SA acute gastroenteritis Flashcards
Causes of non-fatal, self-limiting acute v&d?
Parasitism
Dietry indiscretion
Secondary to other disease - hyperadrenocorticism, liver, kidney etc
Causes of severe, life-threatening v&d?
Enteric infection - parvo, bacterial, haemorrhagic gastri-enteritis, surgical disease
What disease is classed as surgical disease?
Intussusception, volvulus, incarceration, foreign body, stricture/ partial obstruction
Acute gastritis
Acute frequent vomiting, acute diarrhoea
Usually self-limiting
Causes: Dietary indiscretion, foreign material, hairballs, drugs
Acute Enteritis
Acute profuse diarrhoea and acute vomiting
Causes: dietary indiscretion, intoxication, enteric infection
Acute colitis
Acute, frequent, small volumes of diarrhoea
Tenesmus
Mucoid/ fresh haemorrhagic diarrhoea
Causes: Whipworm, dietary indiscretion, protozoa
What initial history should be assessed in acute v&d?
- Age
- Vaccination status
- Recent dietary intake
- Exposure to toxins, fb, infectious disease
- Nature of signs
- Onset/ severity
- Content
- Stool character
- Blood?
What minimum database should be considered?
Haematology
Serum biochemistry
Urinalysis
Faecal exam - parasite
Faecal microbiology?
Emergency diagnostics in peracute crisis?
- PCV/ TP
- Blood smear
- Blood glucose/ urea
- Urinalysis
- Electrolytes
- Blood gases
- ECG
Feeding through diarrhoea?
Traditionally restricted diet for a minimum of 12 hours followed by small and frequent feeds.
Modern theory suggests that feeding through leads to quicker recovery and reduces potential for sepsis
Why don’t we do it? Impracticalities for owner.
Centrally-acting antiemetics
Anti-dopaminergics - reduced stimulation of the central trigger zone
eg Maropitant, metoclopramide, chlorpromazine
Anticholinergic anti-emetics
Atropine
Methylscopolamine
NK1 receptor antagonist
Maropitant
H2 receptor antagonists
Cimetidine
Why are NSAIDS contraindicated?
Lead to mucosal damage (<pg></pg>
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How do antidiarrhoeals work?
Name one..
Bind toxins, bind excess water
Eg. Kaolin, activated charcoa, Aluminium hydroxide
How do opioids act as antidiarrhoeals?
They slow rate of transit through the gastrointestinal tract, therefore encouraging fluid absorption
What are the cons of using antibiotics during diarrhoea?
Encourage resistence
Disruption of the normal gut flora
What clinical indications of acute enteric disease would encourage use of antibiotics?
- Haemorrhagic diarrhoea
- Concurrent pyrexia
- Known infection
- E. coli
- Salmonella
- Campylobacter
Empirical antibiotic therapy in the abscence of culture?
Metronidazole
Tylosin
Enrofloxacin in worstening patients, unresponsive to initial therapy
What agents can be used to encourage emesis?
Recently ingested SMOOTH objects!
Opioids
Xylazine
Washing soda
Ipecacuanha
Viral causes of gastroenteritis
Parvovirus
Coronavirus
Bacterial causes of gastroenteritis
Salmonella
E. coli
Campylobacter
Parasitic causes of gastroenteritis
Helminths
Coccidia
Giardia
Tritrichomonas
Canine haemorrhagic gastroenteritis
Clinical signs: Peracute v, haemorrhagic diarrhoea, haemoconcentration, depression, shock
Unknown aetiology: erosive enteritis, altered ent permeability/ secretion
A dog presents with peracute vomiting and haemorrhagic diarrhoea with a normal skin turgor and elevated PCV..
Treatment
Haemorrhagic gastroenteritis
Treat with aggressive fluid therapy - balanced eletrolytes
