Parenteral nutrition in foals: a retrospective study of 45 cases (2000--2004).
Authors: Krause J B, McKenzie H C
Journal: Equine veterinary journal
Summary
# Editorial Summary: Parenteral Nutrition in Foals When enteral feeding becomes impossible—whether due to recumbency, severe depression, or gastrointestinal dysfunction—parenteral nutrition (PN) offers critical support for sick foals, yet clinical guidance on its safe application in equine practice has been limited. Krause and McKenzie reviewed 45 foals receiving PN over a five-year period at a referral centre, examining whether different formulations (particularly lipid-containing versus lipid-free solutions) and disease severity influenced complication rates and survival outcomes. Notably, the type of PN formulation used had no bearing on either the incidence and nature of complications or patient survival, whilst disease severity emerged as the significant prognostic factor—severely ill foals were substantially more likely to develop PN-associated complications and to have fatal outcomes. The authors' finding that lipid-containing formulations did not increase adverse effects is reassuring for practitioners managing energy-depleted critical patients, suggesting that fat-based solutions can be used safely to maximise caloric delivery without additional risk. For clinical teams, this work underscores that PN complications and poor survival in critically ill foals reflect the underlying disease process rather than nutritional support itself, emphasising the importance of aggressive management of the primary condition alongside appropriate parenteral feeding.
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Practical Takeaways
- •Lipid-based parenteral nutrition formulations are safe and effective for delivering calories to critically ill foals when enteral feeding is not possible, regardless of specific formula composition
- •Disease severity at presentation is a better predictor of PN complications and survival than the choice of PN formula—focus on overall case management and disease management rather than formula selection
- •Monitor for PN-associated complications carefully in all critically ill foals, as their development significantly worsens prognosis
Key Findings
- •PN formulation (lipid-containing vs other) had no significant effect on complication rates or patient survival in 45 critically ill foals
- •Disease severity was positively associated with development of PN-related complications and nonsurvival
- •Lipid-containing PN solutions safely deliver energy to critically ill foals without increasing adverse effects
- •PN complications were significantly associated with increased risk of nonsurvival in foals