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Medicine II > Pericardial & Heartworm Disease > Flashcards

Pericardial & Heartworm Disease Flashcards

1
Q

Obj: Given a patient w/ chronic GI signs:

  • Differentiate between primary and secondary GI disease
  • Formulate an empirical treatment plan based on localization of clinical signs, most likely responses, and possible treatment side-effects
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2
Q

Obj: For diet trials: describe how different diet types work and identify specific examples in each category

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3
Q

Obj: Differentiate how microbiota-targeted therapies work and describe evidence for/against use

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4
Q

Obj: For dogs and Cats w/ Idiopathic IBD:

  • Formulate a medication plan based on available clinical and laboratory results
  • Discuss prognosis, including negative prognostic indicators w/ owners
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5
Q

Obj: For infectious diseases:

  • List major routes of transmission, tissues affected, SI or LI clinical signs
  • Based on a case scenario, prioritize differentials based on the above and unique systemic or laboratory findings and choose the best diagnostic test
  • For a specific patient, decide whether treatment is needed and formulate a treatment plan
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6
Q

What is a ‘Chronic Enteropathy’?

A
  • GI signs ≥ 3-4 weeks duration
    • Non-GI disease has been excluded
  • Includes:
    • GI neoplasia
    • GI infectious disease
    • Idiopathic inflammatory disease
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7
Q

What is the diagnostic approach to chronic GI disease?

A
  • Rule-out systemic disease
    • Baseline blood work
    • Urinalysis
    • Baseline Cortisol (dogs)
    • T4 (cats)
    • specPL (Pancreatic lipase; select cases)
    • Bile acids (select cases)
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8
Q

Obj: For Feline CE:

  • Contrast common imaging and laboratory findings vs dogs
  • Adjust diagnostic and treatment plans based on unique feline physiology, most common differentials, and nutrient deficiencies
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9
Q

What are the common enteropathogens? (Viruses, protozoa, bacteria, fungi, parasites, and misc)

A
  • VIruses:
    • Parvovirus
    • Coronavirus
    • Rotavirus
  • Protozoa
    • Giardia
    • Tritrichomonas
    • Cryptosporidium
  • Bacteria
    • Clostridiu
    • Campylobacter
    • Salmonella
    • E.coli
  • Fungi
    • Histoplasma
  • Parasites
    • Hookworms
    • Roundworms
    • Stomach worms
    • Whipworms
    • Heterobilharzia
  • Misc:
    • Neorickettsia
    • Prototheca
    • Pythium
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10
Q

What is Helicobacter spp?

A
  • Etiologic agent:
    • Gram negative
    • microaerophilic
    • spiral bacteria
  • Normal Flora in:
    • 70-100% of healthy dogs
    • 40-100% of healthy cats
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11
Q

What are the clinical signs of a Helicobacter infection?

A
  • Most asymptomatic
  • +/- Chronic vomiting
  • No relation to GI ulceration
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12
Q

How is a Helicobacter spp. Infection diagnosed?

A
  • Histopathology
    • Spiral bacteria in association w/ gastric mucosa
  • Squash prep cytology
  • Rapid urease test
    • does have false positives
  • Response to treatment
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13
Q

What is the treatment for Helicobacter spp infections?

A
  • Combination therapy for 3 wks
    • Amoxicillin + azithromycin/clarithromycin + bismuth subsalicylate +/- omeprazole
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14
Q

What is Heterobilharzia?

A
  • Etiology: Trematode parasite (Heterobilharzia americanum)
  • Geographic risk: US Gulf Coast
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15
Q

What are the clinical signs of Heterobilharzia?

A
  • LI or SI diarrhea
  • Vomiting
  • Weight loss
  • +/- liver failure, renal failure
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16
Q

How is Heterobilharzia diagnosed?

A
  • Chemistry panel
    • Hypercalcemia
    • Hypoalbuminemia +/- hyperglobulinemia
    • Elevated liver enzymes
    • Azotemia
  • Cytology or histopathology
  • Fecal sedimentation or PCR**
17
Q

What is the treatment for Heterobilharzia?

A
  • Praziquantel
  • Fenbendazole
18
Q

What is the prognosis of Heterobilharzia?

