Logical Approach to Weight Loss Flashcards
How must the problem of weight loss first be defined?
It should be defined as ‘true’ weight loss. This can include ruling out muscle atropy, appropraite caloric intake and palatability of food - i.e. is it actually being eaten by the animal.
What is an absolutely key question when assessing weight loss?
Is the animal losing weight despite a normal appetite? Or is the appetite reduced.
If an animal has weight loss with a decreased appetite, what is the next fundamental question?
Is the appetite decreased because the animal CANT eat or WONT eat.
What are the different reasons for an animal that:
a) can’t eat and
b) wont eat?
a) Prehension difficulties
Painful mouth
Dysphagia
b) Loss of smell
‘true’ annorexia
What are the two problems that may cause annorexia?
Problems that affect the feeding-satiety centres of the hypothalamus (appetite control) and direct pathology of the CNS (which is very rare)
If an animal is losing weight despite a normal appetite, what is the next stage leading to a diagnosis?
Deciding whether it is malabsorption, maldigestion or malutilisation. n.b. malabsorption & maldigestion are grouped as malassimilation.
How can the three mals be distinguished from each other?
The presence of diarrhoea often indicates a problem with malassimilation.
What are the main causes of maldigestion?
Exocrine pancreatic insufficiency.
Secondary enzyme deficiency
Deficiency of bile acid
Loss of BB enzymes
What needs to be decided if an animal seems to have a problem with absorption?
Whether there is a primary structural disease or whether there is a secondary metabolic disease.
What primary GI diseases can lead to malabsorption?
IBD Lyphangiectesia GI Lymphoma Severe intestinal bacterial overgrowth Dry FIP
What are the clinical signs of malabsorption?
Weight loss with normal appetite, but can have a decreased or capricious appetite
Diarrhoea
Coprophagia
What are the common causes of secondary malabsorption?
Right sided heart failure
Hepatic disease
Hyperthyroidism
What are the common causes of malutilisation?
DM Congestive hf Dirofilariasis Neoplasia Hyperthyroidism Liver disease Renal disease
What are the two conditions that pretty much only occur in weight loss with increased appetite?
Diabetes Mellitus
Hyperthyroidism
