Diarrhea Flashcards
Problem based approach with diarrhea
Define the problem, location, system, then lesion
Alteration in normal pattern of defecation
Soft, unformed stools
↑ fecal water content
↑ frequency of defecation
Defining the location
Small bowel, large bowel or mixed
Small bowel diarrhea characteristics
Large amount
Melena or partial digestion of blood
WL with chronic
Borborygmus and flatulence
If unwell dehydrated
Large bowel diarrhea
Small amounts frequently with inflamed bladder
Mucus (hallmark) and fresh blood
Tenesmus (straining)
Secondary GI disorders causing diarrhea
Hepatic disease, pancreatic insufficiency, pancreatitis, hyperthyroidism, hypoadrenocorticism, renal disease
Large bowel or mixed bowel diarrhea as major presenting signs indicates _____________
Primary GI lesion
Secondary GI disease most frequently has characteristics of _____________
small bowel disease
Parasites and protozoa causing acute small bowel diarrhea
Parasites- ascarids, hookworms
Protozoa - giardia, coccidia
Diet related causing acute small bowel diarrhea
Overeating (pups)
Dietary change
Spoiled food
Garbage
Bacterial disease causing acute small bowel diarrhea
Campylobacter (young only, mixed bowel, zoonotic)
Salmonella (raw food, zoonotic)
Clostridium difficile
E. coli
Infection causing acute small bowel diarrhea
Viral enteritis- parvo, corona and rota
Acute Hemorrhagic diarrhea syndrome (AHDS)/ Hemorrhagic Gastroenteritis (HGE)
Acute onset of bloody diarrhea (small bowel)
Significant hemoconcentration (↑ PCV) with normal or low plasma protein
Typically in small breeds
What is Acute Hemorrhagic diarrhea syndrome (AHDS) caused by?
Novel necrotising toxin produced by Type A Clostridia perfringens (antimicrobial therapy doesn’t work)
Parasites causing chronic small bowel diarrhea
Toxocara- roundworms
Ancylostoma (hookworms)
Visceral larval migrans
Diet related causing chronic small bowel diarrhea
Lactose intolerance (common)
Gluten intolerance (uncommon)
Dietary hypersensitivity/ intolerance (common)
Bacteria and protozoa causing chronic small bowel diarrhea
Campylobacter
Clostridium
Giardia
Cryptosporidium (immunocompromised)
Coccidia (young)
Dietary hypersensitivity
Chronic intermittent diarrhea, vomiting and pruritus
Allergens
Pruritus species variation
Cats: ears, face
Dog: axillary region, feet
Allergens species differences
Dog: beef, lamb, chicken, wheat (gluten)
Cat: fish, milk, diary
Types of Chronic Enteropathy (IBD)
Diet response CE (most common)
Antibiotic response CE
Immunosuppressive responsive CE (real IBD)
Non-responsive CE
Antibiotic responsive CE
Abnormal/unbalanced bacterial population
Abnormal gut reaction to normal bacterial population
Chronic Enteropathy dietary trial
Novel protein or hydrolyzed (@ least 2 or 3 diets)
Total compliance
2-10 weeks a response
Harder in cats, keep them indoors
Chronic Enteropathy treatment trials
If no response to dietary trial use metronidazole or tylosin
↑ fiber
Neoplasia causing small bowel diarrhea
Diffuse lymphosarcoma
Adenocarcinoma
Mastocytoma
Other diseases causing chronic small bowel diarrhea
Lymphangiectasia (primary or secondary)
Brush order enzyme biochemical defects
Protein losing enteropathy (PLE)
When diffuse small intestinal disease results in excessive loss of serum proteins into the gut causing hypoproteinemia
Causes of protein losing enteropathy
Immunosuppressive- responsive or non-responsive chronic enteropathy (IBD)
Lymphangiectasia
Lymphoma
Most common clinical signs for protein losing enteropathy
GI signs (V/D)
WL
Ascites, pleural effusion, peripheral edema
Parasites causing large bowel diarrhea
Trichuris vulpis (dogs)
Ancylostoma caninum (cutaneous larval migrans)
Protozoa causing large bowel diarrhea
Giardia
Entamoeba spp.
Tritrichomonas foetus (cats)
Bacteria causing large bowel diarrhea
Campylobacter
Clostridium
Salmonella spp.
Granulomatous colitis (boxers, frenchies)
Diet related large bowel diarrhea
Toxicity (garbage)
Fiber-repsonsive
Dietary hypersensitivity/intolerance
Causes of mixed bowel diarrhea
Giardia
Campylobacter
Tritrichomonas foetus (cats)
Dietary indiscretion/ intolerance/ hypersensitivity
AHDS
Inflammatory
Diagnostic tools for diarrhea
Fecal tests (culture, float, panels, etc.)
Serum trypsin like immunoreactivity (TLI)
Cobalamin and folate
Ultrasound
Biopsy (endoscopy, laparotomy)
