Nestle Purina Critical GI Updates Symposium Proceedings

Frédéric Gaschen,, Dr.habil., DACVIM & DECVIM–CA
Stanley L. Marks, BVSc, PhD, DACVIM (Internal Medicine, Oncology) & DACVN
Debra L. Zoran, DVM, PhD, DACVIM (SAIM)
David A. Williams, MA, VetMB, PhD, DACVIM (SAIM) & DECVIM–CA,

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Critical GI Updates

Protein-Losing Enteropathy: The Beginning of the End?
Frédéric Gaschen,, Dr.habil.,DACVIM & DECVIM–CA, Department of Veterinary Clinical Sciences School of Veterinary Medicine, Louisiana State University ,Baton Rouge, Louisiana

Intestinal protein loss is a sign of failure of digestive function that may result from severe acute or chronic inflammatory lesions or disruption of chyle absorption and intestinal lymph flow. While the exact mechanisms leading to intestinal protein loss have not been elucidated in the dog, three basic mechanisms defined for humans with protein-losing enteropathy (PLE) likely apply to canine PLE. Protein loss may result from1:

1. Erosive or ulcerative mucosal lesions causing secondary exudation of proteins

2. Lymphatic dysfunction causing leakage of protein-rich lymph into the intestinal lumen

3. Mucosal changes disturbing the “mucosal barrier,” causing abnormal permeability and protein leakage into the lumen.1

This article focuses on chronic intestinal disorders associated with intestinal protein loss in dogs. PLE is much less prevalent in cats. In dogs, it is frequently associated with severe chronic idiopathic inflammatory enteropathies, such as inflammatory bowel disease (IBD), or with idiopathic intestinal lymphangiectasia (IL) in specific breeds.

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Rational Approach to Chronic Diarrhea in Cats
Stanley L. Marks, BVSc, PhD, DACVIM (Internal Medicine, Oncology) & DACVN, School of Veterinary Medicine, University of California, Davis, Davis, California

Diarrhea is generally regarded as the most consistent clinical sign of intestinal disease in the cat and one of the most frustrating maladies for many veterinarians to diagnose and manage. Incomplete resolution of the problem can result in frustration and dissatisfaction for the owner and potential suffering for the animal. Antibiotics are commonly administered injudiciously to diarrheic animals, with resolution of clinical signs often wrongly attributed to eradication of a putative infectious pathogen.

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Vomiting Cats: You Can Make it Stop!
Debra L. Zoran, DVM, PhD, DACVIM (SAIM), College of Veterinary Medicine, Texas A&M University, College Station, Texas

Vomiting, one of the most common reasons for cats to be presented for evaluation, is often considered to be “normal.” There is some truth to the idea that cats vomit more readily from eating too much or too fast; eating foods that are unusual, especially food that contains toxins; or grooming (vomiting hair). However, such vomiting should not be routine. If it is, there is often an underlying cause that needs to be addressed. Adult and senior cats have different causes of vomiting than kittens do, but there are similarities in the approach to diagnosis of vomiting in cats of any age.

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Skinny Old Cats
David A. Williams, MA, VetMB, PhD, DACVIM (SAIM) & DECVIM–CA, Small Animal Internal Medicine School of Veterinary Medicine, University of Illinois at Urbana-Champaign, Urbana, Illinois

Decline in body weight is common in cats older than 11 years of age.1 Sometimes this loss is readily attributable to apparent disease, but in many cases there are no obvious signs of illness and routine diagnostic approaches fail to reveal evidence of an underlying problem.2,3 Energy requirements of older cats apparently do not decline as markedly as they do in dogs and humans, perhaps because physical activity does not decrease as much with age in cats. Indeed, the maintenance energy requirement of older cats may increase rather than decrease.3,4 Although cats might be expected to regulate their energy intake to compensate for these changes to maintain body weight, this clearly is not always the case.4,5

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