Parenteral nutrition in dogs: when and how

Question

6-year-old crossbreed dog with severe acute pancreatitis that is still vomiting after 4 days of combined antiemetics. He does not tolerate even small volumes by tube and has hardly eaten for a week.

Which statement about parenteral nutrition is correct?

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A. It is preferable to enteral feeding in any pancreatitis because it rests the pancreas

Enteral nutrition is the first choice whenever it is tolerated: it maintains the intestinal mucosa and has fewer complications. Parenteral nutrition is reserved for when enteral feeding is not possible.

B. It can be given through the same catheter as drugs and blood if it is flushed well between uses

Parenteral nutrition is an excellent culture medium: it needs a dedicated lumen, placed and handled aseptically, to reduce the risk of catheter-related sepsis.

C. It is indicated when the enteral route is not possible or not tolerated; it requires a catheter (ideally central) with a dedicated lumen, and its most common complication is metabolic, such as hyperglycaemia

Correct. As well as hyperglycaemia, monitor electrolytes (including refeeding syndrome) and triglycerides. If possible, maintain minimal enteral nutrition to protect the intestinal mucosa.

D. Partial parenteral nutrition via a peripheral vein easily covers 100% of requirements

To avoid damaging the vein, peripheral parenteral nutrition must have a low osmolarity, so it covers only part of RER and is intended for short periods.

lightbulb Key takeaway

Use the enteral route whenever possible and the parenteral route only when it fails. Parenteral nutrition requires strict asepsis, a dedicated catheter lumen and frequent monitoring of glucose, electrolytes and triglycerides.

Which statement about parenteral nutrition is correct?

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