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Nutritional management of acute pancreatitis in dogs and cats

Authors

  • Kristine B. Jensen DVM, MVetMed, MRCVS,

    1. Department of Clinical Science and Services, The Royal Veterinary College, University of London, North Mymms, Hertfordshire, United Kingdom
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  • Daniel L. Chan DVM, DACVECC, DACVN, MRCVS

    Corresponding author
    1. Department of Clinical Science and Services, The Royal Veterinary College, University of London, North Mymms, Hertfordshire, United Kingdom
    • Address correspondence and reprint requests to Dr. Daniel Chan, Department of Clinical Sciences and Services, The Royal Veterinary College, University of London, North Mymms, Hertfordshire, AL9 7TA, United Kingdom. E-mail: dchan@rvc.ac.uk

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  • Dr. Chan is Editor of the Journal but did not participate in the peer review process other than as an author. The authors declare no other conflict of interest.

  • Dr. Jensen's current address is Djursjukhuset Malmö, Cypressvägen 11, 213 53 Malmö, Sweden.

Abstract

Objective

To review current and emerging nutritional approaches in the management of acute pancreatitis (AP) in people, dogs, and cats, and to provide a framework for further investigation in this field.

Data sources

Veterinary retrospective studies and reviews, human prospective clinical trials and reviews, and experimental animal studies focusing on nutritional management during AP.

Summary

Nutritional management is an important part of the treatment plan for patients with AP. In human medicine, the general approach for providing nutrition in patients with AP has changed in recent years and favors enteral over parenteral nutrition with an emphasis on early enteral nutrition (EN). Although there are limited data available, there is increasing evidence in the veterinary literature that supports the beneficial role of EN in AP and contradicts previous assumptions about poor tolerance to enteral feeding in this patient population. Parenteral nutrition may be appropriate alone or in combination with EN as a temporary measure in malnourished patients that do not tolerate adequate EN; however, enteral feeding should be attempted first in most cases. Immunonutrition is being investigated for its positive role in modulating pancreatic inflammation and improving gut barrier function in cases of human AP.

Conclusions

The nutritional management of veterinary patients with AP remains challenging. Based on clinical evidence in people, experimental animal studies, and preliminary studies in dogs and cats, the choice of EN over parenteral nutritional support during AP in dogs and cats appears to be beneficial and well tolerated. Optimization of nutritional therapies in dogs and cats including the use of immunonutrition during AP warrants further investigation.

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