Clinical techniques in small animal practice
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Clin Tech Small Anim Pract · Feb 2004
ReviewNutritional requirements of the critically ill patient.
The presence or development of malnutrition during critical illness has been unequivocally associated with increased morbidity and mortality in people. Recognition that malnutrition may similarly affect veterinary patients emphasizes the need to properly address the nutritional requirements of hospitalized dogs and cats. Because of a lack in veterinary studies evaluating the nutritional requirements of critically ill small animals, current recommendations for nutritional support of veterinary patients are based largely on sound clinical judgment and the best information available, including data from experimental animal models and human studies. ⋯ The first step of nutritional support is to identify patients most likely to benefit from nutritional intervention. Careful assessment of the patient and appraisal of its nutritional needs provide the basis for a nutritional plan, which includes choosing the optimal route of nutritional support, determining the number of calories to provide, and determining the composition of the diet. Ultimately, the success of the nutritional management of critically ill dogs and cats will depend on close monitoring and frequent reassessment.
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Normal gastrointestinal motility is crucial for maintaining an appropriate balance of microorganisms within the gut. Disruption of this system results in bacterial overgrowth and associated complications such as bacterial translocation, aspiration pneumonia, and sepsis. ⋯ The use of promotility drugs in critically ill patients is a safe, effective means to circumvent the problem of gastric atony and improve patient recovery. Understanding the drugs available and their interaction with the receptors involved in neuromuscular transmission within the gastrointestinal tract will aid the clinician in selecting the optimal prokinetic therapy.