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Weight Loss 1047

• Normal vaginal flora is mixed (Escherichia Technician Tips pups should be allowed to go through an
coli, Pasteurella multocida, beta-hemolytic • When providing services for the breeding • When using transdermal hormone replace-
estrous cycle before ovariohysterectomy.
VetBooks.ir Abnormal flora is typically a single isolate • An empty 3-mL syringe case or an otoscope ment–containing estrogens, consult with Diseases and Diseases and Disorders Disorders
Streptococcus group G most common).
bitch, always recommend regular Brucella
screening.
and/or heavy growth.
your physician about a topical location for
• Vaginal cytologic exam always helps to detect
discharge due to estrus and the presence of cone can be inserted between the vulvar lips application that will not be in contact with
pets.
and used as a sterile guard when collecting
estrogen influence in the bitch. vaginal cultures.
• Video vaginoscopy facilitates the evaluation SUGGESTED READING
of the entire canine vagina, which can be up Client Education Johnston SD, et al: Disorders of the canine vagina,
to 35 cm long in some breeds. • Positive bacterial culture does not necessarily vestibule, and vulva. In Johnston SD, et al, editors:
• Surgical correction of strictures is not advised; indicate infection. Canine and feline theriogenology, Philadelphia,
clitorectomy is advised in cases of clitoral • Prebreeding antibiotics do not prevent Saunders, 2001, pp 225-242.
hypertrophy. vaginitis or pyometra. AUTHOR: Sophie A. Grundy, BVSc (Hons), MANZCVS,
• Puppy vaginitis is usually self-limited and DACVIM
Prevention does not require antimicrobial treatment; EDITOR: Michelle A. Kutzler, DVM, PhD, DACT
Pyometra may be avoided by ovariectomy/ antimicrobial treatment of puppy vaginitis
ovariohysterectomy. may prolong resolution of the problem. These

Weight Loss

BASIC INFORMATION PHYSICAL EXAM FINDINGS • Cats: feline leukemia virus/feline immunode-
Poor body condition (or decrease compared ficiency virus (FeLV/FIV) testing, thyroxine
Definition with historic BW) ± poor haircoat, muscle (T 4 ) level (>5 years old)
Weight loss can be intentional or uninten- atrophy, findings related to cause of weight
tional, but this chapter focuses on decreased loss (e.g., palpable mass might be present if Advanced or Confirmatory Testing
body weight (BW) and/or muscle mass as the cancer cachexia is cause for weight loss) Choice of testing is guided by preliminary data
unintended consequence of disease. but often includes the following:
Etiology and Pathophysiology • Abdominal imaging (radiographs/ultrasound)
Synonyms • BW is affected by caloric intake, absorptive to identify organomegaly, mass, effusion,
Cachexia, emaciation, muscle wasting, capacity, metabolic demand, and nutrient losses. GI tract thickening or intestinal layer loss,
catabolism • Weight loss may result from pancreatitis
○ Inadequate quantity or quality of diet • Urine protein-to-creatinine ratio to rule out
Epidemiology ○ Inability to prehend or swallow food protein-losing nephropathy
SPECIES, AGE, SEX ○ Regurgitation or vomiting of ingesta • Bile acids to rule out liver failure and
Any species, any age, either sex ○ Inappetence portosystemic shunt (can exist even with
○ Inability to digest or absorb ingested normal biochemistry panel)
Clinical Presentation nutrients (e.g., exocrine pancreatic insuf- • Thoracic radiographs: rule out metastatic or
DISEASE FORMS/SUBTYPES ficiency [EPI], enteropathies) other pulmonary disease
• Accompanied or unaccompanied by local- ○ Inability to use absorbed nutrients (e.g., • Comprehensive thyroid testing (p. 503)
izing gastrointestinal (GI) signs diabetes mellitus, liver failure) • ACTH stimulation test to rule out
• Results from one or more mechanisms: ○ Increased metabolic rate (hyperthyroidism) hypoadrenocorticism
decreased caloric intake, increased physiologic ○ Increased catabolism (e.g., sepsis, neopla- • Trypsin-like immunoreactivity (TLI) to
calorie utilization, catabolism associated with sia, heart failure, renal failure) rule out EPI (especially if small bowel
pathology, or nutrient loss. ○ Loss of nutrients (e.g., protein-losing diarrhea)
nephropathy or enteropathy) • Fecal alpha 1-protease inhibitor activity if
HISTORY, CHIEF COMPLAINT protein-losing enteropathy is suspected in
• Often, thin appearance, lethargy, decreased DIAGNOSIS the absence of diarrhea
appetite, muscle atrophy • Upper GI endoscopy to rule out esophageal
• It is important to determine Diagnostic Overview or gastric foreign body, ulcerations, luminal
○ Quantity, quality, and appropriateness of Weight loss is a nonspecific clinical sign. When neoplasms, and lymphangiectasia
the diet it is not deliberate, a broad systemic evaluation • GI biopsies by endoscopy, laparotomy, or
○ Appetite (increased or decreased) beginning with routine blood, urine, and fecal laparoscopy
○ Daily activity/caloric expenditure tests is indicated. • Infectious disease testing when indicated
○ Presence of physiologic conditions that
may increase energy requirements (e.g., Differential Diagnosis TREATMENT
extreme exercise, growth, pregnancy, The differential diagnosis is provided on p. 1295.
lactation) Treatment Overview
○ Presence of localizing GI signs (e.g., Initial Database Treat underlying disease and provide nutritional
dysphagia, regurgitation, vomiting, diar- • CBC, biochemistry panel, urinalysis, fecal support.
rhea) parasite testing

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