An investigation of the relationship between caloric intake and outcome in hospitalized dogs.

Malnutrition in veterinary patients is thought to increase morbidity and mortality, but this has not been statistically quantified. A study was designed to estimate the proportion of hospitalized canine patients in negative-energy balance; relate calories consumed in-hospital to appetite at home shortly after discharge; determine why these dogs were in a negative-energy balance; and assess the relationship between body condition score, physical status score (PSS), diagnosis, and caloric intake with patient outcome. Data were collected from 276 dogs over several days in one of the various referral hospitals. After eliminating partial hospital days, there were 821 dog-days for evaluation. A daily positive-energy balance (> 95% resting energy requirement) was achieved for only 27% of the 821 full dog-days. Of 226 dogs successfully followed after discharge, 83% were considered by their owners to have a normal appetite and/or food intake by the second day home. Of the 601 negative-energy-balance dog-days, 22% were due to poorly written feeding orders and 34% had orders to have feed withheld; most cases (44%) resulted from the dog refusing to eat any or all of the food offered. There were significant relationships between caloric intake and PSS, outcome and PSS, and outcome and caloric intake. In general, canine patients with lower PSSs (i.e., no or mild systemic diseases) consumed more daily calories and were more likely to be discharged whereas patients with higher PSSs (i.e., incapacitating, life-threatening systemic diseases) were less likely to meet the resting energy requirement and be discharged from the hospital.