Chronic Diarrhea Flashcards
What clinical signs are associated with which type of diarrhea?
Small Bowel Diarrhea:
Large Bowel Diarrhea:
Small Bowel Diarrhea:
Large volume of feces
Normal or increased frequency of defecation
Flatulence, steratorrhea (fat)
Melena (tarry, black)
Weight Loss
Vomiting
Large Bowel Diarrhea:
Small volume of feces
Increased frequency of defecation
Mucus in the feces
Hematochezia
Tenesmus
Pain or urgency to defecate
What are some differentials for chronic small bowel diarrhea?
Primary GI
-Lymphangiectasia
-Inflammatory Bowel Disease
-GI parasites
-Dietary indiscretion
-Histoplasmosis
-Neoplasia
Systemic (extra-GI)
-Hypoadrenocorticism
-Exocrine pancreatic insufficiency
-Hepatobiliary disease
-Chronic renal failure
What are the normal blood chemistry results of a dog with PLE?
Loss of albumin and globulins
Low total protein
What are the normal blood chemistry results for PLN?
Globulins normal to increased, albumin low and may have kidney or hepatic insufficiency
Protein in urine
What are the blood chemistry results if there is a hepatic cause of decreased protiens?
Hypoglycemia, low BUN, hypocholesterolemia, hyperbilirubinemia
Low protein
What diagnostics should you perform on an animal with diarrhea?
Fecal
CBC and Chem
Basal Cortisol (ACTH) rule out Addison
Tripsin like immunoactivity (TLI) - EPI
Diet trial
Abdominal Imaging
Biopsy
Upper GI Endoscopy
What is lymphangiectasia?
Swollen lymphatic vessels
Congenital or acquired by injury
What is intestinal lymphangiectasias?
Lacteal dilatation -> rupture and leakage of protein rich fluid into the lumen and interstitium
Lymph is a local tissue irritant -> inflammation and granuloma formation
Hard to tell primary from secondary
What are some breeds that are genetically predisposed to Primary intestinal lymphangiectasia?
Soft coated wheaten terrier
Norwegian Lundehund
Yorkshire Terrier
Maltese
Shar-pei
What are some things that could cause secondary intestinal lymphangiectasia?
Neoplasia(lymphoma)
Inflammation (IBD, Parasite, Food Allergy)
What are some consequences of PLE?
-Thromboembolic Disease
-Vitamin Deficiencies and Malnutrition
-Poor oncotic pressure (Pleural effusion, pulmonary edema, abdominal effusion, limb edema)
How do you treat primary intestinal lymphangiectasia?
Low fat diet long term
Prednisione
How do you treat secondary lymphangectasia?
Immunosuppressant
Low fat diet
What are some differentials for large bowel diarrhea?
Histiocytic ulcerative colitis
IBD (Food responsive, antibiotic responsive, steroid responsive)
Fiber resposive diarrhea
Infectious (clostridium, histo, whip, giardia, prototheca)
IBS
Neoplasia
