Page 279 - Problem-Based Feline Medicine

16 – THE CAT WITH ACUTE DEPRESSION, ANOREXIA OR DEHYDRATION 271

Pathogenesis line, clomipramine) or selective serotonin re-uptake
inhibitors, together with environmental changes may
Removal of significant persons, or other pets from
be effective (see The Cat With Anxiety-Related
the cat’s environment, or removal of the cat from famil-
Behavior Problems, page 1014, for doses). Other treat-
iar surroundings may trigger separation or situation
ments that have been used (but some may have undesir-
anxiety.
able side effects) include hydroxyzine, phenobarbital,
Introduction to new persons, pets or surroundings megesterol acetate, prednisone, diazepam, oxazepam,
may also trigger anxiety. cyproheptadine at standard doses and catnip.
Dependency can develop with some treatments.
The cat’s personality is an important risk factor.
Nasoesophageal, esophagostomy or gastrostomy
Separation/situation anxiety may exacerbate second-
tube feeding or parenteral nutrition should be insti-
ary anorexia and depression in a hospitalized cat.
tuted for hospitalized cats if anorexia persists for more
than 3 days.
Clinical signs
Variable withdrawal, inactivity, anorexia and dehydra- Prognosis
tion.
The ability of the cat to adapt is dependent upon per-
Other behavioral signs may occur, such as aggression sonality.
to other pets or persons, and inappropriate elimination.
Hepatic lipidosis may complicate primary anorexia,
No signs of another disorder causing depression and especially in an obese cat anorexic for more than two
anorexia. weeks.
Weight loss is dependent on degree and duration of
anorexia. Complete anorexia will result in detectable ACUTE HYPOKALEMIA**
lumbar muscle wasting within one week.
Classical signs

Diagnosis ● Ventroflexion of the neck
● Stilted forelimb gait.
History of change in environment.
Ruling-out other causes of depression and anorexia. Pathogenesis

Hypokalemia results from insufficient potassium
Differential diagnosis
intake and/or excessive urinary or gastrointestinal
Other causes of depression and anorexia. potassium loss and/or translocation from extracellular
to intracellular fluid.
Treatment Hypokalemia may be seen in numerous disorders
including chronic renal failure, post-obstructive diure-
No treatment is necessary if signs are mild and it is
sis, intravenous fluid therapy with potassium-poor flu-
likely that the cat will adapt.
ids, furosemide therapy, vomiting, hyperaldosteronism
Return cat to previous environment if possible. (rare) and the treatment of diabetic ketoacidosis.
Anorexia may contribute to hypokalemia, which in turn
Offer a variety of foods, warm the food, increase
may exacerbate anorexia and depression.
palatability of food with clam juice, or canned tuna or
salmon juice.
Clinical signs
Anxiolytic and/or appetite-stimulant drugs or herbal
remedies may be useful if anorexia or anxiety cannot be Lethargy, muscle weakness, anorexia – increasing
quickly resolved. Tricyclic antidepressants (amitripty- risk with decreasing potassium level.