Total parenteral nutrition in a case of stage IVb lymphoma

Abstract

"Astro", a nine-year-old male castrated husky mix, presented to Cornell Veterinary College for treatment of multicentric lymphoma. He was diagnosed after presenting to the referring veterinarian for lethargy, inappetance, and weight loss. Prior to arriving at Cornell, Astro had become icteric, had been vomiting, and refused food for three days. Upon arrival to Cornell, it was planned to start L-CHOP chemotherapeutic protocol. Astro had been anorectic for several days and to initiate treatment could suppress his appetite even further. It was decided that parenteral nutrition would be initiated at the same time as chemotherapy to help sustain nutrition while the underlying causes of anorexia were being treated. Parenteral nutrition is usually given in a central venous catheter as a mixture of carbohydrates, lipids, and amino acids. This report will discuss how to calculate the nutritional needs of the patient, how to manage treatment, and complications of parenteral nutrition.