Gastrointestinal and hepatic Flashcards by Chloe Smith

What are the broad causes of acute diarrhoea?

Diet
Drugs
Infection
Inflammatory disease
Metabolic disease
Anatomical disease
Neoplasia
Anomalous - stress/anxiety

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What is the pre-disposition to getting canine parvovirus (CVP-2)?

Young puppies with low maternal immunity
Older unvaccinated dogs

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What is the incubation period of canine parvovirus?

3-6 days

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What cells does canine parvovirus infect?

Rapidly dividing cells

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What is the general management for canine parvovirus?

Fluid therapy
Antibiotics
Anti-emetics
Pro-motility meds
Antacid drugs and ulcer coating medication
Immunomodulators and ancillary therapies
Oral fluids/nutrients

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What are the general prevention measures for parvovirus?

Vaccination, cleaning and disinfection

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What are the clinical signs of haemorrhagic gastroenteritis?

Foetid diarrhoea including protein loss. Causes depression and anorexia.

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What is the treatment for haemorrhagic gastroenteritis?

Fluid therapy
Colloid/plasma/whole blood

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In what cats is feline panleukopenia most common?

Kittens and colonies

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What part of the GI tract does coronavirus affect?

Villus destruction of the small bowel

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What dogs are pre-disposed for campylobacter?

Usually young, immunocompromised animals or those with additional infectious agents

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What are the clinical signs of acute enterocolitis from campylobacter?

D+, blood and mucus
Vomiting
Straining
Fever, abdominal pain

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What four routes can salmonella take in the dog?

Transient asymptomatic diarrhoea
Acute gastroenteritis
Carrier state
Bacteraemia

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What are the first choice antibiotics for treatment of clostridial enteritis?

Metronidazole - alternatives of Ampicillin and Tylosin

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What are the clinical signs of ascarids infections in puppies and kittens?

Failure to gain weight and pot bellied

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What are the clinical signs of hookworms in kennelled dogs?

Weight loss and diarrhoea. Anaemia, interdigital dermatitis

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How do you diagnose cryptosporidium?

Faecal smear, IFA or PCR

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What is the action of prebiotics?

Selective substrate used by beneficial species and can alter the intestinal flora.

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What is the action of probiotics?

Living organism that exert benefit beyond nutrition

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What are the major differentials for chronic diarrhoea?

Food responsive enteropathy
Dysbiosis
Steroid responsive
Non-responsive
PLE
EPI
Neoplasia
IBD
Non-GI causes

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What is a food responsive enteropathy?

Any clinically abnormal response attributed to ingestion of a food or additive. Categorised as either an allergy or intolerance.

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What responses can the body have to a food responsive enteropathy?

Intolerance
Toxicity
Disturbed microflora
Dysmotility
Pharmacologic reactions
Maldigestion/malabsorption
Physical

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What are the consequences of secondary dysbiosis?

Utilise nutrients/interfere with absorption
Damage epithelium and microvillar enzymes dysfunction
Increase mucosal permeability/fluid loss
Deconjugate bile acids
Hydroxylate fatty acids
Stimulate colonocyte secretion

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What are the clinical signs of steroid responsive enteropathy?

Persistent/recurrent GI signs with histopathological evidenc4e for inflammation

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What dogs are predisposed to SRE/IBD?

Middle aged animals over 12 months old

What are the clinical signs of SRE/IBD?

Weight loss with more severe mucosal disruption. Appetit very variable and variable abdominal discomfort.

What conditions make up the feline triaditis complex?

Chronic Enteritis Pancreatitis Cholangiohepatitis

What is a protein-losing enteropathy?

Loss of protein through the GIT. `

What are the 3 major differentials for protein-losing enteropathy?

IBD Lymphangiectasia Neoplasia

What is the management of EPI?

Pancreatic enzyme supplementation Freeze chopped pig/cow pancreas Dietary management Vitamin supplementation

What are the clinical signs of dehydration?

Skin tent, tacky mms, sucken eyes

What techniques can be used to measure fluid losses?

Weigh the patient Urinary catheter Weight the bedding Faecal catheter

What is the best fluid choice for dehydration?

Hartmann's

What are the clinical signs of hypovolaemia?

Increased CRT, pale mm, cold rectal Increased HR, RR and weak pulses

What are the clinical signs of sepsis?

Decreased CRT, congested MMs, pyrexia, increased HR, RR, bounding/poor pulses

What vasopressors can be used in hypovolaemic shock?

Dobutamine, noradrenaline, dopamine

What are the roles of the liver?

Digestion/metabolism/nutrient storage Waste management Protein metabolism Production an activation of coagulation factors Drug metabolism/detoxification Immunoregulation

In what zone of the liver lobes does hypoxic damage typically occur?

Zone 3

What zone of the liver is typically affected by metabolic and toxic damage?

Zone 1

What are specific signs of liver disease?

Jaundice, hepatic encephalopathy, ascites, drug intolerance, coagulopathy

What neurological signs can be associated to hepatic encephalopathy?

