食欲不振可能有许多起源,作为住院患者的表现或观察,在猫科动物中很常见。鼓励对每位患者进行营养评估,为了确定需要,和适当的类型,干预表明。营养不良对猫科动物患者的影响可能很大,延续疾病,延迟恢复,减缓伤口愈合和负面影响肠道健康和免疫力。延迟干预可能会导致猫的恶化;因此迅速控制促成因素,如潜在的疾病,疼痛,恶心,肠梗阻和压力对于优化自愿食物摄入至关重要。管理是多式联运,包括减少应力,药物和辅助营养形式的管饲或肠外营养。使用止吐药,镇痛药,促食欲和食欲刺激药物可以恢复食欲,但饲管的放置不应延迟。喂食管通常具有良好的耐受性,可以提供食物,压力最小的水和药物,尽管临床医生必须意识到并发症,如造口部位感染和再喂养综合征。
猫由于其独特的新陈代谢和特定的营养需求而容易营养不良。此外,它们作为一个物种的性质意味着它们在医院环境中容易受到压力,这可能会导致食物摄入减少;以前的负面经历可能会加剧这个问题。特别是,不适当的临床环境和/或处理可能导致或加剧住院患者的食欲不振,对复苏产生负面影响。推迟干预措施,如喂食管放置,以等待改善,由于临床医生或护理人员的担忧,可能会阻碍恢复并加剧营养缺乏。
国际猫医学会(ISFM)召集的专家小组制定了2022年ISFM关于无食欲住院猫管理的共识指南。信息基于现有文献,专家意见和小组成员的经验。
Inappetence may have many origins and, as a presenting sign or observation in the hospitalised patient, is common in feline practice. Nutritional assessment of every patient is encouraged, to identify the need for, and appropriate type of, intervention indicated. The impact of malnutrition may be significant on the feline patient, perpetuating illness, delaying recovery, slowing wound healing and negatively impacting gut health and immunity. Delayed intervention may result in the cat\'s deterioration; hence prompt control of contributing factors such as the underlying illness, pain, nausea, ileus and stress is vital to optimise voluntary food intake. Management is multimodal, comprising reduction of stress, medications and assisted nutrition in the form of tube feeding or parenteral nutrition. Use of antiemetic, analgesic, prokinetic and appetite stimulant medications may restore appetite, but placement of feeding tubes should not be delayed. Feeding tubes are generally well tolerated and allow provision of food, water and medication with minimal stress, although clinicians must be aware of complications such as stoma site infections and refeeding syndrome.
Cats are vulnerable to malnutrition owing to their unique metabolism and specific nutritional requirements. Moreover, their nature as a species means they are susceptible to stress in the hospital environment, which may result in reduced food intake; previous negative experiences may compound the problem. In particular, an inappropriate clinic environment and/or handling may cause or exacerbate inappetence in hospitalised patients, with negative impacts on recovery. Postponing interventions such as feeding tube placement to await improvement, owing to clinician or caregiver apprehension, may hinder recovery and worsen nutritional deficits.
The 2022 ISFM Consensus Guidelines on Management of the Inappetent Hospitalised Cat have been created by a panel of experts brought together by the International Society of Feline Medicine (ISFM). Information is based on the available literature, expert opinion and the panel members\' experience.