Premium
Evaluation of a novel non‐surgical post‐pyloric feeding technique in dogs with severe acute kidney injury
Author(s) -
Hinden Sandro E.,
Schweighauser Ariane,
Francey Thierry
Publication year - 2020
Publication title -
journal of veterinary emergency and critical care
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.886
H-Index - 47
eISSN - 1476-4431
pISSN - 1479-3261
DOI - 10.1111/vec.12955
Subject(s) - medicine , interquartile range , pylorus , feeding tube , prospective cohort study , surgery , anesthesia , stomach
Objectives To evaluate the placement and the performance of a new post‐pyloric feeding (PPF) system, and compare it to esophageal (E) feeding in dogs with severe acute kidney injury (AKI). Design Prospective study. Setting University teaching hospital. Animals Twenty client‐owned dogs with severe AKI treated with hemodialysis. Interventions Dogs were randomly assigned to 2 feeding techniques, PPF or E feeding; for PPF, an 8‐Fr jejunal (J) tube was introduced through a standard 18‐Fr E‐tube and advanced endoscopically through the pylorus. A commercial liquid diet was administered at a continuous rate for at least 5 days. After the removal of the internal J‐tube, feeding was continued through the E‐tube. Control dogs were fed blended food 5 times daily through an E‐tube. Placement technique, nutritional efficiency, and metabolic response to nutritional support were compared between the groups. Measurements and main results Feeding tubes were placed a medium of 1 day (interquartile range, 0.8 d) after presentation. Median procedure‐time in the group PPF was 26.5 min (11.5 min), including 8.5 min (2.7 min) for the E‐tube and 17.5 min (5.0 min) for the J‐tube. J‐tubes were used for 5 days (1.5 d) with oral displacement observed in 3/10 dogs. The goal to administer 130% resting energy requirement within 3 days was reached in 13/20 dogs (8/10 PPF, 5/10 E). Despite nutritional support, dogs lost 1.2% body weight per day (1.1%), with no difference between the groups. The metabolic improvement was comparable between the groups, despite marked differences in the diet composition. Conclusions This new feeding technique can be recommended as an efficient method for early nutritional support in dogs with severe AKI. The protein‐energy wasting observed despite active nutritional support suggests, however, the necessity for increased feeding targets or qualitative changes in diet composition for dogs with AKI.