Blackwell's Five-Minute Veterinary Consult: Reptile and Amphibian. Javier G. Nevarez

       Conditions that result in failed food prehension (disorders of the tongue or oral cavity) or processing may result in animals that attempt to eat (have an appetite) but are unable to do so successfully.

       Hypophagia may be mistaken for anorexia in certain circumstances.

       CBC, PCV, TS, biochemistry

       Findings on complete blood count and biochemistry panels are usually non‐specific but may be suggestive of an underlying disease process(es) resulting in the observed anorexia.

       Bile acids and liver leakage enzymes (AST) may be increased if hepatic lipidosis is present secondary to prolonged anorexia.

       Additional diagnostics, including infectious or parasitic disease testing, may be warranted based on patient history and physical examination findings.

       The presumed underlying causes should be thoroughly investigated.

       Findings depend on underlying cause of the anorexia.

       Hepatic lipidosis may be suspected based on the findings of advanced imaging or biochemistry evaluation.

       Nutritional support should be started in anorectic animals that have lost 10% of their body weight acutely (7 days or less) or 20% chronically (longer than 7 days).

       This weight loss must also be monitored together with an assessment of body condition (BCS).

       Anorectic animals with a BCS of 2/5 or lower may be immediate candidates for nutritional support.

       Animals should be housed in appropriate environments and maintained at their preferred optimum temperature zones, to facilitate proper utilization of the provided nourishment.

       Liquid diets may be provided via gavage in smaller animals.

       Placement of an esophagostomy tube should be considered for long‐term support and to minimize stress of force feeding.

       Although poorly understood in veterinary medicine, the potential exists for refeeding syndrome in chronically anorectic patients, necessitating careful planning of nutritional support in these animals.

       Recommendations include feeding chronically anorectic animals half their calculated energy requirements initially, then slowly increasing up to the full energy requirement over 7–10 days.

       The clinician should perform a thorough review of the patient’s current husbandry, including feeding.

       It is important to ensure that a proper diet of an appropriate size is being offered.

       The diet must be presented to the animal appropriately (e.g., feeding diurnal animals during daylight hours, offering prey on land vs. in the water or vice versa).

       Any husbandry or dietary deficiencies should be corrected.

       Clients should be notified that offering live food items to anorectic animals could result in rapid, serious injury to their pet secondary to prey attacks.

       For most cases, live prey should not be offered to chelonians without direct supervision.

       Commercial, high‐calorie formulations designed for nutritional support are recommended when feeding anorectic crocodilians.

       Alternatively, a slurry can be made with a commercial pelleted diet.

       Exercise caution when force feeding, to prevent oral, esophageal, or gastric

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