SI Dz Flashcards
The following describes which tapeworm?
Ingestion of fleas
Shed proglottids within 2-3 wks of infection
Per-rectal irritation
SI impactions (rare)
Diplydium caninum
other tapeworms: Taenia species; echinococcus species
We tx tapeworms with what 2 drugs?
Praziquantel; Fendendazole
T. canis/cati are roundworms that occur from the ingestion of eggs or maternal transmission and adults mature in the SI. Which animal would we be most worried about?
Young puppies and kittens- can be fatal in them!! High worm burdens and pulmonary involvement so never brush off parasites i young or immunocompromised
The following clinical signs are associated with what?
- vomiting of live worms (truly vomiting bc coming from the SI)
- unthrifty
- diarrhea
T. canis/ T. cati
What 3 drugs do we use to tx roundworms?
Fenbendazole, Pyrantel pamoate, preventatives
The following are examples of what?
Giardia, Tritrichomonas foetus, Coccidia (Isospora sp), Cryptosporidium, T. gondii
Protozoa
The following things describe what kind of parasite?
Single celled organisms
Primary clinical signs: diarrhea +/- wt loss
-pathology: destruction of enterocytes & villi
Protozoa
What diagnostic test should we only use the first time when looking for Giardia?
Antigen/ELISA; not recommended as a recheck bc can remain positive for a long time
What diagnostic method should we use for Tritrichomonas foetus (cat)?
- direct fecal smear
- culture
- **fecal PCR preferred (94% sensitivity)
- *large bowel
T/F You need to be careful to not get Giardia transmission from your pet.
False. transmission btwn humans and pets is rare
When doing direct smear for G. duodenalis, what are we looking for?
Checking for trophozoites in diarrheic stools
When performing a direct smear for G. duodenalis, what are the 4 steps of our protocol?
- small, FRESH, unrefrigerated feces
- mix sample into 2-3 drops saline (not water) on a glass slide
- add coverslip
- Lugol’s iodine stain may be added to aid in ID
T/F Subclinical infections are common in G. duodenalis.
True
T/F Our goal for G. duodenalis is to stop diarrhea and eliminate the infection which is difficult to do.
True
What drug combo do we use in resistant G. duodenalis infections?
Fenbendazole x 5 days +/- Metronidazole x 5 days
Bathing on last day
The following describe what ?
Cystoisospora aka Isospora species
Fecal oral OR predation transmission
Sporozoites infect enterocytes
Coccidia
What clinical signs are associated with Coccidia?
Wt loss, dehydration, +/- hemorrhage
Adults: can be self limiting
Young, immunocompromised can be quite sick: anorexia, vomiting, dehydration
What diagnostic methods do we use for Coccidia?
Direct smear, fecal float
What’s our tx method and prognosis for Coccidiosis?
Sulfadimethoxine (Sulfa so don’t wanna use for months on end)
Prognosis: good in adults w mild symptoms
Guarded in systemically ill patients
Cryptosporidium parvum are said to be ________ -like.
Coccidia-like
T/F Zoonosis is a concern for Cryptosporidium.
True
The following describe what?
Fecal oral transmission
Contaminated food, water transmission
Self limiting small bowel diarrhea
Severely life threatening in immunocompromised - can extend into LI and other organs
C. parvum
T/F C. parvum can be found on direct smear and fecal float.
Meh, they’re hard to find.
What 2 drugs do we use to tx C. parvum?
Paromomycin & Tylosin
The following describes what?
ZOONOTIC AF
Oocysts require 1-5 days to become infectious after passed (so clean litter boxes daily)
Dz seen in immunocompromised, immunosuppressed, fetus, elderly
CATS > DOGS
Transmission: predation- bradyzoites/muscle; fecal contamination
Toxoplasma gondii
The following CS are associated with what?
Resp: pneumonitis GI: V, D Neurologic: encephalitis Eye: chorioretinitis Fever Wt loss Lethargy
T. gondii
For T. gondi, unlikely to shed _______ at the time of significantly ill. Significant clinical disease often from _______ effects.
Unlikely to shed OOCYSTS at the time that animal is significantly ill and significant clinical dz often from EXTRA INTESTINAL effects
T/F Fecal float is how we get a definitive dx of T. gondii.
False. It has limited use. Oocyst shedding occurs briefly after infection and not always associated with clinical disease.
