refrigerate after opening, and use EmerAid® Intensive Care HDN™ Canine within 1 month of opening
***WARNING*** EmerAid has been scientifically designed for extreme digestibility. 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.
Ingredients & Nutrient Profile
Hydrolyzed Soy Protein, Glucose Syrup Solids, Corn Oil, Corn Starch, Dehydrated Casein, Canola Oil, Cellulose, Dehydrated Chicken Liver, Defatted Wheat Germ, Cooked Chicken, Dried Whole Egg, Dicalcium Phosphate, Ground Limestone, Glutamine, Potassium Chloride, Glutamic Acid, Choline Chloride, Taurine, Citric Acid (A Natural Preservative), Magnesium Sulfate, Mixed Tocopherols For Freshness, L-Lysine, Cysteine, L-Threonine, L-Tryptophan, DL-Methionine, Copper Lysine, Vitamin E Supplement, Zinc Oxide, Ascorbic Acid, L-Carnitine, Niacin, Carotene, D-Calcium Pantothenate, Biotin, Manganese Oxide, Riboflavin Supplement, Sodium Selenite, Pyridoxine Hydrochloride, Vitamin A Supplement, Thiamine Mononitrate, Vitamin B12 Supplement, Vitamin D3 Supplement, Folic Acid.
Download the Canine EmerAid HDN Nutrient Profile PDF (229 KB)
| Nutrient | Dry Matter | Units |
|---|---|---|
| ME | 4172.62 | kcal/kg |
| Protein (min) | 35.37 | % |
| Fat (min) | 20.00 | % |
| Fiber, total (max) | 3.31 | % |
| Calcium (min) | 1.30 | % |
| Phos total (min) | 1.06 | % |
| Moisture (max) | 6.00 | % |
| Potassium (min) | 0.70 | % |
| Chloride (min) | 0.71 | % |
| Magnesium (min) | 0.08 | % |
| Sodium (min) | 0.38 | % |
| Iron | 368.06 | mg/kg |
| Manganese | 15.00 | mg/kg |
| Copper | 20.00 | mg/kg |
| Zinc | 125.00 | mg/kg |
| Vit A w/o b-carotene | 7800.00 | IU/kg |
| Vitamin D3 | 763.00 | IU/kg |
| Vitamin E | 75.00 | IU/kg |
| Vitamin K | 8.35 | IU/kg |
| Biotin | 0.29 | mg/kg |
| Choline | 2600.00 | mg/kg |
| Folic Acid | 1.50 | mg/kg |
| Niacin | 126.00 | mg/kg |
| Panto Acid | 36.80 | mg/kg |
| Pyridoxine | 9.72 | mg/kg |
| Riboflavin | 12.73 | mg/kg |
| Thiamin | 6.09 | mg/kg |
| Vitamin B12 | 0.07 | mg/kg |
| Vitamin C | 89.00 | mg/kg |
| Lysine | 2.41 | % |
| Methionine | 0.70 | % |
| Taurine | 0.10 | % |
| Carnitine | 0.01 | % |
| Linoleic, n-6 | 7.12 | % |
| Linoleic, alpha n-3 | 0.52 | % |
| 20:4 arachidonic | 0.05 | % |
Mixing Directions
Use a syringe to draw up the mixture. When finished, flush and clean the feeding syringe. Make fresh EmerAid mixture 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 Powder (parts)* | Water** (parts) | ME*** (kcal/ml) |
|---|---|---|---|
| Syringe | 3.5 | 2 | 2.26 |
| Tube (10Fr or larger) | 2 | 2 | 1.69 |
| Tube (5Fr-8Fr) | 1.5 | 2 | 1.36 |
| * “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 Intensive Care HDN pouch (g) | Number of tablespoons a per container b |
|---|---|
| 100 | 10 (11) |
| 400 | 40 (44) |
| 2000 | 200 (222) |
a 1 scoop = 1 tablespoon (tbsp)
b 1 tbsp of EmerAid Intensive HDN weighs 9 grams and the numbers in parentheses reflect these precise calculations
| How many kcal per scoop of EmerAid HDN Canine? | |||
|---|---|---|---|
| 1 scoop*= 8.5 grams | 4172.62 kcal/kg | 4.173 kcal/g x 8.5 g | 35.47 kcal/scoop |
| *1 scoop = 1 TBSP | |||
Using 5fr to 8fr feeding tubeUsing 10fr or larger feeding tube
Feeding Recommendations
Adult Dog Feeding Recommendations
Download Feeding Recommendations (PDF)
EmerAid® Intensive Care HDN™ Canine is a therapeutic product to be used only under the supervision of a veterinarian. Begin with 25% to 30% of resting energy 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. Resting energy requirements can be calculated using the following equation [70 x BW(kg)0.75].
When fed for longer than 1 month, supplement EmerAid® Intensive Care HDN™ Canine daily with 1% fish oil on a dry matter basis. When EmerAid HDN is fed to lactating animals longer than 1 week, it is recommended that the diet be supplemented daily with 1% fish oil (DMB). The NRC recommends a level of 0.11 g/1,000 kcal ME of a combination of DHA and EPA for adult dogs.
