Investigation of the percentage of prescribed enteral nutrition actually delivered to hospitalized companion animals

Abstract

Objective: To investigate the percentage of prescribed enteral nutrition that is actually delivered; the percentage of goal feeds [defined in terms of the animal's estimated resting energy requirement (RER)] that are delivered; and the reasons animals are under or overfed in a small animal teaching hospital. Design: Prospective investigation. Setting: Matthew J. Ryan Veterinary Hospital of the University of Pennsylvania. Animals: All dogs and cats that received tube feeding while admitted to the Ryan Veterinary Hospital during the months of August-December 2003. Interventions: The medical record for each animal was reviewed to determine the feeding prescription, the amount of tube feeds actually delivered, and any reasons why the amount delivered differed from the amount prescribed. The amount prescribed was also compared with the animal's goal feeds which were defined for a patient as 50% RER/day on the first day of feeding and 100% RER/day for the remaining days of hospitalization.Main results: Twenty-five animals (23 cats and 2 dogs) were enrolled in the study. Animals received a median of 91% (range: 68-100%) of their prescribed feeds/day and a median of 90% (range: 36-133%) of goal feeds/ day. Nausea or vomiting and conflict with other treatments were the most common recorded reasons for incomplete feeds. Conclusions: Both prescribed and goal feeds were delivered to the animals in this investigation with a good rate of success. Consultation with the Nutrition Support Service improved the likelihood that prescribed feeds would meet the animal's estimated RER.(J Vet Emerg Crit Care 2006; 16(2)(S1): S2-S6)

Clinical experience utilizing a novel fluoroscopic technique for wire‐guided nasojejunal tube placement in the dog: 26 cases (2006–2010)

“…Veterinary patients with critical illness are often partially or completely anorexic and in need of nutritional support. The importance of nutritional support in critically ill small animal patients is widely accepted 1–5 . Although some debate still exists, the advantages of enteral nutritional (EN) support when compared with methods of parenteral nutritional (PN) support are well documented in critically ill people 6–8 .…”

Continuous versus intermittent delivery of nutrition via nasoenteric feeding tubes in hospitalized canine and feline patients: 91 patients (2002-2007)

“…Studies in human and veterinary patients have shown a discrepancy between the amount of nutrition prescribed by the clinician, and the amount actually delivered to the patient 1,2,6,8 . Identification of causes for this discrepancy has been the focus of multiple studies 1,2,4,6,8–12 . In both veterinary and human studies, cessation of feeding during diagnostic or therapeutic procedures was a common barrier to nutrient delivery 1,2,6,8,12 .…”

Evaluation of jejunostomy tube feeding after abdominal surgery in dogs

“…The fact that estimated RER was met in only 5% of dogs was likely due to slow ramping rate of the constant rate infusion and relatively short period of intrajejunal feeding in the ICU. In contrast, a previous veterinary study of nasoesophageal, esophagostomy, and gastrostomy tubes that set a goal of feeding at 100% RER on the second day of feeding reported that animals received a median of 90% of goal feeds by intermittent bolus feeding via the tube. A faster ramping rate might have increased the number of dogs receiving 100% of estimated RER by the time of discharge.…”