Caroline S Mansfield is presently affiliated with the Faculty of Veterinary Science, University of Melbourne, Werribee, VIC, Australia. The study was performed at Murdoch University, with laboratory assistance from Murdoch University Clinical Pathology Laboratory, Royal Perth Hospital, ScheBo Biotech Germany, and The GI Laboratory, Texas A&M University. The work was presented as an abstract at ECVIM Congress 2009.
A Pilot Study to Assess Tolerability of Early Enteral Nutrition via Esophagostomy Tube Feeding in Dogs with Severe Acute Pancreatitis
Article first published online: 21 MAR 2011
Copyright © 2011 by the American College of Veterinary Internal Medicine
Journal of Veterinary Internal Medicine
Volume 25, Issue 3, pages 419–425, May/June 2011
How to Cite
Mansfield, C.S., James, F.E., Steiner, J.M., Suchodolski, J.S., Robertson, I.D. and Hosgood, G. (2011), A Pilot Study to Assess Tolerability of Early Enteral Nutrition via Esophagostomy Tube Feeding in Dogs with Severe Acute Pancreatitis. Journal of Veterinary Internal Medicine, 25: 419–425. doi: 10.1111/j.1939-1676.2011.0703.x
- Issue published online: 3 MAY 2011
- Article first published online: 21 MAR 2011
- Submitted June 11, 2010; Revised December 26, 2010; Accepted February 1, 2011.
- Nutrition-small animal;
- Pancreatic necrosis;
- Total parenteral nutrition
Background: The putative role of the gut in amplification of systemic inflammation in acute pancreatitis is gaining credence, and intraluminal nutrition has been shown to decrease inflammation in experimental models of pancreatitis. Prepyloric feeding often is used in people with acute pancreatitis, but has not been evaluated in dogs.
Hypothesis: Early intervention with enteral nutrition (EN) delivered proximal to the pylorus will be well tolerated in dogs with acute pancreatitis and provide justification for further larger trials.
Animals: Ten dogs with severe acute pancreatitis in an open-label, prospective pilot study.
Methods: Dogs were treated with plasma transfusion and standard care, and then consecutively assigned to receive either EN via esophagostomy tube feeding or parenteral nutrition (PN). Outcome was used to determine optimal study size for future studies, and complications were compared between the 2 groups.
Results: A significantly greater number of vomiting or regurgitating episodes occurred in dogs receiving PN. The dogs receiving EN did not demonstrate any noticeable postprandial pain. There were more catheter-related complications in the PN group. There was no difference in outcome between the 2 treatments, and 43 dogs for each treatment would be required in future studies to determine a difference in outcome.
Conclusions and Clinical Relevance: Early EN delivered proximal to the pylorus is well tolerated in dogs with severe pancreatitis and resulted in fewer complications than PN. Prospective trials in a larger cohort are justified to fully establish the potential benefit of early EN, preferably compared with minimal enteral nutrition.