Feline Weight Loss
Consider these factors and diagnostic options when evaluating weight loss in cats.
History
Ask about:
Duration of weight loss
Other clinical signs (eg, vomiting/regurgitation, diarrhea)
Time when patient last appeared/acted normal
Changes in diet or eating behavior
Changes in environment (eg, humans, other animals, routines, placement of food bowls)
Dropping of food or difficulty in prehending/chewing
Evidence of orofacial pain
Travel history
Changes in water intake/urination
Changes in attitude, energy, activity/mobility
Changes in litter box use (eg, volume, frequency, character, color)
Examination
Includes:
Body weight
% weight change* and BCS
Muscle condition (normal/wasted)
Blood pressure evaluation
Coat condition
Funduscopic examination
Oral examination
Abdominal palpation
Pulse quality
Thyroid palpation<sup†sup>
Thoracic auscultation
Appetite
Good appetite
Inadequate intake
Poor quality/insufficient quantity of food
Maldigestion/malabsorption
IBD
Lymphoma
EPI
Systemic fungal infection (if regionally likely or if travel history indicates risk)
Excessive nutrient loss
Diabetes mellitus
Hyperthyroidism
Parasitism
Cachexia (cardiac or neoplastic)
Protein-losing nephropathy
Protein-losing enteropathy
Overutilization
Pregnancy/lactation
Strenuous workload
Unable to eat
Oral neoplasia
Orofacial/dental fracture
Dental disease
Dental pain
Neuropathy
Retrobulbar neoplasia/abscess
Oral/pharyngeal/esophageal disease
Poor appetite
Drug therapy (eg, antibiotics, chemotherapeutic agents)
FeLV/FIV
Chronic kidney disease
Acute/chronic renal failure
Cholangitis/hepatitis, hepatic lipidosis
Pancreatitis
Biliary tree disease
Neoplasia
IBD
Systemic fungal infection
CNS disease
Bored with diet<sup‡sup>
Distress (environmental, social)<sup§sup>
Nasal disease
Foreign body
Abscess
Fever
Body system suggested?
Yes
Perform MDB & additional diagnostics appropriate for body system
Orofacial: stabilize for thoroughdental/oral assessment with dental+/- skull imaging under anesthesia; if mass present, biopsy
Abdominal: imaging, cobalamin/folate levels, fTLI (if EPI suspected), fPLI in conjunction with abdominal imaging(if pancreatitis suspected)
Thoracic: imaging
Urogenital: UP/C if persistent proteinuria with inactive urine sediment
No
Offer variety of diets
Perform MDB & diagnostics
CBC with differential and cell morph-ology, serum biochemical profile, retroviral serology, total T4 (older cats), urinalysis, fecal testing (numerous types)
Abdominal imaging
Thoracic imaging
Cobalamin/folate levels
Assess results
Normal
Perform biopsies
Includes:
GI (surgical/endoscopic)
Stomach, intestine, pancreas, liver, mesenteric lymph node, spleen
Normal - Consider CNS disease
Abnormal
IBD
Neoplasia
Fungal disease
Abnormal
Includes:
Renal insufficiency
Renal failure
FeLV/FIV
Hepatopathy
Neoplasia
Hyperthyroidism
Parasitic infection
Cardiomyopathy
* Percentage of weight change = (previous weight – today’s weight)/previous weight ¥ 100† Presence/absence of mass does not rule in/out hyperthyroidism‡ Offer a variety of diets; recheck weight in 10–14 days: if no weight gain, perform MDB; if weight gain, continue with new diet/recheck weight in 14 days§ If history reveals stress: enrich environment with opportunities to hide and perch, move feeding station to quiet and safe place, add feeding stations (easy access, etc)
BCS = body condition score, CBC = complete blood count, CNS = central nervous system, EPI = exocrine pancreatic insufficiency, FeLV = feline leukemia virus, FIV = feline immunodeficiency virus, fPLI = feline pancreatic lipse immunoreactivity, fTLI = feline trypsinogen-like immunoreactivity, GI = gastrointestinal, IBD = inflammatory bowel disease, MDB = minimum database, T4 = thyroxine, UP/C = urine protein:creatinine ratio
For related articles, see the following:Safe Weight Reduction in an Obese Diabetic CatAssessing Weight Loss in Cats
MARGIE SCHERK, DVM, Diplomate ABVP (Feline Practice), opened Cats Only Veterinary Clinic in Vancouver in 1986 and practiced there until 2008. Her interests include all things feline, in particular analgesia, the peculiarities of the feline digestive system, and enabling more positive interactions with cats. Dr. Scherk has published several clinical trials and written numerous book chapters. In addition, she is co-editor of the Journal of Feline Medicine and Surgery. She also has served extensively at the American Association of Feline Practitioners and other veterinary organizations and is an active international speaker who is also involved in online continuing education.