Keynote Message

The term cachexia refers to a syndrome commonly associated with cancer and chronic diseases that is characterized by weight loss, loss of muscle mass (lean body mass) with or without loss of adipose tissue mass. It is commonly associated with cancer and chronic diseases, such as kidney disease, heart disease, and respiratory disease The term sarcopenia refers to the degeneration of skeletal muscle mass, quality, and strength as part of normal aging (i.e., not associated with a disease process). Cachexia and sarcopenia are underrecognized syndromes in veterinary patients, and many elderly pets may have both conditions concurrently. Poor body condition in CKD has been shown to be correlated to a poorer prognosis in several species, including dogs and cats. In people, CKD cachexia is often referred to as protein-energy wasting and many factors are described that may contribute to the condition including hypermetabolism, uremic toxins, metabolic acidosis, inflammation, and comorbidities.Both cachexia and sarcopenia involve muscle dysfunction, which contributes to overall frailty. Frailty can clinically manifest as weakness, hyporexia, perceived poor quality of life, and this, in addition to poor body condition, can lead to a decision for humane euthanasia. In this session, strategies for identification and monitoring of these conditions, as well as targeted nutritional management, will be discussed.

Key References

1.  Freeman LM, Lachaud MP, Matthews S, Rhodes L, Zollers B. Evaluation of weight loss over time in cats with chronic kidney disease. J Vet Intern Med. 2016;30(5):1661–1666. doi: 10.1111/jvim.14561.
http://onlinelibrary.wiley.com/doi/10.1111/jvim.14561/abstract

2.  Freeman LM. Cachexia and sarcopenia: emerging syndromes of importance in dogs and cats J Vet Intern Med. 2012;26(1):3–17. doi: 10.1111/j.1939-1676.2011.00838.x.
http://onlinelibrary.wiley.com/doi/10.1111/j.1939-1676.2011.00838.x/abstract

3.  Argilés JM, Busquets S, Stemmler B, López-Soriano FJ. Cachexia and sarcopenia: mechanisms and potential targets for intervention Curr Opin Pharmacol. 2015;22:100–6. doi: 10.1016/j.coph.2015.04.003. Epub 2015 May 14. Review.
http://www.sciencedirect.com/science/article/pii/S1471489215000405

4.  Carrero JJ, Stenvinkel P, Cuppari L, Ikizler TA, Kalantar-Zadeh K, Kaysen G, Mitch WE, Price SR, Wanner C, Wang AY, ter Wee P, Franch HA. Etiology of the protein-energy wasting syndrome in chronic kidney disease: a consensus statement from the International Society of Renal Nutrition and Metabolism (ISRNM) J Ren Nutr. 2013;23(2):77–90. doi: 10.1053/j.jrn.2013.01.001.
http://www.sciencedirect.com/science/article/pii/S105122761300006X