练习情景

认识 Autumn,一只患有厌食症的成年猫

认识一下 AUTUMN

一只已绝育的 5 岁雌性美国长毛猫

  • Autumn 因呕吐、流涎和厌食被送来问诊。由于家里前段时间在进行改造,Autumn 大部分时间都躲在床底下。其主人还报告称不确定 Autumn 在过去一周吃了多少食物。昨天,猫开始呕吐胆汁和流涎。
  • Autumn 此前的身体状况评分为 7/9,但今天的评分为 6/9。自 6 个月前的最后一次检查以来,它的体重下降了约 1.5 磅。
  • 经检查发现,Autumn 的巩膜、耳廓和黏膜出现黄疸。它的脱水比例约为 10%,伴有唾液分泌,心率和呼吸频率升高。其余检查结果均无异常。

胃肠道疾病

猫慢性肠病

慢性肠病是指临床症状持续超过 3 周的胃肠道 (GI) 疾病,并且没有已发现的肠道病原体、寄生虫、非胃肠道疾病(例如肾脏疾病、甲状腺功能亢进)、持续的异物和/或毒素暴露,或肿瘤。1─4 猫慢性肠病包括食物反应性肠病(包括食物过敏和食物不耐受)、抗生素反应性肠病、免疫抑制剂反应性肠病(即类固醇反应性肠病或炎症性肠病),以及消化性小细胞淋巴瘤。3,5─7

患有 慢性肠病 的猫(无论最终诊断结论如何)可能会合并出现任何多种胃肠道症状3,5,8,9 慢性肠病患猫最常见的临床症状是体重减轻,其次是呕吐、食欲变化和腹泻。3,4,9─11食物反应性肠病(详见其他专题)患猫可能更常以腹泻为主诉症状。5,9,12

调整饮食可作为管理慢性肠病患猫的首要措施。营养干预应提供充足的营养素,以满足猫的营养要求,经胃肠道弥补任何营养损失,并帮助管理临床症状。

猫胃肠图标

重要信息


  • 管理慢性肠病患猫的常见营养策略包括饮食调整、补充维生素 B12(如有需要)和给予益生菌,以帮助解决菌群失调问题并减轻黏膜炎症。3,7 
  • 慢性肠病患猫应喂食极易消化、适口性强、高蛋白配方粮,以最大程度地减少瘦体重流失,解决宏量营养素(例如蛋白质、脂肪或碳水化合物)的消化和/或吸收功能受损以及菌群失调问题。 
    • 与犬不同,大多数慢性肠病患猫不需要限制饮食脂肪摄入。16 
    • 市售治疗性胃肠道饮食经证实可有效管理猫的慢性胃肠道症状。16─18 
    • 对于某些类型的慢性肠病患猫,也可推荐使用水解蛋白质或新型蛋白质成分的饮食,因为人们怀疑食物性抗原在胃肠道炎症中有一定的作用。5 
  • 在慢性肠病患猫中,钴胺素(维生素 B12)缺乏已得到充分证实,尽管在猫饮食中富含此类维生素。19─21 如果经检测显示缺乏维生素 B12,则应经胃肠外或口服途径予以补充。3 
  • 益生菌(特别是那些经证明可调节免疫系统或具有抗炎特性的益生菌)对某些慢性肠病患猫有益,可纳入多模式治疗方法中。7 
    • 慢性肠病患猫表现出与人类 IBD 患者相似的肠道菌群失调模式,但需要进行深入研究。22,23  
    • 益生菌可对胃肠道功能产生积极影响。由于不同益生菌株对宿主的影响各不相同,因此应根据预期目标选择特定益生菌。 
  • 最初,慢性肠病患猫可受益于少食多餐的投喂方式(例如,每天 3 至 6 餐)。少食多餐有助于促进营养吸收并最大程度地减轻胃肠道不良反应。
对话启动器

“体重减轻、食欲变化、呕吐和/或腹泻是猫胃肠道疾病的常见症状,但也可能由与消化系统无关的其他疾病引起。除了我推荐的诊断测试外,我还建议开始为[猫的名字]提供特殊饮食,以确定[猫的名字]是否可能存在食物过敏或食物不耐受问题。喂养这种特殊饮食可帮助您的爱猫恢复正常,或者帮助我们了解是否需要用药或者进行额外的检测。”

相关工具和内容:

