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59 Cards in this Set

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  • Back
The hallmark of intestinal disease is...
...DIARRHEA (cha cha cha)
Characterize SI diarrhea in terms of frequency, volume, tenesmus, and urgency.
little increase in frequency
increase in volume
no tenesmus
normal urgency
Characterize LI diarrhea in terms of frequency, volume, tenesmus, and urgency.
frequent!
smaller than normal
common tenesmus
way urgent!
Characterize SI diarrhea in terms of hematochezia, melena, wt loss, and inappetence.
no hematochezia
melena common
wt loss common
inappetence variable
Characterize LI diarrhea in terms of hematochezia, melena, wt loss, and inappetence.
yay hematochezia (occasional)!
boo melena (none)
no wt loss
no inappetence
Disease isolated to the large intestine are uncommon in small animals. Name two that break this mold!
Granulomatous colitis in boxers
Ulcerative colitis in cats
What are some viral causes of SI diarrhea in cats? In dogs?
FeCoV & FIP, FIV, FeLV, Torovirus

CPV, Canine Coronavirus
What are protozoal causes of SI diarrhea in dogs and cats?
Giardia, Cryptosporidium, Isospora
How does giardiasis typically present? How is it treated?
gassy distention + abdominal pain; Tx: Fenbendazole
What should be the top differential for acute/peracute diarrhea with pyrexia?
Salmonellosis, beeyotch!
"Songbird Fever" is associated with which infectious organism? How is this treated?
...Salmonella typhimurium; treat w/fluoroquinolones
Which infectious intestinal diseases present a potential zoonotic risk?
Salmonellosis
Campylobacteriosis
Cryptosporidium
If you see this on a fecal smear, what do you think of? What is a likely signalment?
Campylobacter (seagull shaped organisms on fecal smears); young or immune compromised pt w/mucoid to hemorrhagic diarrhea
A dog with high fever, hemorrhagic gastroenteritis, vomiting, and peripheral lymphadenopathy in the northwest just might have...
SALMON POISONING (neorickettsia helminthoeca)
If you see a German Shepherd with weight loss, poorly formed greasy stools, and a poor hair coat, what is your differential?
Intestinal Dysbiosis (SIBO)
EPI would be a good diff too
What are some of the main factors influencing the numbers of small intestinal bacteria?
Exocrine pancreatic secretions
Gastric acid secretion
Gastric and intestinal motility
Fermentable substrate input
How does intestinal dysbiosis cause intestinal disease?
Direct competition for substrates and cobalamin.
Deconjugation of bile acids.
Destruction of brush border.
Create hydroxylated fatty acids (irritant)
What effect does bacterial deconjugation of bile acids have on the intestines?
Deconjugated bile acids are more toxic and have a greater detergent effect, thereby damaging enterocyte membranes
What are good differentials to consider with intestinal dysbiosis?
EPI, IBD, LSA, intestinal adenocarcinoma, parasitism, intussusception, food responsive enteritis
How is intestinal dysbiosis commonly treated?
Probiotic, prebiotic, or tylosin + prebiotic
maybe B12 supplementation
What is the difference between IBD and IBS?
IBD is an inflammatory disease (presence of inflammatory cells); IBS is a motility issue (no inflammatory cells)
What are the types of IBD?
Lymphocytic-plasmacytic
Eosinophilic
Granulomatous/pyogranulomatous
Neutrophilic
T or F:
Chronic gastritis is more common in dogs than in cats.
False!
Its common in dogs and cats!
How can chronic gastritis be differentiated from acute?
History and duration (>7d; >2x/wk for 3+ wks)
What is an important rule-out for animals in the SE US showing signs of chronic gastritis?
Pythium insidiosum infection
How is idiopathic chronic gastritis treated?
1) exclusion diet trials
2) mucosal protection pharmaceuticals
3) immunosuppression
A cat with IBD typically presents similarly to which other condition?
EPI
What clinical signs may key you in to IBD upon physical exam?
Thickened intestinal loops
Poor "greasy" coat in cats
Ascites if severe
Weight loss
What is the pathology behind IBD?
