title: A pilot study to assess tolerability of early enteral nutrition via esophagostomy tube feeding in dogs with severe acute pancreatitis.
abstract: BACKGROUND
  The putative role of the gut in amplification of systemic inflammation in acute pancreatitis is gaining credence, and intraluminal nutrition has been shown to decrease inflammation in experimental models of pancreatitis. Prepyloric feeding often is used in people with acute pancreatitis, but has not been evaluated in dogs.
  
  
  OBJECTIVE
  Early intervention with enteral nutrition (EN) delivered proximal to the pylorus will be well tolerated in dogs with acute pancreatitis and provide justification for further larger trials.
  
  
  METHODS
  Ten dogs with severe acute pancreatitis in an open-label, prospective pilot study.
  
  
  METHODS
  Dogs were treated with plasma transfusion and standard care, and then consecutively assigned to receive either EN via esophagostomy tube feeding or parenteral nutrition (PN). Outcome was used to determine optimal study size for future studies, and complications were compared between the 2 groups.
  
  
  RESULTS
  A significantly greater number of vomiting or regurgitating episodes occurred in dogs receiving PN. The dogs receiving EN did not demonstrate any noticeable postprandial pain. There were more catheter-related complications in the PN group. There was no difference in outcome between the 2 treatments, and 43 dogs for each treatment would be required in future studies to determine a difference in outcome.
  
  
  CONCLUSIONS
  Early EN delivered proximal to the pylorus is well tolerated in dogs with severe pancreatitis and resulted in fewer complications than PN. Prospective trials in a larger cohort are justified to fully establish the potential benefit of early EN, preferably compared with minimal enteral nutrition.
authors.affiliation: School of Veterinary and Biomedical Sciences, Murdoch University, Murdoch, WA, Australia. cmans@unimelb.edu.au
authors.forename: C S
authors.initials: CS
authors.lastname: Mansfield
authors.forename: F E
authors.initials: FE
authors.lastname: James
authors.forename: J M
authors.initials: JM
authors.lastname: Steiner
authors.forename: J S
authors.initials: JS
authors.lastname: Suchodolski
authors.forename: I D
authors.initials: ID
authors.lastname: Robertson
authors.forename: G
authors.initials: G
authors.lastname: Hosgood
mesh_terms: D000208:Acute Disease; D000818:Animals; D004283:Dog Diseases / Q000628:therapy*; D004285:Dogs; D004750:Enteral Nutrition / Q000009:adverse effects / Q000379:methods / Q000662:veterinary*; D004946:Esophagostomy / Q000662:veterinary*; D005260:Female; D008297:Male; D010195:Pancreatitis / Q000628:therapy / Q000662:veterinary*; D010288:Parenteral Nutrition / Q000662:veterinary; D010865:Pilot Projects