Chronic Disease of the Small & Large Intestine

Question 1

Which breeds of dog are pre-disposed to IBD?

Answer 1

Basenji, Soft-coated Wheaten terrier, Shar-pei, and

Norwegian Lundehund

Question 2

What is the difference between IBD vs. IBS

Answer 2

inflammatory bowel disease (inflammation present) vs. irritable bowel syndrome (no inflammaiton, fxn)

Question 3

Which layer of the intestine do inflammatory cells infiktrate in IBD?

What is the most common infiltrate?

Answer 3

lamina propria

lymphocytes/plasma cells

Question 4

What is the pathogensis for IBD in GSH?

Answer 4

TLR 4&5→abnormal expresion→do not recognize Ag normally

Question 5

Age and breed predisposition for IBD?

Answer 5

Question 6

What is the most frequent sign of IBD in cats? Dogs?

Answer 6

cat- vomit (variable timing/freq/acute/chronic)

Dog: diarrhea (chronic)

Question 7

What is the clinical presentation of a cat with IBD other than vomiting?

Answer 7

Question 8

If a cat is polyphagic and loosing weight, what are the top DDX?

Answer 8

small cell lymphoma

hyperthyroid

IBD

diabetes

Question 9

Clinical presentation of IBD in dogs?

Answer 9

diarrhea

Question 10

What is a symptom dogs will having associated with PLE from IBD but not cats?

Answer 10

edema/ascites

Question 11

A cat vomiting with IBD produces what kind of vomit?

Answer 11

clear, foam, bile (may have food but less common)

unrelated to eating

Question 12

Is hematemesis common with IBD?

Answer 12

no rare (suggests gastric involvement)

Question 13

In dogs with IBD that have cyclic bouts of vomiting and abdominal pain may be mistaken for what condition?

Answer 13

pancreatitis

Question 14

Why was the canine IBD activity index (CIBDAI) created?

Answer 14

the clinical improvement of IBD did not correlate with improvement of histology samples. Therefore, a scoring system was create to assess for clinical improvement.

Question 15

endoscopic findings for IBD?

Answer 15

Question 16

What result in the biopsy report is highly suggestive of IBD?

What are the common characteristics of IBD described in a biopsy report?

Answer 16

crypt abscesses

Question 17

IBD is a dx of exclusion. What other conditions must be excluded first?

Answer 17

A stepwise approach to diagnosis should initially consider or eliminate intestinal

pathogens and parasites, partial intestinal obstruction, systemic disorders, food responsive

disease, intestinal dysbiosis, and exocrine pancreatic insufficiency.

Question 18

Intestinal lymphoma should be suspected when the albumin level is (low/high/normal) and the Ca conc. (low/high/normal)?

Answer 18

low and normal/high

Question 19

Best way to dx IBD?

Answer 19

BIOPSY

Question 20

What is a good tx if you are having a difficult time differentiating IBD from small cell lymphoma in your cat patient?

Answer 20

chlorambucil & prednisolone

Question 21

Tx for IBD

Answer 21

Diet change (novel protein or hydrolyzed protein or highly digestible)

immunosuppression (pred, azathiaprine, chlorambucil)

Question 22

For fiber responsive colitis, what is tx?

Answer 22

diet change (GI diet with fiber for SCFA production)

also use metamucil or pumpkin

Question 23

Actions of steroids in IBD?

Answer 23

Question 24

What is an alternative steroid to pred that is 7-10x more potent and is injectable?

Answer 24

Dexamethasone

Question 25

What steroid alternative to pred has less systemic affects b/c it is metabolize the the liver first?

Answer 25

budesonide

Question 26

What is the CIBDAI?

Answer 26

Question 27

How to slowly taper off steroids?

Answer 27

reduce 25% q 2-4 wks

Question 28

Adjunct meds to steroid therapy in severe/non-responsive cases?

Answer 28

azathioprine, cyclosporine (PLE), chlorambucil

Question 29

Adjunct therapies for IBD?

Answer 29

Question 30

TX for LI IBD mild? Moderate-Severe?

Answer 30

mild: metronidazole and diet change (hypoallergenic or high fiber)

Severe: sulfasalazne or pred (biopsy first)

Question 31

A boxer (frenchies/boston terriers) presents with LI hematochezia and tenesmus. Likely DDX?

What is a key histo finding?

Tx?

Answer 31

histiocytic ulcerative colitis

PAS-+ macrophages and Adherent & invasive E.coli

Tx with ABX**(enrofloxacin, +/- amoxi/metro)

Question 32

Mechanisms for PLE?

Answer 32

lymphatic obstruction/rupture

increase mucosal perm

mechanical (ulcers)

Question 33

What disease can lead to PLE?

Answer 33

Question 34

In which breed is lymphangiectasia most common?

Answer 34

yorkies

Question 35

C.S. of lymphangiectasia

Answer 35

none in some dogs

weight loss, diarrhea

edema, ascites, pleural effusion

Question 36

What are the blood work findings with lymphangiectasia?

Answer 36

hypoAL and hypoCa

hypoMg

hypochol

lymphopenia

Question 37

Answer 37

speckaling on U/S d/t dilated lacteals in GI mucosa

Question 38

Results form an intestinal biopsy

Answer 38

lymphangiectasia (dilated lacteals)

Question 39

Tx for lymphangiectasia?

Answer 39

Diet - low fat

HA purina- low fat and hypoallergenic

Royal canine lowest fat (GI diet)

Question 40

Causes of infectiosu colitis?

Answer 40

Question 41

A dog from the gulf coast exposed to standing water?

Answer 41

pythium

Question 42

A dog exposed to standing wate in the gulf coast region got an algal infection.

Answer 42

prototheca

Question 43

A dog from tennesse, Ohio river valley area that has inclusions in macrophages?

Answer 43

histoplasmosis