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Written by leading veterinarians to provide you with the information you need to care for your pets.

Your dog's nutrition is important for a healthy & happy life. petMD experts help you to know what to feed your dog, how much food to feed, and the differences in dog foods, so your dog gets optimum nutrition.
Nutrition Nuggets is the newest offshoot of petMD's Dog Nutrition Center. Each week Dr. Coates will use her expertise and wisdom to blog about the intricacies of dog nutrition.

Feeding the Critically Sick, Injured, or Recovering Dog

March 28, 2014 / (3) comments

We all know that good medicine helps to bring a return of good health, but good nutrition is just as important.


Dogs who are fighting their way through a critical illness, have had extensive surgery, or have sustained a major injury need calories and nutrients to recover optimally. When nutritional needs are not met, dogs enter into a negative energy state and begin to lose lean body mass in the form of protein from muscle tissue. This is because sick animals cannot make the adaptive responses necessary to utilize fat for energy like healthy animals do. This negative energy balance can also result in digestive tract dysfunction, organ dysfunction, poor immunity, poor wound healing, and possibly death.


Critical care diets have been developed to deliver the nutrients that recovering animals need. They are:


  • highly palatable (tasty)
  • highly digestible (little waste produced)
  • nutritionally dense (a little goes a long way)
  • have added electrolytes (e.g., potassium) for replacement of losses


Critical care diets have increased calories, protein, and fat, and reduced carbohydrate levels as compared to maintenance diets. They are meant to be fed during states of illness and recovery and not for long term feeding. However, in the severely ill dog, or when there is an “end-of-life” situation, continued feeding of a critical care diet may help deal with appetite loss and ward off a quicker decline that comes with inadequate nutrition.


Enteral feeding (through the digestive tract) is the best way for dogs to receive their nutrition. If the patient will eat, oral feeding is the way to go. Appetite stimulants and anti-nausea medications can help improve the appetite. If the dog will not eat and the digestive tract is healthy, a feeding tube should be placed. Long term feeding is possible through a feeding tube. In rare cases, severe digestive tract dysfunction may necessitate parenteral feeding. This means the dog will receive a sterile mixture of basic nutrients through a central intravenous line directly into the bloodstream.


Two types of critical care diets can be used for enteral feeding:


1) Liquid or modular diets

  • Made up of small molecules (e.g., small peptides, medium and long chain fatty acids, mono/di/tri-saccharides)
  • Easier to use with small-diameter feeding tubes
  • May cause diarrhea
  • More expensive


2) Blended foods

  • More palatable
  • Less expensive
  • Less likely to cause diarrhea
  • Must be thinned with water and blended well to reduce the risk of clogging the feeding tube


Many manufacturers make critical care diets. Veterinarians tend to have a favorite brand, usually one that they have had success with in the past, but if that product isn’t working for a particular individual other brands should be given a try.


Veterinary nutrition has seen many advances in recent years. Critical care diets are a great help when it comes to providing optimal nutrition for recovering pets.


Dr. Jennifer Coates



Freeman, L.M. (2012) Critical Care Nutrition. Presented at the 64th Convention of the Canadian Veterinary Medical Association, Montreal QB, Canada.


Image: Thinkstock


Comments  3

Leave Comment
  • Critical Care Diets
    03/28/2014 08:47pm

    I'm a firm believer that when there is no cure, the critter should eat whatever it would like. I know that critical care diets cannot be fed in lieu of a maintenance diet, but if any meal might be a "last meal," they should have anything they want.

    What little experience I've had with stomach tubes makes me think they're pretty nifty. I once baby-sat a cat that had a stomach tube during chemo treatments and it was quite simple and the cat was happy as a clam.

    Do you think it would make a difference if the animal was high-energy and could possibly dislodge the cap on the tube? (Of course, the high-energy part would probably be unlikely since the critter must be pretty sick to have a stomach tube.)

  • 04/08/2014 03:22pm

    I've always been able to bandage feeding tubes in such a way that even when the patients are feeling better and their activity levels increase, the tubes stay put... most of the time, at least.

  • Care of feeding tubes
    04/21/2014 04:11pm

    Hello, I am a CVT who works with people all time that have pets with feeding tubes. I recently published a book entitled The Feel Better Book for Cats & Dogs - Nursing Care for All Life Stages. Included in the book is a chapter (written with the help of a veterinary internal medicine specialist and her technician) devoted to in home care of feeding tubes and detailed instruction on feeding. The entire book has been reviewed for content by multiple veterinarians and contains info on other aspects of nursing care including feeding, medicating, good hygiene, encouraging water consumption and giving SC fluids, first aid, senior care, end of life decisions and very importantly - when to seek veterinary care. Thank you for letting me pass this information on to you and your readers. Also, I love the topics you write about!




Photo of Jennifer

... graduated with honors from the Virginia-Maryland Regional College of Veterinary Medicine in 1999. In the years since, she has practiced veterinary medicine in Virginia, Wyoming, and Colorado. She is the author of several books about veterinary medicine and animal care, including the Dictionary of Veterinary Terms, Vet-Speak Deciphered for the Non-Veterinarian .

Jennifer also writes short stories that focus on the strength and importance of the human-animal bond and freelance articles relating to a variety of animal care and veterinary topics. Dr. Coates lives in Fort Collins, Colorado with her husband, daughter, and pets.