Management of Anorexia in the Cat

Abstract

One of the most frequent motivations for seeking veterinary attention for a cat is when the owner recognises a loss of normal appetite in his pet. The medical term for a lack of appetite for food is 'anorexia', and it may be partial or complete. While anorexia is a common manifestation of disease, the mechanisms underlying decreased food intake are complex and not completely understood. The regulation of appetite involves interaction of external stimuli with signals from the gastrointestinal tract and central nervous system. Aberrations in any of the internal control systems for hunger and satiety, or changes in external factors such as diet or feeding environment, can result in partial or total anorexia. The challenge for the practitioner is not only to diagnose and treat the underlying condition, but to recognise at what point inadequate food intake has or will impinge on the patient's nutritional status to the extent that it might deleteriously affect clinical outcome. It is also important to bear in mind the significance that the patient's appetite and food intake has for the cat owner in his overall perception of his pet's condition and quality of life.

Use of feeding tubes in 112 cats in an internal medicine referral service (2015–2020)

“…Trying a different food or increasing palatability of the meal is often attempted first. 10–12 Some drugs can be tried to stimulate appetite. Mirtazapine and cyproheptadine are the two main medications recommended for cats owing to their proven efficacy and safety.…”

Pharmacological appetite stimulation

“…Noxious internal (nociception, nausea or ileus) or external (environmental) stimuli may override all other inputs. 9 All stimuli that influence feeding are integrated in the brain by hormonal and neuronal pathways. Important sites within the brain for control of hunger and satiety include the hypothalamus, especially the lateral and ventromedial nuclei, 9,10 and the parabranchial nucleus in the caudal brainstem.…”

“…9 All stimuli that influence feeding are integrated in the brain by hormonal and neuronal pathways. Important sites within the brain for control of hunger and satiety include the hypothalamus, especially the lateral and ventromedial nuclei, 9,10 and the parabranchial nucleus in the caudal brainstem. 11 While the complexity of appetite regulation makes control of all components a challenge, it also offers multiple opportunities to manipulate appetite through management of external environmental and palatability factors, as well as pharmacological support of hunger cues.…”

“…if caloric intake remains insufficient after 2-3 days of using an appetite stimulant (or maximum 3-5 days since cessation of food intake), further measures, including enteral feeding, must be considered. 8,9 Cats have a higher requirement for some B vitamins when compared with dogs. 19 Experimental depletion of B vitamins results in anorexia in other species.…”

Assisted Enteral Feeding

“…14,24 The mouth feel of the food is also important for cats, and they may reject foods with a powdery or greasy texture or a different kibble shape. 15,24 If the voluntary enteral daily caloric intake of the animal still does not meet the desired goal, then other means of increasing intake should be considered. Appetite stimulants have limited success in completely anorectic animals but may increase food intake in partially anorectic animals.…”