Factors Associated with Adverse Outcomes during parenteral Nutrition Administration in Dogs and Cats

Abstract

Background: Parenteral nutrition (PN) is increasingly used to support hospitalized dogs and cats. Published assessments of outcome are limited.Objective: Evaluate type and prevalence of complications and risk factors for death and complications in dogs and cats receiving PN.Animals: Three hundred and nineteen dogs and 112 cats that received PN at a teaching hospital between 2000 and 2008.Methods: Retrospective case review. Diagnosis, duration of PN administration, concurrent enteral feeding, death, and mechanical, septic, and metabolic complications were abstracted from medical records. Association of each parameter with complications and death was analyzed by binary logistic regression.Results: Pancreatitis was the most common diagnosis (109/319 dogs, 34/112 cats), and 137/319 dogs and 51/112 cats died. Dogs and cats received 113 AE 40% and 103 AE 32% of resting energy requirement, respectively. Mechanical (81/319 dogs, 16/112 cats) and septic (20/319 dogs, 6/112 cats) complications were not associated with death (P 4 .05). Hyperglycemia was the most common metabolic complication (96/158 dogs, 31/37 cats). Hypercreatininemia in dogs (8/79) was the only complication associated with death (P o .01). Chronic kidney disease in dogs, hepatic lipidosis in cats, and longer duration of inadequate caloric intake before PN in both species were negatively associated with survival (P o .05). Factors positively associated with survival included longer duration of PN administration in both species, enteral feeding in cats with any disease, and enteral feeding in dogs with respiratory disease (P o .05).Conclusions and Clinical Importance: PN can be effectively used to provide the energy requirements of most critically ill dogs and cats. Most complications accompanying PN administration do not affect survival.

Experimental Hyperlipemia Induces Insulin Resistance in Cats

“…In fact, the possibility of a problem in glucose metabolism in human patients undergoing intravenous nutrition has been suggested [17]. Intravenous nutrition has also been associated with hyperglycemia in cats [5,11]. However, the infusion rate of lipids in this study was two or three times higher than the rate typically used in intravenous nutrition in cats.…”

Nutrición clínica de perros hospitalizados: Revisión

“…Aos poucos o desenvolvimento de técnicas adequadas e os estudos metabólicos e nutricionais permitiram que esse meio de fornecimento de nutrientes, considerado tão utópico, se tornasse realidade PUBVET v.11, n.9, p.901-912, Set., 2017 (Dudrick, 2009). A NP é mais cara do que a NE e tem seu uso restrito ao ambiente hospitalar devido à necessidade da implantação de cateter colocado em condições assépticas (Chan, 2009 , Chan, 2009, Queau et al, 2011, Mansfield et al, 2011.…”

“…A NP é classificada como total (NPT) quando fornece 100% das necessidades de nutrientes e calorias ou como parcial (NPP), ao fornecer apenas uma fração das necessidades nutricionais diárias de um animal (Queau et al, 2011). A NP permite a recuperação de pacientes em estado crítico por fornecer calorias para atividades fundamentais na recuperação do animal, como o sistema imune e a cicatrização (González Domínguez et al, 2008), sendo de extrema importância estabelecer o equilíbrio ácido básico e hidratar o paciente antes de iniciar o suporte de NP, pois podem desenvolverem-se transtornos metabólicos graves.…”

“…Já as complicações metabólicas foram definidas como variáveis bioquímicas ou hematológicas comparadas com os valores de referência normais e classificadas com hiper (valores bioquímicos maiores que os de referência para a espécie) e como hipo (valores bioquímicos menores que os de referência para a espécie). Exemplos de possíveis complicações metabólicas incluem hipocalemia, hiperglicemia, hipomagnesemia, hipofosfatemia e lipemia (Queau et al, 2011, Liu et al, 2012.…”

“…A monitoração frequente dos sinais vitais, das condições do cateter e a realização de exames bioquímicos permitem ao clínico antecipar e/ou diagnosticar precocemente várias complicações. Um método eficiente de evitar contaminações consiste em evitar desconexões desnecessárias do cateter, além da troca da bolsa de solução e todos os componentes do sistema de administração diariamente , Chan, 2009 (Queau et al, 2011).…”