Enteral Nutrition In The Adult Horse
Meri Stratton Phelps DVM, MVPM, DACVIM, DACVN
Proper nutrition helps horses to rapidly recover from surgery and clinical disease. Protein and calorie malnutrition develops quickly when a horse does not consume enough feed. Poor nutrition hinders immune system function, delays wound healing, and can prolong hospitalization. Enteral nutrition provides essential calories and nutrients to sick anorectic horses.
Enteral nutrition for a sick or hospitalized horse provides a blend of nutrients that is administered in a liquid form. Nutrients are provided directly to the enterocytes in a physiologic manner. Studies in many species show an improved recovery from surgery, decreased cost of hospitalization, and decreased bacterial translocation across the intestinal tract when enteral nutrition is administered to a clinically ill patient.
When a horse is anorectic, or is unable to eat, treatment with a balanced enteral diet ensures that the horse is provided with nutrients to meet part to all of their energy, protein, vitamin, mineral, and essential fatty acid requirements.
Managing the Anorectic Horse: Platinum Performance Enteral Immunonutrition Formula
Platinum Performance Enteral Immunonutrition Formula is formulated to provide a balance of energy, protein, and other essential nutrients including glutamine, arginine, omega-3 and omega-6 essential fatty acids, vitamins, and minerals to an anorectic horse. This unique blend of ingredients contains fiber to more closely match the forage rich diet of the healthy horse. High quality whey protein aids in the maintenance of muscle mass. Glutamine is a preferred nutrient source for intestinal enterocytes, and arginine promotes nitric oxide production to enhance the immune system. A blend of B vitamins supports cellular metabolism to ensure adequate levels in horses with gastrointestinal disease. Macro and trace minerals supply essential nutrients. Antioxidants including vitamin E, vitamin C, and selenium provide protection against ongoing cellular oxidative damage, and omega-3 essential fatty acids help to modulate the inflammatory immune response.
Initiating Treatment
Once a horse has been partially to completely anorectic for 36-48 hours, enteral diet therapy should be considered. Enteral diets are used to manage horses that have normal intestinal motility, can tolerate placement of a nasogastric or esophagostomy tube, and in horses that are able to stand, or remain sternal during diet therapy. Enteral nutrition is easy to administer, and horses can be fed both in a field setting, and in a veterinary clinic. The only equipment that is needed is Platinum Enteral Immunonutrition Formula, a nasogastric tube, a bucket, and a stomach pump.
How to Feed an Adult Horse with Enteral Nutrition
- Determine the energy and protein requirements of the horse
Adult horses that are clinically ill, or that are recovering from surgery can initially be fed to meet their resting energy requirements. Energy and protein requirements are shown in Chart 1. If the horse tolerates the diet, but loses body weight or muscle condition, then additional energy or protein may be necessary. The recommended range of volumes of Platinum Enteral Immunonutrition Formula to feed at each meal for adult horses of different body weights is listed in Chart 2. If the horse has been anorectic for more than 5 days, provide 1/3-1/2 of the total recommended volume on the first day of feeding. Gradually increase the volume over 2-3 days until you are feeding the full recommended volume. - Prepare the diet
Mix the Platinum Enteral Immunonutrition Formula with the recommended volume of warm water. A wire wisk can be used to blend the diet. Test the consistency of the diet by infusing it through the selected nasogastric tube. If necessary, add more water to the solution so it can easily be infused through the nasogastric tube. Keep track of the volume of water that is added to the Platinum Enteral Immunonutrition Formula to ensure the horse does not become overhydrated. - Administer the diet
Select a nasogastric tube to administer the diet. A small diameter tube should be used if the tube will remain in place for more than one feeding. Place the tube, and check the stomach for residual fluid. If more than 2 liters of fluid are removed from the stomach, do not feed the diet, and wait 2 hours before checking for residual fluid. If less than 2 liters of residual fluid are removed, slowly administer the diet. Do not pump the solution too quickly.
Once all of the diet has been administered, rinse the tube with an additional 1-2 liters of warm water.
Most horses can tolerate infusion of a total of 6-8 liters of fluid. Horses that have been anorectic for longer than 5 days should be fed with a smaller volume (<4 L/feeding) of fluid. The amount of diet and flush water should be adjusted for Miniature Horses and ponies.
After the tube has been flushed, pull the tube, or cap the tube if it will remain in place between feedings. Use a muzzle to prevent the horse from removing an indwelling tube.
During the time you are managing the horse with Platinum Enteral Immunonutrition Formula, perform a physical examination on the horse, and monitor the horse’s body weight and body condition score daily. Digital pulses should remain within normal limits. If the horse develops ileus, nasal discharge, or respiratory stridor, and cannot tolerate the feedings, then enteral feeding should be discontinued.
Many horses will develop mild diarrhea when an enteral diet is first introduced. The diet can continue to be used as long as the horse remains stable, and does not have evidence of infectious diarrhea, or dehydration.
Basic blood work which includes measuring the packed cell volume, total solids, and electrolytes, should be performed if possible. The horse should remain hydrated, and their electrolytes should be stable.
Horses should be offered high quality hay to entice their appetite during the time they are fed the enteral diet. Grass hay, alfalfa leaves, and small amounts of pasture grass can all be offered during the refeeding period. Pelleted hay and complete feeds can also be used. Any feed with a high concentration of grain or non-structural carbohydrates (NSC) should be avoided.
Once the horse can voluntarily consume between 50-75% of their energy requirements, then the enteral feeding can be discontinued.
Putting it into Practice
- Adult horses that are anorectic rapidly develop protein calorie malnutrition.
- Enteral nutrition is a safe way to give nutrients to a horse that has a functioning gastrointestinal tract.
- Platinum Enteral Immunonutrition Formula can be used to provide a sick or anorectic horse with energy, protein, vitamins, minerals, antioxidants, and essential fatty acids.
- Enteral nutrition can be used for 7-14+ days to provide nutrition to an anorectic horse.
All research has been carried out in the USA and some numerical data has been reported in imperial measurements. Please contact us if you would like converted figures.
