ABSTRACT
Human nutritional studies in acute or hospitalized patients are often characterized by small sample sizes and differing patient populations, making meta-analyses challenging. The paucity of data in the veterinary literature makes definitive conclusions even more elusive. Experience with hospitalized human subjects suggests that nutritional best practices may vary with different diseases; recommendations for patients with acute kidney injury (AKI) or chronic kidney disease (CKD) are quite different, for example. As such, veterinary patients likely also experience different conditionand individual-specific requirements for nutrients and for calories. The level of sophistication of evidence-based interventions in veterinary medicine is therefore poor. Interestingly, dogs display increased adaptability to starvation compared with humans, and are evolutionarily programed for significant post-prandial fasting. Cats, conversely, have constitutive upregulation of gluconeogenesis and a lower gastric volume, suggesting adaptability to frequent feedings. Future studies are needed to better refine clinical knowledge, and the guidelines contained herein should be critically evaluated in such a context.
