Gastrointestinal Flashcards
What are the key GI bacterial phyla in dogs and cats?
Firmicutes, Bacteroidetes, Proteobacteria, Fusobacteria, Actinobacteria
How many cases can you reuse endoscopic biopsy forceps for ?
JVIM 2016: 10-15
What is the preferred biopsy size in cats for diagnostic yield?
JVIM 2019: 2.4mm (better than 1.8)
What modalities exist to measure gastric emptying in cats and how reliable are they?
JVIM 2017: Scintigraphy gold standard (99mTC). Barium unreliable. Breath testing with C13 labelled sodium acetate; fair correlation with scintigraphy. Sonographic method in this study showed good correlation with scintigraphy and was considered a suitable alternative
What is the potential role for vrideocapsule endoscopy?
JVIM 2019: Capsules were able to identify lesions in most dogs in this study, who had biochemical evidence of GI bleeding. However, most would have been identified by traditional endoscopy. Authors suggest use post negative endoscopy
What is the utility of CT for GI obstructions?
JAVMA 2017: Complete agreement with exlap. Good modality, faster than ultrasound. Obstructed dogs had larger intestinal diameter ratios.
How effective are bloods and ultrasound for screening for histopathologic liver and pancreatic lesions in cats?
JFMS 2016: Generally poor. Liver enzymes insensitive for liver pathology ((11-50%), fPLI neither sensitive nor specific in this study. Ultrasound was insensitive for liver lesions and more sensitive for the pancreas, but less specific.
Is loss of caecal wall layering predictive of malignancy in cats?
JFMS 2017: No
What is the PPV for ultrasound to predict mucosal SI disease in cats (based on History) vs submucosal/muscularis lesions?
JVIM 2019: In a population with a high prevalence of GI disease, the PPV for ultrasound predicting mucosal disease on history was high (72-100%) but low for submucosal/muscularis lesions (18-57%)
What RBC abnormalities are more common in dogs with GI lymphoma vs chronic enteropathy?
JAVMA 2019: Anaemia, 3+ RBC anomalies, eccentrocytes
What is a neutrophil based biomarker for chronic enteropathy in dogs?
JVIM 2017: Perinuclear antineutrophil cytoplasmic antibodies; serum marker for dogs with food responsive enteropathy. JVIM 2017: Measured with a granulocyte immunofluorescence assay, Sn 61, Sp 100%
What lymphocyte subtypes are decreased in blood of dogs with IBD?
JVIM 2017: CD21+ B cells and TCR-gamma-delta T lymphocytes
What bile acid changes are expected in dogs with chronic enteropahy? What cell surface changes are present which may be related?
JVIM 2018: Increased % of primary bile acids. Dogs with chronic enteropathy in this paper had reduced expression of the apical sodium dependent bile acid transporter. This was correlated with histopathologic score.
What bacterial groups are assessed in the Dysbiosis index and what is its diagnostic performance?
JVIM Biomarker review: Blautia, Clostridium hiranonis, E coli, Faecalibacterium, Fusobacterium, Streptococcus and Turicibacter.
Sn 74, Sp 95
What tests may screen soft coated wheaten terriers for PLE prior to clinical signs?
JVIM 2018 biomarker review: Faecal alpha protease inhibitor and perinuclear anti-neutrophilic cytoplasmic antibodies (the latter may also be used to detect dogs with FRE)
What biomarker may be able to predict requirement for chronic enteropathy patient to require immunosuppressants?
JVIM 2018 biomarker review: CRP 9.1+ with a Sn of 72 and a Sp of 100
What is a marker of eosinophil activation/degranulation? what is a marker of mast cell activation?
JVIM 2018 biomarker review: 3-Bromotyrosine for eosinophils, N-methylhistamine for mast cells
JVI 2017: 3-Bromotyrosine higher in SRD > FRD > Health
What is calprotectin? What can it potentially differentiate?
