06 - intestinal disorders part III

Question 1

(Chronic IBD)

(lymphocytic-plasmacytic IBD)

1. most common form of IBD in dogs and cats
2. factors that may play a role?
3. Cx?
4. dx?
5. histo shows what?

Answer 1

2. mucosal hypersensitivty to antigens, genetic factors (german shephard, wehten terrier, shar-pei)
3. vomiting, diarrhea, weight loss (signs may be intermittent and last for months to years)
4. exclusion of all known causes

(abnormalities on endoscope = mucosal erythema, ulcers, ^ mucus, friability

4. infiltration of lamina propria with mature lymphocytes and plasma cells

Question 2

(Chronic IBD)

(lymphocytic-plasmacytic IBD)

1. diet tx?
2. medical tx?
3. persistence or recurrence of IBD is likely despite therapy

Answer 2

1. novel protein source, fiber
2. oral prednisolone best… are other options though

Question 3

(chronic IBD)

(eosinophilic gastroenteritis)

1. uncommon form of IBD, characterized by what?
2. most causes are what?
3. Cx?
4. dx?
5. most effective tx?

Answer 3

1. infiltration of GI with mature eosinophils
2. idiopathic
3. chronic vomiting and small or large bowel diarrhea
4. eosinophilic inflammation in intestinal bx
5. oral prednisolone (response to tx is rapid)

Question 4

(chronic IBD)

1. regional granulomatous enterocolitis - an uncommon form of IBD characterized by granulomatous inflammation resulting in a mass like thickening of the bowel wall

Question 5

(chronic IBD)

(histiocytic ulcerative colitis)

1. found in what dogs?
2. dx?
3. tx?

Answer 5

1. young boxer dogs
2. breed and presence of PAS_positive histiocytes on biopsy
3. enrofloxacin, metronidazole

Question 6

(fiber-responsive diarrhea)

1. chronic, non-inflammatory, mucoid large bowel diarrhea
2. tx?

Answer 6

2. give fiber…

Question 7

(Protein-losing enteropathy)

1. accelerated loss of plasma proteins into the gut caused by what or what?
2. Cx?

Answer 7

1. impaired lypmphatic drainage or mucosal injury

(most freq occurs with chronic enteropathies eg lympangiectasia, IBD, histoplasmosis, lymphoma)

2. severe hypoalbuminemia (edema, ascites, hydrothorax) and diarrhea

Question 8

(PLE)

1. typical lab findings in intestinal lymphangiectasia include what?
2. definitive dx requires what?

Answer 8

1. hypoalbuminemia, hypoglobulinemia, lymphopenia, hypocholesterolemia, and hypocalcemia
2. identification of the characteristic lymphatic lesions in biopsies

Question 9

(PLE)

1. tx is similar to that of what?

Answer 9

1. lymphocytic IBD. dietary fat restriction is warranted. response to therapy is unpredicatable

Question 10

(villous atrophy is associated with intestinal malabsorption and chronic diarrhea)

1. primary in what breeds?
2. secondary causes?
3. Cx?
4. tx?
5. prog?

Answer 10

1. irish setter (gluten sens) and german shephards (idiopathic)
2. diffuse infiltrative intestinal diseases (eg chronic IBD, lymphoma) and enteric infections (coronavirus, giardia, bac overgrowth)
3. small bowel diarrhea and wt loss
4. reduce gluten
5. guarded. Cx often persist despite tx

Question 11

(SI bacterial overgrowth)

1. overgrowth in proximal SI that results in what?
2. may develop secondary to other disorders (eg intestinal obstruction, dysfunction of the ileocolic jxn, motility disorders, hyposecretion of gastric acid, EPI)

Answer 11

1. malabsorption and diarrhea

Question 12

(SI bacterial overgrowth)

1. Cx?
2. dx requires what?
3. indirect evidence?
4. tx?

Answer 12

1. chronic watery diarrhea and steatorrhea. blood or mucus is usually absent
2. quantitative aerobic and anaerobic cultues or duodenal juice taken by endoscopy, intestinal intubation, or laparotomy after an 18 hour fast
3. response to abx, elevated serum folate and decreased serum cobalamin
4. tetracycline, tylosin, metronidazole

Question 13

(intestinal neoplasia)

1. 3 benign tumors?
2. two most common malignant?
3. Cx?
4. definitive dx?
5. tx?

Answer 13

1. adenomatous polyps, adenomas, leiomyomas
2. adenocarcinoma and lymphoma
3. vague: progress to vomiting and diarrhea
4. bx
5. sx with adjunt therapy

Question 14

(intestinal obstruction)

1. proximal vs distal - which is more acute and severe?
2. gastric outlet obstruction causes hypochloremic metabolic acidosis or alkalosis?

more distant obstruction?

3. tx?

Answer 14

1. proximal
2. metabolic alkalosis

metabolic acidosis

3. surgical removal, mgmt of complications, supportive medical tx