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Ask Dr. Michael Salkin Your Own Question
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 24420
Experience:  University of California at Davis graduate veterinarian with 44 years of experience
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Why won't my 12 year old Maltese eat?

Customer Question

Why won't my 12 year old Maltese eat?
Submitted: 10 months ago.
Category: Dog Veterinary
Expert:  Dr. Michael Salkin replied 10 months ago.

I can understand your frustration. Anorexia is one of the least specific clinical signs and will not in itself direct the clinical evaluation. Anorexia is purely an indication of underlying disease. For the truly anorexic patient, the causes may be legion. It's vital to differentiate between a patient disinterested in eating and one who experiences difficulty or discomfort while eating. Thereafter, routine laboratory tests and diagnostic imaging complement the history and physical exam for elucidating the cause of anorexia.

Here is a synopsis of the differential diagnosis for anorexia:

Disinterested in food altogether (true anorexia): systemic disease, infection/inflammation, neoplasia, food aversion

Reluctance to eat (pseudoanorexia)

Associated with pain/discomfort

Painful prehension or mastication, odynophagia (repeated attempts at swallowing) as seen with: retrobulbar abscesses from apical/tooth root abscesses, e.g., intraoral masses/foreign bodies, mandibular fractures/temporomandibular joint disease, masticatory myositis (inflammation of the muscles of chewing), periodontal disease, salivary gland disorders, oropharyngeal dysphagia, esophageal disease (masses, foreign bodies), nasal disease affecting sense of smell.

Associated with nausea

Gastrointestinal inflammatory disease Ileus (paralysis of the GI tract), delayed gastric emptying, vestibular disease, side effect of medications; many drugs have GI tract side effects.

The initial database for pseudoanorexia is a neurologic examination, oral, dental, and cranial examination (sedation or general anesthesia); radiographs of the teeth, mandible, or nasal cavity may be required. Thoracic radiographs and/or endoscopy to evaluate the esophagus and gastroesophageal sphincter for any obstruction (e.g., strictures, masses, foreign bodies) or mobility problems. The initial database for true anorexia involves laboratory testing and imaging as suggested by history and physical exam findings.

Please respond with additional information and further questions or concerns if you wish.

Expert:  Dr. Michael Salkin replied 10 months ago.
Hi,
I'm just following up on our conversation about your pet. How is everything going?
Dr. Michael Salkin