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VetVine Client Care

Posted On Jun 23, 2025

Updated On Jul 16, 2025

Nutrition And The Critical Patient

Emergency & Critical Care

This question was asked in a past webinar on the topic of nutritional support of hospitalized patients:

Question:
Do you ever use Hill's a/d?

Answer by Melissa Holahan, DVM, DACVECC:
I don't know if this question is regarding feeding tube options or foods to tempt patients to eat. Dr. Mazzaferro may have more to add but I typically don't use Hill's a/d. The main reason is that I have many other options available to me and a/d (in my experience) is higher in fat and more likely to cause GI disturbances, diarrhea, etc. 

I try to stick to the following options when trying to get patients to eat (in general for any anorexic patient):

  • Royal Canin - low fat
  • Hill's I/d - low fat
  • Eukanuba low residue (now called intestinal plus)
  • Plain cooked chicken breast (plain rotisserie chickens work well)

For feeding tubes – in general I use Clinicare liquid diet for 3 reasons:

1) In the critical care setting the calories are what’s important to me - not necessarily the type of diet (i.e feeding k/d in hospital vs. at home once patient has recovered)

2) Ease both for my staff (no blending / straining and no calculations for kcals per mL once it’s mixed, etc.) and primarily for clients (it’s hard enough to get clients to use the new and often scary feeding tube that their beloved pet has let alone blend and strain diets– compliance is key)

3) In my experience 98-99% of patients (with any disease process; aside from maybe shunt dogs) tolerate the Clinicare for first 1-2 weeks. I’ve only had 2 patients with pancreatitis in the past few years that clinical didn’t seem to tolerate the diet (it doesn’t fit a low fat category)

Hope this helps.


Comment by Elisa Mazzaferro, MS, DVM, PhD, DACVECC:
Yes, I use a/d but it is not as nutrient dense as Max Cal, and can cause more diarrhea, so I prefer Max Cal. A/D is a good substitute if Max Cal is not available.


Originally posted April 27, 2014