Evaluation of a novel non‐surgical post‐pyloric feeding technique in dogs with severe acute kidney injury

Hinden, Sandro E.; Schweighauser, Ariane; Francey, Thierry (2020). Evaluation of a novel non‐surgical post‐pyloric feeding technique in dogs with severe acute kidney injury. Journal of veterinary emergency and critical care, 30(4), pp. 384-395. Wiley-Blackwell 10.1111/vec.12955

Text JVECC 2020 HINDEN - Post-pyloric feeding in dogs.pdf - Published Version Restricted to registered users only Available under License Publisher holds Copyright. Download (697kB)

Objectives - To evaluate the placement and the performance of a new post‐pyloric feeding (PPF) system, and compare it to esophageal (E) feeding in dogs with severe acute kidney injury (AKI).
Design - Prospective study.
Setting - University teaching hospital.
Animals - Twenty client‐owned dogs with severe AKI treated with hemodialysis.
Interventions - Dogs were randomly assigned to 2 feeding techniques, PPF or E feeding; for PPF, an 8‐Fr jejunal (J) tube was introduced through a standard 18‐Fr E‐tube and advanced endoscopically through the pylorus. A commercial liquid diet was administered at a continuous rate for at least 5 days. After the removal of the internal J‐tube, feeding was continued through the E‐tube. Control dogs were fed blended food 5 times daily through an E‐tube. Placement technique, nutritional efficiency, and metabolic response to nutritional support were compared between the groups.
Measurements and main results - Feeding tubes were placed a medium of 1 day (interquartile range, 0.8 d) after presentation. Median procedure‐time in the group PPF was 26.5 min (11.5 min), including 8.5 min (2.7 min) for the E‐tube and 17.5 min (5.0 min) for the J‐tube. J‐tubes were used for 5 days (1.5 d) with oral displacement observed in 3/10 dogs. The goal to administer 130% resting energy requirement within 3 days was reached in 13/20 dogs (8/10 PPF, 5/10 E). Despite nutritional support, dogs lost 1.2% body weight per day (1.1%), with no difference between the groups. The metabolic improvement was comparable between the groups, despite marked differences in the diet composition.
Conclusions - This new feeding technique can be recommended as an efficient method for early nutritional support in dogs with severe AKI. The protein‐energy wasting observed despite active nutritional support suggests, however, the necessity for increased feeding targets or qualitative changes in diet composition for dogs with AKI.

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