Enteral Feeding of a Hyperlipemic Miniature Horse with a Component Feeding Program
Below is a medical abstract concerning a critically ill miniature horse brought into UT Veterinary Services. Credit for its survival was given largely to MD's Choice's Critical Care Meals.
Abstract published in Nutrition in Clinical Practice, vol 17, no 1. Feburary 2002; 68-9
Scientific Poster presented at Nutrition Week 2002, San Diego, CA
Oral Case Presentation at the 2002 American Academy of Veterinary Nutrition Clinical Nutrition and Research Symposium, (ACVIM Annual Meeting, Dallas, TX)
A 6 year old, 100 kg, American Miniature Horse presented to the Veterinary Teaching Hospital with a 3 day history of anorexia, depression, and ventral edema. She was nursing a healthy five week old foal at the time of presentation. Initial physical examination showed weakness, reluctance to move, elevated pulse and respiratory rate, and ileus. CBC and blood chemistry profile showed azotemia, hypocalcemia, metabolic acidosis, and elevated liver enzymes and total bilirubin. A serum triglyceride concentration was greater than 2000 mg/dl.
Based on the above findings a diagnosis of hyperlipemia and hepatic lipidosis was made.
Initial treatment consisted of intravenous polyionic fluids to correct the azotemia and provide maintenance fluids. Intravenous dextrose was provided to correct the negative energy balance. Subcutaneous heparin and insulin were given to treat the hyperlipemia.
Despite aggressive medical therapy, the mare developed signs of hepatoencepalopathy including circling, muscle fasciculations and severe depression, corresponding to elevated blood ammonia. On day 2 of hospitalization, a nutrition consultation was performed.
A three-stage ration was formulated based on the mare's requirements for digestible energy, crude protein, calcium, and magnesium for maintenance and lactation. The custom diet was low in fat and protein, but provided enough calories to decrease the utilization of body fat. The diet was delivered through a small-bore nasogastric tube every 2-4 hours. Each stage was given for 24 hours and by the third day of oral feedings the neurologic signs had disappeared and the serum triglyceride concentration had decreased to within normal range. The liver enzymes and total bilirubin were also decreasing. She began eating on day six of hospitalization and the enteral feedings were discontinued.
She was discharged on day 8 after presentation with instructions to provide supplemental feedings for the next 3 weeks and to wean the foal to decrease the energy demands on the mare. A follow-up visit performed 4 weeks after discharge showed no significant abnormalities on physical examination and a continued decrease in the serum concentration of liver enzymes.
Another good reference is "Nutritional Support and Nursing Care of the Adult Horse in Intensive Care", Clinical Techniques in Equine Practice, vol. 2, No. 2 (June), 2003: 193-198.
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