References
Managing the inappetent hospitalised cat: International Society of Feline Medicine guidelines
Abstract
Inappetence (also called hyporexia or anorexia) is a common presenting symptom in cats, but suboptimal nutrition can have many negative effects on feline patients, including prolonged hospitalisation and shortened survival. Cats are strict carnivores with a high protein requirement, and when starvation is combined with the hypermetabolic state found in sick cats, a loss of lean body mass can occur. This can have negative effects on wound healing, immune function and gut function. Inappetence in hospitalised cats is not just caused by the underlying illness; it can be exacerbated by stress, as well as factors such as pain, nausea, ileus, constipation and the adverse effects of medication. All contributing factors should be managed, along with the primary disease process, to correct malnutrition. Nutritional assessment of each hospitalised cat allows the identification of patients who require prompt intervention. Appetite stimulants can encourage voluntary food intake and feeding tubes allow provision of nutrition, fluids and medications, and can be managed at home to expedite discharge. The food intake of hospitalised cats should be closely monitored and inappetence should not be ignored, nor intervention delayed.
Inappetence (also called hyporexia, with anorexia reserved for complete absence of appetite) is both a common presenting sign in cats visiting the veterinary clinic (Delaney, 2006) and a problem which frequently develops during hospitalisation, for example, post surgery (Chan, 2009). It is important because suboptimal nutrition can have negative effects on feline health and welfare via the multiple physiological consequences affected patients develop. Such effects include reduced immune function, slow wound healing, hepatic lipidosis and even shortened survival from a variety of illnesses (Chan, 2009). Management of inappetence can be challenging, as the cause may be multifactorial and complicated by stress, pain and adverse effects of medication. Therefore, in 2022, the International Society of Feline Medicine produced guidelines on the management of the inappetent hospitalised cat (Taylor et al, 2022a). Much of the information in the guidelines can also be extrapolated to outpatients, as it is important not to neglect the nutrition of any animals under veterinary care. Caregivers should also be educated on the importance of noticing and acting on inappetence. This article discusses some of the key points and recommendations in these guidelines. The guidelines are accompanied by supplementary materials, including feeding tube videos and documents containing information for caregivers.
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