Prospective evaluation of a peripherally administered three-in-one parenteral nutrition product in dogs

OBJECTIVES: Peripheral parenteral nutrition is an option for short-term nutritional support in dogs which cannot be supported with enteral nutrition. The objective of this study was to examine the use of a three-in-one, 840 mOsmol/l peripheral parenteral nutrition product containing amino acids, lipids and glucose in separate compartments in dogs. METHODS: Nine dogs were administered the three-in-one product, and two dogs were administered the amino acid part of the product, via a peripheral vein. Dogs were monitored for mechanical and metabolic complications. RESULTS: Mechanical complications (apparent thrombus or thrombophlebitis) caused failure of infusion at a median of 36 hours. None of the dogs appeared to develop catheter-related sepsis. Using a 10-hour infusion period appeared to decrease the incidence of line failure. Mild and clinically non-significant hyperglycaemia was the only metabolic complication. In four of the dogs, serum folate, cobalamin and homocysteine concentrations were determined before and after peripheral parenteral nutrition administration. Oral and parenteral administration of methionine has been previously associated with lowered serum folate concentrations. Low serum folates and the subsequent hyperhomocysteinaemia have been associated with venous endothelial damage and venous thrombus in other species. Serum cobalamin also affects homocysteine metabolism. Median serum folate, cobalamin and homocysteine concentrations were not affected by the short-term administration of this three-in-one product. CLINICAL SIGNIFICANCE: Using the product for 24 hours/day may require catheter replacement due to line failure. Other than line failure, which may be improved by 10- to 12-hour infusion times, this product was found to be safe and practical for short-term peripheral parenteral nutrition in dogs.