L04: Digestive System Pt. 2 (Brown)

Question 1

Common oral cavity infections

Answer 1

• Gingival and periodontal: Gram - anaerobes ie. Porphyromonas; can be 2ary to FeLV or FIV in cats
• Histoplasma capsulatum –> oral granulomas in dogs

Question 2

Stages of periodontal dz

Answer 2

1) gingivitis, no attachment loss

2) early periodontitis, 50% loss

Question 3

Routes of infection of the liver

Answer 3

• portal vein
• hepatic a.
• ascending via biliary system
• contiguous spread from adjacent sites of infection

*can have systemic spread of virus

Question 4

Common pathogens of the intestines

Answer 4

C. Perfringens
Enterotoxigenic E. Coli
Rotavirus

Vaccination decreases viral enteric infection**

Question 5

Therapy of diarrhea

Answer 5

• fluids
• electrolyte replacement
• maintenance of acid/base balance
• control of discomfort
• motility-modifying drugs

*bacterial etiology usually not identified, abx effectiveness usually unproved; EXCEPTION: neonates will deteriorate rapidly before C&S results

Question 6

Diarrhea in neonates

Answer 6

• loss of intestinal mucosal integrity inc. risk of septicemia or endotoxemia –> severe bloody d, fever, scleral injection, dehydration, altered leukogram (early leukopenia followed by leukocytosis)
• systemic abx w/ NSAIDs WARRANTED

Question 7

Best abx. For neonatal diarrhea

Answer 7

Broad-spec abx:

• fluoroquinolones**
• penicillin or cephalosporin + aminoglycosides
• ampicillin
• tetracyclines
• potentiated sulfonamides
• chloramphenicol

parenteral administration may be needed if GI absorption altered in septic animals

Question 8

Cause of hemorrhagic gastroenteritis

Answer 8

Unknown but Clostridium suspected + presence of enterotoxin

Question 9

CS of hemorrhagic gastroenteritis

Answer 9

• Acute onset profuse bloody diarrhea
• vomiting, anorexia, lethargy, abd. Pain
• marked peracute fluid loss can precede CS of dehydration**

*small dogs at bigger risk

Question 10

Most commonly prescribed abx in dogs/cats for dz assoc. gastrointestinal system

Answer 10

Dogs:

1) metronidazole
2) Tylosin

Cats:

1) Metronidazole
2) Clavamox

Question 11

Features of metronidazole

Answer 11

• tx for systemic and enteric obligate anaerobics (ie. Clostridium, fusobacterium, bacteroides), and some protozoa
• MOA: destroys bacterial DNA fx
• can’t use in food animals

Question 12

Features of Tylosin

Answer 12

• macrolide
• active against most aerobic and anaerobic G+, and atypical mycobacteria, mycoplasma, chlamydia, rickettsia sp.
• MOA: interferes w/ protein synthesis
• more active at high pH

Question 13

Natural defense mechs. Of urinary tract

Answer 13

• urine washout
• bacterial interference via colonization of distal urethra
• glycoprotein layer
• epithelial desquamation
• local/systemic immune system

Question 14

Antimicrobial properties of urine

Answer 14

• high osmolality
• urine pH
• urea, methionine, hippuric & ascorbic acid, ammonium nitrogen in urine have bacteriostatic properties

Question 15

Natural genital defenses against infection

Answer 15

1) anatomic (stratified squamous epithelium, cervix, length of male urethra)
2) hormones (ie. Estrogen)
3) immune system

Question 16

Normal flora in distal urethra

Answer 16

Coag-neg staph
Strep
Corynebacterium
Enterococcus

Question 17

Normal flora in vulva/prepuce

Answer 17

Diphtheroids
Micrococci
Coliforms
Proteus spp.
Enterococci
Yeasts
Anaerobes

Question 18

Normal flora in vagina

Answer 18

Alpha/beta hemolytic strep
Coliforms
Proteus spp.
Diphtheroids 
Lactobacilli
Mycoplasmas
Yeast 
Fungi

dynamic flora influenced by hormones, estrus cycle, age, preg. State

Question 19

Most common infectious dz in dogs

Answer 19

UTI

Routes:

• ascending (most common)
• hematogenous (rare)

*rare in cats except geriatric cats w/ renal failure

Question 20

Common fungal and algal infections of the digestive system of the dog

Answer 20

Fungi: Histoplasma capsulatum –> d, oral ulcers, wt. loss

Algae: Prototheca –> bloody d, multiorgan system failure

none in cats

Question 21

CS of UTI

Answer 21

• Dysuria
• Increased frequency and volume
• excessive thirst
• pyuria and/or hematuria
• crystalluria/uroliths
• lower back pain

Question 22

Rule-outs for UTI

Answer 22

• neoplasm of bladder
• renal masses
• urinary obstruction
• urolithiasis

Question 23

Which breeds predisposed to urolithiasis?

