9 - Chronic Enteropathy Flashcards
What are the four things to think of for treatment of chronic enteropathy
diet, microbiome, vitamin status, immunosuprresion
what are chronic enteropathy treatment failures
failure to apporach all aspects of treatment, failure to recognize mild improvement
What is step 1 in chronic enteropathy treatment
empricial deworming
what drug is used for emperical deworming
Fendbendazole
what is step 2 for chronic enteropathy
diet trials
how many diet trials should you do ideally
3
what is step 3 for chronic enteropathy
microbiome directed trials
what is the last step of chronic enteropathy
immunosupression
food intolerance
non immunologic
food hypersensitivity
immunologic
what percent of patienst response to a diet trial
50 - 60 %
how long does it take for patients to respond to a diet trial
2 week s
patients are more likely to response to food trials when
concurrent atopic dermatitis, younger, normal mucusla
what is the general approach to food allergies
elimination diet
elimination diet is AKA
hypoallerginc diet
what is the gneral approach to lymphangiectasia
low fat diet
which diet is hypoallergenic and low in fat
lympangiectasia
what are the indications for elimination / hypoallergenic diet trials
chronic enteropathies, chronic large intestinal diseae that fails fiber entiched diet, derm signs
2 types of elimination / hypoallergenic diet trials
novel protien diets and hydrolyzed diets
Novel Protein Diet
feeding a new protein source
Hydrolyzed Diet
proteins hydroluyzed into 3-5 kDa
what are the indications for low fat diet trials
lymphaiectsia, evidence of fat malabsorption, concurrent pancreatitis, delayed gastric emptying
why are prescription diets ideal with novel protein
OTC are usually contaminated
Capromporelin is
appetite stimulant
mechanism for capromorelin
ghrelin agonist
Mirtazapine is a
appetitie stimulatn
Cyproheptadine
appetite stimulant for cats
what are additional options for appetite stimulants
steroids and feeding tubes
idiopathic dysbiosis
small intestinal bacterial overgrowth
probiotoic trials are
14 day trials
when should you consider antibiotics
after no respone to diet trials or probiotics
consider antibiotics if
evidence of dysbiosis on GI panel
example of antibiotic trial
Tylosin 14 - 21 day trial or Metro 5 - 10 day trial
What are indications of immunosuppresive therapy
IBD, no response to diet, deworming, or probiotics
What is the three criteria to diagnose idiopathic IBD
lymphophasmacytic and or eosinphils, no response to previous treatments, response to immunosuppressive treatment
with IBD what treatments shoudl be continued
diet, probiotics
what is often started with IBD
corticosteroids
prior to starting pred
rule out large cell lymphoma, infectious disease, no hepatobiliary infections
what dosing is done of pred for immunosuppressive therapy
anti-inflammatory to immunosuppresive dose
what is the side effects of pred
PU/PD, panting, polyphagia, muscle wasting, behavior changes
Budesonide
glucocorticoid with high hepatic clearance
indications for 2nd tier immunosuprresion treatment
refractory to steroids alone, intolerable to side effects
Chlorambucil has efficacuy for
small cell lymphoma
what are the side effects for Chlorambucil
bone marrow supression, Fanconis
Cyclosporoine side effects
vomiting, inappetance, ginigival hyperplasia
Azathioprine is only in
dogs
what are the side effects of azathioprine
neutropenia, thrombocytopenia, hepatopathy, pancreatitis
