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Anorexia in small mammals Flashcards

1
Q

History Q’s

A
  • diet?
  • faeces - quantity? appearance?
  • any recent changes?
  • inside/outside?
  • stress? pain?
  • any new pets?
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2
Q

What can incorrect diet cause?

A
  • bloat
  • diarrhoea (common if fed sugary diet)
  • dysbiosis
  • GI bacterial infections (usually from eating spoilt food or scavenging (ferrets))
  • hepatic lipidosis (common in obese animals)
  • obesity which prevent caecotroph ingestion
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3
Q

Common conditions for indoor and outdoor pets

A
  • outdoor: exposure to wildlife e.g. virus and endoparasites
  • indoor: if loose higher chance of FB and trauma
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4
Q

Why can stress cause gut problems in hindgut fermenters?

A
  • it causes hypo motility which can then lead to anorexia and other problems e.g. gut stasis, gastric ulcers and bloat
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5
Q

Causes of stress in rabbits

A
  • predators
  • new rabbits
  • sudden change of diet
  • change of housing
  • transport
  • extremes of weather/temperature
  • loss of a companion
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6
Q

Main differences to CE cf a dog

A
  • auscultate the GIT in hindgut fermenters
  • need to use an otoscope for visualisation of cheek teeth
  • need to check ear canals and joints (any source of pain/dz can trigger gut stasis/GI issues, hence need to check everywhere)
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7
Q

Hindgut fermenters

A
  • rabbits
  • guinea pigs
  • degus
  • chinchillas
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8
Q

Ferret CE cf cat

A
  • different handling techniques: scrubbing often used as lots of extra skin in the area, therefore shouldn’t be painful or stressful
  • splenomegaly is common and often an incidental finding
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9
Q

Clinical examination

A
  • always examine teeth during CE and whenever under GA for anything else
  • observe and palpate whole head thoroughly
  • retract lips to examine incisors (in rabbits & GPs)
  • in species with radicular hyposdont pre–molars and molars, always use an otoscope to examine molars, tongue, cheeks
  • don’t forget to check eyes (nasolacrimal ducts pass tooth roots)
  • abdo palpation, BCS, checking perineal area all very important
  • can advise further exam under sedation
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10
Q

Reduced wear in hindgut fermenters is due to

A
  • not enough fibre (veg/hay)
  • selective eating
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11
Q

Weaker teeth in hindgut fermenters is due to

A
  • sugary treats and fruit
  • vitamin C deficiency (GP)
  • selenium deficiency
  • Ca/P imbalance (MBD)
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12
Q

Problem with sugary treats and fruit in hindgut fermenters

A
  • decay and caries can develop
  • predisposes to dental abscesses, and deficiencies
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13
Q

What is a tooth overgrowth in rabbits known as?

A
  • a spur
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14
Q

In rabbits which way go the upper and lower cheek teeth other grow towards?

A
  • upper: into the cheek
  • lower: into the tongue
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15
Q

Guinea pig cheek teeth

A
  • same as rabbits
  • but their lower cheek teeth curve slightly inwards (this is normal)
  • when they overgrow they form an arch and can trap the tongue
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16
Q

Ideal rabbit diet

A
  • 85% hay (not alfalfa)
  • 10% veg
  • 5% pellets (not muesli)
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17
Q

Breeding and dental dz

A
  • inherited predisposition
  • malocclusion
  • brachycephalic conformation
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18
Q

Signs of GI dz

A
  • anorexia
  • reduced/no faecal output
  • small dry faecal droppings
  • diarrhoea
  • hunched up / lethargic
  • faecal staining (+/- myiasis)
  • dribbling/wet front paws
  • caecotrophs accumulation (rabbits)
  • anal impactions (GPs)
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19
Q

Diagnostic tests

A
  • oral exam and abdo palpation under sedation
  • haematology & biochem
  • urinalysis
  • faecal flotation & wet smear
  • radiography +/- barium
  • US
  • endoscopy
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20
Q

Haematology & biochem

A
  • often non-specific
  • stress leukogram is a common finding
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21
Q

Hyperglycaemia causes

A
  • stress
  • pain
  • advanced liver dz
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22
Q

Hypoglycaemia causes

A
  • starvation/anorexia
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23
Q

What do elevated TP & HCT +/- urea/creatinine indicate?

