Diarrhoea Flashcards
Suggest charactersitcs that differenitates anatomical location of problem causing diarrhorea (If its Small intestine vs Large intestine)
Small Intestinal Characteristics
Normal to large volume
Frequency of defaecation is normal to mildly increased
Melaena
Concurrent weight loss**
Concurrent vomiting
Ascites if associated with protein-losing enteropathy (PLE)
Large Intestinal Characteristics
Variable but often small volume
Increased frequency of defaecation often associated with urgency
Mucus
Haematochezia (fresh blood)
Faecal tenesmus
Dyschezia (pain associated with defaecation)
Differential Dx for ACUTE haemorrhagic Diarrhoea
Viral: parvovirus, coronavirus
Bacterial: Salmonella, Campylobacter, C perfringens, C. difficile, E.coli*
Miscellaneous
Acute haemorrhagic diarrhoea syndrome*
Abdominal catastrophe*
Parvovirus infection clinical sign
anorexia, vomiting, severe haemorrhagic diarrhoea, pyrexia/hypothermia, SIRS, DIC
When should you suspect/consider Parvoviral infection?
Unvaccinated dogs with signs of ACUTE and severe gastroenteritis
Patients are unwell: dehydration, signs of sepsis (neutropenia)
When should you suspect/consider Salmonella infection?
acute enterocolitis, mucosal sloughing and secretory diarrhoea
in septicaemia (SIRS and MODS)
Disease most likely to be seen in young and/or immunocompromised individuals
Raw diets
Zoonotic
When should you suspect/consider Campylobacter infection?
Disease most likely to be seen in young and/or immunocompromised individuals, with concurrent GI infections, prior antibiotic therapy and Poor hygiene
Superficial erosive enterocolitis
Zoonotic
When should you suspect/consider Clostridium perfringens-associated Diarrhoea
Acute Haemorrhagic Diarrhoea Syndrome
acute onset vomiting (sometimes with haematemesis), severe diarrhoea (haemorrhagic) progressing to severe dehydration
Investigation of parvovirus
Faecal Antigen testing
Serology for anti-CPV antibodies
Haemagglutination inhibition test
PCR on faeces (detection of viral DNA)
Investigation of Entero-pathogenic bacteria
Standard faecal culture (& sensitivity)
PCR to determine exact species
ELISA for enterotoxins
What kind of diet to recommend diarrhoea patient
Low fat diet
Management of Parvoviral enteritis
IVFT- Crystalloids
IV antibiotics if neutropenic due to (risk of) G-ve sepsis
Anti-emetics (often combination therapy)
Early nutritional support (enteral +/- parenteral)
Interferon
Significance of faecal analysis in chronic diarrhoea
Exclusion of Giardia as a cause of and/or contributary factor
Diagnostic Tests for Giardia intestinalis
Zinc Sulphate Faecal Flotation
ELISA for soluble antigen
Immunofluorescence assay
PCR for Giardia DNA
Management of Chronic Idiopathic Enteropathies
Dietary Modification
Allergen Restriction: “Elimination Diets”
Hydrolysed protein diets
Low Fat diets
Prebiotics: fructo-oligosaccharides
Vitamin B12
Immunosuppressive Drug Therapy
