Association of time to start of enteral nutrition and outcome in cats with hepatic lipidosis

Abstract

Background: Enteral nutrition (EN) is essential for management of hepatic lipidosis (HL) in cats.

Objectives: To determine if time to start of EN and other clinicopathologic variables are associated with outcome in cats with HL.

Animals: Forty-eight cats with HL.

Methods: Retrospective study. Information retrieved from medical records and client communications included clinicopathologic findings, time to start of EN, initial % of resting energy requirements provided, type of feeding tube, duration of hospitalization, and 3-month survival. Variables were compared between surviving and nonsurviving cats and between cats fed ≤12 hours and >12 hours after hospital admission. Multivariable statistical testing was performed to further investigate variables of interest.

Results: Seventeen of 25 (68%) cats fed ≤12 hours and 13 of 23 (57%) of cats fed >12 hours after hospital admission survived (P = .55). Only increasing age (odds ratio [OR], 1.313; 95% confidence interval [CI], 1.032-1.671; P = .03) and the presence of ascites (OR, 6.415; 95% CI, 1.354-30.395; P = .02) were associated with death in multivariable analysis. Hospitalization duration (median, interquartile range [IQR]) was shorter in cats fed >12 hours (2.8 days; IQR, 2.1-3.8 days) as compared with cats fed ≤12 hours (4.8 days; IQR, 3.6-6.2 days) after hospital admission (P < .001).

Conclusions and clinical importance: An initial stabilization period before EN introduction does not decrease survival or increase duration of hospitalization in cats with HL.

Keywords: fatty liver; feeding tube; prognosis; steatosis.

FIGURE 1

Scatterplots depicting duration of hospitalization and time to start of enteral nutrition (EN) in (A) cats with hepatic lipidosis that survived to discharge and (B) cats with hepatic lipidosis that survived to discharge, but with the exclusion of 6 cats that resumed eating without feeding tube placement. The Spearman's correlation coefficient (ρ) and associated P values are shown in the upper‐right of each panel. Two data points are not shown in the above scatters to maintain figure clarity. However, their inclusion does not affect the direction or significance of the relationship (ρ = −.453, P = .004).