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Abstract
Malnutrition is the process of body weight, fat and muscle loss associated with acute and chronic illnesses. This syndrome is well defined in people and its diagnosis is based on specific clinical criteria. Unlike in humans, malnutrition in dogs and cats is poorly recognised. This clinical review will highlight the key features of malnutrition in dogs and cats and discuss the clinical methods (such as body and muscle condition scoring) to assess patients for this problem. The nutritional requirements (including calories, macronutrients, micronutrients) to prevent and correct malnutrition will also be highlighted. Finally, the practical steps that can be taken to address malnutrition, including enteral and parenteral feeding techniques, will be outlined.
Malnutrition strictly refers to both under-nutrition and over-nutrition (obesity). However, it is malnutrition secondary to disease that most commonly causes under-nutrition. Malnutrition is usually associated with chronic diseases such as neoplasia, gut disease (such as inflammatory bowel disease or protein-losing enteropathies), kidney disease (such as chronic kidney disease or protein losing nephropathies) and liver disease (such as chronic hepatitis or chronic liver failure). However, severe acute diseases (including trauma, acute kidney injury, septic peritonitis, pancreatitis) can also lead to malnutrition.
A consensus publication by the Global Leadership Initiative on Malnutrition (GLIM) proposed both phenotypical and etiological criteria to diagnose malnutrition in people (Cederholm et al, 2019). Specifically, at least one phenotypical criterion (weight loss, low body mass index, reduced muscle mass) and one aetiological criterion (reduced food intake or assimilation, inflammation) must be present in a patient to make a diagnosis of malnutrition. Furthermore, the consensus statement recommended grading the severity of malnutrition based on the magnitude of the three phenotypical criteria (weight loss, low body mass index, reduced muscle mass).
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