Acute GI disease SA Flashcards
List categories of acute vomiting and diarrhoea
- Self limiting/non fatal
- secondary to systemic disease
- severe, potentially life threatening: enteric infection, AHDS, HGE, intestinal obstruction, Parvo
What is the most important part of care
supportive, making sure doesn’t become dehydrated
What is it called if SI, LI, stomach
Gastritis - stomach
SI - enteritis
LI - colitis
Signs D+ is linked tot SI
Normal/ slight inc freq large volumes associated with WL over time maybe melaena. no blood/mucous no tenesmus
Signs D+ in LI
Normal/slight inc volumes frequent
tenesmus
blood and mucoid
not usually WL
Causes acute gastritis and its presenting signs
Presenting: acute onset, freq vomiting, often acute D+, common, self limiting
Many diff causes dietary indiscretions, garbage intoxication foreign material hairballs (bezoars) in cats certain drugs acute systemic disease
How to assess hydration
PCV / TP MM
skin tenting
What other tests may you want to do?
haematology serum biochemistry urinalysis faecal examinations for parasites other faecal examinations ?
Faecal microbiology
ELISA - viral antigen
Parasitology: direct smear and flotation (Giardia)
Serolofu - Giardia SNAP test, Parvo SNAP test
Tests done, assessed dehydration still not sure.. what may you do
Imaging:
US and Radiograph
Emergency diagnostics- presenting with parachute crisis
PCV/total protein (refractometer) Examine blood smear Blood glucose (glucometer) Blood urea (dipstick) Urinalysis (Electrolytes) (Blood gas analysis) (ECG)
What drugs are conraindicated in acute D+?
Corticosteroids / NSAIDs
When would you use oral rehydration solutions?
not vomiting or several dehydrated
What about food?
Symptomatic treatment suggests that fasting for 12 hrs then frequent small amounts bland low fat food good but
small or pup feed diarrhoea as reduces the potential of sepsis. Don’t have a choice. Larger = fast
What drug would you give to a vomiting animal
Anti-emetic:
maropitant = licensed, long DoA (1 dose), few adverse affects
NK-1 receptor antagonist
Maropitant binds to NK1 receptors in CTZ and vomiting centre
Blocks binding of substance P therefore inhibits vomiting
Vomiting persisting, what would you give dog to protect gastric mucosa so stop / protect ulcer
H2-receptor antagonists = blocks H2 stimulation proton pump = stops histamine = stops acid secretion
E.g. Cimetidine (Zitac)
LICENSED
Omeprazole = proton pump inhibitor (not licensed D
Sucralfate – gastric protective
Antacids
Neutralised existing acid in lumen
e.g. Aluminium or magnesium hydroxide
What would you give a dog to STOp D+
Motility modifier -
Opiate = slows rate of transit = inc segmental contract but decrease peristalsis = slows transit
= inc water absorption
When re antibiotics indicated?
haemorrhagic diarrhoea
diarrhoea + pyrexia
known infection e.g. salmonella, campylobacter, Ecoli
Proc and cons to antibiotics
upset natural flora, cause D+, promote resistance but there is risk of sepsis if mucosal barrier compromised so sometimes needed
Use of probiotics??
Do no harm, easy to admin live micro-organisms administered orally alter the intestinal microflora proposed to have a beneficial effect on health
What is canine acute haemorrhage D+ syndrome? AHDS or HGE
Little dog, severe, acute haemorrhagic D+
affects all ages
especially toy and miniature breeds
syndromeof unknown aetiology
Not an inflame disease but there is altered mucosal permeability or secretion
Clinical signs of acute haemorrhage D+ syndrome?
sudden onset of vomition ± blood may precede diarrhoea by a few hours severe bloody diarrhoea marked haemoconcentration depression shock
Do bloods on a dog with suspected AHDS. what do you expect to see?
Marked PCV elevation
Normal skin turgor
Unremarkable WBC, radiograph, blood chemistry
How do we treat yorkie with AHDS in practice?
Prompt vigorous fluid therapy
IV balanced electrolyte solution
80ml/kg/pr until CRT normal and PCV below 50
How do we treat AHDS once stable?
withhold all food and water
parenteral broad-spectrum antibiotics
protectants
anti-emetics or anti-diarrhoeals ?
If untreated = death due to shock and circulatory failure
If treated mortality is low but note some dogs have repeated episodes
