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