Hyperactive and/or depressed/dull/clumsy Circling, pacing, central blindness Salivation in cats Seizures and coma

Why can liver enzymes be within normal limits with end stage liver disease?

Decreased liver mass

What markers are relevant in hepatocellular injury?

ALT, AST, GLDH

What markers are relevant in cholestasis?

ALP and GGT

What are negative prognostic indicators of acute liver disease?

Ascites and splenomegaly

What is the main encephalopathic toxin involved in hepatic encephalopathy?

Ammonia

How do you manage hepatic encephalopathy?

Identify, remove and treat causes IVFT Glucose Diet Ampicillin IV

What is the most common liver disease in dogs?

Idiopathic chronic hepatitis

What breeds are pre-disposed to copper-associated liver disease?

Lab, Dalmatian, Skye terrier, Doberman pinscher, WHWT

What is the typical histopathology of chronic hepatobiliary disease?

Variable mononuclear or mixed inflammatory infiltrate, apoptosis/necrosis, regeneration and fibrosis

What are the important clinical findings in chronic hepatobiliary disease?

Poor BCS, jaundice and ascities

What treatment should be used for chronic hepatobiliary disease?

Urodeoxycholic acid, antioxidants, corticosteroids, antibiotics, diuretics

What are the common clinical signs of neutrophilic cholangitis?

Lethargy, pyrexia, vomiting, jaundice

What are some causes of extrahepatic bile duct obstruction?

Pancreatitis, tumour, local trauma, cholelithiasis

What is bilirubin a product of?

Haemoglobin metabolism

What causes the yellow colour of urine?

Urobilin

What causes the brown colour of faeces?

Stercobilin

What is the pathophysiology of pre-hepatic breakdown of haemoglobin?

Oversupply of precursors into the system, flooding the body with bilirubin that can't be excreted quickly enough

What are the clinical signs of post-hepatic haemoglobin breakdown?

Ecchymoses/bruising Peripheral oedema Pain Neurological exam BCS Abdominal enlargement

Where is the endocrine tissue located in the pancreas?

Islets of Langerhans

What are the clinical signs of acute pancreatitis?

Lethargy/weakness Anorexia Vomiting and diarrhoea Severe: Shock and collapse

What are the risk factors for pancreatitis?

Hereditary Hyperlipidaemia High fat meal and obesity Pancreatic ischaemia and hypoxia Trauma

How do you treat pancreatitis?

IVFT, electrolytes, underlying cause, analgesia, antiemetics, antibiotics, steroids

What are the three basic principles of toxin exposure?

Decontamination, assessment of effects and treatment of symptoms

How can toxins be absorbed?

Through mucus membranes, intestinal mucosa, skin, inhalation

What are the time frames in which emesis or gastric decontamination can be performed after toxin exposure?

2-8 hours in the dog 2-12 hours in the cat

What are the clinical signs of ibuprofen/NSAID exposure?

Haemorrhagic vomiting, diarrhoea, AKI

What specific treatments can be used for ibuprofen/NSAID exposure?

H2 blockers Proton pump inhibitors Prostaglandin analogue Intralipid infusion

What are the clinical signs of paracetamol toxicity?

Brown mucus membranes Jaundice, abdominal pain, lethargy, vomiting AKI Signs of hypoxia to tissues

How do you treat paracetamol toxicity?

N/acetyl cysteine, H2 receptor antagonists Ascorbic acid Liver, AKI and GI support

What are the clinical signs of chocolate toxicity?

Hyperactivity, vomiting/diarrhoea, arrythmias, seizures, coma and death

What is the treatment for chocolate toxicity?

Charcoal every 4-6 hours. May need intubation and urinary catheterisation

What common products can contain xylitol?

Chewing gum and peanut butters

What are the clinical signs of xylitol toxicity?

Prolonged hypoglycaemia, liver failure, weakness, collapse, seizures, coma, jaundice, death

What are the specific treatments for xylitol toxicity?

Hepato-protectants Glucose supplementation

What are the clinical signs of pyrethroids toxicity?

Ataxia, tremors, disorientation, seizures, dyspnoea, hypersalivation, vomiting

What are the specific treatments for ethylene glycol (anti-freeze)?

Medical ethanol Vodka diluted with saline

What is the biggest issue with rat poison/warfarin ingestion?

Inhibits vitamin K epoxide reductase so caused coagulopathy 36-72hours post injection

What is the definition of regurgitation?

Passive expulsion of food from pharynx/oesophagus

What is the definition of dysphagia?

Failure to prehend/bite and initially swallow Pain on closing or opening of mouth

What is the breed pre-disposition of megaoesophagus?

Labrador, newfoundland, Shar Pei

What is the breed pre-disposition of vascular ring anomaly?

GSD, Irish setter, Great Dane

What is intussusception?

Vigorous contraction of a segment of intestine into the lumen of the adjacent relaxed segment