Don't Wait for Anorexia: Discover Dysrexia & Hyporexia

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Don't Wait for Anorexia: Discover Dysrexia & Hyporexia

Sponsored by Aratana Therapeutics

Today’s veterinarian should consider inappetence as a spectrum that can vary depending on the degree of appetite reduction. Inappetence is commonly associated with anorexia or a lack of appetite leading to no food intake, but it is equally important to recognize and address hyporexia (ie, a decreased appetite leading to decreased food intake) and dysrexia (ie, a change in appetite that results in an altered food intake).1 

There are many potential causes of an altered or absent appetite in dogs. Chronic or systemic conditions may include chronic kidney disease (CKD), cancer, infectious disease, or aging. Acute conditions may include pain, nausea, dehydration, fever, and postoperative ileus.2 Early recognition of inappetence and implementing appropriate nutrition is essential as a long-term poor nutritional state may result in weakness, muscle loss, decreased ability to heal, and overall increased patient morbidity.3

A pet that is unwilling to eat or no longer seems excited to eat is a major concern for clients; clients may also perceive an inappetent pet to have a diminished quality of life, particularly if concurrent weight loss and lethargy are present.3 Necessary medications may be challenging to administer if the patient does not readily accept them in food, and all benefits of a prescription diet are lost if the patient is not eating or consuming enough to meet its daily energy needs, or metabolic energy requirement (MER).4

Practitioners should be diligent in educating the team and clients to recognize inappetence and understand the nutritional requirements of each patient. Key indicators of inappetence are frequently overlooked in a patient’s history because they are considered by the owner as variations of normal. In order to avoid missing vital information, every appointment should obtain the following information to ensure a full nutritional assessment.

Food Type Consumed Daily
  • Considerations: Is the diet complete and balanced to provide adequate nutritional intake for this patient?
  • Action: Instruct all clients to bring photos or samples of pet food labels to every appointment. Train team members to identify and confirm AAFCO nutritional adequacy statements.5
Amount of Food Consumed Daily
  • Considerations: Is this amount of the diet complete and balanced to provide adequate nutritional intake? Are the patient’s MER and resting energy requirement (RER) being met? 
  • Action: Train team members to quickly and easily calculate a patient’s RER (kcals).4
Calculating Metabolic & Resting Energy Requirements4

RER = (BW in kg × 30) + 70

MER (kcal) = Appropriate multiplier to RER  

Owner Assessment of Appetite
  • Considerations: Does the patient seem to be a selective eater? Does the owner find it necessary to routinely change diets to keep the pet interested in eating? Is the patient excited for treats but not for a balanced diet?
  • Action: Make strong recommendations for complete and balanced diets4 that are highly palatable. Advise owners to make any food changes gradually (over several days) in order to avoid potential GI upset, which can lead to subsequent food aversion. 
Weight History
  • Considerations: Is the patient losing weight without any intentional efforts by the owner?
  • Action: Provide clients with a printed weight history and body condition score (BCS) chart at each appointment. Pursue full diagnostic work-ups to determine underlying causes as needed.
Body & Muscle Condition Scores (BCS, MCS)
  • Considerations: Body condition and muscle condition scores can change with or without concurrent weight loss.6 These assessments can help indicate how inappetence should be addressed. 
  • Action: Ensure clients understand that BCS is a subjective assessment of body fat and MCS is a subjective assessment of body muscle.7 

Conclusion

Implementing clear protocols with the practice team and educating clients will ensure that early recognition of inappetence begins at home and can be confirmed in the examination room. Treatment of the underlying causes and use of an appetite stimulant when indicated will ensure that dogs live healthier, happier days than when clinically unwell. Entyce is the only appetite stimulant developed, field-tested, labeled, and FDA-approved for use in dogs with inappetence.3

IMPORTANT SAFETY INFORMATION: ENTYCE® (capromorelin oral solution) is for use in dogs only.  Do not use in breeding, pregnant or lactating dogs. Use with caution in dogs with hepatic dysfunction or renal insufficiency. Adverse reactions in dogs may include Diarrhea, vomiting, polydipsia, and hypersalivation.  Should not be used in dogs that have a hypersensitivity to capromorelin. Please see the full Prescribing Information for more detail.

References

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