Page 315 - Problem-Based Feline Medicine

17 – THE CAT WITH WEIGHT LOSS AND A GOOD APPETITE 307

● Availability of facilities and length of stay in hospi- ● The hypersensitivity may result from a primary,
tal varies from 2 days to 4 weeks depending on possible genetic, disorder, or arise secondary to
country and state, as it often depends on the inter- mucosal injury incurred by a number of different
pretation of radiation safety laws. disorders including bacterial, viral, protozoal or
● Side effects are few and include transient dysphagia fungal infections, bacterial overgrowth, food
or dysphonia, or permanent hypothyroidism (~2%). hypersensitivity, drug administration, metabolic
disease, neoplasia, pancreatitis or cholangiohep-
atitis.
Prognosis
● Regardless of the initial cause of the hypersensitivity,
Without treatment, cats with hyperthyroidism will usu- it results in increased mucosal permeability which
ally die of concurrent renal disease, heart disease, liver allows luminal antigens to cross the mucosa, lead-
disease or systemic hypertension. ing to inflammation and further mucosal damage.
With treatment, prognosis varies from very good to
guarded, dependent on the presence of heart disease,
Clinical signs
renal disease and systemic hypertension, whether or not
any damage has become permanent prior to treatment IBD can occur in any age, sex or breed of cat. While
of the hyperthyroidism, and which treatment options it is most commonly seen in middle-aged to older cats,
are available. a third of cases occur in cats of less than 2 years of age.
Some purebred cats may be predisposed.
Prevention Clinical signs include any combination of progres-
sive weight loss, and/or vomiting and/or diarrhea.
Since it is not known what triggers the development of
hyperthyroidism, it is currently not possible to prevent Weight loss may result from malabsorption and/
its onset. or inappetence (which usually occurs late in the dis-
ease). Not all cases show significant enteric signs,
so some cats present with only weight loss and a
INFLAMMATORY BOWEL DISEASE*** variable appetite.
Vomiting is often intermittent and may occur every
Classical signs
few days to weeks, often accompanied by anorexia and
● Any age, sex or breed of cat. lethargy. Vomiting is rarely associated with feeding. It
● Any combination of progressive weight may contain froth, bile-stained fluid and food or, occa-
loss, vomiting and/or diarrhea. sionally, blood.
Diarrhea can vary in consistency from almost well
formed to liquid. Some cats may show evidence of
Pathogenesis
large bowel involvement with mucus and/or blood and
Inflammatory bowel disease (IBD) is a group of increased frequency.
chronic idiopathic gastrointestinal tract disorders that are
Clinical signs may wax and wane, and tend to vary
characterized by infiltration with inflammatory cells.
with the type and severity of inflammation.
The infiltration may consist of lymphocytes, plasma
cells, neutrophils, eosinophils and/or macrophages, Physical examination is often unremarkable, but
and the inflammation may involve the stomach, small may reveal a thin cat, palpably thickened intestines,
intestine and/or colon. enlarged mesenteric lymph nodes and/or abdominal
discomfort.
The etiology is probably multifactorial and appears
to involve host hypersensitivity responses to antigens Concurrent pancreatitis and/or cholangiohepatitis
within the bowel lumen or mucosa. Suspected antigens may result in jaundice, a palpably enlarged liver and/or
include food, bacteria, parasites or self-antigens. anterior abdominal discomfort.