Conclusions
It is clear that nutritional support is an important adjunct to medical therapy in the sick, injured, or debilitated large animal patient. What is not clear is the optimal route, composition, or amounts of support.
The enteral route should be chosen whenever possible to maximize the benefits to the gastrointestinal tract, as well as the patient as a whole. Complete or partial PN is most useful as a bridge during recovery and transition to enteral feeding in the horse. Although the exact caloric requirement for sick, debilitated animals is unknown, estimates are available to use as a target for nutritional supplementation. Research in humans and laboratory animals suggests that even a little nutritional support is beneficial, and the reader is encouraged to consider nutritional support, whether enteral or parenteral, in any anorexic, chronically debilitated, or sick large animal patient.
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