GI - Small Intestine

Question 1

In the small intestine, how long does it take for make the journey from the crypt up to the tip?

Answer 1

3 days…

Question 2

How do we treat tapeworm in dogs?

Answer 2

Flea treatment and PZQ/fenbendazole

Question 3

In high worm burdens, Toxocara canis can be fatal. Why would there be pulmonary involvement?

Answer 3

Because of the migration thru the lung!

Question 4

If it’s bad enough long enough, what is the weight loss in Protozoa diarrhea coming from?

Answer 4

Malabsorption

Question 5

What type of diarrhea does Tritrichomonas foetus cause in cats?

Answer 5

LARGE bowel

Question 6

How would we treat Cryptosporidium?

Answer 6

Paromomycin Tylosin

Question 7

What aquatic oomycete is documented in mostly Gulf Coast states and is transmitted by exposure to free standing water? What is unique about the clinical presentation in dogs afflicted by this pathogen?

Answer 7

Pythium insidiosum
resembles algae

There aren’t a lot of diseases that present with GI and Skin signs/symptoms…
usually they’re infectious (some are immune-mediated…)

so for the most part,
GI and skin CS = Pythium should be high on your list of dDx

Question 8

How do we diagnose Pythium?

Answer 8

CBC: eosinophilia, anemia
CHEM: hypoalbuminemia, hyperglobulinemia
UA: NSF

PythiumELISA: antibody detection; also used for therapy (titers fall w.Tx)

Culture, FNA of lesions (nonspecific), biopsy of lesions

Question 9

What does P.insidiosum cause in the GIT?

Answer 9

Severe transmural segmental thickening on US
(esophagus—>colon +/- dissemination into other abd.organs);

GI Distress: SI diarrhea, vomiting, weight loss, hematochezia, abd.pain

Question 10

How do we treat Pythium?

Answer 10

Medications
Itraconazole: 10mg/kg PO SID
Terbinafine: 5-10mg/kg PO SID
+/- immunotherapy—>pred 1mg/kg/day

Surgery
removal (3-4cm margins) of limb or GI segment

Question 11

What would large bowel diarrhea look like?

Answer 11

Straining, blood, high frequency/small amounts

Question 12

In a dog with GI signs and respiratory difficulty, radiograph reveals nodules and enlarged thoracic lymph nodes. Also, the owner mentions she visited her sister in Ohio a week ago and brought the dog. You were thinking aspiration pneumonia, but now you’re thinking…

Answer 12

Histoplasmosis

Question 13

How do we diagnose Histoplasmosis?

Answer 13

FNA, biopsy, ELISAantigen

Question 14

How do we treat Histoplasmosis?

Answer 14

Itraconazole: 10mg/kg/day

Severe: Amphotericin B

Question 15

What are the major bacteria associated with Intestinal Disease?

Answer 15

Campylobacter (large bowel),
Salmonella,
Clostridium,
E.coli,
Yersinia,
Mycobacterium

Question 16

What is the name of the fluke as well as the bacteria involved in Salmon Poisoning Dz?

Answer 16

• Nanophyetus salmincola*
• Neorickettsia helminthoeca* and elokominica

Question 17

How do we treat salmon poisoning?

Answer 17

Oxytetracycline,
Doxycycline,
PZQ (for fluke)

Question 18

Top 3 most common GI Neoplasia in dogs vs. cats?

Answer 18

Feline
Lymphoma (small cell)
adenocarcinoma
mast cell

Canine
lymphoma
adenocarcinoma
smooth muscle tumors (leiomyo/sarc-oma, GISTs)

Question 19

How do we treat intestinal lymphoma in cats?

Answer 19

Chlorambucil
Prednisolone
(can survive 1-3+ years)

Question 20

How long in duration does IBD need to be, in order to be considered chronic?

Answer 20

at least 3 weeks

Question 21

What disease state is currently defined clinically as:
“a spectrum of GI disorders associated with idiopathic chronic inflammation of the stomach, intestine, colon, or some combination of these organs…“ ?

Answer 21

IBD

Question 22

What’s the most common type of infiltrate found in IBD patients?

Answer 22

Lymphoplasmacytic!

Question 23

What are the types of IBD?

Answer 23

Lymphocytic-Plasmacytic Enteritis (LPE);
Eosinophilic Enteritis (EE) - food hypersensitivity? Parasitic?;
Lymphangiectasia and Protein Losing Enteropathy;
etc…

Question 24

What is lymphangiectasia?

Answer 24

Dilation/dysfunction of intestinal lymphatics -
they rupture, fluid leaks out (pro-inflammatory), and you’re losing protein/lymphocytes…(usually secondary to lymphatic obstruction of some sort)

Question 25

What is the “ideal diet” for cases of lymphangiectasia?

Answer 25

fat-restricted, calorie-dense, and highly digestible

Question 26

What hypersensitivity is IgE-mediated and can manifest as food allergies, eczema, anaphylaxis, hives, hay fever, asthma, etc?

Answer 26

Type I

Question 27

Which hypersensitivity is cell-mediated and can manifest as contact dermatitis, tubercular lesions, and graft rejections?

Answer 27

Type IV

Question 28

Which hypersensitivity is IgG- or-M- mediated cytotoxic, and manifests as blood transfusion reactions, autoimmune hemolytic anemia, etc?

Answer 28

Type II
*complement activation

Question 29

Cobalamin levels below the control range are often seen in patients with what disease?

Answer 29

EPI,
bacterial overgrowth in the upper SI {this also goes for HIfolate},
disease affecting the distal SI

Question 30

What does a clinical diagnosis of IBD require?

Answer 30

1. Chronic GI signs (>3weeks; anorexia, vomiting, weight loss, diarrhea, hematochezia, mucoid feces)
2. Histopathological evidence of mucosal inflammation
3. Inability to document other causes of gastroenterocolitis by through diagnostic evaluation
4. Inadequate response to therapeutic trials
5. Clinical response to anti-inflammatories or immunosuppressives