publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active. 301 • Thin cat eating well. • Weight loss and a good appetite. • Weight loss with a good appetite occurs when the cat is unable to gain sufficient nutrition from its diet. • Diseases involving many body systems can lead to weight loss with a good appetite. • In older cats the most common causes of weight loss with a good appetite are hyperthyroidism, diabetes mellitus and inflammatory bowel disease. In younger cats, inflammatory bowel disease and intestinal parasites are the most common causes. PART 6 Cat with weight loss or chronic illness 17. The cat with weight loss and a good appetite Danièlle Gunn-Moore and James B Miller DIAGNOSIS Initial diagnostic evaluation should include history, physical examination, hematology, serum biochemistry, serum thyroxin if > 8 years of age, urinalysis, and fecal examination for parasites. Age of cat is an important consideration. Younger cats are more likely to develop parasitism, inappropriate nutrition, or protein-losing nephropathy. Middle-aged cats have a greater risk of hyperadrenocorticism, while older cats develop hyperthyroidism, diabetes mellitus, alimentary lymphosarcoma or acromegaly. Inflammatory bowel disease can affect cats of any age, but most typically affects middle-aged or older individuals. The history is essential. Determine the cat's environment (inside or outside, competition over food supplies), what and how much is fed, whether nutritional requirements have changed (pregnancy, going outside in cold weather), or whether diabetogenic drugs have been given. Other clinical signs are important to consider. These signs may result from underlying or concurrent disease processes. Polyuria and/or polydipsia are suggestive of an endocrinopathy or protein-losing nephropathy. Vomiting and/or diarrhea are suggestive of enteric disease, hyperthyroidism, lymphocytic cholangiohepatitis or protein-losing nephropathy. Feces becoming bulky or fatty suggest malassimilation syndromes or hyperthyroidism, and increased aggression or restlessness are suggestive of hyperthyroidism. Careful physical examination is essential for diagnosis. Careful palpation of the ventral cervical region is required to detect thyroid mass(es). Thorough abdominal palpation is essential to detect anterior abdominal pain (pancreatitis, hepatopathy), liver enlargement (diabetes-associated hepatopathy, hyperadrenocorticism, lymphocytic cholangiohepatitis), thickened bowel loops (inflammatory bowel disease, alimentary lymphosarcoma), mesenteric lymphadenopathy (alimentary lymphosarcoma, occasionally eosinophilic or suppurative inflammatory bowel disease), ascites (lymphocytic cholangiohepatitis, protein-losing nephropathy) or an enlarged uterus (late pregnancy). General physical examination is important to detect mild generalized lymphadenopathy (lymphosarcoma, lymphocytic cholangiohepatitis), an ill-kept coat (hyperthyroidism), a greasy coat (exocrine pancreatic insufficiency), alopecia and thin skin (hyperadrenocorticism), subcutaneous edema (protein-losing nephropathy), or extremities that appear disproportionately enlarged (acromegaly).
Output: QUICK REFERENCE SUMMARY Diseases causing weight loss and a good appetite METABOLIC • Hyperthyroidism*** (p 304) DISEASES CAUSING SIGNS OF A THIN CAT WITH A GOOD APPETITE HYPERTHYROIDISM*** Classical signs