A
  • Acute: Good
  • Chronic: Guarded-poor
  • Chronic Carriers possible
  • Hypercalcemia, acute azotemia do NOT affect prognosis
19
Q

What is Giardia?

A
  • Etiologic Agents: Giardia duodenalis (Binucleated flagellate)
  • Pathogenesis:
    • 2 forms: trophozoite and cyst
      • Trophozoite lives in Small intestine
    • Fecal oral transmission
20
Q

What is the common signalment of animals w/ Giardia?

A
  • Young (<1-2 years)
  • Immunocompromised
  • Steroids (recrudescence)
  • Group-housed animals
21
Q

What are the clinical signs of Giardia?

A
  • Small intestinal diarrhea (acute or chronic)
  • Cats may have mucoid diarrhea
22
Q

How is Giardia diagnosed?

A
  • ZnSO4 centrifugation-flotation
    • Intermittent shedding
    • 95% sensitivity w/ 3 repeated tests
  • Immunoassays (fecal antigen) ***
    • SNAP point-of-care: good sensitivity (90%) and specificity (99%)
  • Direct IFA (fecal cysts)
    • High discordance between antigen and cyst-based tests
23
Q

What is the treatment/prevention for Giardia?

A
  • Treatment: Fenbendazole 50 mg/kg q24h for 5 days
  • Prevention:
    • Treat all group-housed animals
    • Clean/disinfect environment
    • Bathe at beginning/end of treatment
24
Q

How is Histoplasmosis transmitted?

A
  • Inhalation or ingestion
  • Intracellular yeast replication
  • Granulomatous inflammation
25
Q

What are the clinical signs of Histoplasmosis?

A
  • GI more common in dogs
    • SI or LI diarrhea
    • Protein-losing enteropathy - Panhypoproteinemia, effusion, edema
  • Weight loss
  • Concurrent respiratory disease, ocular disease, cytopenias, fever
26
Q

How is Histoplasmosis diagnosed?

A
  • Urine histoplasma antigen
  • Cytology/Histopathology
    • Rectal scrape
    • Intra-abdominal LN, liver, spleen
    • GI endoscopy
    • If systemic: Bone marrow aspirate, lung aspirate, skin lesion impression cytology, aqueocentesis
27
Q

What is the treatment for Histoplasmosis?

A
  • Itraconazole 10 mg/kg q24h for at least 6 months
  • Fluconazole 5 mg/kg q12h for at least 6 months
    • treatment of choice w/ ocular or CNS involvement
28
Q

What is the prognosis for Histoplasmosis?

A

Guarded to poor for severe GI involvement

29
Q

What is Pythium insidiosum?

A
  • Aquatic oomycete organism
  • Causes GI infiltration and pyogranulomatous inflammation
  • Located in the Gulf States
  • Come from warm, swamp water or fields post-flooding
  • Large breed, male dogs, less than 3yo most commonly affected
30
Q

How is Heterobilharzia americanum transmitted? Pathogenesis?

A
  1. Cercaria form penetrates dog skin
  2. Organism migrate to liver
  3. Eggs laid in mesenteric venules
  4. migration of organisms through GI wall → severe granulomatous inflammation
31
Q

What are the clinical signs of a Pythium insidiosum infection?

A
  • Mass lesions resulting in partial or complete GI obstruction
    • transmural pyloric-duodenal thickening
  • Small intestinal diarrhea
  • Weight loss
32
Q

How is a Pythium insidiosum infection diagnosed?

A
  • Baseline bloodwork
    • CBC: Eosinophilia
    • Chemistry: Panhypoproteinemia, hypercalcemia
  • Histopathology:
    • Granulomatous inflammation with special stains to identify organism
      • branching, non-septate or poorly septate hyphae
  • Serum ELISA or PCR
33
Q

What is the treatment for a Pythium insidiosum infection?

A
  • Combination of:
    • surgical excision
    • +herbicide (mefenoxam)
    • +antifungals (itraconazole, terbinafine)
    • +/- Vaccination
34
Q

what is the prognosis for a Pythium insidiosum infection?

A
  • Poor to grave
  • Poorly responsive to therapy

Medicine II (46 decks)

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