Chronic Diarrhea And Disease

Question 1

What are the important aspects of history in a patient with chronic diarrhea?

Answer 1

Species, age, breed, duration, diet, progression, exposure to other animals, exposure to parasite-infected environment, working dog or pet, indoors/outdoors, recent change in environment, boarding, new pet, travel

Question 2

What are common hematologic findings seen with chronic diarrhea?

Answer 2

MOST are normal; neutrophilia, monocytosis, eosinophilia, lymphopenia, erythrocytes/MCV

Question 3

What is the diagnostic approach for patients with chronic diarrhea of the small bowel?

Answer 3

Complete fecal exam (centrifugation, saline smear, cytology), culture, Idexx PCR panel, diet trials (food responsive diarrhea), cobalamin/folate (SIBO), diagnostic imaging (rads, contrast films, U/S), intestinal biopsies (essential for IBD, intest tumors, mycotic infxns), endoscopy, exploratory laparotomy, laparoscopy

Question 4

What are some potential biochemical findings you may see with chronic diarrhea?

Answer 4

Panhypoproteinemia - PLE, hemorrhage; Decr Ca - hypoalbuminemia; Incr liver enzymes = reactive hepatopathy, concurrent dz (Triaditis), hyperthyroidism

Question 5

What is the diagnostic approach for patients with chronic diarrhea of the large bowel?

Answer 5

Diet trial, test feces for Clostridium, response to rational therapy, contrast radiographic studies, colonoscopy/biopsy