248 Retrospective investigation of the relationship between nutrition support plan and outcome in hospitalized cats at a veterinary teaching hospital.

Abstract Hospitalization of domestic cats (Felis catus) presents challenges due to their nutritional needs as obligate carnivores. These stringent nutritional requirements, combined with fear/anxiety/stress can exacerbate malnutrition during hospitalization for illness/injury. Therefore, our study aimed to evaluate hospitalized cats’ nutrition support plans at a veterinary teaching hospital (VTH) over a 12-month period to determine the relationship to hospital outcome (discharge versus euthanasia/death within 30 days of discharge). A retrospective analysis of all electronic records in VetView© Veterinary Hospital and Laboratory Management System and Instinct© from March 1, 2022 to February 28, 2023 was conducted for the University of Georgia VTH with owner consent. All data were sorted to separate felines with hospitalization periods of 72 hours or more. Client-owned cats (N=144) with individual hospitalizations (N=155) were organized based on signalment, intake and discharge body weight, hospitalization length, nutrition support plan, intravenous catheter (IVC) placement, and patient outcome. A multiple logistic regression analysis was performed to assess the effect of weight change (as a percentage of weight at intake), age in years (median = 10.0; IQR = 1.0-19.0), the presence/absence of an IVC, and appetite stimulant (AS) use on the probability of death. Significance level was set to 0.10. Length of hospitalization ranged from 72.3 to 387.6 hours (median = 114.8; IQR = 52.2-167.0). Throughout 155 hospitalizations, 78 patients lost weight (mean = 2.60%; SD = 3.08), 58 patients gained weight (mean = 6.0%; SD = 6.5), and 19 patients had inadequate weight history to determine weight loss/gain. All factors in the model (P< 0.10) affected probability of death. A 1% loss of body weight during hospitalization increased (P=0.082) the odds of death by 5%. A 1-year age increase led to a 22% increase (P< 0.001) in death. Cats receiving an IVC or AS were 7.37 (P=0.003) and 1.42 times more (P=0.68) likely to die, respectively. In terms of the probability of death, average marginal effects of weight change and age were 0.7 and 2.6%. The discrete changes for IVC and AS were 18.1 and 12.9%. The concordance index of the statistical model was 0.80. These findings demonstrate weight loss, greater age, IVC presence, and requirement of an AS were correlated with a higher mortality rate in hospitalized cats. Our results highlight the importance of nutrition support plan intervention early in hospitalization, especially for older cats and cats receiving hydration support via an IVC, to prevent malnutrition and improve survival.