9 - Chronic Enteropathy

Question 1

What are the four things to think of for treatment of chronic enteropathy

Answer 1

diet, microbiome, vitamin status, immunosuprresion

Question 2

what are chronic enteropathy treatment failures

Answer 2

failure to apporach all aspects of treatment, failure to recognize mild improvement

Question 3

What is step 1 in chronic enteropathy treatment

Answer 3

empricial deworming

Question 4

what drug is used for emperical deworming

Answer 4

Fendbendazole

Question 5

what is step 2 for chronic enteropathy

Answer 5

diet trials

Question 6

how many diet trials should you do ideally

Answer 6

3

Question 7

what is step 3 for chronic enteropathy

Answer 7

microbiome directed trials

Question 8

what is the last step of chronic enteropathy

Answer 8

immunosupression

Question 9

food intolerance

Answer 9

non immunologic

Question 10

food hypersensitivity

Answer 10

immunologic

Question 11

what percent of patienst response to a diet trial

Answer 11

50 - 60 %

Question 12

how long does it take for patients to respond to a diet trial

Answer 12

2 week s

Question 13

patients are more likely to response to food trials when

Answer 13

concurrent atopic dermatitis, younger, normal mucusla

Question 14

what is the general approach to food allergies

Answer 14

elimination diet

Question 15

elimination diet is AKA

Answer 15

hypoallerginc diet

Question 16

what is the gneral approach to lymphangiectasia

Answer 16

low fat diet

Question 17

which diet is hypoallergenic and low in fat

Answer 17

lympangiectasia

Question 18

what are the indications for elimination / hypoallergenic diet trials

Answer 18

chronic enteropathies, chronic large intestinal diseae that fails fiber entiched diet, derm signs

Question 19

2 types of elimination / hypoallergenic diet trials

Answer 19

novel protien diets and hydrolyzed diets

Question 20

Novel Protein Diet

Answer 20

feeding a new protein source

Question 21

Hydrolyzed Diet

Answer 21

proteins hydroluyzed into 3-5 kDa

Question 22

what are the indications for low fat diet trials

Answer 22

lymphaiectsia, evidence of fat malabsorption, concurrent pancreatitis, delayed gastric emptying

Question 23

why are prescription diets ideal with novel protein

Answer 23

OTC are usually contaminated

Question 24

Capromporelin is

Answer 24

appetite stimulant

Question 25

mechanism for capromorelin

Answer 25

ghrelin agonist

Question 26

Mirtazapine is a

Answer 26

appetitie stimulatn

Question 27

Cyproheptadine

Answer 27

appetite stimulant for cats

Question 28

what are additional options for appetite stimulants

Answer 28

steroids and feeding tubes

Question 29

idiopathic dysbiosis

Answer 29

small intestinal bacterial overgrowth

Question 30

probiotoic trials are

Answer 30

14 day trials

Question 31

when should you consider antibiotics

Answer 31

after no respone to diet trials or probiotics

Question 32

consider antibiotics if

Answer 32

evidence of dysbiosis on GI panel

Question 33

example of antibiotic trial

Answer 33

Tylosin 14 - 21 day trial or Metro 5 - 10 day trial

Question 34

What are indications of immunosuppresive therapy

Answer 34

IBD, no response to diet, deworming, or probiotics

Question 35

What is the three criteria to diagnose idiopathic IBD

Answer 35

lymphophasmacytic and or eosinphils, no response to previous treatments, response to immunosuppressive treatment

Question 36

with IBD what treatments shoudl be continued

Answer 36

diet, probiotics

Question 37

what is often started with IBD

Answer 37

corticosteroids

Question 38

prior to starting pred

Answer 38

rule out large cell lymphoma, infectious disease, no hepatobiliary infections

Question 39

what dosing is done of pred for immunosuppressive therapy

Answer 39

anti-inflammatory to immunosuppresive dose

Question 40

what is the side effects of pred

Answer 40

PU/PD, panting, polyphagia, muscle wasting, behavior changes

Question 41

Budesonide

Answer 41

glucocorticoid with high hepatic clearance

Question 42

indications for 2nd tier immunosuprresion treatment

Answer 42

refractory to steroids alone, intolerable to side effects

Question 43

Chlorambucil has efficacuy for

Answer 43

small cell lymphoma

Question 44

what are the side effects for Chlorambucil

Answer 44

bone marrow supression, Fanconis

Question 45

Cyclosporoine side effects

Answer 45

vomiting, inappetance, ginigival hyperplasia

Question 46

Azathioprine is only in

Answer 46

dogs

Question 47

what are the side effects of azathioprine

Answer 47

neutropenia, thrombocytopenia, hepatopathy, pancreatitis