Objective: The purpose of this retrospective study was to evaluate the use of total parenteral nutrition (TPN) in cats, to determine the frequency of complications, and to evaluate risk factors for complications.
Design: The medical records of all cats receiving TPN at Tufts University between 1991 and 2003 were reviewed using a standardized data sheet.
Setting: University hospital.
Animals: Forty cats that received TPN were included in the analysis.
Measurements and main results: Complications were classified as metabolic (e.g., hyperglycemia, hypokalemia), mechanical (e.g., catheter dislodgement, cellulitis), or septic (e.g., clinical suspicion of sepsis, in combination with a positive catheter culture). The most common underlying diseases were hepatic disease (n=16), gastrointestinal disorders (n=10), and pancreatitis (n=8). Median duration of TPN administration was 3.7 days (range, 0.3–9.5 days). Of the 40 cats receiving TPN, 26 experienced at least one complication with a total of 45 complications overall. These included metabolic (n=33) and mechanical (n=12). No cases of sepsis were documented. The most common metabolic complication was hyperglycemia (n=9). Most complications were mild and did not require discontinuation of TPN or adjustment of formula. Cats provided with energy above the resting energy requirement (RER) were more likely to develop hyperglycemia than those using RER as the initial calorie goal (P=0.02). Neither the presence nor number of complications impacted the duration of hospitalization or outcome.
Conclusions: A more conservative estimate of energy requirements was associated with a lower risk of hyperglycemia. Future studies are warranted to determine the optimal formula and efficacy of TPN in cats.