When cats have illnesses that wreak havoc on their gastrointestinal system, it can be impossible to feed them. They often refuse to eat on their own, and “assisted” feeding methods like syringe feeding, nasogastric tubes, and tubes that are surgically placed into the esophagus, stomach, or small intestine aren’t always successful.
Good nutrition is necessary for optimal healing. Add this to the fact that cats who aren’t taking in adequate amounts of food are at high risk for hepatic lipidosis, a disease that can be fatal in and of itself, and you can see how critical it is that sick cats get all the nutrients they need.
When enteral feeding (food delivered into the gastrointestinal tract) is not sufficient to support a sick cat, it is time to consider parenteral feeding (nutrients are delivered through a catheter into a cat’s vein). But let me be clear… if the gut works, we should be using it. Enteral feeding is always superior to parenteral (intravenous) feeding.This is true for many reasons, not the least of which is the fact that parenteral feeding is not without risk
A study published in 2006 looked at the frequency of complications associated with parenteral nutrition in cats. The researchers looked at all the cats (40) who received total parenteral nutrition at Tufts University between 1991 and 2003. The term total parenteral nutrition (TPN) means that all of the cat’s nutritional needs were included in the intravenous solution. This is in contrast to partial parenteral nutrition in which only those nutrients that can’t be delivered through enteral feeding methods are included in the intravenous solution.
The most common health crises that led to cats needing total parenteral nutrition were liver disease (16), gastrointestinal disorders (10), and pancreatitis (8). The cats received TPN for an average of 3.7 days (the range was from just over 7 hours to 9.5 days).
More than half the cats (26) experienced one or more complications associated with receiving TPN. The most common types of complications (33) were categorized as being “metabolic,” the most frequent of which was an abnormally high blood sugar level. Twelve instances of mechanical complications (e.g., the catheter becoming dislodged or tissue around the catheter becoming inflamed) were also noted. Interestingly, no cases of sepsis (blood infection) occurred, and when I was in veterinary school this was the complication we were taught to fear most with regards to TPN.
The authors state:
Most complications were mild and did not require discontinuation of TPN or adjustment of formula…. Neither the presence nor number of complications impacted the duration of hospitalization or outcome.
The take home message? When it’s needed, parenteral nutrition can be a lifesaver, and the risks associated with it can usually be managed.
Retrospective Evaluation of Total Parenteral Nutrition in Cats: 40 Cases (1991-2003). Sara E. Crabb, Lisa M Freeman, Daniel L Chan, Mary A Labato. J Vet Emerg Crit Care. June 2006;16(2):S21-S26.
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