A
  • dehydration
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24
Q

Reduced albumin causes

A
  • production
  • loss
  • ingestion
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25
Q

Liver parameters

A
  • TBIL
  • ALT
  • AST
  • GGT
  • ALKP
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26
Q

Common GIT conditions in hindgut fermenters

A
  • dental disease (primary or secondary)
  • gut stasis (motility decreases and gas builds up in the intestines)
  • bloat (gas accumulation in the stomach)
  • gastric ulceration (stress and slowing of the GIT can predispose to them)
  • impaction or FB
  • neoplasia (e.g. lymphoma, adenocarcinoma)
  • bacterial (dysbiosis and enteritis)
  • viral (e.g. coronavirus, rotavirus, rabbit hemorrhagic dz (RHD))
  • parasitic (e.g. pinworm, eimeria)
  • liver lobe torsion (rabbits)
  • GDV (GP)
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27
Q

Why can rabbits get liver lobe torsion?

A
  • 1 lobe is quite loose and mobile
  • check for this if present with acute sudden pain
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28
Q

Gut stasis

A
  • slowing/stopping of the passage of food through the GIT
  • typically affects the hindgut of hindgut fermenters
  • clinical sign not diagnosis, but needs to be specifically treated
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29
Q

Causes of gut stasis

A
  • pain
  • stress
  • incorrect diet
  • lack of caecotrophy
  • GI bacterial infection, viral , parasites
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30
Q

2 types of causes of gastric bloat

A
  1. physiological obstruction e.g. gastric stasis due to pain or diet
  2. physical obstruction e.g. FB, neoplasia, GDV
    - aggressive stabilisation required in all cases
    - surgery may be required if a physical obstruction
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31
Q

Onset of gastric bloat

A
  • quite acute
  • in a lot of pain
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32
Q

Normal commensals of hindugt fermenters

A
  • Bacteroides
  • Enterococcus
  • Staphylococcus
  • E.coli
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33
Q

Dysbiosis

A
  • microbial imbalance
  • usually an overgrowth of clostridia and/or coliform secondary to diet change, stress or oral antibiotics
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34
Q

What do Bacteroides appear to inhibit?

A
  • pathogenic bacterial growth
35
Q

Is Lactobacillus present or absent in rabbits?

A
  • absent
  • therefore, use rabbit specific probiotics that do not contain Lactobacillus
36
Q

Enteritis (bacterial) clinical signs in hindgut fermenters

A
  • anorexia
  • diarrhoea
  • haematochezia
  • dehydration
  • shock
  • death
37
Q

Bacterial enteritis

A
  • Clostridia spp overgrowth
  • E.coli overgrowth in juvenile rabbits under stress
  • Salmonellosis
  • Pseudomonas
  • Yersinia psuedotuberculosis (acute and chronic forms)
  • Lawsonia intracellularis
38
Q

Dysautonomia

A

= idiopathic malfunction of the autonomic nervous system

39
Q

Clinical signs of dysautonomia

A
  • GI stasis
  • dry mm and conjunctiva
  • mydriasis
  • bradycardia
  • urine retention
  • megaoesophagus
  • mucoid enteritis
  • LI impaction (as often very dehydrated)
  • may be found dead with food impacted in mouth
40
Q

Caecal impaction

A
  • occasionally occurs in adult rabbits
  • aetiology is often unclear, may be secondary to stress or ingestion of substances e.g. cat litter
  • prostaglandins have been used to try and empty the caecum but generally few respond and prognosis is poor
41
Q

Anal impaction

A
  • common in older male GPs
  • gental manual expressio
42
Q

Clinical signs of Eimeria steidae

A
  • weight loss
  • ascites
  • jaundice
  • causes GI and liver dz
43
Q

Common GIT conditions of ferrets

A
  • inflammatory bowel disease
  • endoparasites (e.g. ascarids)
  • protozoa (e.g. eimeria, giardia)
  • viral (e.g. ferret enteric coronavirus, rotavirus, canine distemper)
  • bacterial (e.g. Helicobacter mustelae, Lawsonia intracellularis, Salmonella, Campylobacter and E.coli)
  • obstruction (e.g. intestinal, anal glands)
44
Q

Is Giardia zoonotic?

45
Q

What is ferret enteric coronavirus emergent from?

46
Q

Ferret rotavirus

A
  • can make them very poorly
  • D+++ and GI dz
47
Q

Helicobacter mustelae in ferrets

A
  • affects the GIT, but particularly the stomach which is uncommon for bacterial infections
  • needs specific and intense tx
  • a lot of ferrets are carriers
  • majority of ferrets don’t have clinical dz
  • may increase risk of gastric neoplasia, gastric ulceration and possibly liver dz
  • can cause megaoesophagus
  • debate about relevance if find it and what to do
48
Q

Neoplasia in ferrets

A
  • lymphoma and adenocarcinoma are common
  • possibly secondary to helicobacter mustelae
  • often find enlarged LN on ex-lap (histology required)
49
Q

