GI med 3 Flashcards
what is IBD?
collective term of disorders of the GIT characterized by persistent or recurring GI signs and histologic evidence of inflammation
chronic, immune-mediated enteropathy of middle-aged or older cats/dogs
loss of self tolerance and lack of protection, dysregulated inflammatory response –> leads to malabsorption, maldigestion, clinical signs
extremely complex interaction b/t environment and immune system of host
wayyyyy over diagnosed!!
IBD is a loss of _______ and lack of _____, dysregulated _______. leading to…?
need to know this
self-tolerance, protection, inflammatory response
leads to malabsorption, maldigestion, C/S
what are the C/S of IBD?
progressive, GI urgency markers, failed therapy
- chronic V+
- chronic d+
- borborygmi, flatulence
- weight loss
- altered appetite
- abd discomfort
tell me the general steps of the IBD workup
- hx
- lab work
- GI panel
- medical imaging
- targeted therapy or GI biopsies (ideally biopsy)
what lab work do you need to get done during the IBD workup?
CBC, chem, UA, baseline cortisol
what is included in the GI panel?
folate, cobalamin, TLI, PLI
what changes do you expect in the GI panel with IBD?
increase folate, decrease cobalamin (may be supplementation)
what are you looking for in medical imaging during the IBD workup?
GI thickening, layering changes
true or false: you do a GI biopsy and it comes back as mildly inflammated. you are most likely dealing with IBD
false! mild inflammation is likely not IBD
the most common IBD disease is ______. another one is _____; for this one, consider deworming.
lymphoplasmacytic
eosinophilic
describe the first line treatment for IBD
- hypoallergenic or novel protein diet
- prednisone
- consider cobalamin, probiotics, tylosin
describe second line treatment for IBD
add another agent (cyclosporine, azathioprine, etc)
new diet?
describe third line treatment for IBD
other immunosuppressant agent, injectables? fecal transplant? (no strong evidence thus far)
what are the other names for cobalamin
cyanocobalamin
vit B-12
what is the px for IBD?
good to guarded (relapse common when meds tapered)
treament success not guaranteed (cats have better outcome than dogs)
severe IBD can lead to ____.
PLE (protein-losing enteropathies)
what is the most common cause of PLE?
lymphangiectasia
what is lymphangiectasia and why does it cause PLE?
marked dilation and dysfunction of intestinal lymphatics (lacteals)
leakage of protein-rich lymph into intestinal lumen
what are the C/S of lymphangiectasia?
d+ (SI and LI), weight loss, ascites, hyporexia
how do you dx lymphangiectasia?
panhypoproteinemia (albumin>globulin), hypocholestrolemia, lymphopenia
US: protein poor transudate, rule out PLN, other losses of protein
GI biopsy
how do you tx lymphangiectasia?
- marked fat restriction (most important tx!!!)
- immunosuppressive therapy (prednisone)
- cobalamin suplement
what is the px of lymphangiectasia
good to poor (depends on response, worse than IBD alone, relapse
what breed gets familial PLE?
Soft-coated Wheaten terriers
what breed + age is predisposed for histiocytic ulcerative colitis? why?
young boxers
E. coli in macrophages