JVIM 2018: Is a DAMP, a product of macrophages and neutrophils, its ligand is TLR4. In this study, it was able to differentiate steroid responsive dogs from food/antibiotic responsive dogs with a Sn of 80% and Sp of 75%. Was also correlated with the CCECAI score
JVIM 2018: Calprotectin in this study was associated with the CIBDAI score and significantly decreased after treatment
What factors in CE are associated with lower Vitamin D?
JVIM 2019: Higher clinical activity scores, lower Vitamin E (alpha tocopherol), cholesterol and albumin. Vitamin D binding proteins were not different. Hypothesis fat malabsorption contributes
What factors in CE are associated with lower Vitamin D?
JVIM 2019: Higher clinical activity scores, lower Vitamin E (alpha tocopherol), cholesterol and albumin. Vitamin D binding proteins were not different. Hypothesis fat malabsorption contributes
What cytokines are under expressed in CE GSD biopsies? What immunologic phenotype may this be associated with?
JVIM 2019: Lower IL 13 and IL 33. These are TH2 cytokines.
What plasma amino acid has been associated with a higher CCECAI score in dogs?
JVIM 2019: Serine
Are serum and saliva for allergen specific globulins useful for identifying dietary allergies?
JAVMA 2019: No, high level of positive results in healthy dogs
What is the optimal cut off for CCECAI for predicting diet responsiveness in PLE?
JVIM 2020: 8, Sn 82, Sp 89
What is the difference in biopsy samples between CE dogs with normal and low albumin?
JVIM 2017: More likely to have villous stunting, crypt distension, lacteal dilation, intraepithelial lymphocytes and lamina propria neutrophils
What can contrast enhanced ultrasonography potentially detect?
JVIM 2019: Duodenal inflammation. Was higher in symptomatic CE dogs in this study and correlated with clinical score
What may serum Vitamin D status be predictive of in dogs with CE?
JVIM 2015: Death
What stain could be used to identify eosinophils on biopsy samples of the intestine?
JVIM 2018: Antibodies against eosinophil peroxidase
What organism is neutrophilic enteritis in cats associated with?
JVIM 2016: Campylobacter coli
What was the effect of the microbiome in dogs with FRE after feeding an animal protein free diet?
JVIM 2018: Increased richness
What changes to SCFA have been seen in dogs with CE?
JVIM 2019: Reduced concentrations, Reduced acetate and propionate
Is clonality on PARR always associated with neoplasia?
JVIM 2019: No, in this population of older cats, clonality was detected in healthy cats. Possibilities include benign clonality, which can occur from antigenic stimulation OR pseudoclonality due to insufficient target DNA or primer binding issues
Based on a JAVMA study, what biochemical variables differentiated FRE from PLE?
JJAVMA 2015: CRP, CPLI and SERUM alpha proteinase inhibitor (lower in PLE)
What scintigraphy could be useful to diagnose PLE?
JVIM 2017: 99mTc labelled albumin; given IV, look for exudation into the bowel
What amino acid is lower in dogs with PLE?
JVIM 2018: Tryptophan
By how much does a 1 point increase in CCEAI increase the hazard of death?
JVIM 2019: 22.9%. If your score was <8 and your urea <7 you survived 256 days longer
What cell predominates in the LN paracortex? What about the germinal centre? Where does lymph enter?
JVIM 2019 PLE review: Paracortex: T cell. Germinal Centre: B cell. Lymph enters subcapsular sinus and cortex
What IHC markers can be used to differentiate lymphatic from capillary endothelium?
JVIM 2019 PLE review: Prox-1 and CD31
What bacteria/toxin is associated with AHDS in dogs?
JVIM: Clostridium perfringens, NetF
What is the effect of hospitalisation on gastric emptying time in dogs?
Java 2017: prolongs, median 71 hours vs 17 hours
What was the effect of metronidazole for acute diarrhoea in dogs?
JVIM 2019: reduced time to resolution (2.1 vs 3.6 days) and reduced C perfringens isolation post treatment, Long term effects and overall utility not studied
What was the effect of 6 weeks of SQ cobalamin supplementation in cats?