Common GIT conditions in rodents

A
  • enteritis
  • antibiotic associated enterotoxaemia
  • cheek pouch impactions and infections
  • overgrown incisors e.g. malocclusion, trauma
50
Q

Enteritis in rodents

A
  • rodents aren’t hindgut fermenters, therefore bacterial causes are most likely to cause enteritis
  • bacterial e.g. salmonella, Clostridium piliforme (Tyzzer’s disease), Lawsonia intracellularis (wet tail - common in hamsters)
  • viral
  • parasitis e.g. oxyurids, cestodes
  • dietary change
51
Q

Dental clinical exam

A
  • look at incisors by parting the lips
  • look at cheek teeth by using an otoscope, view is limited when conscious
  • look at a minimum of 4 points in the mouth with an otoscope when they’re conscious
52
Q

Why do dental imaging?

A
  • 2/3rd of teeth are sub-gingival
  • acquired dental dz is progressive and teeth/bone are often abnormal and used to stage dental dz
  • radiographs are helpful but CT is best
53
Q

Frances Harcourt-Brown staging for acquired dental dz

A

Stage 1 = normal
Stage 2 = root elongation & deterioration
Stage 3 = acquired malocclusion
Stage 4 = cessation of tooth growth
Stage 5(a) = end stage with osteomyelitis and abscess formation
Stage 5(b) = end stage with calcification of teeth and alveolar bone

54
Q

Views for dental radiography

A
  • lateral: open mouth, closed mouth
  • latero-oblique
  • dorsoventral
55
Q

Underlying principles for tx for all spp

A
  • restore circulatory volume (fluid therapy)
  • analgesia
  • restore GI motility (pro kinetics)
  • restore GI hydration (syringe feed q4h)
  • prevent ulceration and hepatic lipidosis
  • eliminate stress (correct husbandry/handling)
  • identify and tx underling dz
57
Q

Prokinetics (including doses) for rabbits

A
  • Cisapride (acts on upper and lower GI): 0.1-1mg/kg q8-12h
  • Metoclopramide (upper GI only) 0.5-1mg/kg q6-12h
  • Ranitidine (mostly upper GI) 4-6mg/kg q8-12h
  • only give if no obstruction
  • gut stasis generally affects the lower GIT
  • metoclopriamide alone is not good enough tx for gut stasis, but good for slow stomach emptying or crop stasis in birds
  • metoclopramide and ranitidine work synergistically so good together
58
Q

Antacids for rabbits

A
  • Ranitidine
  • Omeprazole
59
Q

Fluid therapy (including doses) for rabbits

A
  • SC fluids: 10ml/kg, max 20 ml per site, isotonic saline, warmed
  • IV (or IO): shock rate - 100ml/kg (divide into 15m boluses), maintenance - 4ml/kg/hr (can also divide into boluses)
  • too much sc fluid in 1 site can be painful
  • need to warm as smaller pts are more likely to get hypothermic if giving cold fluids
  • nibblers so drip lines not always a great choice
  • if pt bright and generally well consider giving days fluids in regular small slow boluses
60
Q

Safe antibiotics in hindgut fermenters

A
  • Medications For Treating Small Mammals
  • metronidazole
  • fluoroquinolones (except pradofloxacin)
  • tetracyclines
  • sulfonamides
  • macrolides (except erythromycin)
61
Q

Possibly dangerous antibiotics for hindgut fermenters

A
  • PLACE
  • penicillin
  • lincosamides (e.g. clindamycin)
  • aminoglycosides (possibly)
  • cephalosporins
  • erythromycin
62
Q

Other tx

A
  • anthelmintics: fenbendazole
  • coccidiostats/cides: TMPS, toltrazuril
  • simethicone for gastric bloat? seems to help gastric bloat but not gut stasis
  • lactulose? if worried about hepatic lipidosis - is a liver protectant
  • probiotics?
63
Q

Kennelling

A
  • keep away from busy areas as well as away from the sight, sound and smell of predators
  • hospitalise with cage mate
  • encourage owners to bring normal food and utensils
  • ensure soft, dry bedding and plenty of fresh hay
  • provide hide box
  • gentle handling and restraint
64
Q

Nursing care

A
  • hand and syringe feeding
  • cleaning soiling and discharges
  • note faecal output (type, consistency, size)
  • gentle abdominal massage
  • allow to exercise daily if condition allows (can allow gas movement out if their intestines in gut stasis)
65
Q

Nutritional support

A
  • hindgut fermenters need to eat regularly
  • when fasted their gut motility slows/stops and this can be fatal
  • never starve rabbits, even before GA
  • success of assisted feeding plans are dependent on the frequency of feedings, and what is being fed
  • oral feeds: 10-20ml/kg per feed, 6 feeds per day (q4h)
  • critical care foods e.g. EmerAid, Oxbow
  • ground up, watered down pellets
66
Q

