Food intake or administration of nutritional support for hospitalized patients should be reviewed at least daily. Body weight
and condition should be recorded daily; however, an animal's BCS is unlikely to change during the course of a hospital stay.
Laboratory assessments specifically for patients receiving nutritional support are generally not necessary beyond those tests
already routinely performed for critically ill patients. The most common alterations that occur in laboratory parameters associated
with nutrient administration are decreases in serum potassium and phosphate levels, increases in serum glucose, blood urea
nitrogen and hyperlipidemia.
Even apparently stable patients might develop metabolic complications of refeeding syndrome (decreasing serum potassium and/or
phosphorous). However, most patients show subjective improvement in attitude within 36 hours of refeeding when stabilized
prior to refeeding.
Most parameters used to assess the nutritional status of patients will not change as a result of assisted feeding during the
course of hospitalization. Laboratory parameters (e.g., albumin and total protein concentrations, RBC count and hemoglobin
content) are unlikely to change in less than two weeks. The lack of measurable parameters should not be a deterrent to providing
nutritional support to hospitalized patients within three days. Feeding patients early prevents protein–calorie malnutrition
on the cellular level, which in turn improves outcome.
Dr. Remillard is staff nutritionist at MSPCA Angell Animal Medical Center in Boston. She received her DVM degree from Tufts
University in 1987 and her diplomate certification from the American College of Veterinary Nutrition in 1991. She received
specialty training as a nutrition resident at the Virginia Polytechnic Institute and did a research fellowship with the Johns
Hopkins School of Medicine.