15. Non-infective diseases of the small intestines in dogs and cats. Protein loosing enteropathies Flashcards
acute small intestinal disorders
AHDS
Chronic small intestinal disorders
food responsive enteropathy
antibiotic responsive enteropathy
immuneosuppressant responsive enteropathy
non responsive enteropathy
AHDS
acute haemorrhagic diarrhoea syndrome
used to be called haemorrhagic gastroenteritis
possible causes of AHDS
Dietary indiscretion
Toxins
Immune-mediated
Pancreatitis
Anxiety
Hyperreactivity
Stress
Intestinal bacteria
Intestinal parasites
Infection
Trauma
Intestinal ulcer
Foreign body
GI tumour, ulcer
Coagulation disorder
predisposition of AHDS
young - middle aged
small & toy breeds
in winter
Clinical signs of AHDS
acute onset of vomiting
profuse haemorrhagic diarrhoea –> hypovolemic shock
anorexia
lethargy
abdo pain
fever
diagnosis of AHDS
increased PCV
neutrophilic leucocytosis
normal / decreased TP
hypoglycaemia
electrolyte imbalances
treatment of AHDS
IVFT
parenteral AB
symtptomatic treatment
intestinal diet
Food Responsive Enteropathy
enteropathy that improves by alteration of the diet
causes of Food Responsive Enteropathy
food allergy
food intolerance
difference between food allergy and intolerance
allergy - immune related. can be due to genetics
intolerance - non immune related
most common allergens
dog - beef, chicken, wheat, milk
cat - beef, chicken, wheat, fish, corn
clinical signs of Food Responsive Enteropathy
pruritis
recurrent chronic diarrhoea
diagnosis and treatment of Food Responsive Enteropathy
work together
diagnosis by exclusion
prescription diet
homemade diet
avoid hidden allergens
how to do trial diets
Pruritis - trial for 8-12 weeks
Diarrhoea - trial for 3 weeks
No more than 1 therapeutic change every 2-3 weeks
Antiobiotic Responsive Enteropathy
enteropathy that improves by administration of antibiotics
Primary Antiobiotic Responsive Enteropathy
Loss of tolerance by local immune system
secondary Antiobiotic Responsive Enteropathy
damage of microbiome
dysbiosis
consequences of Antiobiotic Responsive Enteropathy
endotoxin secretion
Brush border enzymes become damaged
competition for nutrients
Clinical signs of Antiobiotic Responsive Enteropathy
chronic s. intestinal diarrhoes
gas production
fat malabsorption
weight loss
womiting
diagnosis of Antiobiotic Responsive Enteropathy
no specific tests
microbiota dysbiosis index
treatment of Antiobiotic Responsive Enteropathy
aim is to decrease the microbioma and dysbiosis
metronidazole but withdra if there is any relapse
Immunosuppresant Responsive Enteropathy
enteropathy that improves with immunosuppressive treatment
aka IBS in humans
predisposed to Immunosuppresant Responsive Enteropathy
middle aged animals,
g. shepherd, terriers, sharpei
Histopath types of Immunosuppresant Responsive Enteropathy
LPE
EGE
Neutrophilic gastroenteritis
granulomatous gastroenteritis
pathophys of Immunosuppresant Responsive Enteropathy
diffuse cellular infulatration
mucosal inflammation
oedema
clinical signs of Immunosuppresant Responsive Enteropathy
chronic diarrhoea
abdominal discomfort
flatulence
weight loss
inappetence
vomiting
what may occur in case of severe Immunosuppresant Responsive Enteropathy
protein losing enteropathy
diagnosis of Immunosuppresant Responsive Enteropathy
non specific - hypoproteinaemia, leucocytosis, eosiniphilia
specific - intestinal biopsy
treatment of Immunosuppresant Responsive Enteropathy
immunosuppressive drugs - pred, azathioprine (not for cats), budesonide, cyclosporine
non Responsive Enteropathy
enteropathy that doesnt respond to any treatment
idiopathic
possible choices of treatment
pre & pro biotics
faecal transplantation
Mesenchymal stem cell treatment
intestinal biopsy
types of Intestinal Neoplasia
Alimentary lymphoma
lymphosarcoma
intestinal adenosarcoma
intestinal leiomyoma/ leiomyosarcoma
clinical signs of Intestinal Neoplasia
Chronic diarrhoea
Excess weight loss
haematemesis
anorexia
melaena
vomitting
Protein Losing enteropathies
any gi condition resulting in a net loss of protein from the body
causes of Protein Losing enteropathies
lymphangiectasia
IBD
intestinal neoplasia / lymphoma
gi haemorrhage
general clinical signs of Protein Losing enteropathies
chronic diarrhoea
intestinal protein loss
ascites
oedema
cachexia
lymphangiectasia
abnormal dilation & dysfunction of lymphatic vessels
Predisposition to lymphangiectasia
yorkie
rottweiler
classification of lymphangiectasia
Primary - idiopathiclymphatic abnormality
Secondary - infiltration of lymphatics by; inflammation, fibrosis, neoplasia, infection
Clinical signs of lymphangiectasia
prolonged protein loss
decreased oncotic pressure
ascites
hydrothorax
fat malabsorption
protein loss
weight loss
chronic diarrhoea
diagnosis of PLE
intestinal biopsy
Hypoproteinaemia, hypocholesterolaemia, lymphopenia, hypocalcaemia, hypomagnesaemia
endoscop - mucosal oedema, rice grain nodules
Abdo US - streaks in submucosa
Treatment of PLE
protein loss with ultra low fat diet with high bioavailability
inflammation with - cyclosporin or corticosteroids
Antithrombin III
Weekly monitoring of albumin
