Anorexia and Weightloss

T/F: BCS does not change depending on body type/confirmation of animal

False, it can depend on body type

T/F: Weight loss is a diagnosis

False, it is a clinical sign, the diagnosis would be what is causing the weight loss

The first thing you should investigate if a patient has had weight loss is the _____, what are some things you investigate?

• Diet

  • Ask the owner about amount ofg snacks, treats, and supplements

  • Weigh/measure accurately

  • Investigate the quality of feed

    • Type of kibble

    • Quality of silage/hay

  • Observe if

    • Is there any competition for the food?

    • If the P is receiving/eating the whole diet

What is the difference between Hyporexia and Anorexia?

• Hyporexia

  • Decreased/reduced food intake

• Anorexia

  • Patient is not eating at all

What are important points/questions to ask if a patient has had weight loss?

• Diet

• Appetite

• Activity Level

  • Is the diet appropriate for the expected activity level?

  • Is the diet appropriate for the growth stage/other metabolic demands that the patient is undergoing?

• Health History

What are the 3 most common causes of weight loss? (aka the Triangle of Weight Loss)

1. Nutrition

   1. Feed Quality/Quantity

   2. Is the diet deficient in

      1. Macronutrients (Protein, fat, carbs)

      2. Vitamins

      3. Trace minerals

2. Parasitism

3. Dentition

What are the 2 main classification systems of weight loss?

1. Appetite

2. Underlying mechanisms

What does it mean when you classify a weight loss as Appetite?

• This looks at whether or not the weight loss is seen with or without an altered appetite

• 2 different types of classifications

  • Weight loss despite a good appetite

    • Inadequate feed provided

    • Adequate feed provided, but inadequate intake

    • Adequate feed provided, adequate intake

  • Weight loss with a decreased appetite

If a patient has a good appetite, adequate feed, but inadequate intake, what could be causing them to lose weight, why?

• Inadequate intake

  • Competition/bullying

  • Painful conditions → Dysphagia

  • Dysphagia

    • Difficulty/pain eating

  • Esophageal obstruction

    • Physically cannot take in food

If a patient has a good appetite, adequate feed, and adequate intake, what could be causing them to lose weight?

• Poor feed quality

• Poor dentition (not breaking down the food enough for good digestion)

• Malabsorption

  • Issues within the GIT → prevent proper absorption of nutrients

    • Parasitism, diarrhea, intestinal inflammation/hypoplasia

• Maldigestion

  • Lactose intolerance, pancreatic insufficiency

What could cause a patient to have decreased appetite?

• Oral pain

• Systemic illness

• Behavioral vices

• Oral medication

What are the 3 mechanisms that can cause weight loss?

1. Decreased dietary intake

   1. Inadequate diet

   2. Decreased feed access

   3. Poor dentitions

2. Malabsorption/Maldigestion

   1. Poor feed quality

   2. Poor dentition/mastication

   3. Lactose intolerance

   4. GI parasites

   5. Diarrhea

3. Increased metabolic demand

   1. Systemic infection/inflammation

   2. Protein-losing enteropathy

   3. Protein-losing nephropathy

   4. Pregnancy/lactation

What are the first 3 things you would attempt to rule out if a patient of yours presents with weight loss?

1. Nutrients

2. Parasites

3. Dentition

After those 3 have been ruled out, what do you do next in order to figure out the cause of the weight loss?

• Thorough physical exam

• Labwork

  • CBC, CHEM, UA

• Identify the body systems involved

• Further diagnostic testing

T/F: Most causes of weight loss fit into only one category

False, it is often overlapping causes of weight loss

What issues with the GIT could cause/contribute to weight loss? How can you rule out/test issues here?

• Diarrhea

• Vomiting

• Abdominal pain

• Ptyalism

  • Overproduction of saliva

• Bloodwork, fecal exam, imaging, rectal/abdominal palpation