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Alimentary - Diarrhoea > Small Animal > Flashcards

Small Animal Flashcards

1
Q

What needs to be differentiated when assessing diarrhoea in small animals?

A

Acute or chronic

If acute with/without systemic signs

Small intestinal/large intestinal/mixed

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2
Q

Define diarrhoea

A

Increased frequency, volume or fluidity of stools

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3
Q

Define melaena

A

Dark, tarry faeces

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4
Q

Define flatulence

A

Excess gas

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5
Q

Define dyschezia

A

Difficult or painful defecation

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6
Q

What is melaena usually a sign of?

A

Upper GI bleeding

  • Blood gets digested
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7
Q

Define haematochezia

A

Fresh blood in the stool

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8
Q

Define tenesmus

A

Ineffectual straining

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9
Q

How long should diarrhoea have gone on, even intermittently, before being classed as chronic?

A

Over 3 weeks

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10
Q

How does follow up differ between acute and chronic diarrhoea?

A

Acute

  • Symptomatic treatment
  • Treat signs

Chronic

  • Investigation
  • Underlying disease needs to be treated
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11
Q

What is used to determine whether diarrhoea is small intestinal, large intestinal or mixed?

A

History

  • Differential diagnoses differ between diarrhoeas
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12
Q

What is the main difference between small intestinal and large intestinal diarrhoea?

A

Small intestinal could be GI or extra-GI

Large intestinal is confined to the colon

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13
Q

Describe small bowel diarrhoea

A

Large volume

Infrequent

Moderate weight loss

Little vomiting

Abnormal general condition

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14
Q

What are the 4 differential diagnoses for acute small intestinal diarrhoea with no other systemic signs?

A

Diet - main cause

Helminths

Protozoa (Giardia)

Iatrogenic (drugs)

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15
Q

What can give you a clue that acute diarrhoea has something more going on?

A

Flat, high heart rate - CVS problems

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16
Q

What are the differential diagnoses for acute small intestinal diarrhoea with systemic signs?

A

Bacterial infection - very rare

Viral infection

Toxins

Haemorrhagic gastroenteritis

Acute pancreatitis

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17
Q

How can bacterial infection with acute small intestine diarrhoea be diagnosed?

A

Faecal culture

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18
Q

How can acute small intestinal diarrhoea caused by viral infections be diagnosed?

A

Faecal antigen test

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19
Q

What are the differential diagnoses for acute large intestinal diarrhoea?

A

Whipworms

Clostridia

Giardia

Campylobacter

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20
Q

What will show up with chronic diarrhoea on physical examination?

A

Not that much

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21
Q

What are the differential diagnoses for chronic small intestinal diarrhoea caused by extra-GI?

A

Metabolic

  • Hepatic disease
  • Hyperthyroidism
  • Addison’s disease
  • Renal insufficiency

Pancreatic

  • EPI
  • Chronic pancreatitis
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22
Q

What usually presents with metabolic caused small intestine diarrhoea?

A

Other clinical signs

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23
Q

What are the differential diagnoses with chronic small intestine diarrhoea caused by primary problems?

A

Giardia infection

Chronic partial obstruction

Lymphangiectasia

Neoplasia

Food-responsive disease

Inflammatory Bowel Disease

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24
Q

What is the only place that chronic large intestinal diarrhoea occurs?

A

Colon

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25
Q

What are the differential diagnoses for chronic large intestinal diarrhoea?

A

IBD

Polyps

Food-responsive disease

Neoplasia

Chronic partial obstruction

Tritrichomonas foetus

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26
Q

What are the various investigations for chronic diarrhoea?

