VETTECH U 2024 / HOUSTON, TX
LIFELINES: THE CRITICAL ROLE OF TUBE FEEDING (CONT.)
Sponsored by
SATURDAY AM • SEPTEMBER 21
KARA M. BURNS, MS, MEd, LVT, VTS (NUTRITION) PRESIDENT, PET NUTRITION ALLIANCE
and fats are provided by medium chain triglycerides (MCT) or vegetable oil. These foods require normal digestive processes and are appropriate for most veterinary clinical situations, especially when a small tube (<8 Fr.) has been placed and specific nutrient profiles are needed (e.g., low sodium, high protein, soluble fiber). One of the leading liquid veterinary foods is a polymeric form that meets the current AAFCO nutrient allowances for adult dogs and cats. This product is a homogenized liquid containing 1 kcal/ ml and is usually accepted better than human liquid products containing MCT oil. This liquid food is the best option currently available in North America when small-diameter nasogastric and jejunostomy feeding tubes have been placed, or when continuous drip feedings are necessary. Historically, these polymeric foods have caused diarrhea in cats after 24 hours of feeding. However, the manufacturer recently reformulated the product to reduce the incidence of diarrhea. The number of osmotically active particles was decreased by replacing a small-chain maltodextrin source with a larger-chain maltodextrin, and the casein source no longer contains lactose, thereby eliminating a lactase degradation process. Several liquid milk replacer products are available; however, these products are not appropriate to feed to adult dogs and cats. They typically contain lactose, have high osmolarity, are lower in caloric density and do not meet AAFCO nutrient allowances for adult animals. Module products are concentrated powder or liquid forms of nutrients and are primarily supplemental. These products may be added to a liquid product to increase the concentration of a specific nutrient. There are protein, fat and carbohydrate modules (e.g., casein powder, vegetable oil, or corn syrup). For example, a protein modular product may be added to a human liquid product for an animal with high protein requirements. Soluble fiber can be added to these foods using psyllium husk fiber or pectin; however, these fibers may block the small side ports in 8-Fr. and smaller tubes.
Blended pet foods refer to commercial products nutritionally complete and balanced according to AAFCO allowances for dogs and cats. These products can easily be blended with a liquid to make a consistency that flows through a feeding tube. Some products have a blended texture, a high water content and very small particle size, whereas others are products that must be blenderized with water and may have to be strained to remove particulate matter. The best recommendation when using the blended pet food method is to use a product that has been tested in feeding trials and is proven to be balanced and complete for dogs or cats. 5 These products are more readily available, better tolerated, and less expensive than human liquid foods. These pet food products contain essential amino acids and essential micronutrients properly balanced to the caloric density of the food. Fewer medical complications (e.g., diarrhea) are likely to result. However, blended products are more likely to plug the feeding tube if the tube is not properly flushed after feeding. Patients may later consume the pet food orally, eliminating a diet change when the patient's appetite returns, and the tube has been removed. These products are appropriate for patients in catabolic states that are using fat and protein substrates from body stores. When using small-diameter (<8 Fr.) feeding tubes, it will be necessary to dilute the pet food with water, which dilutes the caloric density. Blenderized moist veterinary therapeutic foods may have a place in assisted feeding of patients with specific disease conditions. Veterinarians have fed human baby food packed in jars because some canine and feline patients would voluntarily eat these products. The meat and/or egg baby foods are high in protein (30 to 70% DM) and fat (20 to 60% DM), which compares favorably with blended pet food products. However, baby foods are more costly, contain only one or two food types (protein, protein/grain) and do not contain a balanced mixture of other essential nutrients (amino acids, vitamins and minerals). For example, these products contain
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SEPTEMBER 20-22, 2024 | PROCEEDINGS | VETGIRLONTHERUN.COM
VETTECH U
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