FORM & FUNCTION (Cachexia & Pregnancy Toxemia)

Question 1

Cachexia:

Answer 1

-metabolic wasting disorder accompanied primarily by loss of lean body mass (muscle)

Question 2

Cachexia symptoms:

Answer 2

-decrease skeletal muscle mass
-with or without weight loss
-loss of appetite
-increase metabolic rate

Question 3

Cachexia is commonly observed in:

Answer 3

-cancer
-congestive heart failure
-chronic kidney disease
-COPD (chronic obstructive pulmonary disease)

Question 4

Cachexia vs. starvation:

Answer 4

Starvation:
-no nutrient intake
-adaptive response to conserve muscle mass (CHO to lipids to proteins)

Cachexia:
-nutrient intake
-no adaptive response: proteins are targeted as first source of nutrient (proteins to lipids to
CHO)

Both:
-progressive loss of muscle mass
*non-muscle proteins are preserved in cachexia, but NOT in starvation

Question 5

TNF-a

Answer 5

-an inflammatory cytokine (small signalling protein)
-highly elevated in many disease states
*triggers another enzyme which leads to inhibition of growth and maintenance of muscle mass
*metabolic effects

Question 6

TNF-a triggers another enzyme

Answer 6

-promotes ubiquitin-proteasome system
-promotes inflammation
-inhibits myogenesis (muscle build up)
*increase catabolism of muscle

Question 7

Metabolic effects of TNF-a

Answer 7

1. Increase muscle loss
2. Decrease food intake: anorexia
3. Impaired glucose control: insulin resistance (inhibits IRS-1: so don’t get GLUT4)
4. Increase lipid metabolism/lipolysis (elevated serum triglycerides
   >inhibition of PP1

Question 8

Muscle wasting:

Answer 8

-primary feature of cachexia
*elevated inflammation is the underlying mechanism
-can be followed by subsequent weight loss (anorexia)

Question 9

Congestive heart failure:

Answer 9

-inadequate blood pumping to the body
>hypoxemia: impaired oxygen to tissues
*50% of dogs with CHG display cachexia
-loss of lean muscle mass is greater than total weight loss
-elevated levels of TNF-a

Question 10

Cardiac cachexia: multifactorial cause of muscle and fat loss (lesser extent)

Answer 10

-lack of appetite
-decrease perfusion to GI system: malabsorption and maldigestion
-increase in inflammatory factors: enhances muscle protein degradation
-increased resting energy requirement

Question 11

Cyclical relationship of cardiac cachexia:

Answer 11

1. Heart failure leads to increased TNF-a
2. Muscle loss
3. Contributes more to heart failure
   REPEAT

Question 12

Cachexia: edema and ascites

Answer 12

-have reduced levels of serum albumin
-increase in metabolism of AA for energy reduces the protein synthesis in liver
>loss fluid to interstitial space or abdominal cavity

Question 13

Body weight vs. muscle mass:

Answer 13

-increase in fluid retention can mask loss of muscle and fat in terms of total body weight
-assessing total body weight can underestimate the development of cachexia
-need to use direct assessment of muscle mass

Question 14

Cachexia and morbidity:

Answer 14

-increases morbidity of animals with CHF

Question 15

Obesity paradox:

Answer 15

-obese animals have increased survival rate in CHF, cancer and chronic kidney disease
-excess fat may be protective against cachexia by reducing starvation-related complications

Question 16

Pregnancy toxemia:

Answer 16

-metabolic disease in pregnant animals caused by imbalance between dam nutritional intake and fetal demand
-commonly occurs during late gestation
-most common in sheep and goats pregnant with multiple offspring

Question 17

Late gestation:

Answer 17

-large fetus size can cause compression on dams stomach=decrease appetite=reduced nutritional uptake
-exponential energy requirement of fetus (rapid growth)

Question 18

Primary markers of pregnancy toxemia:

Answer 18

-lethargy and anorexia
-blood chemistry test: hypoglycemia and hyperketonemia

Question 19

Nutrients crossing the placenta:

Answer 19

-glucose is most important
-glucose depleted: ketones can be passed through (last resort)

Question 20

Maternal:fetus ketone ratio:

Answer 20

-human 2:1
-rats 1:1
-ruminants 10:1
*has to make so much more ketones to actually get it to the fetus

Question 21

Pregnant human: maternal hyperketonemia

Answer 21

-due to starvation or diabetes
-leads to excess fetus ketone=metabolic acidosis

Question 22

Metabolic acidosis of fetus: causes increases in

Answer 22

-stillborn
-malformations
-impaired neurophysiological development (due to change in pH)

Question 23

Pregnancy toxemia leads to:

Answer 23

-fatty liver disease
-metabolic acidosis
-ketonuria (dehydration)

Question 24

Effects of pregnancy toxemia cause:

Answer 24

-reduced activity
-ataxia, muscle tremor
-coma: leading to death

Question 25

How to treat/prevent pregnant toxemia:

Answer 25

1. Glucose supplementation
   >Corn syrup
   >Polyethylene glycol to propionate
2. Fluid & electrolyte therapy