猫犬肠道菌群失调

饮食调整是管理肠道菌群失调患犬和患猫的治疗计划的关键组成部分。

查看简介 1 分钟至 5 分钟

猫食物反应性肠病

饮食在食物反应性肠病患猫的诊断和管理方面发挥重要作用。

查看简介 1 分钟至 5 分钟

与宠物主人分享:

如何鼓励挑食的宠物进食

宠物挑食、挑剔或者对食物不感兴趣是颇具挑战性的难题。

查看简介 1 分钟至 5 分钟

猫身体状况系统表

Purina 猫身体状况评分系统的视觉辅助工具。

查看工具 1 分钟至 5 分钟

更换宠物食品 - 猫

逐渐过渡到新的饮食可以最大程度地降低肠胃不适的风险。

查看简介 1 分钟至 5 分钟

参考文献

  1. Marsilio, S. (2021). Differentiating inflammatory bowel disease from alimentary lymphoma in cats: Does it matter? Veterinary Clinics of North America: Small Animal Practice, 51(1), 93─109. doi: 10.1016/j.cvsm.2020.09.009 
  2. Ganz, H., Kingsbury, D., & Dahlhausen, K. E. (2021, March 31). A new framework for chronic GI disease in dogs and cats. IVC Journal, 11. Available online at https://ivcjournal.com/chronic-enteropathy-chronic-gi-disease-dogs-cats 
  3. Jergens, A. E. (2012). Feline idiopathic inflammatory bowel disease: What we know and what remains to be unraveled. Journal of Feline Medicine and Surgery, 14(7), 445─458. doi: 10.1177/1098612X12451548 
  4. Jergens, A. E., Crandell, J. M., Evans, R., Ackermann, M., Miles, K. G., & Wang, C. (2010). A clinical index for disease activity in cats with chronic enteropathy. Journal of Veterinary Internal Medicine, 24(5), 1027─1033. doi: 10.1111/j.1939-1676.2010.0549.x 
  5. Guilford, W. G., Jones, B. R., Markwell, P. J., Arthur, D. G., Collett, M. G., & Harte, J. G. (2001). Food sensitivity in cats with chronic idiopathic gastrointestinal problems. Journal of Veterinary Internal Medicine, 15(1), 7─13. 
  6. WSAVA International Gastrointestinal Standardization Group, Washabau, R. J., Day, M. J., Willard, M. D., Hall, E. J., Jergens, A. E., Mansell, J., Minami, T., & Bilzer, T. W. (2010). Endoscopic, biopsy, and histopathologic guidelines for the evaluation of gastrointestinal inflammation in companion animals. Journal of Veterinary Internal Medicine, 24(1), 10─26. doi: 10.1111/j.1939-1676.2009.0443.x 
  7. Marsilio, S. (2021). Feline chronic enteropathy. Journal of Small Animal Practice, 62(6), 409─419. doi: 10.1111/jsap.13332 
  8. Al-Ghazlat, S., Eriksson de Rezende, C., & Ferreri, J. (2013). Feline small cell lymphosarcoma versus inflammatory bowel disease: Diagnostic challenges. Compendium: Continuing Education for Veterinarians, 35(6), E1─E6. 
  9. Gianella, P., Pietra, M., Crisi, P. E., Famigli Bergamini, P., Fracassi, F., Morini, M., & Boari, A. (2017). Evaluation of clinicopathological features in cats with chronic gastrointestinal signs. Polish Journal of Veterinary Sciences, 20(2), 403─410. doi: 10.1515/pjvs-2017-0052 
  10. Burke, K. F., Broussard, J. D., Ruaux, C. G., Suchodolski, J. S., Williams, D. A., & Steiner, J. M. (2013). Evaluation for fecal α1-proteinase inhibitor concentrations in cats with idiopathic inflammatory bowel disease and cats with gastrointestinal neoplasia. Veterinary Journal, 196(2), 189─196. doi: 10.1016/j.tvjl.2012.09.019 
  11. Norsworthy, G. D., Estep, J. S., Hollinger, C., Steiner, J. M., Lavallee, J. O., Gassler, L. N., Restine, L. M., & Kiupel, M. (2015). Prevalence and underlying causes of histologic abnormalities in cats suspected to have chronic small bowel disease: 300 cases (2008─2013). Journal of the American Veterinary Medical Association, 247(6), 629─635. doi: 10.2460/javma.247.6.629 
