Nasogastric ( NG ) or naso-oesophageal ( NO ) feeding tubes do not require general anaesthesia and are considered a safer alternative . Unfortunately , placing a NG / NO tube in a feline flea-anaemic patient is not always possible , due to the nasal passage being too narrow . These challenges can often result in the VN needing to syringe-feed the cat , which also poses a degree of risk . Care should be taken to syringe small volumes ( e . g . 0.1 – 0.5 ml for kittens ) of food at a time and wait for the patient to swallow before providing more , to avoid the risk of aspiration . Feeding this way is labour intensive , so the use of a high-calorie food given little and often is recommended to increase the chances of a successful outcome .
Once initial stabilisation has occurred and the anaemia begins to improve , it is common for these patients to start to feed independently , so a suitable highly palatable food should be offered before the commencement of any other form of active feeding . Regardless of what form of feeding is used , the amount of food eaten should be recorded and the patient should be weighed at the same time each day to monitor for improvement or deterioration . It is important to remember that an initial increase in weight is expected in any patient with dehydration once this has been corrected , and this would not be an indicator of caloric RER being exceeded . The overall goal for any inpatient is to maintain their bodyweight during the hospitalisation period and , for the flea-anaemic cat , this is no different despite many of these animals presenting in a malnourished state . Once the disease has been successfully treated and the patient is suitable for discharge , a long-term plan to establish a healthy body condition score should then be implemented .
The feline flea-anaemic patient highlights the need for preventative anti-ectoparasite medication and education of the client and general public to reduce the incidence of these cases . Further research is needed to review the incidence of this disease and to establish the varying extents of anaemia presented . This information will be valuable in understanding the prognosis for these cases and to further aid in educating veterinary professionals and the general public .
Assessment of learning
1 . Which type of regenerative anaemia is caused by fleas ?
2 . Which type of reticulocyte is used to calculate the level of regenerative anaemia in cats ?
3 . At what percentage PCV is it currently recommended to consider a blood transfusion in feline flea-anaemic patients ?
4 . Which product is currently licensed to treat fleas in kittens from 2 days old ?
5 . Which type of feeding tubes do not require general anaesthesia to place ?
Conclusions
Fleas are a common parasite causing disease in cats all over the world . When severe infestations occur , this can cause life-threatening anaemia , which requires intensive nursing care . Where possible , a full nursing assessment should be undertaken to review the needs of the patient and provide the basis for a NCP . Addressing the heavy adult flea burden is of paramount importance . This can take time , with multiple grooming interventions alongside adulticide flea medication required .
Following this , the role of the VN is often supportive , addressing the dependent needs of the patient , such as feeding and fluid therapy . However , severe cases may require a blood transfusion , which carries a high level of risk if not performed correctly . Every feline patient receiving a blood transfusion must receive type-specific blood and be monitored closely for a transfusion reaction . This risk is just one example of why nursing the feline flea-anaemic patient can be more challenging than their canine equivalents .
1 . ( External ) haemorrhage 2 . Aggregate 3 . < 10 % 4 . Frontline Spray 0.25 % 5 . Nasogastric or naso-oesophageal
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Volume 38 ( 2 ) • April 2023
45