Gastric bloat tx

A
  • critical pts -> IVFT necessary
  • analgesia & sedation
  • decompress with orogastric tube (slowly as easy to rupture)
  • can give liquid barium via a tube and take lateral radiograph
  • start drug therapies
  • if recurs or barium doesn’t pass into intestines = surgery
67
Q

Dysbiois/enterotoxaemia tx

A
  • fluid therapy
  • stop any offending antibiotics
  • cholestryramine
  • probiotics?
  • transfaunation of caecotrophs?
  • start required drug therapies
  • antibiotics? metronidazole + enrofloxacin can be used (protected but these animals are close to dying therefore use justified)
68
Q

Accumulated caecotrophs tx

A
  • clip and clean perineum (often need sedation)
  • start required drug therapies
  • treat underlying causes e.g. husbandry, obesity, perineal folds, arthritis, dental disease, etc
  • exclude treats, fruit and root vegetables from diet
  • provide ad-lib hay and grass
  • for stubborn/repeat cases can think about putting them on a hay only diet
70
Q

Dentistry

A
  • deep sedation/GA mandatory for cheek teeth tx
  • good lighting
  • aim is to restore normal, pain-free occlusion as much as possible
  • don’t lower crowns too far esp if molars stopped growing
  • warm owners of need for multiple tx (and repeating extractions if they snap, e.g. 4-6w later)
71
Q

Elodonts

A
  • rabbits & hystrcomorph rodents e.g. GPs, chinchillas, degus
  • continuously growing cheek teeth
  • large occlusal surface for grinding
  • tend to be herbivores
72
Q

Anelodonts

A
  • rats, mice, gerbils, hamsters
  • short crowned, rooted cheek teeth - don’t grow
  • grain eaters or omnivores
73
Q

Cheek teeth dentistry equipment

A
  • stand -> positions body and opens mouth
  • mouth gag -> opens mouth if not using a stand
  • cheek dilators -> widens the mouth
  • diamond burrs -> to attach to the low speed hand piece of a dental machine with a straight nose cone
  • hand rasps not recommended
74
Q

Cheek tooth crown reduction

A
  • manual hand rasps generally not advised as may cause loosening of teeth, soft tissue trauma and haemorrhage (inferior alveolar vessels)
  • motorised burrs on a straight slow speed handpick is preferred
75
Q

Cheek tooth extraction equipment

A
  • specialist locating elevator available (Crossley elevator)
  • can use a bent 18g needle to break down attachment if don’t have a suitable elevator
  • can refer if a complex case e.g. CT scan cf radiographs
76
Q

Cheek tooth extraction

A
  • use rabbit molar Crossley elevator or bent 18G needle
  • difficult unless already significant loosening
  • break down ligaments until the tooth is very loose then use extraction forceps to gently remove (to prevent the tooth from snapping)
  • if it snaps, wait 4-6w for it to re-grow then try again
77
Q

Incisor dentistry equipment

A
  • slow speed hand piece attachment
  • fast speed hand piece attachment
  • always place a syringe behind the incisors to protect the soft tissue with both methods
78
Q

Why should you never cut incisors with tooth cutters?

A
  • micro-fractures occur every time you cut an incisor with these
  • eventually this can fracture the tooth in half
79
Q

Incisor extraction

A
  • use rabbit incisor Crossley elevator or bent 18G needle
  • be patient and gentle and work on all 4 sides of the tooth equally
  • ensure the germinal epithelium is removed or destroyed
80
Q

Do you need to remove the opposing tooth as wells the one that is diseased?

A
  • incisor: yes as there’s less teeth/occlusal surface
  • molar: maybe not due to grinding motion, but if remove 2 next to each other potentially as may not grind down
81
Q

Dental nerve blocks

A
  • infraorbital nerve
  • mental nervve
  • deep mandibular nerve
82
Q

Dental abscesses

A
  • rabbits and GPs have thick pus so abscesses need surgical excision
  • tx involves surgical removal/shelling out abscess and its lining/capsule
  • the wound is then kept open by suturing the edges of the incision to the skin (marsupialisation)
  • find and address underlying cause of the abscess e.g. removing the tooth roots involved
  • imaging is a necessity (radiographs or CT)
  • abscess surgery and tooth removal can be performed in 1st op practice
  • a swab of the abscess pus and a section of the abscess lining sent for C&ST
  • whilst waiting for results never use enrofloxacin (not 1st line, and rarely found to be effective for abscesses in rabbits)
  • TMPS or injectable penicillin effective, if using 1 of these 2 also want to use metronidazole for anaerobic coverage

Y4 exotics (9 decks)

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