FREE SHIPPING over $40
OVER 10000 FIVE-STAR REVIEWS
5% OFF ALL SUBSCRIPTIONS
100% HAPPINESS GUARANTEE
Analyze Diet
0
Journal of veterinary emergency and critical care (San Antonio, Tex. : 2001)2021; 31(5); 668-673; doi: 10.1111/vec.13074

Refeeding syndrome in a miniature donkey.

Abstract: To describe refeeding syndrome in an equid without a history of recognized risk factors. Methods: Refeeding syndrome with marked hypophosphatemia developed in an aged miniature donkey gelding during treatment of suspected enterocolitis. Hypophosphatemia (manifested clinically as ileus and neuromuscular weakness) developed despite a short (3 day) history of hyporexia, increased body condition (7/9), and adherence to nutritional recommendations for critically ill equids. Nutritional support included nasogastric enteral feeding with a commercial equine nutrition product claiming to provide 100% of the National Research Council's daily recommended protein, vitamin, and mineral requirements for equids. Hypophosphatemia developed despite this enteral supplementation and was ultimately corrected by intravenous administration of sodium phosphate solution. Conclusions: This case report suggests that risk factors for refeeding syndrome in equids may be broader than previously recognized. Specifically, critically ill equids at risk for insulin dysregulation may have unique nutritional co-morbidities and requirements. This report highlights the need for both broader recognition of risk factors for refeeding syndrome, and revised best-practice nutritional guidelines and supplementation products to improve equine critical care.
© Veterinary Emergency and Critical Care Society 2021.
Get Full Text
Publication Date: 2021-07-14 PubMed ID: 34259376DOI: 10.1111/vec.13074Google Scholar: Lookup
The Equine Research Bank provides access to a large database of publicly available scientific literature. Inclusion in the Research Bank does not imply endorsement of study methods or findings by Mad Barn.
LinkedInCopy
  • Case Reports

Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

This research article presents a case of refeeding syndrome in a miniature donkey, showing that risk factors for this condition may be more widespread than previously understood. The article underscores the significance of recognizing these risk factors and improving nutritional guidelines and supplements for the critical care of horses and related animals.

Research Context and Methodology

In thisexperiment, a miniature aged donkey gelding developed refeeding syndrome during treatment for suspected enterocolitis. The condition was characterized by notable hypophosphatemia, which manifested clinically as ileus and neuromuscular weakness. This development was surprising as the donkey did not present traditional risk factors for refeeding syndrome:

  • The donkey had a short history (3 days) of hyporexia, which is an abnormally reduced appetite for food.
  • Its body condition was relatively healthy, with a score of 7 out of 9.
  • There was strict adherence to standard nutritional recommendations for critically ill equids.

Nutrional Support and Response

The donkey received nutritional support through nasogastric enteral feeding, which used a commercial equine nutrition product. This product claimed to provide the full quota of daily recommended protein, vitamin, and mineral requirements for equids according to the National Research Council. Despite such supplementation, the donkey developed hypophosphatemia. This condition was corrected later through the intravenous administration of a sodium phosphate solution.

Implications and Conclusion

The implications of this case study extend to a broader scope of understanding risk factors for refeeding syndrome in equids. The study suggests that these factors may not be as narrow as was previously believed. Particularly, the findings indicate that critically ill equids at risk for insulin dysregulation may also be susceptible to unique nutritional co-morbidities and requirements.

This case highlights the necessity of a wider recognition of risk factors for refeeding syndrome amongst equids. Further, the research advocates for revising existing best-practice nutritional guidelines and supplementation products to enhance equine critical care, thereby preventing the occurances of such scenarios.

Cite This Article

APA
Bookbinder L, Schott HC. (2021). Refeeding syndrome in a miniature donkey. J Vet Emerg Crit Care (San Antonio), 31(5), 668-673. https://doi.org/10.1111/vec.13074

Publication

Journal of veterinary emergency and critical care (San Antonio, Tex. : 2001)
ISSN: 1476-4431
NlmUniqueID: 101152804
Country: United States
Language: English
Volume: 31
Issue: 5
Pages: 668-673

Researcher Affiliations

Bookbinder, Lauren
  • Department of Large Animal Clinical Sciences, Michigan State University, East Lansing, Michigan.
Schott, Harold C
  • Department of Large Animal Clinical Sciences, Michigan State University, East Lansing, Michigan.

