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.

Pathogenesis

Etiology

• End stage of chronic disease process, eg chronic renal failure Renal failure, chronic dental disease Periodontal disease, neoplasia Insulinoma, cardiac disease Heart disease.

Predisposing factors

General

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

Specific

• Renal failure Renal failure leading to protein losing nephropathy.
• Chronic intestinal disease, eg inflammatory bowel disease Inflammatory bowel disease leading to protein losing enteropathy.
• Neoplastic disease Insulinoma.
• Cardiac disease Heart disease.
• Chronic infectious / inflammatory disease.

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

Treatment

Prevention

Outcomes