What is Inappetence?

Inappetence is a common clinical complaint with varying levels of appetite reduction. Almost any disease can cause inappetence, which can manifest as:

Hyporexia

A dog that is hyporexic will eat some, but is not obtaining adequate caloric intake

Dysrexia

A dog with dysrexia may display various altered eating patterns:

  • Unwilling to eat optimal diet
  • Requires additional treats, topping or flavor enhancers to eat diet
  • Loses interest in diet after eating it a few days (e.g., the picky eater)

Anorexia

A dog reaches anorexia when they refuse to eat any food

Early recognition of any changes in appetite is essential. Prolonged inappetence, if left untreated, can become more detrimental to the patient than the underlying condition.

Common Causes of Inappetence

Acute medical conditions

Dogs may display changes in eating behavior caused from many acute conditions, such as gastroenteritis, pain, post-surgical recovery, psychological (i.e., change in routine, boarding, unfamiliar surroundings), among others.

Chronic medical conditions

The clinical impact of inappetence may be profound for dogs with chronic medical conditions.

Chronic kidney disease

Higher body condition score (BCS) at diagnosis is associated with significantly improved survival1

Congestive heart failure

Dogs that gained body weight had longer survival times2

Cancer

Nearly 40% of dogs experienced ≥ 5% weight loss3

  • Dogs underweight at diagnosis with lymphoma had shorter survival times4

Chronic gastrointestinal disease

Malnutrition in chronic GI disease is multifactorial

  • Nutrient loss, malabsorption, lack of intake

Consequences of Inappetence

Physiological changes occur early, often before noticeable weight loss

When you consider that ≥5% unintended weight loss is clinically significant,5 there is a clear need to support nutritional intake in dogs with chronic medical conditions. Without adequate intake, changes take place within the body even before weight loss is noticeable.

  • Decline in GI tract function
  • Weight loss and muscle wasting6
  • Failure of extremely frail patients to respond to treatments
  • Decreased immune response
  • Substantial GI effects
    • Metabolic
    • Immunologic
  • Impaired healing, recovery
  • Altered intermediary drug metabolism

The Role of Ghrelin Appetite Regulation

The regulation of appetite involves the coordination of many signals from the brain (mainly the hypothalamus), peripheral tissues (such as adipose tissue) and endocrine system (such as ghrelin, leptin and insulin).

Ghrelin is the PRIMARY hormone that increases appetite

What ghrelin does

  • Promotes food intake
  • Impacts energy, homeostasis and metabolism
  • Essential for survival

How ghrelin works

  • Binds to specific cell receptors
  • Affects signaling in the hypothalamus, causing the feeling of hunger
  • The feeling of hunger leads to food intake

See how ENTYCE® (capromorelin oral solution) mimics ghrelin, the “hunger hormone,” to effectively stimulate appetite for improved food consumption.

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Clinical References

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In-Clinic Tools

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Professional Education

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References:

  1. Parker VJ and Freeman LM. Association between body condition and survival in dogs with acquired chronic kidney disease. J Vet Intern Med. 2011;25(6):1306-11.
  2. Slupe JL, Freeman LM, Rush JE. Association of Body Weight and Body Condition with Survival in Dogs with Heart Failure. J Vet Intern Med. 2008;22:561-565.
  3. Michel KE, Sorenmo K, Shofer FS. Evaluation of body condition and weight loss in dogs presented to a veterinary oncology service. J Vet Intern Med. 2004;18(5):692-5.
  4. Romano FR, Heinze CR, Barber LG, Mason JB, Freeman LM. Association between Body Condition Score and Cancer Prognosis in Dogs with Lymphoma and Osteosarcoma. J Vet Intern Med. 2016;30:1179–1186.
  5. Freeman L. Cachexia and Sarcopenia: Emerging Syndromes of Importance in Dogs and Cats. J Vet Intern Med. 2012;26:3-17.
  6. Ettinger SJ, Feldman EC. Textbook of Veterinary Internal Medicine. Vol 1. 7th ed. St. Louis, MO: Saunders Elsevier; 2010.