How to identify the cause of weight loss in geriatric cats

How to identify the cause of weight loss in geriatric cats

When their senior cats lose weight, owners frequently think it's part of normal aging. But weight loss is often a sign of underlying disease. Use a complete workup to uncover the possible cause.
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Jul 01, 2006

Weight loss occurs when more calories are expended than are consumed. Healthy animals can experience weight loss, but in a geriatric cat, a subtle decrease in weight can also be the first indication of illness. For example, cats with small intestinal disease may lose weight before exhibiting anorexia, vomiting, or diarrhea. Unfortunately, weight changes in older cats are often attributed merely to aging, so clients may not seek veterinary care or veterinarians may inadvertently delay a diagnostic workup until marked weight loss is evident or additional clinical signs arise. Starting with a detailed history, work your way through a complete workup in these patients.

ASK ALL THE RIGHT QUESTIONS


Differential diagnoses for weight loss
To start narrowing the differential diagnoses (see sidebar titled "Differential diagnoses for weight loss"), collect a complete history. Use open-ended questions to explore the owner's knowledge of the cat's diet, eating habits, and energy level: What changes have occurred regarding activity? What diet is being fed? How much, where, and how often is the cat being fed? What treats and supplements are given? How has the diet changed? How is the cat's appetite?

The answers to these questions may reveal important clues about the cat's weight loss. For example, in some households, pets compete for food, and underfeeding results. Clients may feed a weight-loss diet and continue it even after an optimal weight has been achieved. An arthritic or visually impaired cat may not be able to make it to food bowls that are difficult to access, such as on a countertop or in a dark basement. And an inability to smell food, the administration of certain medications, or a systemic illness can result in a decreased appetite, even in cats being fed a high-quality, palatable food.


Detecting weight loss
Keep in mind that a good appetite does not rule out disease, because cats with certain conditions (e.g. hyperthyroidism, diabetes mellitus, malnutrition from malabsorption or maldigestion, internal parasites, exocrine pancreatic insufficiency, nonsuppurative cholangitis-cholangiohepatitis complex) may have a normal or increased appetite. And if an owner reports that the cat is interested in food but is unable or reluctant to eat, consider dental disease, oral or pharyngeal masses or foreign bodies, chronic gingivitis-stomatitis,1 or retrobulbar masses or abscesses.

Remember to ask about travel history; feline leukemia virus (FeLV) and feline immunodeficiency virus (FIV) testing, exposure, and vaccination history; environmental exposures (e.g. second-hand smoke, herbicides); prior anesthesia; and any medications being given. Many medications can cause gastrointestinal (GI) distress. Common examples are nonsteroidal anti-inflammatory drugs, glucocorticoids, chemotherapeutics, fluoroquinolones, amoxicillin, ACE inhibitors (e.g. benazepril, enalapril), and digoxin. Medications (notably doxycycline), improper medication administration, and reflux into the esophagus during anesthesia may cause esophageal stricture.


Checklist for Diagnosing the Cause of Weight Loss in a Geriatric Cat
Next, ask the owner about specific body systems and other clinical signs. Cats with abdominal pain may lie in an unusual position or object to being held in a way that puts pressure on the abdomen. Vomiting and diarrhea may help localize the problem to the GI tract, although these are nonspecific signs of many conditions.