NOBODY KNOWS!!!
What special diagnostics should be employed when working up IBD?
Serum TLI
Cobalamin/Folate
Fecal float/smears
Fecal alpha1 proteinase inhibitor (if protein losing)
What are the 5 F's that must be worked through when presented with LI diarrhea?
Food
Fiber
Fecal
Finger
Flagil (metronidazole)
How can IBD be definitively diagnosed?
Need biopsy! IBD is a histopathological diagnosis!
T or F:
Inflammation is a natural state of the GI tract.
True
What protozoans may play a role in chronic colitis in cats? In dogs?
Cats (giardia and tritrichomonas foetus)
Dogs (giardia and pentatrichomonas)
Severe, acute, hemorrhagic diarrhea with some vomiting and marked hemoconcentration describes...
...hemorrhagic gastroenteritis (HGE)
What is the common signalment of an animal with HGE?
Adult small breed dog
HGE = hemorrhagic gastroenteritis
What are some common clinical abnormalities associated with HGE?
hypothermic
Marked hemoconcentration
What are two differentials that look like HGE and how are they different from HGE?
Parvo (young dogs; HGE has no leukopenia)
Salmonellosis (doesn't hemoconcentrate due to loss of whole blood)
What is a good therapeutic regimen for treating HGE?
volume expansion (crystalloids then colloid)
Broad spectrum ABX
Warm animal
Why do all Norweigian Lundehunds have lymphangectasia?
They lack lymphatic valves
Which dog breeds are predisposed to lymphangectasia?
Basenji, Yorkie, Soft-coated Wheaten, Norweigian Lundehund
What is the pathogenesis of lymphangectasia?
Some lymphatic obstruction leads to increased lymphatic pressure and lymph/protein leakage into GI lumen.
What is the mechanism for protein uptake in the lower small intestine?
NO REUPTAKE MECHANISM DISTAL TO THE DUODENUM
What are some pretty bad sequellae to lymphangectasia and why?
Ascites (you know why)
Coagulopathy (ATIII is lost along with albumin)
What are diagnostic steps in working-up a protein losing case?
Liver test (pre/post BA) to rule-out not making protein.
Urine protein:creatinine to rule out PLN
May need to confirm excess protein loss w/fecal alpha 1 proteinase inhibitor
What is a pathognomic ultrasound finding consistent with lymphangectasia?
Tiger stripe pattern on wall of SI
What is the most common cause of PLE in the dog? Second most common?
IBD #1
alimentary lymphosarcoma #2
How can lipogranulomas from ruptured lacteals be treated?
glucocorticoids
Loss of 2/3 or more of the small intestine =
sort bowel syndrome
What is the common cause of small intestinal dumping?
inflammation!
What are the motility modifiers available? What is the mechanism for each?
Metoclopramide (Dopaminergic)
Cisopride (Dopaminergic)
Erythromycin (unclear mechanism)
Renitidine (Ach inhibition)
What are causes of acute colitis?
Dietary indiscretion
Diet change
possible acute bacterial disturbance
how may stress colitis be prevented in dogs?
fortiflora before stress (eg: before boarding)
What is the first diagnostic/therapeutic step that should be performed with pure LI diarrhea?
Fiber increase
How does fiber prevent LI diarrhea?
Bulk formation provides water absorption and drives haustration contractions which slow transit
Which colonic disease features enteroinvasive E. coli colonizing tissue macrophages? What is the signalment for this?
Histiocytic ulcerative colitis;
young male boxers
If a dog w/large bowel signs has failed the 5 f's, what is the next pharmacologic step? What is a side effect to this?
Give sulfasalazine (cleaves into sulfapyridine + salicylic acid);
Sulfapyridine can cause KCS
What is the difference between constipation, obstipation, and megacolon?
Constipation - infrequent, difficult defecation
Obstipation - permenant constipation
Megacolon - obstipation where smooth muscle does not respond to stimulation
What are the major causes of constipation/obstipation/megacolon?
Idiopathic is #1!!!
#2 is trauma (usually pelvic fracture)