Anorexia Mapa Fisiologia

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M a n a g m e n t T r e e / CRITICAL CARE/NUTRITION Peer Reviewed

Managing Anorexia Lisa P. Weeth, DVM, Diplomate ACVN


Red Bank Veterinary Hospital,
Tinton Falls, New Jersey

Determine energy requirement


Anorexia • RER = 70 × BWkg0.75
• Based on current body weight

Select feeding method


• Physical examination
• Body condition score
• Lean muscle mass
• Expected delay in voluntary intake
• Concurrent disease state(s)

Expected anorexia/hyporexia
Anorexic
• Stable clinical disease
< 7 days
• No evidence of concurrent • Poor anesthetic candidate
gastrointestinal disease • Normal nasopharynx
• Normal mentation

Assess feeding & extraneous Nasoesophageal or nasogastric


factors tube
• Unfamiliar diet type/flavor/aroma • 5- to 8-Fr
• Noisy feeding location • Liquid solution
• Frequent treatments
• Food near litter box (cats)

Offer food for voluntary intake


• Familiar, highly palatable foods
• Minimize environmental stressors
• Consider appetite stimulants

Investigation Treatment Result

16 ....................................................................................................................................................................NAVC Clinician’s Brief / August 2010 / Management Tree


Expected anorexia/hyporexia Protracted vomiting/diarrhea,
>
_ 7 days ileus; poor anesthetic candidate

Normal esophagus Esophageal disease Severe pancreatitis


Parenteral nutrition

Jejunostomy tube
Esophagostomy tube Gastrostomy tube
• 5- to 8-Fr
• 12- to 18-Fr • 18- to 24-Fr
• Monomeric liquid
• Blended canned food • Blended canned food
solutions

Monitor & adjust method as needed


• Body weight (check daily)
• Change in lean muscle mass
• Biochemical/electrolyte abnormalities

BW = body weight; RER = resting energy requirement

Management Tree / NAVC Clinician’s Brief / August 2010 ....................................................................................................................................................................17

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