Diseases of the Small Intestine Flashcards
Diseases of the small intestine
Acute enteropathy
Small intestinal obstruction
Breed related enteropathy
Chronic inflammatory enteropathy
CS of dz in the small intestine
V/D, WL, anorexia/ polyphagia
Borborygmus, painful abdomen, fluid in bowel loops
Systemic/ metabolic illness (shock, hyperthermia, etc)
Which diseases cause diarrhea in young?
Parvo, pythiosis, intestinal parasites and diet repsonse enteropathy
Which diseases cause diarrhea in older animals?
Middle: chronic enteropathies
Old: neoplasia
SI dz in cats
↑ T4, FeLV/ FIV, FIP
SI dz in dogs
Addison’s, pythosis, whipworms
Small bowel diarrhea
Large amount, melena (black), rare mucus and tenesmus, maybe fat vomiting and WL, gas sometimes
Large bowel diarrhea
Small amount, mucus, fresh blood, tenesmus, ↑ frequency, urgency, rare WL, maybe vomiting
Acute hemorrhagic diarrhea syndrome (HGE)
Acute onset of vomiting
Hematochezia, hematemesis (bloody), rapidly progressive
Differentials for Acute hemorrhagic diarrhea syndrome
Parvo, gastric ulceration, parasites or addisons
Dx for Acute hemorrhagic diarrhea syndrome
Routine + coagulogram, parvo, fecal, baseline cortisol or ACTH, rads and US
Tx for Acute hemorrhagic diarrhea syndrome
Aggressive fluids, Abx, same tx as acute gastritis
K9 parvo CS
PUPPIES
Depressed, anorexia, V/D (bloody), fever, dehydration, tender abdomen
DX parvo
Fecal Ag test
Detects wild type and vx virus
Bloodwork for parvo
↓ WBC
Hypoglycemia (septicemia, low glycogen)
Low potassium and ↑ ALP
Tx for k9 parvo
IV fluids (or oral)
Anti-emetics (cerenia, metoclopramide)
Abx (ampicillin and enrofloxacin)
don’t use anti-diarrheals
Chronic SI dz (CIE)
Diet responsive enteropathy
Abx responsive enteropathy
Steroid responsive enteropathy
IBD
Lymphangiectasia
Diet responsive enteropathy
Diarrhea secondary to dietary Ag
Young dogs or cats
Food intolerance and hypersensitivity
Skin CS for food hypersensitivity
Pruritus (facial, pedal)
Otitis externa
Self trauma → pyoderma
Miliary dermatitis
GI CS for food hypersensitivity
V/D, borborygmus, flatulence, abdominal pain, WL
Diet responsive enteropathy dx
C-reactive protein
intra-dermal skin test
Dietary trial
Indirect tests: cobalamin, food specific IgE and IgG
Tx for Diet responsive enteropathy
Restricted diet
Skin lesions: baths, fish oil, ketoconazole, antihistamines
Abx responsive diarrhea (ARD)/ SI bacterial overgrowth
Bacterial overgrowth
Caused by: EPI, partial intestinal obstruction, pancreatitis, CIE, neoplasia, dietary responsive enteritides
CS in dogs with Abx responsive diarrhea
Young
Chr. intermittent diarrhea, WL, borborygmus, flatulence, vomiting, ↑ urgency/ frequency
Pathogenesis of Abx responsive diarrhea
↑ bacterial numbers in SI: ↑ competition for nutrients and by-products of metabolism and damage to mucosal brush border
Dx tests for Abx responsive diarrhea
TLI, cobalamin, folate
C-reactive protein
Serum conjugated bile acids
Histopath and dysbiosis index
ARD tx
Broad spectrum abx: tylosin, metro
4-6 w course
Relapse = lifelong therapy
Steroid responsive enteropathy (chr. inflammatory enteritis/ CIE)
Persistent or recurrent GI signs
Intestinal inflammation
CS of CIE
Vomiting, SI, LI and mixed diarrhea
Thickened bowel loops, borborygmus, flatulence, WL
Hypoproteinemia: ascites, pleural effusion, SQ edema
Histopath of CIE
Lymphocytic-plasmacytic
Eosinophilic, granulocytic, neutrophilic
DX CIE
Stress leukogram, non-regen anemia
↓ cholesterol, albumin, globulin, hypocalcemia
Rads and US: thickened bowel loops
Endoscopy
Tx for CIE
Diet: hydrolyzed, limited Ag, low fat
Probiotic
antimicrobials (tylosin and metro)
Cobalamin +/- folate
Glucos (pred)
Gastroprotectants (H2 blockers, sucralfate)
Cytotoxic drugs (azathioprine)
Primary Lymphangiectasia
Intestinal lymphatic disorder, congential
Secondary Lymphangiectasia
Intestinal lymphatic obstruction
Obstruction of the thoracic duct
Right heart failure
Lymphangiectasia
Marked dilation and dysfunction of intestinal lacteals
Lymphatic leakage of proteins
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