Therapeutics: nutrition

Parenteral nutrition

• Nutritionally adequate substitute    where oral intake not possible, insufficient or contraindicated over long period.
• Enteral nutrition (eg via naso-esophageal, esophagostomy    , or gastrostomy tube    ) always preferable whenever possible. Enteral nutrition reduces the risk of gut mucosal trophy and bacterial translocation.
• Based on high concentrations of glucose or lipid emulsions for calories, soya or casein protein hydrolysates or amino acids for protein source.
• Provide daily energy requirements as 60-90% carbohydrate, 60-90% lipids; increase calorie requirement by 50% in ill or trauma patients.
• Requirements vary depending on condition treated - see specific clinical condition.
• Give only IV via central veins.
• Daily calorie requirements:
  • Basal energy requirement (kcal/day) = 30 x bodyweight (kg) + 70.
• Partial parenteral nutrition (only meeting part of total daily caloric needs) can be provided with IV amino acids or IV lipid emulsions; peripheral vein can be used.

Sources

Publications

Refereed papers

• Recent refereces from PubMed .
• Bennett N et al (2006) Comparison of a low carbohdrate-low fiber diet and a moderate carbohydrate-high fiber diet in the management of feline diabetes mellitus. J Fel Med Surg 8 (2), 73-84 PubMed .

Other sources of information

• Hand et al (2000) In: Small Animal Clinical Nutrition . 4th Edn.