Table 1. In adult dogs, EmerAid® Intensive Care HDN™ Canine feeding recommendations are based on predicted resting energy requirements (RER)a
| BW (kg) | BW (lb) | RER (kcal/day) | Feed (G/day)b | Feed (ml/day)c |
|---|---|---|---|---|
| 1 | 2.2 | 70 | 16.8 | 31 |
| 2 | 4.4 | 118 | 28.3 | 52 |
| 4 | 8.8 | 198 | 47.4 | 88 |
| 6 | 13.2 | 268 | 64.2 | 119 |
| 8 | 17.6 | 333 | 79.8 | 147 |
| 10 | 22 | 394 | 94.4 | 174 |
| 15 | 33 | 534 | 128 | 236 |
| 20 | 44 | 662 | 158.6 | 293 |
| 25 | 55 | 783 | 187.6 | 346 |
| 30 | 66 | 897 | 215 | 397 |
| 35 | 77 | 1007 | 241.3 | 446 |
| 40 | 88 | 1113 | 266.7 | 492 |
| 45 | 99 | 1216 | 291.4 | 538 |
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 Intensive Care HDN Canine contains 4.173 kcal/grams (1 scoop = 1 tbsp = 8.5g)
c Recommendations based on 3.5:2 mixing ratio and RER. See our Feeding Example below.
Puppy Feeding Recommendations
Puppies have relatively high energy requirements compared to adult dogs. Begin with 25% to 30% of daily energy 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. Daily energy requirements can be calculated using the following equation [70 x BW(kg)0.75] x 3.
EmerAid® Intensive Care HDN™ Canine meets or exceeds requirements for all life stages with the one exception of docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) levels. When EmerAid HDN is fed to growing animals longer than 1 week, it is recommended the diet be supplemented daily with 1% fish oil (DMB). The NRC recommends a level of 0.13 g/1,000 kcal ME of a combination of DHA and EPA for both puppies.
Table 2. In puppies, EmerAid Intensive Care HDN feeding recommendations are based on predicted daily energy requirements (DER)
| BW (kg) | BW (lb) | Est DER (kcal/day)d | Max Fed (G/day)e | Max Fed (ml/day)f |
|---|---|---|---|---|
| 0.2 | 0.4 | 63 | 15 | 28 |
| 0.4 | 0.9 | 106 | 25 | 47 |
| 0.6 | 1.3 | 143 | 34 | 63 |
| 0.8 | 1.8 | 178 | 43 | 79 |
| 1.0 | 2.2 | 210 | 50 | 93 |
| 1.8 | 4 | 328 | 79 | 145 |
| 2.7 | 6 | 445 | 107 | 197 |
| 3.6 | 8 | 552 | 132 | 244 |
| 4.5 | 10 | 653 | 156 | 289 |
| 6.8 | 15 | 885 | 212 | 392 |
| 9.1 | 20 | 1098 | 263 | 486 |
| 11.3 | 25 | 1298 | 311 | 574 |
| 13.6 | 30 | 1488 | 357 | 658 |
| 18.1 | 40 | 1846 | 442 | 817 |
| 22.7 | 50 | 2182 | 523 | 965 |
| 27.2 | 60 | 2502 | 600 | 1107 |
d Daily energy requirements for puppies less than 4 months of age were calculated as 3 x RER where RER = 70 x BW(kg)0.75
e EmerAid Intensive Care HDN Canine contains 4.173 kcal/grams (1 scoop = 1 tbsp = 8.5g)
f Recommendations based on 3.5:2 mixing ratio and RER.
Feeding Example
Debilitated, anorectic, 6-year-old Golden Retriever weighing 23 kg (51 lb) BCS 3/5
| BW (kg) | BW (lb) | RER (kcal/day) | Feed (G/day) | Feed (ml/day) |
|---|---|---|---|---|
| 20 | 44 | 662 | 158.6 | 293 |
| 25 | 55 | 783 | 187.6 | 346 |
Patient body weight falls midway between the guidelines listed above. Consequently, the recommended volume to feed falls between 293 ml and 346 ml per day. The median value is 320 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 320 ml by 4 gives us approximately 80 ml per feeding. It is important to begin feedings cautiously, with 30% to 50% of this estimated volume for the first feeding: ~24 ml to 40 ml.
| First meal: | 1/3 of calculated energy requirements | ~ 24 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 | ~ 24 ml |
| Second Meal | 2/3 of calculated energy requirements | ~ 48 ml |
| Third meal | 3/3 of calculated energy requirements | ~ 80 ml |
If patient tolerates the increase in frequency and in volume of EmerAid® Intensive Care HDN™ Canine, continue feeding per below:
Daily meals: 80 ml four times/day
Long-Term Feeding
Patients requiring long-term (4+ weeks) nutritional support may remain on EmerAid® Intensive Care HDN™. If the patient is able to tolerate more whole nutrients they may gradually be transitioned to EmerAid® HDN™ Sustain™ Recovery Nutrition, under the direction of a veterinarian. EmerAid® Sustain™ HDN™ Canine is indicated for patients recovering from a critical illness that are not ready for their normal diet.