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Gastro - Diarrhea Flashcards

1
Q

What is diarrhea?

A

increased frequency, volume, or fluidity of feces

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2
Q

What is melena?

A

dark, tarry feces

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3
Q

What is flatulence?

A

excess gas

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4
Q

What is dyschezia?

A

difficult or painful defecation

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5
Q

What is hematochezia?

A

fresh blood in stool

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6
Q

What is tenesmus?

A

ineffectual straining

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7
Q

When does something go from acute to chronic?

A

if it has been over 3 weeks

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8
Q

Differentiate between small and large bowel diarrhea.

A

Small bowel diarrhea will have a large volume, weight loss, vomiting, and poor general condition associated with it

Large bowel diarrhea has less volume than small, it has mucus present, increased frequency, tenesmus, some dyschezia, weight loss, and vomiting

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9
Q

What type of diarrhea is this?

A

large bowel

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10
Q

What type of diarrhea is this?

A

small bowel

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11
Q

What type of diarrhea is this?

A

small bowel - note the melena

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12
Q

What type of diarrhea is this?

A

small bowel - large volume

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13
Q

What are the differential diagnoses for small intestinal diarrhea if there are no systemic signs?

A

Diet, helminths, Giardia, and iatrogenic

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14
Q

What are the differential diagnoses for small intestinal diarrhea if there are systemic signs?

A

Bacterial infection, viral infection, toxins/medications, hemorrhagic gastroenteritis, acute pancreatitis, foreign body obstruction, intussusception

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15
Q

What bacterial agents can cause acute small intestinal diarrhea with systemic signs?

A

Salmonella and campylobacter

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16
Q

What viral agents can cause acute small intestinal diarrhea with systemic signs?

A

Distemper, parvovirus, and panleukopenia

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17
Q

What diagnostic test do you want to do to confirm bacterial infection as the cause of acute small intestinal diarrhea with systemic signs?

A

fecal culture

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18
Q

What diagnostic test do you want to do to confirm viral infection as the cause of acute small intestinal diarrhea with systemic signs?

A

fecal antigen test

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19
Q

What are the differential diagnoses for acute large intestinal diarrhea?

A

Whipworms, Clostridia, Giardia, and Campylobacter

20
Q

What diagnostic tests should you do to confirm the cause of acute large intestinal diarrhea?

A

fecal examination for parasites, culture

21
Q

What are the differential diagnoses for extra-GI chronic small intestinal diarrhea?

A

Metabolic - hepatic disease, hyperthyroidism, Addison’s disease, renal insufficiency

Pancreatic - exocrine pancreatic insufficiency and chronic pancreatitis

22
Q

What are the differential diagnosis for GI caused chronic small intestinal diarrhea?

A

Giardia infection, chronic partial obstruction, lymphangiectasia, lymphoma, food-responsive disease, inflammatory bowel disease

23
Q

What are the differential diagnosis for chronic large intestinal diarrhea?

A

Inflammatory bowel disease, polyps, food-responsive disease, neoplasia, chronic partial obstruction, and tritrichomonas foetus in cats

24
Q

What diagnostics should be done when investigating the cause of chronic diarrhea?

A

Fecal examination, blood work, UA, ultrasound, if no response to elimination diets then endoscopy

25
What tests should you consider if the diarrhea is of small intestinal origin?
Trypsin-like immunoreactivity (TLI), pancreatic lipase (PLI), cobalamin, and folate tests
26
What are the benefits to doing endoscopic guided biopsies?
They are non-invasive except of anesthesia, direct visualization of mucosa is possible, and it gives diagnosis in a majority of cases
27
What makes endoscopies difficult?
Intestinal lymphoma and lymphangiectasia
28
When do you want to caution doing exploratory laparotomy?
In sick animals, cats, and animals with decreased albumin levels
29
Why are exploratory laparotomies not recommended?
It only yields 2-3 biopsies from the stomach and small intestine, not for colonic biopsies They are more expensive and painful for the animal 20% mortality vs. 2% mortality for endoscopy
30
What are the main causes for chronic small intestinal diarrhea in the dog?
Food-responsive disease and Inflammatory bowel disease being the most common followed by antibiotic-responsive diarrhea and neoplasia
31
How will you know when a patient has food responsive diarrhea?
Their diarrhea gets better when given elimination diet or a hydrolyzed diet
32
When should a patient respond to an elimination diet or hydrolysed diet if they have food responsive diarrhea?
Within the first 2 weeks of the diet change
33
What breed of dogs is antibiotic responsive diarrhea most commonly seen in?
young german shepherd dogs
34
What kind of diarrhea is associated with antibiotic responsive diarrhea?
Chronic small intestinal or mixed diarrhea
35
What is the treatment of choice for antibiotic responsive diarrhea?
Metronidazole or Tylosin
36
True or False: Patients with antibiotic responsive diarrhea usually relapse.
True
37
What is the most common chronic enteropathy in dogs?
inflammatory bowel disease
38
What is the most common finding on histopathology of inflammatory bowel disease?
Lympho-plasmacellular
39
What can also be found on histopathology (they are rare)in IBD cases?
Eosinophilia and ulcerative colitis (only large intestine, in boxers)
40
What is the sequential treatment protocol for chronic enteropathies/IBD in dogs?
Elimination diet Then Metronidazole or Tylosin for 3-4 weeks Then Biopsies
41
If there is an inadequate response to the sequential treatment protocol in dogs, what should be done next?
Prednisolone at 2.2 mg/kg/day for at least 10 days and then taper the dose
42
If steroids are poorly tolerated or unsuccessful in dogs, what is the next step?
Give azathioprine or cyclosporine
43
How is IBD treated in cats?
Elimination diet, then prednisolone 2 mg/kg/day for 10-14 days, then slow taper. If there is no response to Chlorambucil Do not forget Cobalamin supplementation
44
In a general sense, what is protein losing enteropathy?
A syndrome of intestinal diseases that leads to non-selective protein loss - albumin and globulins are low
45
What are the causes of protein losing enteropathyies?
IBD, lymphangiectasia, and Neoplasia (lymphoma)
46
How do patients with protein losing enteropathies present?
Diarrhea, vomiting, anorexia, weight loss, ascites, pleural effusion, peripheral edema, and usually albumin and globulin serum concentrations are low
47
What is an important diagnostic tool that should be done in patients that you suspect to have protein losing enteropathies?
biopsies

Small Animal Medicine (100 decks)

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