DM3 Pt3-1 The Anorexic Cat

Question 1

What are common causes of anorexia in cats?

Answer 1

Causes include upper respiratory tract disease, oral disease, renal failure, pancreatitis, liver disease, cardiac disease, anemia, neoplasia, acute or chronic pain, and nausea.

Question 2

Why is nutrition important in hospitalized anorexic cats?

Answer 2

Adequate nutrition is vital for energy, protein synthesis, vitamin/mineral supply, immune system function, and tissue repair. Without it, cats may experience muscle weakness, delayed healing, sepsis, altered drug metabolism, and hepatic lipidosis.

Question 3

What are the consequences of prolonged anorexia in cats?

Answer 3

Consequences include dehydration, hepatic lipidosis, muscle and fat loss, weakness, hypoglycemia, immune suppression, delayed healing, altered drug metabolism, and reduced quality of life.

Question 4

Why should force feeding or syringe feeding be avoided in anorexic cats?

Answer 4

Force feeding can lead to food aversions, making the cat more likely to refuse food long-term, especially if they are feeling nauseous.

Question 5

How can the environment be adjusted to encourage a cat to eat?

Answer 5

Reduce environmental stress, keep the food bowl far from the litter tray, offer familiar or more palatable food, provide small frequent meals, use wide shallow bowls to avoid whisker contact, and create a calm environment by covering the cage or allowing the cat to hide while eating.

Question 6

What clinical examination points should be assessed in an anorexic cat?

Answer 6

Examine for oral/dental disease, nasal discharge, upper respiratory tract noise, pale or jaundiced mucous membranes, goiter, abdominal pain, skin wounds, and check for post-surgical pain or infection.

Question 7

What foods can be offered to stimulate appetite in an anorexic cat?

Answer 7

Offer familiar foods, increase palatability by adding flavors, warming the food, or changing the texture. Tempting strategies include smearing food on the cat’s paws or face to trigger a licking response.

Question 8

How should feeding bowls be chosen for anorexic cats?

Answer 8

Use wide shallow bowls to prevent the cat’s whiskers from touching the sides, as whisker contact may cause discomfort.

Question 9

What medications might cause inappetence in cats?

Answer 9

Some drugs, such as metronidazole, can cause nausea or inappetance and should be reviewed in anorexic cats.

Question 10

Why is hepatic lipidosis a concern in anorexic cats?

Answer 10

Cats are highly prone to hepatic lipidosis after short periods of anorexia, leading to fat accumulation in the liver, which can result in severe illness if not addressed early.

Question 11

Which antibiotics are known to cause anorexia in cats?

Answer 11

Antibiotics such as penicillin, trimethoprim/sulphonamides, and doxycycline can cause anorexia in cats.

Question 12

What NSAIDs can lead to anorexia in cats?

Answer 12

Meloxicam is an NSAID that can cause anorexia.

Question 13

Which opioids are associated with causing anorexia in cats?

Answer 13

Morphine and methadone are opioids that can lead to anorexia.

Question 14

Which diuretic can cause anorexia in cats?

Answer 14

Furosemide is a diuretic that may lead to anorexia.

Question 15

What are some chemotherapeutic drugs that may cause anorexia in cats?

Answer 15

Vincristine and cyclophosphamide can cause anorexia as side effects.

Question 16

What appetite stimulants can be used for anorexic cats?

Answer 16

Diazepam, cyproheptadine, and mirtazapine are commonly used appetite stimulants.

Question 17

Why is long-term use of diazepam not recommended for stimulating appetite in cats?

Answer 17

Long-term use of diazepam is not recommended due to its association with idiosyncratic hepatic necrosis and potential to cause food aversions.

Question 18

What are the benefits of using mirtazapine for anorexia in cats?

Answer 18

Mirtazapine is useful because it has anti-emetic properties, is administered only every 72 hours, and is effective for treating nausea-related anorexia.

Question 19

What side effects are associated with mirtazapine in cats?

Answer 19

Side effects of mirtazapine include hyperactivity and vocalization, which can be treated with cyproheptadine.

Question 20

What are some non-drug-related strategies to encourage eating in anorexic cats?

Answer 20

Strategies include reducing environmental stress, offering familiar foods, improving food palatability, using wide shallow bowls, and hand-feeding.

Question 21

Why is syringe or force feeding not recommended in anorexic cats?

Answer 21

Syringe feeding is not recommended because it can cause food aversions that are difficult to reverse, especially in cats experiencing nausea.

