Diarrhea Flashcards
Passing of loose or liquid stool, disorders of small OR large intestine, and MANY non- primary GI causes all describe what?
Diarrhea
What part of the GIT absorbs almost all of the nutrients?
SI
Enzymes from where facilitate breakdown of food into smaller molecules which facilitates transport across epithelium of the SI.
bile and pancreatic enzymes
The absorption of water is dependent on the solutes. Solutes not absorbed for any reason =
= water remains in the lumen and that explains the osmotic pathologic aspect of diarrhea
secretion of water into lumen»_space; reabsorption describes what?
the secretory aspect of diarrhea. Bacterial toxins and other agents open channels to allow water loss.
With regards to infection, we know that the disruption and destruction of the epithelium takes place. Water and nutrients not effectively absorbed describes what aspect of an infection resulting in diarrhea?
Osmotic
Exudation of serum and blood with destruction describes what aspect of an infection resulting in diarrhea?
Secretory
Inflammatory cytokines from inflammatory cells induces what aspect of inflammation that results in diarrhea?
Secretory
High rate loss of epithelium –> replaced w immature cells which are less fxn’al enzymes and transporters –> malabsorption –> this describes what aspect of an inflammatory condition resulting in diarrhea?
Osmotic
T/F Diarrhea can be caused from deranged motility.
True. Deranged motility = increased motility
How long does diarrhea last to be considered acute?
Acute
How long does diarrhea last to be considered chronic ?
Chronic > 3 weeks
The physical exam for melena is highly variable but what is something that we should always, always do on every animal whether melena is present or not?
Rectal!
At what point should our tx of diarrhea be more aggressive?
If weight loss, inappetence or dehydration is present
If an animal has acute diarrhea but is systemically well, what therapy, if any, should we utilize?
Diet, Psyllium or Metronidazole
We can expect to see the following CBC when dealing with what kind of dz?
Anemia
Thrombocytosis
Leukopenia or Leukocytosis
Normal
Primary GI dz
As an aside: on the chemistry, basically gonna see HYPO anything … HYPOAlb, HYPOCholesterolemia, HYPOCa, HYPO or HYPERK, HYPOCl, HYPONa . . . or it can be normal sooo that’s not helpful
Our fecal analysis is super helpful. When performing a simple saline float, what would we be able to see?
Ova, parasites like coccidia
What organisms would we be able to see on a stained smear slide?
Campylobacter; Clostridium
What organisms would we be able to see on zinc centrifugation?
Ova, parasites, Giardia
GI panel!! Important shit
T/F If the B12 and folate are within normal range, then we do not have GI dz.
False! Do not rule out GI dz just bc these numbers are normal
B12 and Folate do NOT tell you type of GI dz nor do they rule out GI dz but they are important to guide therapy and next steps of testing.
B-12 vitamin absorbed in the ileum. Needs intrinsic factor from pancreas. If B-12 is low then what does that tell us?
Low= malabsorption from primary GI (specifically the ileum) or EPI
Folate: B-vitamin that’s absorbed in the jejunum. If it’s low = malabsorption. What does it mean if it’s high?
High= dysbiosis: bacterial
TLI= Trypsin Like Immunoreactivity. If it’s low, what does that mean?
Low consistent w EXOCRINE Pancreas Insufficiency
PLI= Pancreatic Lipase. It’s elevations are consistent w what?
Elevations consistent with concurrent pancreatitis
Speckling on US tells us what?
inflammatory dz
Striations on US tells us what?
lymphangestasia . . . looks at slides 33-35 for pics
T/F On US, neoplasia can show up as a mass lesion OR as diffuse thickening.
True
What can we aspirate in relationship to GI dz?
Very thick small bowel wall
Mass lesions
Suspect infiltrative organs- LNs, liver, spleen
Really unsure if we need to know the extra tests on slide 39.
Send help.
The following are examples of what?
Metronidazole, Unasyn, Clavamox, Tylosin, Oxytetracycline, Enrofloxacin
Antibiotics !
Why do we use antibiotics as part of our diarrhea therapy?
Bc of potential break in mucosal barrier
What should we be careful of when using antibiotics?
DO NOT STOP BEFORE DOSE IS UP. Be careful with your suspect granulomatous colitis patients and tx duration. Tx for 8-12 wks. Do NOT stop it early even if they’re feeling better bc can develop resistance and animal could die.
Metamucil, Konsil, generi psyllium powder, canned pumpkin, w/d diets are all adding what ?
Fiber! Bind that baby up.
All of the following are true for diet management except what ?
Novel protein Grain free Hydrolyzed proteins High fat Home cooked diets
High fat.
Nah, we gotta restrict fat.
We give folic acid/folate B9 supplementation to help a patient with diarrhea but what drug depletes this vitamin?
Sulfa drugs deplete this vitamin
T/F Injectable Vitamin B-12 (cyanocobalamin) can be given to patient with diarrhea.
True
T/F Prednisone/Prednisolone have longer DOA than Dexmethasone.
False. Dex has longer duration of effect.
T/F We utilize steroids for diarrhea therapy.
True
T/F Budesonide is a topical activity steroid and is 15x more potent than prednisolone but with less systemic
True
Atopica/Cyclosporine, Azathioprine and Chlorambucil are all what ?
They handle the immune modulation aspect of our diarrhea therapy
Atopica/Cyclosporine work by reducing what?
Reduce cell mediated immune responses (T cell suppression)
Azathioprine inhibits what?
Inhibits lymphocyte activation and proliferation
T/F Azathioprine is used dogs and cats.
FALSE –> NEVER IN CATS
Chlorambucil cross links cellular DNA –> cell cycle is nonspecific anti neoplastic and immunosuppressive medication. Small cell lymphoma or high grade IBD. What species can we use this immune modulator in?
Cats and dogs!
Sulfasalazine is an antibacterial and anti inflammatory that is used for ______ ______ diarrhea.
Large bowel diarrhea
Bismuth subsalicylate is a diarrhea tx and sometimes part of Helicobacter therapy. It has antimicrobial properties, weak antacid and anti secretory. What are the 2 MAJOR things to know about it???
RADIOOPAQUE AND DARK STOOLS!!
Clicker question: A 2 YO lab presents w a concern for acute onset lethargy and dark stools which you determine to be melena. If finances are limited, which blood work tests would you prioritize?
A. CBC, coagulation profile (PT, PTT)
B. Fecal analysis
C. Chem panel
D. Urinalysis
A. CBC, Coag profile
Living microorganisms used to impart health benefits bc they improve epithelial barrier fxn, modulate mucosal immune system, alter intestinal flora- replace bad with good are called what?
Probiotics
Non digestible dietary carbs that stimulate growth and metabolism of enteric protective bacteria (Bran, psyllium, lactosucrose, fructoligosaccharides) are called what?
Prebiotics
