M.A. Brunetto; M.O.S. Gomes; E. Teshima; J.T. Jeremias; S.P. Nogueira; R S. Vasconcellos; A.C. Carciofi
The goal of nutritional support in any hospital should be to deliver adequate calories to patients that are already malnourished and to minimize the development of malnutrition in those patients that are at-risk. This study investigates the effects of assisted nutritional support on hospital outcome in dogs and cats, and the correlation between hospital outcome and caloric intake, body condition score and nutritional support type used. From March 2003 to December 2005, retrospective analysis of nutritionally managed hospitalized animals (467 dogs and 55 cats) was performed in the Teaching Veterinary Hospital of the São Paulo State University, Jaboticabal - Brazil. The following measurements were recorded for each patient: caloric intake, body weight at admission and discharge, body condition score, physical status score and type of nutritional support employed. All patients had their maintenance energy requirement (MER) calculated, received a high-protein and high-energy diet, had their caloric ingestion monitored, and received enteral and parenteral nutritional support when necessary. The statistical analysis of the results included chi-square and Spearman's correlation. The animals had a mean caloric intake of 52.7±31.5% of their maintenance energy requirement (MER), and caloric intake was positively associated with hospital discharge (p < 0.05). Animals that received less than 33% of their MER had a discharge rate of 62.7% whereas those receiving more than 67% of their MER had a discharge rate of 93.2% (p < 0.001). Outcome was dependent on body condition score (BCS) with discharge rates of 73% for animals with low BCS, and 84.7% for those at an ideal BCS or overweight (p < 0.01).
Sixty-four percent of animals showed voluntary food intake (92.9% discharged, 64.8% in positive caloric balance [CB]), 19.0% received enteral support (71.8% discharged; 59.2% positive CB), 7.0% were forced fed (75.0% discharged; 27.7% positive CB), 6.0% received parenteral support (61.9% discharged; 46.3% positive CB) and 4.0% did not receive calories (38.4% discharged), demonstrating an association between the type of nutritional support, caloric balance and outcome (p < 0.01). Supplementation of calories, even if modest and close to the energy needs at rest appears to be positively associated with the rate of hospital discharge. The body condition of the animal was associated with discharge rate; animals without body reserves, in weight loss or cachexia condition, showed greater mortality.