JVIM 2017: B12 levels normalised transiently but by 10 weeks post supplementation they had reduced again. Clinical score improved during treatment. Serum MMA concentrations did not normalise in 12/20 cats by week 6
What is Imerslund-Grasbeck syndrome? What breed does it affect? What is the treatment?
JVIM 2018: Congenital cobalamin malabsorption. Beagles. Monthly or bimonthly 1mg cobalamin was effective in this paper
JVIM 2019: 1mg orally SID was also effective
what is cobalamin a cofactor for (two enzymes). What does an increase in MMA lead to?
JVIM 2019 Cobalamin review: Methionine and Methylmalonyl CoA. Methyl malonic acid increases if MMCoA not active. MMA inhibits Carbamoyl phosphate synthetase which converts ammonia to carbamoyl phosphate. Hyperammonia results
What are methods of identifying cobalamin deficiency apart from a serum cobalamin level?
JVIM Cobalamin review: Homocysteine increases, methyl malonic acid increases
What is epileptoid cramping syndrome? What breed does it affect and how do you treat it?
JVIM 2015” movement disorder (dystonia, chorea, tremor) in border terriers. May get worse with excitement. These can be positive to antibodies anti-gliadin and anti-transglutaminase. Respond to a gluten free diet. Border terriers may also experience GI or dermal signs from gluten sensitivity
What is intestinal leiomyositis?
JVIM 2016: Inflammatory condition affecting the smooth muscle of the intestine. Causes dysmotility and pseudoobstruction. Histology; mononuclear inflammation, myofiber degeneration and fibrosis. MST 19 days
Are faecal calprotectin and IgA useful for puppies in diagnosis of enteropathogens
JVIM 2016: No. Calprotectin levels are affected by age though, higher concentrations in younger puppies
What is the impact of tylosin administration in healthy dogs?
JVIM 2019: Decreased bacterial diversity, increased primary bile acids (at day 21). At day 63 bacterial taxa had reduced to normal but not uniformly
What was the effect of symbiotic on diarrhoea in kennelled dogs?
JVIM 2017: pre-probiotic mixture, decreased the incidence, number of days and occurrence of 2+ days of diarrhoea
What is the effect of synbiotic administration to healthy cats receiving clindamycin
JVIM 2017: reduced vomiting and improved appetite. Did not reduce diarrhoea
What was the affect of prokolin on acute diarrhoea
JVIM 2019: Placebo controlled trial; reduced diarrhoea to 32 hours medium compared to 47 hours median. rate of resolution was 1.6 times faster in the ADPP group
What medication increases the risk of major complications associated with a PEG tube?
JVIM 2016: Glucocorticoids
What are the two primary complications with O tubes in cats?
JVIM 2019: Tube dislodgement 15%, infections 12%. Increased risk of infection with steroids, oncolytic agents or discharge
Does prophylactic administration of maropitant and metoclopramide reduce the incidence of GI reflux post op?
JAVMA 2019: No
What is the incidence of GER during anaesthesia for cats?
JVIM 2017: 33% (similar to dogs). Gastric pH of cats receiving omeprazole in this study was 7, compared to 2.8 in the control
Do swallow study findings change with age?
JVIM 2017: No differences between juvenile and older dogs
What oesophageal dysmotility disorders have been described in brachycephalic dogs?
JVIM 2019: Prolonged oesophageal transit time, decreased secondary waves, GERD, HH
What type of hiatal hernia is most common in cats? What % had comorbidities? What treatment was associated with longer survival?
JVIM 2019: Type 1 in 85%. 77% had comorbidities (commonly respiratory). Medically managed cats survived longer
What type of hiatal hernia is most common in cats? What % had comorbidities? What treatment was associated with longer survival?
JVIM 2019: Type 1 in 85%. 77% had comorbidities (commonly respiratory). Medically managed cats survived longer
What is oesophageal achalasia?
