Page 290 - WSAVA2018
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 25-28 September, 2018 | Singapore
weight. On day two, feed 2/3-3/4 of this number and on day three, feed the full calories needed for the current weight. For weight gain, gradually increase to the calories needed for the cat’s healthy weight.
Example:
3.4 kg sick cat BCS 3/9, healthy weight 4.0 kg BCS 5/9
3.4 kg X 50 kcal/kg/day = 170 kcal by day 3
170 kcal = 81 ml Eukanuba Maximum Calorie
OR 131 ml of Hill’s a/d or Royal Canin Recovery or PVD CN
Day 1 feed 30-40 ml of Max Cal or 44-65 ml of the other diets
Day 2 feed 54-61 ml of Max Cal or 87-98 ml of the other diets
Day 3 feed 81 ml Max Cal or 131 ml of the other diets.
Once stable, gradually increase to meet caloric requirements for 4 kg healthy weight.
4 kg X 50 kcal/kg/day = 200 kcal (95 ml Max Cal vs.154 ml of the other diets).
With surgically placed tubes there is a delay in how quickly one can start to use them; with an esophageal tube only a 2-3 hour delay is required to ensure full recovery from anaesthesia whereas gastrostomy
and jejunostomy tubes require a longer wait of 10-12 hours. Cats can eat with any of these tubes in place. It
is recommended to avoid offering food for a week to reduce the likelihood of them developing aversion to the food offered. Once a cat is eating well with tube
in place the question becomes when one can remove the tube. Weigh the cat and, as long as he/she is eating well, avoid using the tube (for nutrients) for a week then reweigh the kitty. If the weight is stable (or increased), then it is safe to remove the tube. Because of stoma formation (except nasoesophageal tubes), removal does not require anaesthesia. Remove the suture (purse-string or stay sutures) and pull the tube out. In the case of a gastrostomy tube, its bulb must be straightened out the bulb/balloon by inserting a straight probe through the tube while concurrently pulling the tube out. Suturing
is not required for any of the skin openings. Cleanse minimal serous discharge that may occur for 2-3 days.
Feeding frequency: the number of feedings per day, (and hence intervals), is determined based on the volume of food tolerated per feeding. Start with 6 ml and increase by 6 ml increments to about 36-48 for most cats. In the uncommon case of the patient who cannot tolerate
even 6 ml boluses despite antiemetic therapy (see Pancreatitis notes in these Proceedings), trickle feeding may be instituted. Trickle feeding is a technique in which liquefied food is syringed into an empty fluid bag and administered gravitationally or by pump assistance via an
intravenous line attached to the large bore feeding tube or by use of a large syringe filled with food and syringe pump. Renew food and delivery tubing and syringe
at 12-hour intervals to avoid bacterial contamination.
A promotility agent may be warranted as well. A
good client reference is the Animal Medical Center of Canberra’s website: www.animalmedicalcentre.com.au => Pet Health => Articles => Cats => Tube feeding.
The success of assisted feeding is measured objectively by weight gain. Subjective measures will include improved coat quality, increased energy, muscle recovery and innumerable other effects that the client will appreciate. An improved quality of life is the goal whether recovery form the underlying problem is possible or not.
Table 1: Caloric densities of convalescent diets, for calculating feeding volumes:
ReboundTM: 1 kcal/ml
ClinicareTM: 1 kcal/ml
Royal Canin/MediCal RecoveryTM: 1.23 kcal/ml
Hill’s a/dTM: 1.3 kcal/ml
Purina PVD CNTM: 1.23 kcal/ml
Eukanuba Maximum CalorieTM: 2.1 kcal/ml
Please email me if you would like the video of how to place an e-tube or for the using a feeding tube video.
SUGGESTED READING
Hodshon B, Tobias K. Esophagostomy Feeding Tubes Clinicians Brief February 2014 (www.cliniciansbrief.com/ article/esophagostomy-feeding-tubes)
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43RD WORLD SMALL ANIMAL VETERINARY ASSOCIATION CONGRESS AND 9TH FASAVA CONGRESS































































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