Question 22

What should be considered when assessing an anorexic cat in hospital?

Answer 22

Key considerations include checking for pain, nausea, stress, hypokalemia, and evaluating for conditions such as oral disease, renal failure, and hepatic lipidosis.

Question 23

How does hepatic lipidosis develop in anorexic cats?

Answer 23

Hepatic lipidosis occurs when cats, after even a short period of anorexia, start breaking down fat for energy, leading to fat accumulation in the liver and liver dysfunction.

Question 24

Which diagnostic tests are recommended for an anorexic cat?

Answer 24

Perform routine haematology, biochemistry, and consider testing for pancreatic lipase immunoreactivity (PLI) for chronic pancreatitis, which may present only as anorexia.

Question 25

How should inappetant cats be monitored in a hospital setting?

Answer 25

Inappetant cats should be weighed daily, and their food intake should be carefully recorded and compared to their nutritional requirements.

Question 26

What should owners know about inappetant cats being discharged from the hospital?

Answer 26

Owners must understand the seriousness of their cat not eating and should be instructed to bring the cat back if anorexia persists, as prolonged anorexia can lead to serious complications such as hepatic lipidosis.

Question 27

What medications can be used to treat pain as a possible cause of anorexia in cats?

Answer 27

Buprenorphine (0.01-0.02mg/kg i/m or sublingual every 8 hours) can be used to treat pain in cats. It is effective when absorbed across the buccal mucosa and can be administered at home.

Question 28

When should enteral assisted feeding be considered for anorexic cats?

Answer 28

Enteral assisted feeding is recommended if the cat has not been consuming enough for 3 or more days, has lost 10% bodyweight, or has increased nutrient demands due to trauma, surgery, or illness.

Question 29

What type of diet is recommended for enteral feeding in cats?

Answer 29

Diets should be highly digestible and high in energy density, particularly rich in fat and protein. Commercially prepared formulations are preferred to ensure cats’ unique nutritional requirements are met.

Question 30

Why should human baby food not be used for enteral feeding in cats?

Answer 30

Human baby food often contains onion powder, which can cause oxidative damage to feline red blood cells and lead to hemolytic anemia.

Question 31

What are the indications for using a naso-oesophageal tube for enteral feeding?

Answer 31

A naso-oesophageal tube is indicated for short-term nutrition (up to 7 days) and in cases of mild anorexia where general anesthesia is not required.

Question 32

What are the contraindications for using a naso-oesophageal tube?

Answer 32

Contraindications include vomiting, regurgitation, or presence of nasal, oral, or esophageal disease.

Question 33

What are the advantages of using a gastrotomy tube for enteral feeding?

Answer 33

Gastrotomy tubes can be used for long-term nutrition, accommodate larger tube diameters, are well tolerated, and can be used by owners at home.

Question 34

What are the disadvantages of using a gastrotomy tube?

Answer 34

Disadvantages include requiring general anesthesia (GA), specialist equipment, and the risk of complications like dislodgement, peritonitis, and stoma infection.

Question 35

How should food be introduced to a cat with a feeding tube?

Answer 35

Introduce food gradually over 3 days:
- Day 1: Feed 1/3 total daily requirement, mixed 1:2 water.
- Day 2: Feed 2/3 total daily requirement, mixed 2:1 water.
- Day 3: Feed total daily requirement undiluted.

Question 36

What is the formula to calculate a cat’s Basal Energy Requirement (BER)?

Answer 36

For cats > 2kg: 30 x BW (kg) + 70.
For cats < 2kg: 70 x BW^0.75.

Question 37

How is the total daily food requirement calculated for an anorexic cat?

Answer 37

Total daily food requirement (ml) = BER / Metabolisable Energy (ME) of the food.

Question 38

What are the additional water requirements for a cat on enteral feeding?

Answer 38

Additional water requirements = 50ml/kg/day, minus the amount of water provided by the food.

Question 39

What are the potential complications of jejunostomy tube feeding in cats?

Answer 39

Complications include easily dislodged tubes, the need for continuous feeding, and the requirement for surgical placement under GA.

Question 40

What is a major disadvantage of syringe feeding in anorexic cats?

Answer 40

Syringe feeding can induce food aversion and is unlikely to meet the cat’s caloric requirements.

Question 41

What should be monitored closely in hospitalised cats receiving assisted feeding?

Answer 41

Bodyweight, body condition score, and food intake should be closely monitored daily, and compared to the cat’s nutritional requirements.