Weight Loss

Question 1

Step 1: Define problem

Answer 1

Is it actually weight loss?

Could be muscle atrophy, insufficient caloric intake?, palatability? (diet changed?)

Question 2

Step 2: Refine Problem

Answer 2

Definitely weight loss-
weight loss associated with inappetence
weight loss associated with normal or increased appetite

Question 3

Name causes for inappetence

Answer 3

Can’t: Prehension difficulties, painful mouth, loss of smell, dysphagia
VS
Won’t eat: True anoxeria - satiety centre in hypothalamus not working
PRIMARY: CNS pathology (early stages - lethargy, depression with A)

Question 4

What can influence the appetite control which could result in anorexia?

Answer 4

LOWERED APPETITE influenced by high Body temp, glucose levels, substances released from neoplasia, psychic levels - fear and anxiety
(many diseases having A as manifestation seen in PE: constipation or not seen in PE: toxins, electrolyte disturbance, neoplasia, hepatic disease

Question 5

What are the 3 ‘mals’ and what type of weight loss are they involved in, in terms of appetite?

Answer 5

Maldigestion, Malabsorption (together called: Malassimilation), and Malutilisation
Involved in weight loss due to normal/increased appetite- 3 processes that disrupt the normal physiology when food is ingested

Question 6

Describe Maldigestion and name example:

Answer 6

Maldigestion is impaired digestion

Examples: exocrine pancreatic insuffiency - amylase, protease, lipase (treat with supplements) - common in dogs

Question 7

Describe Malabsorption and name example:

Answer 7

Malabsorption is digested food but nutrients cannot be absorbed
within Small I - primary or secondary disease
Primary: impaired structure - IBD (Dog: diarrhoea, Cat: vomit) and Lymphangiectasia (pathogenic dilation of Lvessels), Dry Feline Infectious peritonitis (intestines granuloma - chronic inflammation - cobblestone)

Question 8

Clinical Signs of Dry Feline Infectious Peritonitis

Answer 8

FIP has wet and dry forms
intestines granulomas causing - weight loss (normal/increased appetite), diarrhoea (slight to severe) and coprophagia - eating faeces - nutrients present!

Question 9

Name secondary gut diseases associated with Malabsorption:

Answer 9

Hepatic disease, right sided cardiac disease (perfusion problem infers with gut), hyperthyroidism (high metabolic rate, less time for food in transit in gut common in cats

Question 10

Describe Malutilisation and name example

Answer 10

Malutilsation - food is digested and absorbed - but lost nutrients (protein/glucose) or failure to utilise (normal/increased appetite)
MAIN DIAGNOSTIC: normal faeces (slight diarrhoea)
Example: diabetes mellitus (calories lost), congestive heart failure, Dirofilariasis (heartworm), Neoplasia/cancer cachexia, hyperthyroidism, Liver disease? Renal disease

Question 11

Name two diseases which can be diagnosed from knowing the appetite is increased in malutilised patients

Answer 11

True polyphasia - Diabetes mellitus and hyperthyoidism (drink and urinate more)