NUTRITIONAL OPTIONS FOR THE CRITICALLY ILL EQUINE

摘要

Nutritional deficit in the form of starvation ultimately leads to death, hence the main goal of artificial nutrition is improving outcome in critical care. It is considered a treatment provided to anorectic patients which improves energy and protein intake, but with concerns that it is unphysiologic and may produce complications. Current nutritional guidelines in man recommend the use of low calorie enteral nutrition in critical care cases, rapid reintroduction of food after surgery and avoidance ofearly introduction of parenteral nutrition; rather than the historic wait for motility and give increased calories parenterally approach. Despite these recommendations many human clinicians "preserve these sacred cows of medical dogma" and starve for prolonged periods and then aggressively hyperalimentate.There is limited information regarding the potential benefits and complications of different strategies for nutritional support of the critically ill adult horse, indeed nutrition is often overlooked in clinical practice and seen as unduly complicated. As many of the nutrient recommendations for critically ill horses are based upon these out-dated human guidelines we need to update and simplify our practice. This should be followed by systematic critical appraisal of the effect of timing, composition and method of delivery of nutrition in the commonest equine critical care patient, those with acute medical and surgical gastrointestinal disturbance.