Harris Jessica P, Parnell Nolie K, Griffith Emily H, Saker Korinn E
Departments of Molecular Biomedical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, 27607.
the Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Purdue University, West Lafayette, IN, 47906.
J Vet Emerg Crit Care (San Antonio). 2017 Jul;27(4):425-433. doi: 10.1111/vec.12612. Epub 2017 May 16.
To evaluate the effect of early enteral nutritional therapy on time to return to voluntary intake, maximum food consumption, incidence of gastrointestinal intolerance (GI), and total hospitalization time for dogs with acute pancreatitis.
Retrospective analysis of dogs with pancreatitis at a veterinary teaching hospital between 2010 and 2013.
Thirty-four client-owned dogs diagnosed with acute or acute-on-chronic pancreatitis.
Medical records of dogs evaluated for inappetence, anorexia, and GI for which a diagnosis of pancreatitis was recorded were reviewed. The time to initiation of food offerings since hospitalization were recorded in addition to signalment, historical medical conditions, chief complaint, physical examination findings, diagnostic results, treatments provided, timing of food offering (within 48 h of hospitalization, early feeding group (EFG) versus delayed feeding group (DFG), diet therapy (low fat versus high fat), caloric intake (% resting energy requirement), incidence of GI (%), and length of hospitalization (LOH) (days). A Clinical Severity Index Score (CSIS) was determined for each patient.
Dogs in the EFG demonstrated a decreased time to return of voluntary intake (2.1 days, EFG versus 2.7 days, DFG; P = 0.05) and time (days) to maximum intake (3, EFG versus 3.4 DFG) as compared to the DFG dogs. The DFG exhibited more GI versus EFG irrespective of CSIS grouping (60% versus 26%, P = 0.04). A CSIS ≥ 7 was associated with prolonged LOH (P = 0.004); however, time to initiation of feeding and diet selection did not impact LOH (P = 0.8).
Results of the study suggested that feeding within 48 hours of hospitalization for canine pancreatitis has a positive impact on return to voluntary intake and decreases the frequency of GI in these patients, independent of CSIS. The traditional protocol of withholding food during hospitalization may not be necessary nor yield the most benefit for patient recovery; subsequently early enteral refeeding should be considered.
评估早期肠内营养治疗对急性胰腺炎犬恢复自主进食时间、最大食物摄入量、胃肠道不耐受（GI）发生率及总住院时间的影响。
对2010年至2013年一家兽医教学医院收治的胰腺炎犬进行回顾性分析。
34只客户拥有的被诊断为急性或慢性复发性胰腺炎的犬。
回顾记录有食欲不振、厌食和胃肠道问题且诊断为胰腺炎的犬的病历。记录自住院以来开始提供食物的时间，以及品种特征、既往病史、主要诉求、体格检查结果、诊断结果、所提供的治疗、提供食物的时间（住院48小时内，早期喂食组（EFG）与延迟喂食组（DFG））、饮食治疗（低脂与高脂）、热量摄入（占静息能量需求的百分比）、胃肠道不耐受发生率（%）及住院时间（LOH）（天）。为每只患者确定临床严重程度指数评分（CSIS）。
与DFG组犬相比，EFG组犬恢复自主进食的时间缩短（2.1天，EFG组对2.7天，DFG组；P = 0.05），达到最大摄入量的时间（天）也缩短（3天，EFG组对3.4天，DFG组）。无论CSIS分组如何，DFG组的胃肠道不耐受情况均比EFG组更常见（60%对26%，P = 0.04）。CSIS≥7与住院时间延长相关（P = 0.004）；然而，开始喂食的时间和饮食选择对住院时间无影响（P = 0.8）。
研究结果表明，犬胰腺炎患者在住院48小时内喂食对恢复自主进食有积极影响，并可降低这些患者胃肠道不耐受的频率，与CSIS无关。住院期间禁食的传统方案可能并非必要，对患者康复也未必最有益；因此应考虑早期肠内再喂养。
