Clinical Approach to acute diarrhea and Disease

Question 1

What are the common causes of self-limiting diarrhea?

Answer 1

dietary indiscretion, sudden diet changes, food poisoning, and drugs/toxins

Question 2

What are some causes of acute life-threatening diarrhea?

Answer 2

parvovirus, hemorrhagic gastroenteritis (HGE), intussusception, hypoadrenocorticism, pancreatitis, and some infectious organisms (e.g., Salmonella , Clostridium, hookworms).

Question 3

DDX for acute diarrhea

Answer 3

Question 4

Parasites that cause acute diarrhea

Answer 4

Question 5

Bacterial species that cause acute diarrhea?

Answer 5

Question 6

What cells in body are targeted by parvovirus?

Answer 6

rapidly dividing cells (marrow and GI)

Question 7

What can you use to tx giardia?

Answer 7

Metronidazole or fenbendazole

Question 8

Which breeds of dogs are more susceptible to parvovirus?

Answer 8

Doberman Pinschers and Rottweilers are more susceptible than other breeds. Black Labradors, bull terriers and Shar-Pei’s are also susceptible.

Question 9

What are the two most common strains of parvovirus in US?

Answer 9

CPV-2b & c

Question 10

What are the key sign of parvovirus?

Answer 10

fever

leukopenia

V/D ( may be bloody)

Question 11

If I have a puppy showing all the signs of parvo, but my test is negative, DDx?

Answer 11

PARVO

test comes up negative after day 8 of infection (shedding stops)

Question 12

Incubation period of parvo?

Answer 12

3-7d

Question 13

What is the best test for parvo and timing?

Answer 13

ELISA 10-12d post-infection

(recent MLV may make it positive)

Question 14

Pathogenesis of parvovirus

Answer 14

Question 15

Even though puppies with parvo are dehydration , a PCV of >55% rare. Why?

Answer 15

young (less concentrated blood in general) and loosing blood through GI

Question 16

Tx for parvo?

Answer 16

replacement fluids

parenteral abx

antiemetics

feed through V/D

intestinal parasite control

Question 17

A puppy presents with acute diarrhea (orange feces) with no vomiting or leukopenia or fever.

DDX? Test to Dx?

Tx?

Answer 17

coronavirus enteritis

EM of fresh feces or PCR

spontaneous resolves in 8-10d

Question 18

What organism is Canine hemorrhagic gastroenteritis most often associated with?

Answer 18

clostridium perfringens (anaphylaxis from toxins)

Question 19

Which ages of dogs and breeds of dogs most susceptible to HGE?

Answer 19

peak 2-4 yrs

mini/ toy breeds (schnauzer)

Question 20

Lab results for HGE?

Answer 20

Question 21

TX for HGE?

Answer 21

IV fluids

antiemetics

abx?

Initially NPO