If you suspect T. gondii, what test should you run?
Antibody titers: IgG and IgM will be useful when associated with a sick pet
T/F Positive antibody titers for T. gondii tells us that oocyst shedding is occurring.
False. Positive titers do NOT = oocyst shedding or clinical disease
Oocyst shedding occurs right when the animal is infected and if clinical signs are seen, they often occur well after oocyst shedding has happened.
Clinamycin and Trimethoprim-sulphonamide are used to tx what?
T. gondii
Pythiosis, Histoplasmosis and Candidiasis are all what?
Fungal dz’s!
All of the following are true about Pythium Insidiosum except:
- aquatic oomycete: fungus-like and resembles algae
- feeds on rotting material or living plants by absorbing nutrients through fine threads
- occasionally infects mammalian hosts such as dogs
- found in Canada and the Midwest
- exposure to free standing water –> penetration of skin or mucosa by motile zoospores
found in Canada and the Midwest
It is found in tropical, subtropical and temperate climates . . mostly Gulf Coast states (NJ, VA, NC, CA etc) BUT! Since people travel with their pets then it’s now being found all over
T/F Pythium insidiosum is zoonotic and that’s why it’s of interest to us.
False. Zoonosis has not been documented.
What are some important clinical signs associated with P. insidiosum?
GI distress and non healing skin lesions!!
GI: palpable abdominal mass; dehydration; poor body condition
Cutaneous: Dog: lesions at base of tail, extremities, ventral neck, perineum
Cat: cervica, inguinal, truncal
-ulcerative nodules
-draining tracts
T/F The GI and dermatologic clinical signs occur concurrently in P. insidiosum?
False!! Do NOT occur together
In, P. insidiosum, we see eosinophilia and anemia on our CBC during what form?
GI form
chem: see HYPOAlb and HYPERglobulinemia
What are the 2 best dx methods to use for P. insidiosum?
Pythium ELISA and biopsy of lesions
How is the Pythium ELISA helpful and when is it used to dx P. insidiosum?
Antibody detection; also used for response to therapy- titers fall with therapy
How is taking a biopsy of the lesions helpful in P. insidiosum?
SEVERE transmural segmental thickening (esophagus –> colon +/- dissemination into other abdominal organs)
Pyogranulomatous and eosinophilic inflammation on biopsy
GMS stain on histopath to ID organisms
What would we expect to see on rads of P. insidiosum?
Poor serosal detail w weight loss
Mass lesion in abdomen or esophagus
What would we expect to see on US of P. insidiosum?
Segmental thickening of GI
Thickened gastric outflow tract possible
Enlarged LNs
The recommended tx of P. insidiosum is sx and medications. When performing surgery, you removal 3-4 cm margins of limb or GI segment. What medications should be used?
At least 2 -3 months: Itraconazole, Terbinafine +/- immunotherapy (pred) in non-resectable cases
Medication alone –> less than 20% chance of survival
At what point can we discontinue oral meds when tx’ing P. insidiosum?
Monitor ELISA: if COMPLETE resection and NO recurrence then ELISA usually drops by 50% or more within 3 months and can discontinue oral meds
Histoplasmosis is a dimorphic fungi that occurs worldwide but is most commonly found where in the US?
Mississippi and Ohio River valleys
Histo occurs in dogs and cats. How does transmission work?
Aerosols into lungs and thoracic LN GI tract (D>C) Organisms enter bloodstream from primary site and can cause widespread dz
The following clinical signs are found in what?
Diarrhea (LARGE >SMALL)*
Wt loss to emaciation*
Hepatomegaly, splenomegaly, lymphadenopathy
Nasopharyngeal and GI ulceration
Lameness
Resp difficult (Nnodules & thoracic LNs)*
Skin lesions
Clinical signs of Histo in the Dog . .. Cat has same CS EXCEPT for GI signs
What are some ways we can dx Histo?
Chest rads: nodules, enlarged LNs
US: spleen, liver, LN enlargement; thickened LI and/or SI wall
FNA of abnormal tissue and fluid
Biopsy of abnormal tissues
ELISA antigen test: urine, serum and CSF: cross reactivity occurs w bastomycosis
Histo requires PROLONGED therapy. What drugs do we use?
Itraconazole, Fluconazole or Ketoconazole in mild cases, Amphotericin B in severe cases
What is the prognosis for Histo?
