Nutrition in animal shelters: Refeeding syndrome? 11 facts you should know

I am sure you are familiar with the body score condition scales that are used in veterinary medicine.  They exist for dogs (see here), for cats (see here), and they are used more and more since overweight condition seems to become more and more important in our pet population. However, in shelters, the situation can sometimes be quite different.

We mentioned it in previous posts: one of the challenges we have is that very often we have no idea what the animal went through before it enters the shelter. It is not uncommon that some animals did not have access to proper nutrition… That’s why you also see from time to time very underweighted or even emaciated dogs and cats. First reflex we will have, nearly instinctive: give them access to food asap. But that is not as simple as it seems unfortunately, because of something that is called the “refeeding syndrome”, a metabolic disorder that can quickly have severe consequences. Not that common fortunately, but in shelters , it is always important to be prepared and to know a bit about it. Here are 11 facts that you need to have in mind before feeding this severely underweight individual.

#1: Very underweighted or emaciated dogs and cats usually had to deal with “chronic negative energy balance” (=understand that they did not have access to proper nutrition for a long time and they develop deficiencies).

#2: Because of that, their organism underwent metabolic modifications: they start to utilize fat and muscular tissues to be able to maintain their organic functions. There are also modifications of their electrolytes (sodium, potassisum, etc.) concentration in the different body compartments.

#3: Because of these modifications (especially the ones concerning electrolytes), if food is reintroduced too fast, this can lead to serious and potentially fatal metabolic derangements.

#4: This is known as the “refeeding syndrome” . There are very little information in dogs and cats in the scientific literature, but it is described in horses and in humans.

#5: A wide range of symptoms can be observed: weakness, seizures, coma, irritability, aggression and even death.

#6: Refeeding syndrome in horses can be fatal withing days !

#7: Monitoring the reintroduction of food is mandatory particularly during the first week of feeding

#8: In horses, small feedings are recommended to begin (up to 6 times a day).

#9: Starved animals should be fed at a level that results in only minimal weight gain for the first 10-14 days.

#10: The amount fed can be gradually increased at each meal and the number of feedings gradually reduced over a period of about 10 days to 2 weeks.

#11: As I said, there are very few data and recommended protocols, I know that sometimes shelters develop their own. Here is what I found in what of the textbooks of shelter medicine that can help in determining the amount of food required.

“The feeding amount is determined by calculating the resting energy rate (RER) using the formula 70 x (weight –kg)^0.75 . This value is then multiplied by a factor depending on the physiological stage of the animal (see table below) in order to determine the daily energy requirement (DER) and therefore estimate the amount of food to give the animal.




<4 months of age

RER x 3

RER x 2.5

>4 months of age

RER x 2

RER x 2.5

Average neutered   healthy adult

RER x 1.6

RER x 1.2

From R. Weisman in Shelter Medicine for Veterinarians and Staff

Additional resource: we recently did a webinar focusing on the importance of nutrition in animal shelters. The video is right below, don’t hesitate to watch it to learn more about the zootechnical approach recommended in shelter environments. Following this webinar, we also received some questions from the attendees, you can find this FAQ right here . Also, if you have one, do not hesitate, feel free to ask, they are always welcomed! 

"An investment in knowledge always pays the best interest.“ Benjamin Franklin. If you enjoyed reading this post, please share it! Good way to spread information inside our PRO community! And stay in touch with us to get our latest updates, just click on one of the icons below!

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