Answer 23

• Miniature schnauzer
• Dachshund
• Dalmatian
• Pug
• Bulldog
• Welsh corgi
• Basset hound
• Beagle
• Terriers

Question 24

Gram POSITIVE Bacteria most likely to cause UTI

Answer 24

Enterococcus

Coag-pos staph

Question 24

Gram NEGATIVE Bacteria most likely to cause UTI

Answer 24

E. Coli (42-26%) Proteus mirabilis Klebsiella sp. Pseudomonas sp.

Question 25

Most likely pathogens responsible for mastitis in dogs

Answer 25

E. Coli | Staphylococcus sp.

Question 26

Abx to treat mastitis in dogs

Answer 26

Cephalexin or clavamox **don't use tetracycline, chloramphenicol, or aminoglycosides because abx can pass to offspring

Question 27

Predisposing causes of metritis in SA

Answer 27

Prolonged delivery Dystocia Retained fetuses or placenta

Question 28

Most common pathogens responsible for metritis in SA

Answer 28

E. Coli Strep Staph Proteus spp.

Question 29

Primary CS of metritis

Answer 29

Purulent vulvar discharge ``` Others: Depressed Febrile Lethargy Inappetence ```

Question 30

Metritis diagnostics/clinical findings

Answer 30

- Large/flaccid uterus on palpation - rads to determine if fetuses or placentas are retained - chemistry: +/- leukocytosis with left shift

Question 31

Tx of metritis in SA

Answer 31

- IV fluids - supportive care - abx based on C/S - prostaglandin to evacuate uterine contents - OVH after stable

Question 32

Cause of pyometra

Answer 32

- Hormonally mediated diestrual disorder --> cystic endometrial hyperplasia w/ SECONDARY bacterial infection - usually in older bitches (>5 yrs) 4-6 wks post estrus

Question 33

Factors assoc. with occurrence of pyometra

Answer 33

- use of long lasting progestational compounds to delay or suppress estrus - admin. Of estrogens to mismatched bitches - postinsemination or postcopulation infections

Question 34

Why is pyometra less common in queens than bitches?

Answer 34

Queens require copulatory stimulation to ovulate and produce progesterone from CL

Question 35

Most common pathogens assoc. with pyometra

Answer 35

E. Coli #1 Others: staph, strep, pseudomonas, proteus spp., etc.

Question 36

CS of pyometra

Answer 36

-Variable; lethargy, dehydration, anorexia, PU/PD, vomiting -20% of cases have fever +/- shock -uterine enlargement, sanguinous to mucopurulent vaginal discharge

Question 37

When most common time to see pyometra?

Answer 37

During diestrus (4-8 wks after estrus), or after admin. Of exogenous progestins

Question 38

Chemistry findings of pyometra

Answer 38

- normal or leukogram - leukocytosis with neutrophilia and left shift - *leukopenia may occur if animal is septic - mild normocytic normochromic nonregenerative anemia - hyperproteinemia due to hyperglobulinemia

Question 39

Chars. Of prostatitis

Answer 39

- hematogenous or ascending from urethra in origin - can cause concurrent UTI - usually suppurative and may cause abscesses - painful!

Question 40

Potential agents causing prostatitis

Answer 40

E. Coli Staph Strep Mycoplasma/ureaplasma

Question 41

CS of prostatitis

Answer 41

- pain, fever, dehydration | - septicemia/shock in severe cases

Question 42

Clinical findings of prostatitis

Answer 42

- Chemistry: neutrophilia w/ L shift, monocytosis, +/- toxic WBC - UA: hematuria, pyuria, bacteriuria - US: hypoechoic areas = pockets of fluid

Question 43

Tx of prostatitis

Answer 43

- fluid therapy if dehydration or shock - abx selected from S testing - surgically drain large abscesses - consider castration after infection resolved * chronic bacterial prostatitis difficult to resolve*

Question 44

Which pathogens/viruses linked to abortion in SA?

Answer 44

Canine herpesvirus Brucella canis Mycoplasma ?

Question 45

Which virus linked to immune complex glomerulonephritis in SA?

Answer 45

Canine adenovirus 1

Question 46

Which virus linked to balanoposthitis and female infertility in SA?

Answer 46

Canine herpesvirus | +/- Mycoplasma

Question 47

Which pathogens linked to epidydimitis in SA?

Answer 47

Brucella canis | E. Coli

Question 48

Which pathogen assoc. with orchitis?

Answer 48

E. Coli

Question 49

Which pathogens assoc. with prostatitis?

Answer 49

E. Coli | Mycoplasma

Question 50

E. Coli can cause what urogenital issues?

Answer 50

``` Cystitis Epidydimitis Orchitis Prostatitis Pyometra Vaginitis ```

Question 51

Leptospira sp. assoc. with what urogenital issues?

Answer 51

Interstitial nephritis | Renal failure

Question 52

Feline infectious peritonitis virus causes what urogenital issue?

Answer 52

Immune-mediated pyogranulomas of kidney

Question 53

Feline leukemia virus causes what urogenital issues?

Answer 53

Immune-mediated glomerulonephritis Fetal absorption Abortion Renal lymphoma

Question 54

Feline panleukemia virus causes what urogenital issues?

Answer 54

Abortion | Congenital abnormalities

Question 55

Feline rhinotracheitis virus causes what urogenital issues?

Answer 55

Abortion

Question 56

Most frequently prescribed abx for DOGS with UTI

Answer 56

1) Clavamox 2) Amoxicillin 3) Fluoroquinolones 4) Cephalexin 5) Convenia

Question 57

Most frequently prescribed abx for CATS with UTI

Answer 57

1) clavamox 2) fluoroquinolones 3) cefovecin 4) amoxicillin 5) cephalexin