Page 1386 - Cote clinical veterinary advisor dogs and cats 4th

700 Obesity

TREATMENT ○ Metronidazole toxicosis: typically good Technician Tips
prognosis with discontinuation of met- • Use caution when cleaning external ear
Treatment Overview
VetBooks.ir • Supportive care therapy may speed improvement. • Patients often do better with self-induced
ronidazole and supportive care. Diazepam
canals.
movement. Quick movements can exacerbate
• Alleviate nausea if present.
vestibular disease.
• Treat underlying cause.
Acute and Chronic Treatment PEARLS & CONSIDERATIONS Client Education
Comments
• Vestibular: supportive care (pp. 403 and • Nystagmus is usually absent with bilateral • Signs often improve within several days.
1037) and treatment of the inciting disorder vestibular disease. • Diagnostics evaluate possible causes, need
○ Prolonged use of antinausea drugs can • Physiologic nystagmus can persist for a few for specific treatment, and help determine
delay vestibular compensation/recovery. seconds after head rotation has stopped. prognosis.
○ Discontinue metronidazole. • Idiopathic peripheral vestibular disease • Harness and sling helps patient handling.
usually causes nystagmus; nystagmus should • Nightlights can help. Loss of balance (ves-
Possible Complications resolve spontaneously in 1-2 weeks. tibular disease) together with low visibility
Use caution when cleaning external ear canals. ○ Compensation can also occur initially with can make it difficult for animals to stay
If tympanic membrane is ruptured, most other disease processes. oriented and upright.
cleaning solutions and antibiotics can cause ○ When compensation occurs with causes
damage. other than idiopathic vestibular disease SUGGESTED READING
or vascular causes, then decompensation/ Rossmeisl JH: Vestibular disease in dogs and cats. Vet
PROGNOSIS & OUTCOME relapse typically occurs. Clin North Am Small Anim Pract 40:81-100, 2010.
• Many (but not all) patients with nystagmus
• Spontaneous nystagmus often resolves within caused by central vestibular disease have other AUTHOR: James Lavely, DVM, DACVIM
EDITOR: Leah A. Cohn, DVM, PhD, DACVIM
the first several days of a vestibular event. CNS signs (mentation changes, cranial nerve
• Vestibular: varies, based on underlying cause deficits, proprioceptive deficits).

Obesity Bonus Material Client Education
Online
Sheet

BASIC INFORMATION • Crossbreed, mixed-breed, and Manx cats are • Hypertension (dogs)
at higher risk for obesity. • Pancreatitis (dogs)
Definition • Feline lower urinary tract disease (cats)
In companion animals, obesity is defined as RISK FACTORS • Urolithiasis (cats and possibly dogs)
25% above ideal body weight, which cor- • Neutering (dogs and cats) • Respiratory compromise (dogs and cats)
responds to a body condition score (BCS) of • Age (dogs and cats) • Dystocia (dogs and cats)
7 on a 9-point scale. • Female sex (dogs) • Exercise intolerance (dogs and cats)
• Male sex (cats) • Heat intolerance (dogs and cats)
Epidemiology • Strict indoor housing (cats) • Decreased immune function (dogs and
SPECIES, AGE, SEX • Apartment living (dogs and cats) cats)
Prevalence ranges up to 63% in some • Orthopedic or neuromuscular disease imped- • Increased anesthetic risk (dogs and cats)
canine populations and 59% among cats. ing mobility • Decreased life span (dogs and cats)
Incidence increases with age in both species. • Medications such as phenobarbital and
Female dogs and male cats appear to be glucocorticoids (dogs > cats) Clinical Presentation
predisposed. • Endocrine disease (e.g., hypothyroidism, Noted on routine wellness consultation or with
hyperadrenocorticism, acromegaly) associated concurrent disease
GENETICS, BREED PREDISPOSITION
• Predisposed dog breeds include Labrador and ASSOCIATED DISORDERS HISTORY, CHIEF COMPLAINT
golden retrievers, Cairn and Scottish terriers, • Hyperlipidemia/dyslipidemia (dogs and cats) Associated concurrent issue, such as exercise
collies, basset hounds, Cavalier King Charles • Insulin resistance and glucose intolerance intolerance or impaired mobility. Many owners
and cocker spaniels, dachshunds, rottweilers, (pre-diabetes; dogs and cats) do not recognize or acknowledge that their
Saint Bernards, and Newfoundlands. A • Diabetes mellitus (dogs and cats) pet is obese.
mutation in the proopiomelanocortin gene • Hepatic lipidosis (cats)
(POMC) is associated with body weight, • Orthopedic disease (dogs and cats) PHYSICAL EXAM FINDINGS
adiposity, and greater food motivation in • Dermatological disease (dogs and cats) Excessive adipose tissue is generally readily
Labrador retrievers. • Oral cavity disease (cats) recognized, but ascites or organomegaly may
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