Clinical Approach to Chronic Diarrhea Flashcards
What are the 11 aspects of the history that should be obtained for a chronic diarrhea case?
1) duration
2) diet
3) progression
4) appetite
5) weight loss
6) appearance of the feces
7) frequency of defecation
8) presence of vomiting
9) tenesmus
10) the environment in which the animal is kept
11) the animals breed and character.
What conditions are GSH dogs most likely to have?
What other breeds are prediposed to chronic diarrhea?
EPI>ARD>IBD
soft coated terriers and basenji
What is the clinical association for these physical findings?
How does hypoproteinemia present in large vs. small breed dogs?
large: peripheral edema
small: ascites
What does a thickened bowerl indicate?
Enlarged mesenteric l.n.?
infiltrative disease
reactive, neoplastic, or infiltrative disease
What are the two common causes of chronic anemia?
How can they be differentiated based on cytology?
chronic blood loss in GI or anemia of inflammatory dz
microcytosis w/ chronic blood loss
Why would a dog with PLE have hypoCa?
hypoalbuminemia leads to hypoCa
Which chemistry values commonly increase with IBD?
ALT & ALP (liver enzymes)
When would culturing a fecal sample be beneficial?
with salmonella and campylobacter
Which disease can cause lymphopenia associated with chronic diarrhea?
lymphangiectasia
What is the clinical association with these biochemical findings?
What trypsinogen-like immunoreactivity (TLI) values indicated EPI?
< 2.5 μg/L dog
< 8 μg/L cat
How long do you need to run a diet trial to know if the chronic diarrhea is a result of a food responsive disease?
2-6wks
In which breed is Abx responsive diarrhea common?
GSH
What does it mean if folate is high or low?
high: SIBO/dysbiosis
low: absorbed in proximal SI →malabsorption from SI dz
What does it mean if serum cobalamin is low?
severe mucosal dz or SIBO in distal SI (bacteria use cobalamin)
What is the important molecule that aids B12 absorption?
What is the difference in location of production in dogs and cats?
intrinsic factor
dog: parietal cells & pancreas
cat: pancreas (more likely to have def)
What test is essential for diagnosing IBD, tumors, and mycotic infections in the intestines?
biopsy
How can a biopsy be obtained?
endoscopy
laparotomy
laparoscopy
What are the common abx used for ARD trials?
tylosin/amoxicillin
severe cases: metronidazole & enrofloxacin
unresponsive: tatracycline
DDX for LI disease chronic diarrhea?
What parasties are of concern in the LI?
Tx?
trichuris (whipworms) and tritrichomonas
fenbendazole
What is the abx of choice for LI diarrhea?
sulfasalazine
(metro/tylosin for clostridium)
What is the best way to get a definitive dx for LI diarrhea?
colonoscopy and BIOPSY