  12. Mueller, R. S., & Olivry, T. (2018). Critically appraised topic on adverse food reactions of companion animals (6): Prevalence of noncutaneous manifestations of adverse food reactions in dogs and cats. BMC Veterinary Research, 14(1), Article 341. doi: 10.1186/s12917-018-1656-0 
  13. Allenspach, K., Wieland, B., Gröne, A., & Gaschen, F. (2007). Chronic enteropathies in dogs: Evaluation of risk factors for negative outcome. Journal of Veterinary Internal Medicine, 21(4), 700─708. doi: 10.1111/j.1939-1676.2007.tb03011.x 
  14. Jergens, A. E., Schreiner, C. A., Frank, D. E., Niyo, Y., Ahrens, F. E., Eckersall, P. D., Benson, T. J., & Evans, R. (2003). A scoring index for disease activity in canine inflammatory bowel disease. Journal of Veterinary Internal Medicine, 17(3), 291─297. doi: 10.1111/j.1939-1676.2003.tb02450.x 
  15. Nahon, S., Ramtohul, T., Paupard, T., Belhassan, M., Clair, E., & Abitbol, V. (2018). Evolution in clinical presentation of inflammatory bowel disease over time at diagnosis: A multicenter cohort study. European Journal of Gastroenterology & Hepatology, 30(10), 1125─1129. doi: 10.1097/MEG.0000000000001201 
  16. Laflamme, D. P., Xu, H., & Long, G. M. (2011). Effect of diets differing in fat content on chronic diarrhea in cats. Journal of Veterinary Internal Medicine, 25(2), 230─235. doi: 10.1111/j.1939-1676.2010.0665.x 
  17. Laflamme, D. P., Xu, H., Cupp, C. J., Kerr, W. W., Ramadan, Z., & Long, G. M. (2012). Evaluation of canned therapeutic diets for the management of cats with naturally occurring chronic diarrhea. Journal of Feline Medicine and Surgery, 14(10), 669─677. doi: 10.1177/1098612X12446906 
  18. Perea, S. C., Marks, S. L., Daristotle, L., Koochaki, P. E., & Haycock, R. (2017). Evaluation of two dry commercial therapeutic diets for the management of feline chronic gastroenteropathy. Frontiers in Veterinary Science, 4, Article 69. doi: 10.3389/fvets.2017.00069 
  19. Simpson, K. W., Fyfe, J., Cornetta, A., Sachs, A., Strauss-Ayali, D., Lamb, S. V., & Reimers, T. J. (2001). Subnormal concentrations of serum cobalamin (vitamin B12) in cats with gastrointestinal disease. Journal of Veterinary Internal Medicine, 15(1), 26─32. doi: 10.1111/j.1939-1676.2001.tb02293.x 
  20. Ruaux, C. G., Steiner, J. M., & Williams, D. A. (2005). Early biochemical and clinical responses to cobalamin supplementation in cats with signs of gastrointestinal disease and severe hypocobalaminemia. Journal of Veterinary Internal Medicine, 19(2), 155─160. doi: 10.1111/j.1939-1676.2005.tb02676.x 
  21. Reed, N., Gunn-Moore, D., & Simpson, K. (2007). Cobalamin, folate and inorganic phosphate abnormalities in ill cats. Journal of Feline Medicine and Surgery, 9(4), 278─288. doi: 10.1016/j.jfms.2007.01.005 
  22. Marsilio, S., Pilla, R., Sarawichitr, B., Chow, B., Hill, S. L., Ackermann, M. R., Estep, J. S., Lidbury, J. A., Steiner, J. M., & Suchodolski, J. S. (2019). Characterization of the fecal microbiome in cats with inflammatory bowel disease or alimentary small cell lymphoma. Scientific Reports, 9, Article 19208. doi: 10.1038/s41598-019-55691-w 
  23. Ramadan, Z., Xu, H., Laflamme, D., Czarnecki-Maulden, G., Li, Q. J., Labuda, J., & Bourqui, B. (2014). Fecal microbiota of cats with naturally occurring chronic diarrhea assessed using 16S rRNA gene 454-pyrosequencing before and after dietary treatment. Journal of Veterinary Internal Medicine, 28(1), 59─65. doi: 10.1111/jvim.12261