Early oral voluntary nutrition in anorexic critical ill dogs: a retrospective study in 137 dogs.

Critically ill dogs are characterized by marked variations in energy requirement. The aim of this study was to evaluate retrospectively the effect of early oral voluntary nutrition on mortality and length of hospitalization in anorexic dogs with SIRS. Medical records of anorexic dogs admitted with criteria of SIRS (Hauptman, 1997) at Ospedale Veterinario Gregorio VII and OVUD of University of Teramo, between January 2012 and August 2014 were reviewed. The severity of anorexia was defined by the time of on-set and duration of anorexia prior to presentation (mild < 24 hour, moderate 24–72 hours, severe anorexia > 72 hours). Medical treatment for SIRS was instituted depending on the underlying disease and mainly consisted of fluid-therapy support, analgesia, antibiotics; antithrombotic therapy and blood or plasma transfusion when required. Antiemetic therapy (maropitant, 1 mg/kg q 24 h SC and metoclopramide 1.1–2.2 mg/kg q 24 h CRI) was given to each anorexic dog independently by the concurrent presence of vomiting. Nutritional requirement was calculated by basal metabolic rate (BMR - 97 x BWkg 0.655 -); recovery diet (Royal Canine) or a/d (Hill's) was given via oral voluntary or friendly eating. The partial parenteral nutrition (0.70 x BMR) was given in each dog with severe anorexia. Chi squared test was utilized for statistical analysis of categorical data, and Mann Whitney test for independent non parametric data (MedCal). One hundred thirty-seven dogs were included, fourteen (10%) were mildly anorexic, 34 (25%) moderately anorexic and 89 (65%) severely anorexic. Fifty-six dogs (41%) were diagnosed with acute gastroenteritis, 11 (8%), with septic peritonitis, 10 (7%) with pyometra, and 7 (5%) with acute pancreatitis. Forty-six dogs (34%) started eating voluntarily within 72 hours from admission, 30 dogs (40%) 72 hours after admission, and 61 dogs (44%) never ate food voluntarily. Fiftynine dogs (43%) died: fifty-seven dogs (42%) never resumed eating, and two dogs (1%) started eating after 72 hours from admission. Significant difference in mortality rate was found between severe anorexic group and moderate anorexic group (p = 0.0095). No significant differences were found in mortality rate and in length of hospitalization among different disease processes. Statistically significant difference was observed in length of hospitalization between dogs that gained voluntary eating within 72 hours (5 ± 2 days) and after 72 hours (8 ± 3 days) after admission (p = 0.001). In conclusion, early oral voluntary nutrition in anorexic dogs with SIRS is associated with a lower mortality rate and shorter length of hospitalization.