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injury, and those dogs get thinner as the an optimized diet for cancer or kidney have a number of patients with some
days go by because they’re on multiple disease or pancreatitis, capromorelin degree of chronic malnutrition in which
medicines and they’re in pain. Maybe may get them to eat the more optimal I am using ENTYCE®. Finally, remember
they’re getting 60% of their caloric diet and help them long term. how important it is to clients to see their
needs, but it’s not nearly enough for pets eagerly eating. They want their pets
what those dogs are facing. Something Dr. Johannes: Hopefully with the to come into the kitchen looking for food
to improve food intake and potentially availability of capromorelin, we have and treats. They equate so much of a
reverse muscle loss after acute injury the opportunity to really make a clinical pet’s quality of life to eating.
could be tremendously helpful for impact in a disease category that we’ve
getting those dogs up and home much struggled with. That for me is exciting. Dr. Freeman: One of my take-home
more quickly. We still have a lot to learn. We don’t points also would be thinking about
know exactly how this is going to be patients in which ENTYCE can be used,
Dr. Freeman: Changes in the gut incorporated in clinics. It’s potentially which raises one issue: The fact that it’s
mucosa and immune function also can going to change some treatment not just the animals with anorexia that
occur very quickly. A healthy individual dynamics. That’s the fun part. can benefit. That’s the smallest propor-
can go for long periods without eating. tion. The much bigger populations are
But because an ill or injured animal is Dr. Cook: I have tremendous difficulty those with hyporexia and dysrexia—get-
using primarily lean body mass, negative getting good treatment outcomes when ting them to eat the food they need. The
effects, including malnutrition, immune patients are dysrexic or hyporexic. It’s other point is that even if you don’t have
function changes, and gastrointestinal extremely distressing to owners whose changes in appetite, start to be aware of
atrophy, can start to occur within 3 to 5 pet is not eating well—particularly us muscle loss from cachexia and sarcope-
4
days. So we want to intervene before dog owners. We communicate love and nia in every patient.
that. affection for our dog with food. If our dog
looks at our food and pulls a sad face, it’s References
Dr. Johannes: I talk to our critical care very disturbing. It’s also hard to get 1. Johnson LN, Freeman LM. Recognizing,
specialists and our cardiologists, and it owners to be compliant about medical describing, and managing reduced food
intake in dogs and cats. J Am Vet Med Assoc.
becomes quite clear that there are a lot therapy if the patient is not consistently 2017; 251(11):1260-1262.
of other areas of veterinary medicine in eating. We might instruct them to give 2 2. Johannes C. Clinical impact and manage-
which we struggle with appetite and or 3 drugs, some with food and some ment of inappetence in oncology patients.
Proc N Am Vet Conf. Feb 6, 2017.
could start utilizing capromorelin. The without. Very quickly clients will get 3. Freeman LM. Cachexia and sarcopenia:
easy ones are acute conditions. The overwhelmed and say, “I stopped giving Emerging syndromes of importance in dogs
more challenging ones are chronic cases, the antibiotic because I think it made his and cats. J Vet Intern Med. 2012; 26(1):3-17.
where we have to add this on to the poor appetite worse.” 4. WSAVA Nutritional Assessment Guidelines
drugs they’re already getting. I have a Task Force (Freeman L, Becarova I, Cave N,
list of patients that are now receiving Dr. Johannes: So much of the social et al). J Small Anim Pract. 2011; 52:385-396.
ENTYCE® (capromorelin oral solution), interaction our clients experience with IMPORTANT SAFETY INFORMATION:
and I encourage you to start thinking their pets is appetite-related, appetite- ENTYCE® (capromorelin oral solution) is
how you can use this therapeutic. driven. Clients know their pets best. for use in dogs only. Do not use in
I myself have a Schnauzer that had breeding, pregnant or lactating dogs. Use
Dr. Burney: When we address the pancreatitis, and if he doesn’t eat his with caution in dogs with hepatic
primary cause but still have to fight the breakfast in 20 seconds, I know dysfunction or renal insufficiency. Adverse
patient’s appetite problems—that’s where something’s wrong. reactions in dogs may include diarrhea,
ENTYCE will be so useful. It’s already a real vomiting, polydipsia, and hypersalivation.
boon to our patients’ quality of life and Should not be used in dogs that have a
enhancing their recovery. Calls to Action hypersensitivity to capromorelin. Please
Dr. Larson: What are some key see the full Prescribing Information for
Dr. Cook: CKD is an endemic disorder. take-aways for general practi- more detail.
If that dog’s weight is moving down, its tioners regarding management of
days are numbered even if the blood- inappetence and hyporexia,
work is barely changed from the last particularly in dogs?
visit. Half-eaten cans of food are going
straight in the trash and the owner is Dr. Burney: If you can, detect the ENTYCE® is a registered trademark
getting more and more desperate. underlying cause. Sometimes an obvious of Aratana Therapeutics, Inc.
lesion or condition is not the cause of a
Dr. Freeman: If you identify muscle poor appetite. The other thought I would
loss in a chronic case, there are probably like to leave you with is that getting these
some challenges with nutritional status patients to eat is important not only for
that need intervention. If they’re not on the short term but for the long term. I ENT-0183

February 2018 clinician’s forum 5