Gastro - Diseases of the Colon Flashcards
What is the normal function of the colon?
Fluid storage, motor function, mucus secretion, passive water flux, and bacteria flora
Do anaerobes or aerobes prevail in the colon?
anaerobes
What are clinical signs of colon disease?
LB diarrhea, hematochezia, mucus, tenesmus, frequent defecation, small volumes of stool, and there are rarely systemic signs
What are the causes of chronic colitis?
Infectious (parasites, fungi), infiltrative disease, intussusception, and motility disturbances
What infiltrative disease can cause chronic colitis?
IBD colitis, neoplasia, and mycotic colitits
Where does Trichuris vulpis preside?
the cecum and the colon
Is diarrhea due to Trichuris vulpis chronic or acute?
It can be acute, chronic, or intermittent
What is the treatment of choice for Trichuris vulpis?
fenbendazole for 5 days
What are the common causes of bacterial colitis?
Clostridial species (perfringens and difficile), Salmonellosis, E. coli, and C. jejuni
What common etiologic agent of bacterial colitis is zoonotic?
Campylobacter jejuni
Why is bacterial colitis tough to diagnose?
because the problem bacteria are commensals
What is the etiologic agent of fungal/algal colitis?
Histoplasmosis
What clinical signs are associated with fungal colitis?
Large bowel diarrhea +/- systemic signs
How is fungal colitis diagnosed?
rectal scrapes/endoscopic biopsy; urine Ag
What is the therapy of choice for fungal colitis?
itraconazole/fluconazole for long-term therapy of 4-6 months
Prednisone to reduce inflammation seen with fungal death for 1-2 weeks
What is the prognosis for Prototheca colitis?
poor
What causes the clinical signs of inflammatory bowel disease?
infiltrates and mediators
How is inflammatory bowel disease diagnosed?
Diagnosis of exclusion and GIT biopsy
How is Inflammatory Bowel Disease treated?
nutrition and drugs
What are some structural causes of chronic GI disease?
intussusception and neoplasia
What are some metabolic diseases that cause chronic GI disease?
Renal disease, liver disease, Addison’s disease, and hyperthyroidism
What are some parasites that cause chronic GI disease?
Giardia, Cryptosporidia, T. felis, and Physaloptera
What are some infectious diseases that cause chronic GI disease?
FeLV/FIV, Toxoplasmosis, and histoplasmosis
How would you treat chronic enteropathy due to Giardia?
Fenbendazole
If you have a dog or cat that comes into the clinic and has chronic enteropathy, what is the first therapy you should try?
You have already ruled out parasites.
Try a food trail
In cats - 7 day elimination trial
In dogs - 14 day elimination trial
If a food trial does not work to treat chronic enteropathy, what should your next therapy be?
Try antibiotics - Metronidazole is the most common
Others that could be used are Tylosin and Oxytetracycline
What food additive should you use to try and treat for colitis?
Fermentable fiber (psyllium)
What supplementation should be given to patients with chronic enteropathies?
Cobalamin
How many biopsies should you take from the stomach when testing for IBD?
At least 8 gastric biopsies
How many biopsies should you take from the duodenum when testing for IBD?
At least 15 duodenal biopsies
Can you cure IBD?
It is rarely curative; control is possible in most patients
Will relapses occur in patients with IBD?
yes
What therapy is important for treatment of IBD?
Nutrition therapy
What type of diet would you want to give to a patient with IBD?
Hydrolized rations or novel single Ag
What percentage of IBD patients respond to nutritional therapies?
50%
What drugs would you want to give to patients with IBD?
Prednisone and other immunosuppressives to decrease mucosal inflammation
What agents, in food therapy, will help with clinical recovery of IBD?
bulking agents (fermentable fiber)
Why are bulking agents good?
They bind to irritants, promote motility, and provide short-chain fatty acids
What effects do corticosteroids have?
anti-inflammatory/antiprostaglandin
What is the first choice corticosteroid to use in cats and dogs?
Prednisone in dogs and prednisolone in cats at 1-2 mg/kg/day
What do corticosteroids suppress (side effects)?
HPA supression
Other immunosuppressives may need to be given for IBD therapy. What drugs may you want to use?
Cyclosporine or chlorambucil
How will lymphopcytic-plasmacytic colitis look on biopsy?
Hyperplastic lymph nodes, multiple erosions, and no significant macrophage infiltrate
What is granulomatous colitis a variant of?
It is a canine IBD variant
What breed is granulomatous colitis common in? Age?
Boxers, <2 years
What clinical signs are associated with granulomatous colitis?
LB diarrhea and systemic signs
How will granulomatous colitis look like on biopsy?
Intense granulomatous infiltrate
What is the etiologic agent of granulomatous colitis?
Attaching/invasive E. coli
What is the drug therapy of choice for granulomatous colitis?
Fluoroquinilones
Recent data supports the use of enrofloxacin
What is the prognosis for granulomatous colitis?
good
What are the clinical signs for fiber-responsive colitis (FBD)?
Large bowel diarrhea +/- blood and mucus
What type of disease is irritable bowel syndrome?
It is a functional disease - decreased motility
What clinical signs are associated with irritable bowel syndrome?
Abdominal pain, diarrhea, and constipation
How is FRD and IBS diagnosed?
Diagnosis of exclusion - marked resolution on high fiber diets, consider motility modifiers
What colorectal neoplasias predominate?
Malignant tumors - Adenocarcinoma, lymphosarcoma, and leiomyoma/sarcoma
Where do most colorectal neoplasias reside?
in the left colon
Where are colorectal neoplasias commonly located in cats?
ileocolic area
At what age are colorectal neoplasias commonly found?
Middle-aged or older animals
What clinical signs are associated with colorectal neoplasias?
Large bowel diarrhea +/- systemic signs
How are colorectal neoplasias diagnosed?
examination, imaging, and endoscopic biopsy
What diagnostic tool is critical for determining colorectal neoplasia therapy?
histology
What is the prognosis for lymphosarcoma?
8-12 months with UW-25 protocol
What is the prognosis for colorectal adenocarcinomas?
good remission with surgery
15-22 months in dogs and cats
What is the prognosis for adenomatous polyps?
excellent