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.