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Flashcards in Logical Approach to Weight Loss Deck (17)
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What is the first step in approaching a weight loss problem?

DEFINE the problem - is it actually weight loss due to a pathology?
> Caloric intake correct? [for life stage and exercise]
> Palatability? [ food change? fake dog food?]
> Muscle atrophy rather than fat weight loss? eg. temporal myositis


What is the second diagnositc step?

REFINE the problem - Weight loss due to inappetance
Weight loss despite a normal or increased appetite


If decreased appetite is noted, how may the problem be refined further?

CANT eat or WONT eat?
- Cant eat:
Prehension difficulties eg. temporal myositis
Painful mouth eg. dental disease
Dysphagia eg. melanomas
- Wont eat:
Loss of smell? Esp cats. Eg respiratory disease
True anorexia - no apetite


What may cause true anorexia?

Direct CNS pathology
Feeding satiety centres in hypothalamus affected by
- blood glucose
metabolic products (eg.renal/hepatic disease)
neural GIT input (inflammation/distenion)
substances released by neoplasia
psychic factors (stress, separation enxiety etc.)


What is the next stage after the problem has been defined and refined as True Anorexia?

- Define the system: CNS
- Then.. Primary v secondary CNS problem?
Secondary most common BUT anorexia with lethargy may be only early manifestation of CNS disease


What are potential secondary CNS disease causes of anorexia?

- Endogenous toxins
- Exogenous toxins
- Pyrexia
- Electrolyte disturbance
- Hepatic disease
- Neoplasia
- Pyschic factors


If no decreased appetite is noted, what are the potential causes of weight loss?

Maldigestion (normal digestion impaired)
Malabsorption (digested normally but not absorbed)
(sometimes termed malassimilation together)
Malutilisation (utilised abnormally by the body OR lost)


What are the potential causes of maldigestion? Which is most common?

EPI in dogs, most common
2ndry enzyme deficiency (luminal conditions not optimal for enzyme function.)
Bile acid deficiency
Loss of brush border enzymes


What are the potential causes of malabsorption?

Structural disease of SI (1ry GI disease)*
Metabolic disease making absorption more difficult (2ndry GI disease)*


Give 5 examples of primary GI disease causing malabsorption

Infiltrative diseases of the gut
- Lymphangiectasia
- GI lymphoma
- severe SI bacterial overgrowth
- dry FIP
+ fungal infection is abroad (US, Asia etc.)


What are the clinical signs associated with malabsorption?

-Often despite normal/increased appetite BUT may have decreased/capricious appetite due to inflame etc.
-Diarrhoea from slight to severe
-Sometimes coprophagia


Give 3 examples of secondary GI disease causing malabsorption

- Hepatic disease (bile acids important for digestion and absorption of fats esp.)
- Right sided cardiac disease (->portal hypertension and pericardial effusion)
- Hyperthyroidism -benign but functional tumour (Gut transit time decreased, poor absorption. Weight loss also due to ^metabolic rate)


What two ways may malutilisation occour?

Failure to utilise nutrients OR loss of nutrients after absortion


How may malutilisation be identified?

Usually diarrhoea not present
- except hyperthyroidism


What are the potential causes of malutilisation if normal or slightly increased appetite is present?

Diabetes mellitus
Dirofilariasis (Not UK)
Liver disease? Usually inappetant
Renal disease
- protein losing nephropathy
- tubular disease with only slight decrease in appetite


What are the two possible causes of malutilisation with INCREASED appetite?

Diabetes Mellitis


How may hyperthyroidism be identified in dogs? Is it common?

Thyroids will be massively enlarged