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GI tract and prevents further deterioration of the mucosal barrier, which is critical in minimizing the translocation of bacteria and toxins that can lead to sepsis. Administering frequent, small meals is key to avoiding overburdening the already compromised GI system. Studies have shown that puppies receiving smaller meal sizes exhibit quicker normalization of GI motility, which is vital for nutrient absorption and overall recovery. For instance, a study by Hall et al. (2003) demonstrated that puppies fed smaller, more frequent meals showed a faster return to normal fecal consistency and reduced time to discharge from veterinary care. 12 This method minimizes the risk of exacerbating GI distress and promotes a quicker recovery, as the GI tract is less likely to experience the strain that can come with larger meal portions. FEEDING METHODS In terms of practical implementation, the route of feeding must be carefully considered based on the severity of the illness and the puppy's ability to tolerate food. In mild cases, puppies may voluntarily consume food, which is ideal. However, in more severe cases, alternative methods such as coax feeding techniques or placing a feeding tube may be necessary. 12,13 While the coax feeding methods of hand or syringe feeding may be effective, they can sometimes lead to food aversion if the puppy associates eating with discomfort, which is not an imprint we want to place upon them. 14 Therefore, the use of feeding tubes is often recommended for puppies that cannot consume sufficient nutrients voluntarily.
Regardless of the feeding method selected, the introduction of nutrition needs to be at a gradual rate to avoid overwhelming the puppy's GI system. Initial feeding often begins at 25% of the resting energy requirement (RER), increasing gradually over several days as tolerated. This cautious approach will also help to prevent refeeding syndrome, a potentially fatal condition that can occur when malnourished animals are reintroduced to food too quickly. 17
SELECTING A DIET Food selection for puppies with CPV-2 involves several
considerations, including the method of feeding, the size and placement of feeding tubes (if used), and practical factors such as the availability and cost of products. Given the wide range of diets available, being mindful of the World Small Animal Veterinary Association (WSAVA) guidelines can help ensure an appropriate choice: 1. Safety: Ensure confidence in the food manufacturer. This includes considering the quality control processes. If you need to prepare the diet access to clean and appropriate utensils or tools such as a blender need to be available 2. Complete and Balanced: Determine whether the diet is complete and balanced for the animal's specific life stage. For growing puppies, it is particularly important that the diet meets all nutritional requirements. If a complete and balanced diet isn't immediately available, a suitable temporary diet may be used for a short period but is not optimal. 3. Rightness for the Patient: Assess whether the diet meets the nutritional specifications needed for a puppy with CPV; it should be highly digestible, energy-dense, and moderate in fat. For voluntarily eating puppies, consider their texture preferences to ensure they will consume the food willingly. For tube feeding, ensure the diet is compatible with the tube size and can flow through it easily without clogging. 3,13,18 Prioritize diets that are highly digestible, energy-dense, and moderate in fat, and that are approved for growth. Palatability becomes a significant factor when the puppy begins eating voluntarily or upon discharge. Fortunately, there are several suitable options, including gastrointestinal veterinary therapeutic diets, critical care diets, and liquid diets, each designed to meet the specific needs of puppies fighting CPV-2, as well as during recovery. While the selection can seem overwhelming, focusing on the key attributes of safety, completeness and suitability can simplify the decision-making process and support the puppy's recovery.
TECHNIQUES TO USE IN COAX FEEDING • Hand feeding (allow them to take from hand) • Syringe feed • Sitting in room with them • Quiet room
• Warming food • Petting and praise • Owner brings in food bowl • Owner brings in favorite foods
Nasoenteric tubes, which include nasoesophageal (NE) and nasogastric (NG) tubes, are less invasive and do not require anesthesia, making them a preferable option for short-term feeding. They are particularly useful for decompressing the stomach and reducing nausea. For longer-term nutritional support, more involved tube places such as esophagostomy, gastrostomy, or jejunostomy tubes that require anesthesia may be necessary. These methods provide reliable and continuous access to the GI tract, ensuring that the puppy receives the necessary nutrients to support recovery. 15-17
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