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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

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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