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A Quick Guide to... Feeding Hospitalized Cats
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Rene Dorfelt
DVM, Dip. ECVAA (Anesthesia and Analgesia)
Dr. Dörfelt studied at the University of Leipzig, Germany, qualifying in 2003. After completing a dissertation on hemodialysis and an internship at the Small Animal Clinic of the Freie Universität Berlin, he worked at the Norderstedt Veterinary Clinic in Germany from 2005-2007 before undertaking a residency in anesthesia and analgesia at Vienna’s University of Veterinary Medicine. Since 2011 he has been head of the Emergency and Critical Care Service at the Medical Small Animal Clinic of Ludwig Maximilian University in Germany.
When should a cat be fed?
- Basically, as soon as possible!
- If anorexia is or may be present for more than 3 days
- In kittens after a few hours of anorexia
- As soon as cardiovascular and hemodynamic parameters are stable; major electrolyte abnormalities such as hyperkalemia should be corrected before feeding commences
- Within 24 hours of presentation
- Within 6-12 hours following gastrointestinal surgery
What diet should be offered?
- Tasty food with a pleasant odor
- Consider starting with some “treats” to stimulate appetite
- A critical care diet with high energy and high protein content
- Food should be at room temperature
How should the cat be fed?
- Enteral if possible
- Partial parenteral if enteral nutrition does not provide adequate energy intake
- Parenteral nutrition if enteral nutrition is not possible
What is the best way to stimulate appetite?
- Use highly palatable food
- Create a cat-friendly, calm environment with soft, warm bedding and a place to hide
- Make sure the cat is not in pain; administer analgesia as appropriate
- Give anti-emetics and gastric protectants if the cat appears nauseous
- Appetite in cats is stimulated by smell; clean the cat’s nose if obstructed with mucus or other material
- Offer fresh food at room temperature on a regular basis
What about appetite-stimulating drugs?
- May be used if conventional techniques do not work
- Cyproheptadine is an H1-antihistaminic drug (1-4 mg/cat every 12-24h PO)
- Mirtazapine is a 5-HT3 antagonist (3-4 mg/cat every 3 days PO)
- Benzodiazepines (e.g., midazolam) may be used as a short-term option if other drugs fail. They may induce appetite at a very low dose (0.05 mg/kg IV) but may also cause sedation. However, hepatic failure has been described after giving diazepam to cats
What if the cat will not eat?
- Careful force-feeding using a syringe may be carried out if other techniques fail. It may also be beneficial to put some food on the cat’s paws, as the cat may lick it off whilst trying to clean itself
- Feeding tubes should be used if enteral feeding is possible, but the energy requirements are not fulfilled by spontaneous food intake
Naso-esophageal feeding tube
- Easy to place without general anesthesia
- Can be removed whenever required
- Usable for three or more days
- Only suitable for liquid diets
Materials required:
- Feeding tube 4.5-6 FG
- Lidocaine-containing lubricant
- Suture material
- Needle holder
- Scissors
Placement technique:
- Place some lubricant on the lower nasal meatus and at the tip of the tube (Figure 1) [...]
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