Achalasia, a primary esophageal motility disorder in people, results from a selective loss of inhibitory myenteric neurons leading to failure of the LES to relax in response to a pharyngeal swallow and impaired esophageal peristalsis.
What treatments are available for oesophageal achalasia?
JVIM 2019; balloon dilation, botulism or myotomy. This study tried balloon first and 100% of dogs had significant CSx improvement (reduction in R+ by 80%) for 40 days. 6 dogs later had myotomy and fundoplication and had sustained improvement
what factors were associated with oesophageal perforation from FB?
JAVMA 2018: Fishhooks, delay between ingestion and evaluation
What factor was associated with risk of death from O FB?
JVIM 2017: Surgery, complications, bleeding and perforation. Length of clinical signs was not
What treatment options are available for oesophageal stricture?
JVIM 2018: Balloon dilation. This paper described a balloon dilatation oesophagostomy tube to be kept indwelling for 6 weeks. 91% of animals had improved dysphagia post treatment
What coagulation factors are increased in ascites fluid?
JVIM: D dimers, FDP higher. Fibrinogen lower
What co-morbidity is commonly seen with chronic feline gingivostomatitis?
JVIM 2017: Oesophagitis with to without columnar metaplasia. pH same as controls
What is the recommended treatment for sialocoele and what is the rate of recurrence? What is an alternative therapy?
JVIM 2018: Surgery, recurrence in up to 14%. This study looked at RT, 54% had a complete response
What are some differences clinically and biochemically between dogs with chronic gastritis and gastric carcinoma?
JVIM 2019: Dogs with carcinoma were older, had lower BCS, lower folate and higher CRP (25+)
What is the increased odds of GI lesions (specifically lesion scores 4+ = >25 hemorrhages or punctate erosions, ≥1 invasive erosion, and/or ≥1 ulcer) associated with prednisolone and prednisolone/aspirin combination in healthy dogs? How about prednisolone/clopidogrel?
JVIM 2019: Prednisolone 11 X higher odds, combination pred/aspirin 31.5X higher odds. Clopidogrel/Prednisolone was in a different study but 7 X higher odds (same as solo pred in that study)
No clinical signs in this study. Lesions worse on Day 14 c/f Day 28
What is the effect of liver disease on mirtazapine pharmacokinetics in cats?
JVIM 2018: Delayed time to maximal concentration (4 vs 1 hour) and prolonged half life (14 hour vs 7 hour). Half life was correlated with ALT and TBIL
What is the effect of sucralfate on ex-vivo stomach exposed to acid injury?
JVIM 2018: Significantly reduced the time to recover barrier function if applied before or after the injury
What is superior at gastric acid suppression? Pantoprazole alone or Famotidine/Pantroprazole combo? Measured by % time pH 3 or 4+
JVIM 2015: No significant differences between groups
Can you use fractionated enteric coated omeprazole in cats?
JIM 2015: Yes, both this formula and a paste was effective over famotidine and placebo
Can you use fractionated enteric coated omeprazole in cats?
JIM 2015: Yes, both this formula and a paste was effective over famotidine and placebo
Is once daily omeprazole effective in suppressing gastric acid in cats?
JVIM 2015: No, it was comparable to ranitidine and placebo. Twice daily was effective (67% 3+)
What is the difference between omeprazole and esomeprazole? Is the latter effective in dogs? What is the dose for the latter?
JVIM 2017: Omeprazole racemic mixture of R and S enantiomers. Esomeprazole is the S enantiomer. In this study was effective given PO, IV and SQ to beagles (highest % for PO). 0.5-1mg/kg IV BID were no different in another study
How may famotidine be given to improve its efficacy? What occurs with chronic use (14 days) or oral admin?
JVIM 2019: Famotidine CRI will suppress acid production to human targets, as opposed to IV bolus therapy. Chronic use diminishes efficacy of oral famotidine (note: in cats this was avoided by EOD dosing)
