Don't Kill them with Kindness: Treating Emaciation in Dogs while Avoiding Refeeding Syndrome

We wish it weren't the case, but emaciation is a problem commonly encountered in rescue. This is a treatable condition, but best practice is often difficult to stomach, even though it's in the dog's best interest. Pictured above is Piper, a recent intake who was emaciated almost to the point of death. 

This was written by our rehab coordinator, Paulina, regarding Piper's treatment:

I have recently been asked about Piper's slow recovery and want to post some information about the process of caring for emaciated dogs and refeeding syndrome...
Why do emaciated dogs take several weeks to gain proper health weight? Why not give them free choice of food?
When dogs that have essentially been starved suddenly have free access to large amounts of food, they can become very sick and even die. This is an especially tough situation because our natural first instinct to seeing an emaciated animal is to give it food … lots and lots of food. In truth, the best thing to do is bring the dog to the veterinarian immediately for an assessment and feeding plan. A refeeding plan can consist of very small amounts (1/3 cup) over several feedings (4-6) depending on the body score and previous access to food. It is ESSENTIAL to prevent Refeeding Syndrome. Don't kill them with kindness!
To read more: 
https://wagwalking.com/…/caring-for-a-malnourished-dog-what…
https://www.sheltermedicine.com/library/resources/…

Refeeding Syndrome, essentially, is when the malnourished dog's system is flooded with nutrients, causing sudden chemical changes in the body. The metabolism kicks into high gear, quickly using up nutrients that are already depleted in the malnourished body. This can make the affected animal very ill and possibly even kill them. ​

The before and after pictures above accompanied the post. You can see in the upper picture that Piper has regained some weight, but is a long way from her completed recovery. As Paulina says, the best thing to do with any health condition, before anything else, is to take the animal straight to your local veterinarian. Health issues can be more complex than they first appear, the obvious answer may not be the correct one, and it's best to get an expert opinion.