Acute his to may be fatal after 2-5 wks
Poor condition and multi system involvement= guarded to poor
One organ involved= better (obviously)
Candidiasis is a normal inhabitant of nasopharynx, GI tract and genitalia. But opportunistic infections can be seen. Opportunistic infections are associated with the disruption of what?
Associated with disruption of MUCOSAL INTEGRITY
How do we tx opportunistic infections caused by Candidiasis?
Immunosuppressive meds, antibiotics, IV or urinary catheters
What CS would we expect to see in cats w Candidiasis?
Oral and upper respiratory dz, pyothorax, ocular lesions, intestinal disease, cystitis
When would we expect to see dogs w Candidiasis?
Perforating intestinal lesions after sx
Mucosal and cutaneous candidiasis has been noted in immunosuppressed dogs
The following are all what?
Campylobacter Salmonella Clostridium E. coli Yersinia Mycobacterium
Bacterial dz.’s of intestine
What are the top 3 bacteria associated with intestinal dz?
- Campylobacter: large bowel
- Salmonella
- E. coli
Can all be associated w acute diarrhea
Prone: young, kenneled, immunocompromised; apparently healthy pets
Salmonella is a gram -, facultative anaerobic with a low prevalence in normal pets. It’s part of the normal flora in 30% of dogs and 18% cats. If it cultures positive and clinical signs then = likely association. How does an animal contract this disease and why is it of importance to humans?
Raw and/or contaminated food –> young, parasitized, immunocompromised, or stressed kennel dogs
ZOONOTIC!!
What are the clinical signs of Salmonella?
Acute, transient illness (diarrhea) - supportive care
How do we dx Salmonella?
culture, blood in septicemia, feces . .. PCR lacks validation
T/F We don’t tx animals with Salmonella.
Meh, kinda.
No tx for primary infection and when transient . . . BUT need to tx for bacterial translocation in very ill animals: typically when we see them and test them (IV antibiotics like fluoroquinolones, amoxicillin, TMS, chloamphenicol
T/F E. coli is natural part of mammalian flora and is gram -, anaerobic and rod shaped.
True
T/F E. coli causes severe disease.
False most non pathogenic
In what circumstances would we see acute disease from E. coli occur?
Puppy- unclean crowded breeding environments
Immunocompromised- w Parvovirus
Food and water contamination including raw food
What are the clinical signs for E. coli?
V & D, dehydration, lethargy
How do we dx E. coli?
culture: blood in septicemia; feces
How do we tx E. coli?
IV supportive care, antibiotics like fluoroquinolones, unasyn, others
Good prognosis unless septic (fair-guarded)
What fluke and bacteria are associated with Salmon poisoning disease (SPD)?
Fluke: Nanophyetus salmincola
Bacteria: Neorickettsia helminthoeca & elokominica
T/F Salmon poisoning disease affects dogs and is predominantly found in the Pacific NW.
True
What clinical signs do we typically see with SPD?
High fever, hematemesis, V and D, nasal and ocular discharge, enlarged LNs
How do we dx SPD?
- fluke eggs in feces
- history of ingested fish
- inclusion bodies in macrophages in LN
- CBC: thrombocytopenia (94%!)
Clicker Question: A client brings you a sick feline with neurologic and ocular signs on lab work you determine the cat to be positive for toxoplasmosis. The owner is concerned about parasite shedding and contracting toxoplasmosis. You advise:
A. Tx the patient, scoop litter box daily. Risk of oocyst (the contagious bit) shedding is extremely unlikely.
B. Don’t tx the patient and euthanize.
C. Tx the patient but find it a new home.
D. Tx the patient. Scoop the litter box twice a day. The risk of oocyst shedding is high.
A. Tx the patient, scoop litter box daily. Risk of oocyst (the contagious bit) shedding is extremely unlikely.
Because oocyst shedding is immediately once they’re infected . . . by the time they show clinical signs oocyst shedding is looooong gone.
What condition does the following tx protocol tx?
Hospitalized support Antibiotics Oxytetracycline Doxy Praziquantel for \_\_\_\_\_\_
Praziquantel for FLUKE sooo tx’ing SPD
What’s our prognosis lookin like for SPD?
Fairr to good with aggressive support care BUT death in up to 90% of untreated animals w SPD
Elokomin fluke fever (EFF): milder form: 10% death in untreated animals