MeSH Terms

  • Animals
  • Critical Illness
  • Enteral Nutrition / veterinary
  • Equidae
  • Horse Diseases
  • Horses
  • Hypophosphatemia / veterinary
  • Male
  • Refeeding Syndrome / veterinary

References

This article includes 25 references
  1. Amanzedah J, Rielly RF. Hypophosphatemia: an evidence based approach to its clinical consequences and management.. Nat Clin Pract 2006;2(3):136-148.
  2. Brenner K, KuKanich KS, Smee NM. Refeeding syndrome in a cat with hepatic lipidosis.. J Feline Med Surg 2011;13(8):614-617.
  3. Deavilla MD, Leech EB. Hypoglycemia associated with refeeding syndrome in a cat.. J Vet Emerg Crit Care 2016;26(6):798-803.
  4. Friedli N, Stanga Z, Sobotka L. Revisiting the refeeding syndrome: results of a systematic review.. Nutrition (Burbank, Los Angeles County, Calif.) 2017;16(35):151-160.
  5. Ritz E. Acute hypophosphatemia.. Kidney International 1982;22(1):84-94.
  6. Geerse DA, Bindels AJ, Kuiper MA, Roos AN, Spronk PE, Schultz MJ. Treatment of hypophosphatemia in the intensive care unit: a review.. Critical Care (London, England) 2010;14(4):1-8.
  7. Toribio RE. Phosphorus homeostasis and derangements.. 2015:88-100.
  8. Dibartola SP, Willard MD. Disorders of phosphorus: hyperphosphatemia and hypophosphatemia.. 2006:195-209.
  9. Adams LG, Hardy RM, Weiss DJ, Bartges JW. Hypophosphatemia and hemolytic anemia associated with diabetes mellitus and hepatic lipidosis in cats.. Journal of Veterinary Internal Medicine 1993;7(5):266-271.
  10. Stroud M. Nutritional support in adults: oral nutrition support, enteral tube feeding and parenteral nutrition.. 2006.
  11. Mehanna HM, Moledinna J, Travis J. Refeeding syndrome: what it is, and how to prevent and treat it.. Brit Med J 2008;336(8):1495-1498.
  12. Clore ES, Freeman LM, Bedenice D, Tony Buffington CA, Anderson DE. Retrospective evaluation of parenteral nutrition in alpacas: 22 Cases (2002-2008).. Journal of Veterinary Internal Medicine 2011;25(3):598-604.
  13. Bamford NJ, Rosales CM, Williamson AJ, Steel CS, Tennent-Brown BS. Severe hypophosphataemia associated with the management of hyperlipaemia in a miniature pony.. Equine Vet Edu 2018;30(7):352-355.
  14. Brooks D, Churchill J, Fein K. 2014 AAHA nutritional guidelines.. J Am Animal Hosp Assoc 2014;50(1):1-11.
  15. Justin RB, Hohenhaus AE. Hypophosphatemia associated with enteral alimentation in cats.. Journal of Veterinary Internal Medicine 1995;9(4):228-233.
  16. Knochel JP. The pathophysiology and clinical characteristics of severe hypophosphatemia.. Archives of Internal Medicine 1977;137(2):200-203.
  17. Durham AE. Clinical application of parenteral nutrition in the treatment of five ponies and one donkey with hyperlipaemia.. Vet Record 2006;158(5):159-164.
  18. Durham AE, Thiemann AK. Nutritional management of hyperlipaemia.. Equine Vet Edu 2015;27(9):482-488.
  19. Burden FA, Du Toit N, Hazell-Smith E, Trawford AF. Hyperlipemia in a population of aged donkeys: description, prevalence, and potential risk factors.. Journal of Veterinary Internal Medicine 2011;25(6):1420-1425.
  20. Forhead AJ, French J, Ikin P. Relationship between plasma insulin and triglyceride concentrations in hypertriglyceridaemic donkeys.. Research Vet Sci 1994;56(3):389-392.
  21. Moore BR, Abood HK, Hinchcliff KW. Hyperlipemia in 9 miniature horses and miniature donkeys.. Journal of Veterinary Internal Medicine 1994;8(5):376-381.
  22. Frank N, Elliot SB, Brandt LE, Keisler DH. Physical characteristics, blood hormone concentrations, and plasma lipid concentrations in obese horses with insulin resistance.. Journal of the American Veterinary Medical Association 2006;228(9):1383-1390.
  23. Dunkel B. Severe hypertriglyceridaemia in clinically ill horses: diagnosis, treatment and outcome.. Equine Veterinary Journal 2010;35(6):590-595.
  24. Dunkel B, Wilford SA, Parkinson NJ. Severe hypertriglyceridaemia in horses and ponies with endocrine disorders.. Equine Veterinary Journal 2013;45(1):118-122.
  25. Carr EA, Holcombe SJ. Nutrition of critically ill horses.. Vet Clin Equine 2009;5:93-108.

Citations

This article has been cited 1 times.
  1. Morrone S, Sechi S, Carta C, Senes A, Cocco R, Pinna Parpaglia ML, Sanna Passino E, Cappai MG. Nutritional management of hyperlipaemia in a jenny: a brief report. Vet Res Commun 2024 Oct;48(5):3323-3329.
    doi: 10.1007/s11259-024-10460-7pubmed: 38963468google scholar: lookup
Subscribe to our newsletter
Join 99,780 horse owners like you who receive our email updates on horse health and nutrition.