Post on 25-Aug-2020
wsava.org
When to intervene in a hospitalized patient
Days of anorexia/hyporexia (include days of anorexia/hyporexia at home)
5 days: Nutritional support is required! Place feeding tube or initiate parenteral nutrition. 3-4 days: Nutritional support likely needed if recovery is not imminent. Consider feeding tube placement if patient will be anesthetized. 1-2 days: Write feeding orders, monitor food intake and clinical condition daily. Note: If the patient is already malnourished, nutritional support should be instituted as soon as hemodynamically stable.
Create a plan for hospitalized animals:
Create a feeding plan (ie, diet, route, amount, and frequency). Goal is to meet resting energy requirements (RER), although it may take 2-3 days to reach RER.
1. If able to eat, try voluntary oral feeding or coax feeding. Write specific feeding orders: “Feed 1/4 can Diet X orally q 6 hrs.” (diet, route, amount, frequency)
2. Monitor intake. If adequate intake is not achieved orally, assisted feeding techniques are needed:
Feeding Guide for Hospitalized Dogs and Cats
Patient anoretic orunable to eat
Upper GI tractnon-functional
Jejunostomy tube
Patient notmalnourished and
anorexia likelyfor<5 days
Patient notmalnourished and
anorexia likelyfor>5 days
Enteral nutritionlikely
for<5 days
Enteral nutritionlikely
for>5 days
Upper GI tractfunctional
Entire GI tractnon-functional
Reassess daily forneed for parenteralnutrition (3-5 days
anorexia)
Parenteralnutrition
Nasoesophageal/nasogastric tube
Patient anoretic orunable to eat
Patient anoretic orunable to eat
Laparotomyindicated
Surgicalgastrostomy tube
Laparotomynot indicated
PEG oresophagostomy
tube
© World Small Animal Veterinary Association (WSAVA) 2013. All rights reserved.wsava.org
Weight* (kg)
1.0
1.5
2.0
2.5
3.0
3.5
4.0
4.5
5.0
5.5
6.0
6.5
7.0
7.5
8.0
8.5
9.0
9.5
10.0
11.0
12.0
13.0
14.0
RER (kcals/day)
70
95
118
139
160
179
198
216
234
251
268
285
301
317
333
348
364
379
394
423
451
479
507
Weight *(kg)
15.0
16.0
17.0
18.0
19.0
20.0
22.5
25.0
27.5
30.0
32.5
35.0
37.5
40.0
42.5
45.0
47.5
50.0
52.5
55.0
57.5
60.0
RER (kcals/day)
534
560
586
612
637
662
723
783
841
897
953
1007
1061
1113
1165
1216
1267
1316
1365
1414
1462
1509