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Weakness Weight Loss 1295

Weakness
VetBooks.ir Major Causes Hemorrhage Neuromuscular/polyneuropathies

Anemia
Orthopedic disorders
Fever
Cardiovascular disorders Infectious disease states Nutritional disorders
Chronic wasting diseases Metabolic dysfunction states Overactivity
Drug or toxin Myopathic disorders Pain
Electrolyte disorders Neoplasia Pulmonary diseases
Endocrine disorders Neurologic disorders
Modified from Ettinger S, Feldman E: Textbook of veterinary internal medicine, ed 5, St. Louis, 2000, Saunders.

Weight Loss

Category Disorder Key Feature
Adequate calorie intake absent GI signs
Inadequate calorie provision Dietary history, including amount fed
Physiologic increases in energy demand (e.g., exercise, History and physical exam
pregnancy, lactation, growth)
Pathologic increases in energy demand (e.g., hyperthyroidism) History and physical exam; serum T 4 Differentials, Lists, and Mnemonics
Compromised Ability to Eat or Retain Food
Unwilling or unable to prehend or masticate food Shows interest in food; observe animal eating; thorough oral exam (sedation may be
required)
Dysphagia Observe eating and ability to swallow; neurologic exam; dynamic barium esophagram
under fluoroscopy
Regurgitation History of frequent regurgitation (differentiate from vomiting-passive); thoracic
radiographs to r/o megaesophagus
Vomiting, chronic History of frequent vomiting (differentiate from regurgitation-active); pursue diagnostic
evaluation
Small bowel diarrhea, chronic History of small bowel diarrhea; pursue diagnostic evaluation
Anorexia/Decreased Appetite
Nausea related to GI disease (e.g., ulcers, IBD, partial Can have weight loss even with infrequent or absent vomiting; lip licking or drooling;
obstruction, GI neoplasia) physical exam; abdominal imaging
Nausea due to stimulation of CRTZ (e.g., uremia, hepatic Can have weight loss even with infrequent or absent vomiting; lip licking or drooling;
failure, drugs) history and exam often helpful; biochemical testing and imaging studies
Nausea of any other cause (e.g., chronic pancreatitis, CNS Can have weight loss even with infrequent or absent vomiting; lip licking or drooling;
disease, vestibular disease, pain, hypoadrenocorticism) history and exam often helpful; biochemical testing and imaging studies
Maldigestive/Malabsorptive Conditions
Exocrine pancreatic insufficiency Though a good appetite is common, poor appetite does not rule out EPI; trypsinlike
immunoreactivity is diagnostic
Infiltrative small intestinal disease (e.g., IBD, lymphoma, Physical exam; abdominal imaging; endoscopy and biopsy
pythiosis)
Inability to Utilize Nutrients
Diabetes mellitus Blood glucose concentration; urinalysis for glucose, ketones
Cachexic Conditions
Neoplasia (cancer cachexia) Physical exam may be suggestive; imaging studies as indicated; aspirate or biopsy
Heart failure (cardiac cachexia) History and physical exam suggestive; thoracic radiographs; echocardiography
Kidney failure (renal cachexia) History and physical exam suggestive; biochemical profile; urinalysis
Chronic infections (septic cachexia) Physical exam findings indicative; CBC generally indicates toxic WBC changes, left
shift, or both
Brain tumor Neurologic deficits that indicate intracranial disease are almost always present when a
brain tumor is responsible for weight loss
Continued

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