IBD, Pancreatitis Flashcards
What are the clinical signs of IBD in dogs vs cats and how is it treated?
Cats: vomiting, lethargy, change in appetite, weight loss, hairball accumulation
Dogs: diarrhea (usually chronic), vomiting, edema/ascites
Treatment: deworm, diet, anti/probiotics, steroids or azathiprine/cyclosporine/chlorambucil
What are the differential diagnoses for IBD?
EPI
Food responsive disease
Antibiotic responsive disease (intestinal dysbiosis)
Intestinal tumors (diffuse intestinal lymphoma)
What is the pathogenesis and treatment of histiocytic ulcerative colitis? How does it different from other forms of IBD?
Infectious IBD (E. coli)
Treat with enrofloxacin with amoxicillin and/or metronidazole 4-6 weeks
NO STEROIDS
What is the pathogenesis of lymphangestasia?
Obstruction of lymphatics -> dilatation of lacteals in the villi as they absorb lipid and lipoprotein
With excessive dilation, the lacteals rupture releasing lymph (containing protein, lipid, and lymphocytes) into the intestinal lumen.
What are the clinical signs of lymphangectasia?
Diarrhea (variably present) Weight loss Edema/ascites Pleural effusion Panhypoproteinemia (decreased albumin and globulin) Hypocholesterolemia Hypomagnesemia Lymphopenia
How do you diagnose lymphangectasia and what is the treatment?
Diagnosis: clinical and lab findings, exclusion of hepatic and renal causes of hypoalbuminemia, dilated lymphatics seen on endoscopy or laparotomy, intestinal biopsy
Treatment: treat underying disease, low fat diets, anti-inflammatories
How are pancreatic enzymes activated?
Pancreas does not digest itself because proteolytic enzymes are secreted as inactive zymogens and activated in the lumen of the small intestine by enterokinase (trypsinogen -> trypsin).
Trypsin in turn activates the other zymogens.
Pancreatic Secretory Trypsin Inhibitor can inactivate trypsin if it’s in the wrong area
Why doesn’t the pancreas digest itself?
Intracellular compartmentalization
Proteases formed and secreted in an inactive form (zymogens)
PSTI is secreted in parallel with trypsin
Eneterokinase is extrapancreatic
Low intracellular calcium
What are the risk factors for pancreatitis?
Dietary (high fat) Pancreatic ischemia Reflux of duodenal contents- bile Drugs Duct obstruction Genetic factors Idiopathic
What are differential diagnoses for pancreatitis?
IBD
Cholangiohepatitis
How do you diagnose pancreatitis?
Not one good test
Canine and feline pancreatic lipase (cPLI, fPLI)
Radiographs
Ultrasound- bright white (hyperechooic) peirpancreatic fat
How do you treat pancreatitis?
Supportive care (fluids, pain meds, anti-emetics)
GI rest
Blood, plasma, or plasma expander
Parenteral antibiotics
