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Cachexia

ISSN 2398-2985

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Introduction

  • Cause: inadequate access to food, inappropriate diet, stress induced anorexia, disease process leading to anorexia (eg dental disease, renal disease, neoplasia), altered metabolism or absorption.
  • Signs: poor body condition, muscle atrophy, weakness.
  • Diagnosis: clinical appearance, body condition score, history, diagnosis of underlying disease process
  • Treatment: correct hydration and electrolyte imbalances prior to implementing assist feeding, treat underlying medical cause.
  • Prognosis: poor if underlying clinical disease.

Presenting signs

  • Weakness or collapse Collapse.
  • Debilitation.
  • Emaciated body condition (body condition score 1/5) Assessment of growth / body condition scoring.
  • Signs related to underlying disease, eg polyuria, polydipsia, diarrhea Diarrhea.
  • Anorexia Anorexia if underlying disease process, may have normal or increased appetite if due to metabolic or chronic disease.

Acute presentation

Age predisposition

  • May occur more frequently in aged animals if related to underlying or chronic disease, eg neoplasia Insulinoma.

Cost considerations

  • Intensive treatment protocol requiring hospitalization for supportive care: fluid therapy, blood electrolyte monitoring, nutritional support, pain management.
  • Cost of diagnostics, eg bloods, diagnostic imaging to investigate underlying cause.

Special risks

  • Anesthetic risk of emaciated, unstable animal.
  • Risk of refeeding syndrome: monitor electrolytes as start to introduce feeding after period of anorexia.

Pathogenesis

Etiology

Predisposing factors

General

  • Any chronic disease process leading to altered metabolism, impaired digestion or absorption.

Specific

Pathophysiology

  • Malnutrition.
  • Maldigestion.
  • Malabsorption.
  • Leads to loss of protein from skeletal muscle leading to atrophy.
  • Loss of body fat reserves.
  • Loss of protein from liver, heart, intestine impairs function.
  • Increased mobilization of fat reserves by the liver may result in hepatic lipidosis due to excessive fat accumulation in the liver.

Timecourse

  • Chronic: weeks, months.

Diagnosis

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Treatment

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Prevention

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Outcomes

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Further Reading

Publications

Refereed papers

Other sources of information

  • van Zeeland Y R A & Schoemaker N J (2021) Nutrition and Fluid Therapy. In: Exotic Animal Emergency and Critical Care Medicine. Eds: Graham J E, Doss G A & Beaufrere G. Wiley Blackwell, USA. pp 109-122.