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522 (dog & cat class) > GI med 3 > Flashcards

GI med 3 Flashcards

1
Q

what is IBD?

A

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!!

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2
Q

IBD is a loss of _______ and lack of _____, dysregulated _______. leading to…?

need to know this

A

self-tolerance, protection, inflammatory response

leads to malabsorption, maldigestion, C/S

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3
Q

what are the C/S of IBD?

A

progressive, GI urgency markers, failed therapy

  • chronic V+
  • chronic d+
  • borborygmi, flatulence
  • weight loss
  • altered appetite
  • abd discomfort
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4
Q

tell me the general steps of the IBD workup

A
  1. hx
  2. lab work
  3. GI panel
  4. medical imaging
  5. targeted therapy or GI biopsies (ideally biopsy)
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5
Q

what lab work do you need to get done during the IBD workup?

A

CBC, chem, UA, baseline cortisol

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6
Q

what is included in the GI panel?

A

folate, cobalamin, TLI, PLI

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7
Q

what changes do you expect in the GI panel with IBD?

A

increase folate, decrease cobalamin (may be supplementation)

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8
Q

what are you looking for in medical imaging during the IBD workup?

A

GI thickening, layering changes

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9
Q

true or false: you do a GI biopsy and it comes back as mildly inflammated. you are most likely dealing with IBD

A

false! mild inflammation is likely not IBD

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10
Q

the most common IBD disease is ______. another one is _____; for this one, consider deworming.

A

lymphoplasmacytic
eosinophilic

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11
Q

describe the first line treatment for IBD

A
  • hypoallergenic or novel protein diet
  • prednisone
  • consider cobalamin, probiotics, tylosin
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12
Q

describe second line treatment for IBD

A

add another agent (cyclosporine, azathioprine, etc)

new diet?

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13
Q

describe third line treatment for IBD

A

other immunosuppressant agent, injectables? fecal transplant? (no strong evidence thus far)

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14
Q

what are the other names for cobalamin

A

cyanocobalamin
vit B-12

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15
Q

what is the px for IBD?

A

good to guarded (relapse common when meds tapered)

treament success not guaranteed (cats have better outcome than dogs)

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16
Q

severe IBD can lead to ____.

A

PLE (protein-losing enteropathies)

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17
Q

what is the most common cause of PLE?

A

lymphangiectasia

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18
Q

what is lymphangiectasia and why does it cause PLE?

A

marked dilation and dysfunction of intestinal lymphatics (lacteals)

leakage of protein-rich lymph into intestinal lumen

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19
Q

what are the C/S of lymphangiectasia?

A

d+ (SI and LI), weight loss, ascites, hyporexia

20
Q

how do you dx lymphangiectasia?

A

panhypoproteinemia (albumin>globulin), hypocholestrolemia, lymphopenia

US: protein poor transudate, rule out PLN, other losses of protein

GI biopsy

21
Q

how do you tx lymphangiectasia?

A
  • marked fat restriction (most important tx!!!)
  • immunosuppressive therapy (prednisone)
  • cobalamin suplement
22
Q

what is the px of lymphangiectasia

A

good to poor (depends on response, worse than IBD alone, relapse

23
Q

what breed gets familial PLE?

A

Soft-coated Wheaten terriers

24
Q

what breed + age is predisposed for histiocytic ulcerative colitis? why?

A

young boxers

E. coli in macrophages

25
Q

what is the typical hx and C/S of histiocytic ulcerative colitis?

A

young boxer (<2yo), severe and chronic large bowel diarrhea, weight loss, hematochezia

26
Q

how do you dx histiocytic ulcerative colitis?

A

colonic biopsies by endoscopy, submission for fluorescent in situ hybridization (FISH)

27
Q

how do you tx histiocytic ulcerative colitis?

A

enrofloxacin

28
Q

true or false: constipation in SA is common

A

false.

rare in dogs, ± common in cats

29
Q

what are the causes of constipation in SA?

A

pelvic fx/canal stenosis, neuro abnormalities, recent diet change, dehydration, CKD, idiopathic megacolon in cats

30
Q

what are the C/S of idiopathic megacolon in cats?

A

males >females, DSH, middle aged

reduced or absent poopies

painful poopy, dry stool

dehydration, weight loss, decreased appetite, vocalization, hiding

31
Q

how do you dx megacolon

A

PE, rads

32
Q

what is the acute tx for megacolon in cats?

A

enema if mild constipation

severe: deobstipation under anesthesia, or oral osmotic agents given by NG tube

33
Q

what is the chronic tx for megacolon in cats?

A
  • weight loss of overweight
  • chronic laxative therapy, once deobstipated
  • diet: low fat and low residue
  • prokinetics
  • sx (severe cases)
34
Q

what is the pathophys of Tritrichomonas fetus?

A

young kitten disease

chronic large or small bowel D+ in cats

risk factors: youth, exposure to catteries or shelters, immune compromise, pure breeds

35
Q

how do you dx Tritrichomonas fetus?

A

fresh feces

PCR

36
Q

how do you tx Tritrichomonas fetus?

A

ronidazole

37
Q

true or false: you should suture close anal gland abscesses after draining and flushing

A

false

38
Q

list the rectoanal diseases we have to know

A
  • anal gland impaction
  • anal gland abscess
  • perineal hernias
  • perianal fistulas
39
Q

what is the pathogenesis of perineal hernias?

A

unknown, or chronic straining or IBD

40
Q

what are the C/S of perineal hernias?

A

nothing, or perianal swelling, straining, tenesmus, painful defecation

41
Q

how do you dx and tx perineal hernias?

A

dx: rectal exam
tx: surgery

42
Q

what are perianal fistulas and what is the pathogenesis?

A

chronic, progressive immune disease of perineal region of older GSD

pathogenesis: immune dysfunction

43
Q

what are the ddx for perianal fistulas?

A

neoplasia, anal gland disease

44
Q

how do you diagnose perianal fistulas?

A

typical signs, biopsies

45
Q

what is the treatment for perianal fistulas? what is the px?

A

tx: cyclosporine
px: good

522 (dog & cat class) (31 decks)

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