Early nutritional support is associated with decreased length of hospitalization in dogs with septic peritonitis: A retrospective study of 45 cases (2000–2009)

Abstract

OBJECTIVE: To determine whether the timing and route of nutritional support strategy affect length of hospitalization in dogs with naturally occurring septic peritonitis. DESIGN: Retrospective study encompassing cases from 2000 to 2009. SETTING: University teaching hospital. ANIMALS: Forty-five dogs that survived septic peritonitis. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Nutritional strategy for each dog was categorized as either enteral nutrition (EN: free choice voluntary eating or assisted tube feeding) or central parenteral nutrition (CPN). Early nutritional support was defined as consistent caloric intake initiated within 24 hours postoperatively. Consistent caloric intake occurring after 24 hours was defined as delayed nutritional support. Data reflective of nutritional status included body condition score, serum albumin concentration, and duration of inappetence before and during hospitalization. Body weight change from the beginning to the end of hospitalization was calculated. A modified Survival Prediction Index 2 score was calculated for each dog at admission. Additional clinical data recorded for comparison of illness severity included indicators of severe inflammation (eg, presence of toxic changes in neutrophils and immature neutrophils), coagulopathy (eg, prolonged prothrombin time and activated partial thromboplastin time), the use of vasopressors and blood transfusions, and presence of concurrent illnesses. Nutrition-related complications were classified as mechanical, metabolic, or septic complications. Multivariate linear regression analyses were used to determine the relationship of nutritional strategy with hospitalization length, while considering the presence of nutrition-related complications, the nutritional status- and illness severity-related variables. While controlling for other variables, dogs that received early nutrition had significantly shorter hospitalization length (by 1.6 days). No statistically significant association was found between route of nutrition and hospitalization length. The presence of concurrent illnesses and nutrition-related metabolic complications were also associated with longer hospitalization length (by 2.1 and 2.4 days, respectively). CONCLUSION: Early nutritional support in dogs with septic peritonitis is associated with a shorter hospitalization length.