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Small Animal Medicine II > Gastroenterology - Diarrhea > Flashcards

Gastroenterology - Diarrhea Flashcards

1
Q

Describe the two types of diarrhea

A

osmotic - absorption of water dependent on solutes
- solutes not absorbed = water remains in lumen

secretory - secretion of water into lumen exceeds reabsorption

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2
Q

What are the effects on infection on the GIT?

A
  • disruption and destruction of epithelium
  • water and nutrients not effectively absorbed
  • exudation of serum and blood with destruction
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3
Q

What are the effects of inflammation on the GIT?

A
  • inflammatory cytokines induce secretions
  • high rate loss of epithelium resulting in malabsorption
  • fibrosis and loss of functional cells
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4
Q

What is the effect of decreased motility on the GIT?

A

decreases absorption of nutrients

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5
Q

What are the possible causes of melena?

A
  • ingestion of blood
  • GI erosion/ulceration
  • immune-mediated thrmbocytopenia
  • foreign body
  • coagulopathies
  • neoplasia
  • drug-induced
  • vascular anomaly
  • paraneoplastic
  • organ disease
  • inflammation
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6
Q

What can be seen on physical exam in a dog with diarrhea?

A
  • abdominal pain +/- distension
  • peripheral edema
  • coat color change
  • muscle wasting
  • enlarged lymph nodes
  • thickened intestines
  • dehydration
  • signs of systemic illness
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7
Q

What diagnostics should be run for a systemically well dog with acute diarrhea?

A

Big 4/QATS

Fecal

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8
Q

How is a systemically well dog with acute diarrhea treated?

A
  • usually self-limiting

- symptomatic therapy

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9
Q

Which physical exam finds would be of concern in a systemically unwell dog with diarrhea?

A
  • abdominal palpation abnormal
  • significant hematochezia or melena
  • dehydration
  • weight loss
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10
Q

What diagnostics should be done for a systemically unwell dog with diarrhea?

A
  • QATS/Big 4 + blood smear
  • BP, CBC, chem, UA, fecal
  • abdominal imaging
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11
Q

What are possible abnormalities seen on CBC with diarrhea?

A
  • anemia
  • thrombocytosis (blood loss)
  • leukopenia, leukocytosis, or circulating neoplasia
  • eosinophilia
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12
Q

What are the possible abnormalities seen on serum chemistry with diarrhea?

A
  • hypoproteinemia +/- hypocholesterolemia
  • hyperglobulinemia
  • hypo/hypercalcemia
  • hypoglycemia
  • hyponatremia with hyperkalemia
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13
Q

What can be done for fecal analysis?

A
  • direct smear with saline
  • stained smear slide +/- rectal scrape
  • zinc centrifugation
  • parvovirus SNAP test
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14
Q

What is measured on a GI panel?

A
  • B-12
  • Folate
  • Trypsin-like Immunoreactivity
  • Pancreatic Lipase Immunoreactivity
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15
Q

When might antithrombin be decreased?

A

malabsorptive GI disease

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16
Q

What might low B-12 indicate?

A

malabsorption or bacterial competition

17
Q

What might high folate indicate?

Low folate?

A
  • high: bacterial dysbiosis

- low: malabsorption

18
Q

What might low TLI indicate?

A

exocrine pancreatic insufficiency

19
Q

What might high TLI indicate?

A
  • pancreatitis
  • emaciation
  • renal disease
  • small intestinal disease
20
Q

What does hight PLI indicate?

A

pancreatitis

21
Q

What does PLI measure?

A

lipase of specific pancreatic origin

22
Q

What are the therapy options for diarrhea?

A
  • fluids
  • fiber
  • diet modification
  • antibiotics
  • vitamins
  • steroids
  • immune modulation
  • probiotics
  • prebiotics
23
Q

When are antibiotics indicated for treatment of diarrhea?

A

chronic diarrhea

hematochezia

24
Q

Which antibiotics are used for diarrhea?

A

Metronidazole or Tylosin

More serious: Unasyn, Clavamox, Enrofloxacin

25
Q

Which vitamins are supplemented to treat diarrhea?

A
  • Folic acid/Folate/Bp

- Injectable B-12

26
Q

Which steroids are used in the treatment of diarrhea?

A
  • Prednisone/Prednsiolone
  • Dexamethasone
  • Budesonide
27
Q

What are the features of Budesonide?

A
  • topical activity
  • less systemic side effects
  • more potent than pred
  • needs to be compounded
28
Q

What drugs are used for immune modulation and what are their actions?

A

Atopica/cyclosporine - reduces cell mediated immune response

Azathioprine - inhibits lymphocyte activation/proliferation (do not used in cats)

Chlorambucil - cross links cellular DNA (anti-neoplastic)

29
Q

What are the effects of Bismuth Subsalicylate?

A

anti-microbial, weak antacid, anti-secretory, and anti-inflammatory

30
Q

What are probiotics and their effects?

A

living organisms

  • improve epithelial barrier function
  • modulate mucosal immune system
  • alter intestinal flora
31
Q

What are prebiotics and their effect?

A

non-digestible carbohydrates

- stimulate growth and metabolism of protective bacteria

Small Animal Medicine II (15 decks)

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