Adults in good body condition should be reassessed regularly. Decisions regarding specific frequency of visits are made appropriately on an individual basis, based on the age, species, breed, health and environment of the pet. Healthy pregnant, lactating, senior and growing animals require more frequent monitoring. Pet owners should monitor their pet at home including:
- Food intake and appetite
- BCS and BW
- Gastrointestinal signs (e.g., feces consistency and volume; vomiting)
- Overall appearance and activity
Animals with disease conditions and/or recommended nutritional changes
Non-hospitalized animals for which extended nutritional evaluation was indicated may require more frequent monitoring of nutritional assessment parameters. Monitoring should include the items in Table 2.
Frequent monitoring of BCS and MCS is important, as many diseases are associated with suboptimal scores. Also, animals with medical conditions are more likely to receive dietary supplements and to have medications administered with food, so specific attention to and review of these issues, with an update of the dietary plan, are important at each visit to ensure that the overall nutritional plan is optimized.
Daily monitoring of hospitalized animals includes the items in Table 2, also evaluating these additional items:
- Specific feeding orders, which should include diet, route, amount, and frequency.
- Fluid balance. Assessment of clinical signs (e.g., BW changes, pulmonary crackles) or diagnostic tests (e.g., central venous pressure).
- Addressing optimal route of intake. The optimal route required to achieve nutrient requirements could change during hospitalization and should be reassessed daily (see above).
- Quantifying and documenting nutrient intake (via all routes).
Many hospitalized animals are discharged prior to complete resolution of their underlying disease. Document and communicate to the client the feeding method, caloric intake, diet, frequency and specific monitoring parameters, and the schedule for rechecks and re-assessment.
Discuss with the client any issues that may limit adherence to dietary recommendations (e.g., feeding schedule issues, complex instructions, financial restrictions) and address appropriately (e.g., offer over-the-counter options for appropriate diets if financial restrictions will prevent the owner from consistently feeding the prescribed diet). Create a specific schedule for follow-up via telephone to elicit questions and verify compliance/adherence.
Provide choices in diets that meet nutrient goals. Create a plan with the client about what to do if calorie/nutrient goals are not achieved.
When abnormal parameters have returned to normal or stabilized, the animal may continue on a therapeutic diet or be transitioned to a non-therapeutic diet. If a new diet is necessary, it may be introduced gradually, as previously described.