Topic 9: Enteral and Parenteral Nutrition

Question 1

What is one of the main conditions we are trying to prevent by offering a patient optimal nutrition?

Answer 1

• starvation -metabolisation of own muscle

Question 2

When are we required to intervene with an animals nutrition?

Answer 2

• anorexia lasting longer than 3 days
• serious underlying disease is present
• large protein losses

Question 3

What are the main considerations for nutrition?

Answer 3

• Energy requirement – although a sick animal require less energy for exercise and basic metabolism, they will have an increased requirement due to stress and disease.
• Type of food – sick animals often have a reduced desire to eat, therefore, it is important to make sure that any food they do eat is highly palatable, energy dense and stimulate the animals sense of smell.
• Route of administration – Nutritional support can be by the enteral route or the parental route.

Question 4

What is enteral feeding?

Answer 4

• nutrition which makes use of GIT; directly into GIT

Question 5

List different methods of enteral feeding

Answer 5

• offering food
• hand feeding
• force feeding (placing directly in mouth)
• syringe feeding
• tube feeding

Question 6

What is an enteral nasoesophageal tube?

Answer 6

• placed in nose
• relies on upper portion of GIT to be operating
• Short term <5 days
• liquid diet

Question 7

What is an enteral oesophageal tube?

Answer 7

• surgical placement into distal oesophagus thru skin
• long term (months)
• calorie dense diets may be used
• can cause cellulitis if removed early
• need anaesthesia for placement

Question 8

What is an enteral gastrostomy/PEG tube?

Answer 8

• long term (years)
• placed surgically or percutaneously via endoscope (PEG) thru left abdominal wall
• calorie dense diet
• cannot be used in animals w/ primary gastric disease

Question 9

What is an enteral enterostomy (duodenostomy or jejunostomy) tube?

Answer 9

• long term
• cannot be maintained at home, patient must be hospitalised
• used when stomach or duodenum must be bypassed, or pancreatic disease
• inserted into SI via surgical laparotomy
• small bore tube
• constant rate of infusion of nutrition

Question 10

What is parenteral nutrition?

Answer 10

• given directly into the circulation through intravenous access.
• An indwelling catheter can be placed either central i.e. through the jugular or peripheral i.e. through the cephalic/saphenous vein.

Question 11

Indications for parenteral nutrition?

Answer 11

• protracted vomiting
• acute pancreatitis
• severe malabsorptive disorders
• severe ileus.

Question 12

Problems w/ parenteral nutrition?

Answer 12

• expensive
• requires strict asepsis
• needs careful monitoring of blood glucose levels.

Question 13

What does a parenteral nutrition formula contain?

Answer 13

Parental nutrition usually contains a formulation of dextrose, amino acids and lipids, vitamins and minerals for IV delivery.