Anorexia and weight loss Flashcards by Helen West

List the 3 broad causes of weight loss

Malnutrition
Maldigestion/ Malabsorption
Malutilisation

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List 4 reasons why an animal may not want to eat

Pain - e.g. dental
Stress- common in cats
Nausea
pyrexia- common cause in cats

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what is the most common cause of animal not physically be able to eat

Dental disease

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what is Masticatory muscle myositis

Immune mediated inflammatory condition
Inciting cause unknown
Immune system forms antibodies towards a specific component of myosin found only in muscles of mastication

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Describe the acute phase of Masticatory Muscle Myositis

inflammed masicatory muscle
hard to open jaw as painful

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describe the what the chronic phase of Masticatory Muscle Myositis

Fibrosis and atrophy - cannot open mouth
§ (differentiates from Trigeminal Neuritis)
No pain but anorexia and wt loss

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Describe how to diagnose Masticatory Muscle Myositis

Presentation
ELectromyography (EMG)- spontaneous electrical activity
biopsy histology

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describe how to treat Masticatory Muscle Myositis- in acute phase

best chance in acute phase
Immunosuppressive therapy (prednisolone 2mg/kg)
Dose gradually tapered over months

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describe how to treat Masticatory Muscle Myositis in chronic phase

Chronic- attempt to stretch jaw open under GA?
Recurrence common
PTS

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what is Cricopharyngeal atelectasis

Neuromuscular motility disorder causing incomplete/asynchronous relaxation of the upper oesophageal sphincter
usually congenital, rarely acquired

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Describe how to treat Cricopharyngeal atelectasis

Surgery
Cricopharyngeal myotomy or cricopharyngeal and thyropharyngeal myectomy
65% success (less if acquired)

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describe how to diagnose Cricopharyngeal atelectasis

Fluoroscopy
Cricopharyngeal muscle doesn’t relax
retention of barium in the caudal pharyn

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what is Maldigestion/ Malabsorption always associated with

GI disease
appetite often increased (unless nausea associated)

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where does the problem tend to be with maldigestion

stomach

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where does the problem tend to be with malabsorption

small intestine

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List 2 examples of systemic diseases that can cause maldigestion/malabsorption

Hyperthyroidism in cats
Hypoadrenocorticism (Addison’s disease) in dogs

List 3 possible causes of abnormal nutrient handling in animals

Protein losing nephropathies
Diabetes Meletus
Liver disease

List 5 causes of increased demand for nutrients in animals

Neoplasia
Hyperthyroidism
Infection
Cardiac cachexia
Parasites

What is weight loss with increased appetite commonly associated with

malabsorption or malutilisation

what is hyporexia

not eating enough for normal maintenance

what is anorexia

not eating at all

List 3 common causes of anorexia/ hyporexia

Renal/ Hepatic dx (toxin accumulation)
Any inflammatory /infectious process causing pyrexia
Neoplasia

List 3 common causes of reluctance to eat

Association of food with nausea/pain/ stressful event
stressors
change to less palatable diet

List 3 common causes of mechanical inability to eat

Dental disease
Gingivostomatitis
Oral/pharyngeal/oesophageal masses

describe how to treat anorexia

Treat underlying condition Tempt to eat (beware of causing food aversions) Appetite stimulants (e.g. mirtazapine) Antiemetics if nausea (e.g. maropitant) Analgesia if painful conditions Minimise stress

when is hepatic lipidosis common in cats

if rapid weight loss due to absolute/relative calorie deficit increased risk if high BCS

List the clinical signs of hepatic lipidosis

Hepatomegaly Jaundice Lethargy Vomiting/diarrhoea Ileus Hypersalivation Pallor Neck ventroflexion, Coagulopathies

Describe how to treat hepatic lipidosis

IVFT - 0.9% NaCl NOT hartmans suppliment K+, phosphate and B12 according to biochem start feeding slowly- high protein low carb diet Consider antiemetics- maropitant

what is the prognosis for hepatic lipidosis

>80% recovery if treatment started early

How does refeeding syndrome occur

If patient fed too much/too quickly after prolonged anorexia. Starvation causes electrolyte depletion (K+) Insulin released by pancreas when refeeding implemented- this will use K+ and will cause it to drop even further

List the clinical signs of refeeding syndrome

Seen within 5 days of refeeding - cervical ventroflexion, - severe muscle weakness - acute red blood cell lysis - respiratory failure

Describe how to treat refeeding syndrome

Immediately reduce feeding 50% and lower carb diet and increase slowly over 4-6 days supplement electrolytes - monitor carefully Monitor PCV ECG- heart rate and rhythm

Describe how to prevent refeeding syndrome

Reintroduce feeding slowly - Max speed- 1/3rd RER on day one , 2/3rd day two, all day three Monitor K+, Mg2+ and phosphorus at least daily and supplement as needed.

Which of the following endocrine conditions is likely to result in weight loss? - Hyperadrenocorticism - Diabetes Insipidus - Insulinoma - Diabetes Meletus - Hypothyroidism

Diabetes Mellitus

if anorexia/hyporexia continues chronically, what can occur

GI disturbances (dysbiosis, intestinal hypomotility, reduced mucosal integrity) hepatic lipidosis refeeding syndrome