MODULE 3 PART 4: POLYSYSTEMIC DS. - CACHEXIA

Question 1

Define cachexia.

Answer 1

Abnormally thin body condition for the animal’s size and body type

Question 2

What are the causes of cachexia?

Answer 2

1. Inadequate nutrition
2. Starvation
   * insufficient caloric or nutritional intake
   * unbalanced diet
3. GIT parasites
4. Inability to digest and absorb nutrients
   * maldigestion
   * malabsorption
5. Caloric loss
   * protein-losing nepropathy
   * GIT abnormalities
6. Neoplasia
7. Metabolic disorders
   * heart failure
   * chronic renal ds
   * chronic liver ds.
8. Endocrine diseases
   * diabetes mellitus
   * hyperadrenocorticism
   * hypoadrenocorticism
   * hypethyroidism
9. Chronic infectious ds.
   * systemic fungal infection
   * feline infectious peritonitis (FIP)
   * Conditions associated with feline leukemia virus
   * Rickettsial ds. (such as ehrlichiosis and Lyme ds.)

Question 3

What are the effects of cachexia?

Answer 3

• Protein-calorie malnutrition leading to digestive and absorptive abnormalities
• Hypoalbuminemia, alongside decreased plasma protein and altered plasma protein binding of medications
• Reduced hemoglobin production, resulting in anemia
• Decreased resistance to bacterial infections
• Impaired wound healing, with a higher incidence of decubitus ulcers
• Growth retardation

Question 4

In nutrition, if the animal is cachexic and has decreased food intake and weight loss, what could be the possible reasons?

Answer 4

• Environmental disturbances leading to anorexia, especially in cats
• Neurological disorders
• Illness or treatment resulting in malaise, anorexia, or nausea

Question 5

In nutrition, if the animal is cachexic and has increased appetite and weight loss, what could be the possible reasons?

Answer 5

• Underfeeding
• Hyperthyroidism
• Hyperadrenocorticism
• Diabetes mellitus
• Maldigestion

Question 6

In GI system, if the animal is cachexic and has abnormal feces quality (voluminous, soft, and foul-smelling stools), what could be the possible reasons?

Answer 6

• Maldigestion
• Hyperthyroidism

Question 7

In GI system, if the animal is cachexic and has intermittently watery to firm stools or persistent diarrhea, what could be the possible reasons?

Answer 7

• Malabsorption
  *. GI parasitism
• Metabolic ds. (e.g., renal or liver ds., hypoadrenocorticism)

Question 8

In GI system, if the animal is cachexic and melena, what could be the possible reasons?

Answer 8

• GI parasites
• GI neoplasia
• GIT disorders (renal or liver ds., hypoadrenocorticism)

Question 9

In GI system, if the animal is cachexic and vomiting, what could be the possible reasons?

Answer 9

• GI inflammatory diseases, gastric or high intestinal neoplasia
• Metabolic disorders (renal or liver ds., diabetic ketoacidosis, hypoadrenocorticism)

Question 10

In respiratory system, if the animal is cachexic and experiencing respiratory dyspnea, what could be the possible reasons?

Answer 10

• Pleural effusion
• FIP
• Hypoalbuminemia
• Heart failure
• Pulmonary infections

Question 11

If the animal is cachexic and has diaphragmatic hernia, what could be the possible reasons?

Answer 11

• Lymphosarcoma
• Thymoma
• Heart base tumor

Question 12

If the animal is cachexic and has pulmonary edema, what could be the possible reasons?

Answer 12

• Heart failure
• Uremia
• Hypoalbuminemia
• Infections

Question 13

If the animal is cachexic and has cough, what could be the possible reasons?

Answer 13

• Heart failure particularly in dogs
• Heartworm ds.
• Heart base tumor
• Hilar lymphadenopathy
• Pulmonary infections

Question 14

If the animal is cachexic and has history of lameness, what could be the possible reasons?

Answer 14

• Mycotic osteomyelitis
• Neoplastic bone lesions
• Septic or immune complex arthritis
• Orthopedic problems
• Neurological issue

Question 15

If the animal is cachexic and has visual system history (?), what could be the possible reasons?

Answer 15

• Diabetic cataracts
• Intraocular, CNS, or generalized neoplasia
• Certain infectious ds. (systemic mycoses, FIP, ehrlichiosis)
• Hypertension related to renal ds.
• Hepatic encephalopathy
• CNS ds.

Question 16

If the animal is cachexic and has history of endocrine ds.: PU/PD, what could be the possible reasons?

Answer 16

• Hyperthyroidism
• Hypoadrenocorticism
• Hyperadrenocorticism
• Diabetes mellitus
• Chronic renal and liver ds.
• Rarely, heart failure

Question 17

If the animal is cachexic and has history of pseuodoobesity, what could be the possible reasons?

Answer 17

1. Peritoneal effusion
   * Hypoproteinemia
   * Portal hypertension
2. Right heart failure
3. Liver ds.
4. Abdominal neoplasia
5. Extreme hepatomegaly or splenomegaly
6. SC edema
   * Liver ds. with decreased albumin production
   * Protein-losing nepropathy and hypoalbuminemia
   * Protein-losing enteropathy and hypoproteinemia
   * Right heart failure

Question 18

A thorough PEX is crucial when assessing animals with cachexia. Significant findings may include ?

Answer 18

1. Mass lesions
   * May be indicative of neoplasia, adenomatous thyroid hyperplasia or osteomyelitis
2. Peritoneal effusion
   * Hypoproteinemia
   * Portal hypertension
   * Abdominal neoplasia
   * FIP
3. Dyspnea and cough
   * Pleural effusion
   * Pulmonary edema
   * Heart failure
   * Pulmonary/intrathoracic neoplasia
4. Limb masses
   * Neoplasia/infections
   * Septic/immune complex arthritis
5. Neurological abnormalities
   * Neoplasia
   * Mycotic ds.
   * FIP
   * Ehrlichiosis of CNS

Question 19

What are the causes of inadequate dietary intake?

Answer 19

• Neglect or ignorance
• Aggression from other animals
• Physical limitations
• Nutritional deficiencies during stress
• Lack of proper food
• Inadequate feeding practices

Question 20

What is the tx. for inadequate dietary intake?

Answer 20

By providing sufficient amounts of a well-balanced diet and initially supplementing with vitamins