Management of anorexia in the cat

Insights to Study, Understand and Manage Extruded Dry Pet Food Palatability

Pet food production is a fast-growing industry. While extruded dry pet food is the favored pet food due to its convenience of use, it may have poorer palatability than other pet foods such as wet pet foods. However, palatability plays a pivotal role in meeting nutritional requirements or providing therapeutic benefits in cats and dogs, as it ensures food acceptance. Thus, both academics and manufacturers conduct routine palatability tests to assess acceptance and preference of products among pets, alongside sensory analyses involving human panels. Palatability is greatly influenced by species-specific and environmental factors in cats and dogs. The review will hence present the current knowledge on palatability assessment and animal food perception; it will then aim to explore strategies for effectively managing palatability in dry pet food by examining the impact of key ingredients and process parameters on the finished product's palatability. Moreover, the demands and needs for sustainable and healthier products as well as supply constraints present novel challenges and opportunities for academics and manufacturers.

SARS-CoV-2 in Domestic UK Cats from Alpha to Omicron: Swab Surveillance and Case Reports

Although domestic cats are susceptible to infection with SARS-CoV-2, the role of the virus in causing feline disease is less well defined. We conducted a large-scale study to identify SARS-CoV-2 infections in UK pet cats, using active and passive surveillance. Remnant feline respiratory swab samples, submitted for other pathogen testing between May 2021 and February 2023, were screened using RT-qPCR. In addition, we appealed to veterinarians for swab samples from cats suspected of having clinical SARS-CoV-2 infections. Bespoke testing for SARS-CoV-2 neutralising antibodies was also performed, on request, in suspected cases. One RT-qPCR-positive cat was identified by active surveillance (1/549, 0.18%), during the Delta wave (1/175, 0.57%). Passive surveillance detected one cat infected with the Alpha variant, and two of ten cats tested RT-qPCR-positive during the Delta wave. No cats tested RT-qPCR-positive after the emergence of Omicron BA.1 and its descendants although 374 were tested by active and eleven by passive surveillance. We describe four cases of SARS-CoV-2 infection in pet cats, identified by RT-qPCR and/or serology, that presented with a range of clinical signs, as well as their SARS-CoV-2 genome sequences. These cases demonstrate that, although uncommon in cats, a variety of clinical signs can occur.

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

OBJECTIVES

The aims of this study were to describe diseases, complications and outcomes associated with the use of feeding tubes in a population of sick cats with appetite disturbance managed at an internal medicine referral service.

METHODS

Clinicopathological data from cats receiving nasoenteral (NE) or oesophagostomy (O) tubes were studied. Cats were categorised according to their underlying disease and divided into subgroups (NE or O tube). The following factors associated with survival were analysed: disease category, type of tube and return to appetite.

RESULTS

Included in the study were 112 cats, representing 118 cases. Of the 118 cases, 98 (83%) and 20 (17%) received NE or O tubes, respectively. The most common underlying conditions were digestive (13.5%), hepatobiliary (11%) and upper urinary tract (11%) disorders. Hepatobiliary (50%) and upper respiratory tract (30%) conditions were predominant in the O tube group. Digestive (15%) and upper urinary tract (12%) diseases were more common in the NE tube group. Complications following tube placement occurred in 22/118 cases (18.6%). The global survival rate was 73% and did not differ between NE (71.4%) and O tube (80%) groups (P = 1.00) or disease categories (P = 0.61). Return of appetite before feeding tube removal occurred in 56 cases (47%), within a median of 3 days (range 1-30) and was not associated with mirtazapine administration (P = 1.00). Appetite returned earlier for cats with NE tubes (3 days, range 1-17) than for those with O tubes (33 days, range 5-60; P <0.05). Voluntary food intake was positively associated with survival (odds ratio 15.17). After discharge and feeding tube retrieval, return of appetite was observed in 67% of cases.

CONCLUSIONS AND RELEVANCE

Feeding tubes were predominantly placed for the management of appetite disturbance in cats with digestive, hepatobiliary and upper urinary tract diseases. While complications were frequent, they were mostly mild, easily managed and did not preclude feeding tube use. Return to appetite occurred in a large proportion of cats during or after assisted enteral feeding and was associated with survival.

Pharmacological appetite stimulation: rational choices in the inappetent cat

PRACTICAL RELEVANCE

Inappetence is a commonly encountered problem in feline medicine. Primary goals in managing the inappetent or anorectic cat are to diagnose and treat the underlying disease and reinstate adequate nutrition.

RATIONALE

As cats are intolerant of prolonged periods of inadequate nutritional intake, especially given their propensity to develop hepatic lipidosis, their increased requirements for amino acids, and inability to slow their rate of gluconeogenesis, symptomatic therapy and nutritional support is often required during diagnostic investigations.

CLINICAL CHALLENGES

Most cats presenting with reduced food intake will be suffering from an underlying systemic disease, and so the mechanism of action, pharmacokinetics and contraindications of appetite-stimulating medications will need to be considered in each case to ensure rational use of these agents. Pharmacological appetite stimulation should never replace monitoring and ensuring adequate caloric intake, and may not be appropriate in some cases, such as critically ill or severely malnourished patients.

EVIDENCE BASE

While there are no medications approved specifically for the treatment of anorexia in cats, some drugs have proven efficacious in the clinical field. Although several agents have been used historically for appetite stimulation, due to potential side effects and/or lack of efficacy or predictability only cyproheptadine and mirtazapine can currently be recommended for use.