Diarrhoea - Cat and Dog Flashcards

1
Q

diarrhoea - define

A

incr freq, volume or fluidity

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2
Q

melaena - define

A

dark, tarry

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3
Q

flatulence - define

A

excess gas

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4
Q

dyscezia - define

A

difficult/painful defacation

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5
Q

haematochezia - define

A

fresh blood in stool

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6
Q

tenesmus - define

A

ineffectual straining

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7
Q

Differentiation small/ large bowel diarrhoea - small

A
volume +++
mucus - 
freq +
tenesmus - 
dyschezia -
weight loss ++
vomiting +
general condition +
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8
Q

Differentiation small/ large bowel diarrhoea - large

A
volume +
mucus +++
freq +++
tenesmus +++ 
dyschezia +
weight loss +
vomiting +
general condition -
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9
Q

Differential Diagnoses acute small intestinal diarrhoea - No systemic signs

A

Diet
helminths
Protozoa (Giardia)
Iatrogenic (drugs)

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10
Q

Differential Diagnoses acute small intestinal diarrhoea - systemic signs - bacterial

A

Salmonella
Campylobacter
faecal culture needed

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11
Q

Differential Diagnoses acute small intestinal diarrhoea - systemic signs - viral

A

Distemper (dogs)
Parvovirosis (dogs)
Panleukopenia (cats)
faecal antigen test

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12
Q

Differential Diagnoses acute small intestinal diarrhoea - systemic signs - other

A

Toxins
Hemorrhagic Gastroenteritis (dogs)
Acute pancreatitis

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13
Q

Differential Diagnoses acute large intestinal diarrhoea

A
Whipworms 
Clostridia 
Giardia 
Campylobacter 
faecal examination, culture
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14
Q

DDx chronic small intestinal diarrhoea - metabolic

A

Hepatic disease (Portosystemic Shunt!)
Hyperthyroidism (cats)
Addison’s disease (dogs)
Renal insufficiency

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15
Q

DDx chronic small intestinal diarrhoea - pancreatic

A

exocrine pancreatic insufficiency

chronic pancreatitis

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16
Q

DDx chronic small intestinal diarrhoea - intestinal

A
Giardia infection 
Chronic partial obstruction 
Lymphangiectasia 
Neoplasia: Lymphosarcoma 
food-responsive disease 
Inflammatory Bowel Disease - Lympho-plasmacellular
17
Q

DDx chronic large intestinal diarrhoea - Colon

A
Inflammatory Bowel Disease - Lympho-plasmacellular, Ulcerative Colitis (Boxer) 
Polyps 
Food-responsive disease 
Neoplasia 
Chronic partial obstruction 
Cats: Tritrichomonas foetus!
18
Q

Investigations for chronic diarrhoea

A
Faecal exam 
Haematology, Biochemistry, UA 
If small intestinal diarrhoea: consider serum tests
Abdominal ultrasound
Empiric treatment with elimination diet 
If no response: Biopsies
19
Q

faecal exam

A

flotation, culture

exclude Parasites, bacterial infection

20
Q

Haematology, Biochemistry, UA

A

exclude renal failure, hepatic disease

21
Q

serum tests

A

Trypsin-like Immunoreactivity (TLI), Pancreatic

lipase (PLI), cobalamin

22
Q

Empiric treatment with elimination diet

A

Food-responsive disease

23
Q

biopsy

A

endoscopy
exploratory laparotomy
Food-responsive disease

24
Q

biopsy via endoscopy

A

Multiple biopsies from stomach, proximal small intestine, ileum and colon possible
Non-invasive (except for anaesthesia)
Direct visualization of mucosa possible
Gives diagnosis in majority of cases
Difficulty: Intestinal lymphoma, lymphangiectasia
dont sample from peyers patch - looks like lymphoma

25
biopsy via ex lap
Invasive - Caution in sick animals, cats, animals with decreased albumin levels Only yields 2-3 biopsies from stomach and small intestine, not for colonic biopsies! More expensive and painful for the animal 20% mortality vs 2% mortality for endoscopy
26
main causes for chronic SI diarrhoea in dogs
Food-responsive disease Antibiotic-responsive diarrhoea Inflammatory Bowel Disease - lympho-plasmacellular Enteritis/Colitis Neoplasia
27
food-responsive disease
Diarrhoea gets better when given elimination diet = protein that the animal has never eaten before: Better within first 2 weeks Keep on diet for at least 6-8 weeks
28
antibiotic responsive diarrhoea (ARD)
Former Small intestinal bacterial overgrowth = SIBO Most commonly seen in young German Shepherd Dogs Chronic small intestinal or mixed diarrhoea Treatment - Metronidazole For 4 weeks But: usually relapse!
29
IBD - inflammatory bowel disease
Diagnosis by clinical exclusion! Most common chronic enteropathy in dogs Histopathology - Lympho-plasmacellular (most common!), Eosinophilic (rare), Ulcerative colitis
30
Therapy of chronic enteropathies/IBD in dogs: Sequential treatment protocol
Elimination diet Metronidazole for 3-4 weeks If inadequate response - prednisolone for at least 10 days, then taper dose to e.o.d. azathioprine or cyclosporine if steroids poorly tolerated or unsuccessful
31
therapy of IBD in cats
Elimination diet Prednisolone for 10-14 days, then slow taper if no response: Chlorambucil Cobalamin supplementation
32
Protein losing enteropathy - define
Syndrome of intestinal diseases Non-selective protein loss: Albumin low, +/- Globulins low
33
Protein losing enteropathy - causes
IBD Lymphangiectasia Neoplasia (Lymphoma)
34
clinical picture
Diarrhoea vomiting, anorexia Weight loss Ascites, pleural effusion, peripheral oedema Usually albumin and globulin serum concentrations low Important to biopsy early on in workup