A

Faecal exam

Haematology, biochemistry, UA

Serum tests (TLI, LPI cobalamin)

Abdominal ultrasound

Empiric treatment with elimination diet

Biopses

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27
Q

Describe how biopsies are done via endoscopy

A

Multiple taken from stomach, proximal SI, ileum and colon

Non-invasive - except for anaesthesia

Direct visualization of mucosa possible

Gives diagnosis in most cases

28
Q

Describe biopsies taken via exploratory laparotomy

A

Invasive - need to take care in sick animals, cats and animals with decreased albumin levels

Only yields 2-3 biopsies from stomach and small intestine

More expensive and painful for the animal

20% mortality vs 2% mortality for endoscopy

29
Q

What are the four main causes for chronic small intestinal diarrhoea in the dog?

A

Food-responsive disease

Antibiotic-responsive diarrhoea

Inflammatory Bowel Disease

Neoplasia

30
Q

How is food-responsive disease treated?

A

Elimination diet - protein that the animal hasn’t eaten before and usually broken down

Usually get better within the first 2 weeks

Keep on diet for at least 6-8 weeks

31
Q

What breed is antibiotic responsive diarrhoea most commonly seen in?

A

German Shepherd Dogs

32
Q

What is the treatment for antibiotic responsive diarrhoea?

A

Metronidazole 15mg/kg orally twice daily for 4 weeks

Usually relapse though

33
Q

How is IBD diagnosed?

A

Clinical exclusion

34
Q

What is the most common chronic enteropathy in dogs?

A

Inflammatory bowel disease

35
Q

What are the three histopathologys of IBD?

A

Lymphoplasmacellular - most common

Eosinophilic - rare

Ulcerative colitis - only large intestine, rare in Boxers

36
Q

What is the therapy for chronic enteropathies in dogs?

A

Elimination diet

Metronidazole 10-15mg/kg twice daily for 3-4 weeks

If no response then prednisolone 2.2mg/kg/d for at least 10 days then taper dose

Azathioprine or cyclosporine if steroids poorly tolerated

37
Q

What is the terapy for IBD in cats?

A

Elimination diet

Prednisolone 2mg/kg/day for 10-14 days then slow

Chlorambucil if no response

Supplementation with cobalamin

38
Q

Define protein losing enteropathy and its causes

A

Syndrome of intestinal diseases with non-selective protein loss - low albumin and globulins

Causes are IBD, lymphangiectasia and neoplasia

39
Q

What can rabbits and rodents not do in regards to the GI tract?

40
Q

What is a vital dietary component of normal digestion of small furries?

A

Indigestible fibre

  • Stimulate gut motility and dental wear

Digestible fibre

  • Fermented by GI bacteria to produce fatty acids
41
Q

What controls the large intestinal motility of rabbits?

A

Fusus coli

  • Distal part of proximal colon
42
Q

What happens to indigestible fibre and digestible fibre in rabbits?

A

Contractions separate indigestible fibre which is passed to produce pellets

Digestible fibre washed back to caecum for fermentation

43
Q

Describe caecotrophy

A

3-8 hours after eating caecum contracts to produce mucus coated caecotrophs

Digested in intestines to provide:

  • Microbial protein
  • B and K vitamins
  • Fatty acids
44
Q

What do rodents still need even if eating caecotrophs?

A

B vitamins

45
Q

What will some oral antibiotics cause in rabbits/rodents?

A

Death due to reduction in intestinal bacteria allowing overgrowth of others

46
Q

What is gut stasis usually associated with in small furries?

A

Anorexia - can be potentially fatal

47
Q

What are some common causes of gut stasis?

A

Stress

Dehydration

Anorexia

Pain

Primary GI disease

Toxin ingestion

Insufficient Fibre

48
Q

When should primary GI disease be suspected with gut stasis in small furries?

A

History of poor diet

Dietary change

Abnormality palpable in gut

Onset preceded any development

Depression

Anorexia

49
Q

When should secondary GI disease be suspected with gut stasis in small furries?

A

History of stress

Obvious source of pain

50
Q

What should be done when a small furry presents with gut stasis after refining the problem?

A

Admit for supportive care and diagnostics

51
Q

What five things need to be provided when stabilizing the rabbit with gut stasis?

A

Warmth

Fluids

Nutrition

Gut stimulants

Analgesia

52
Q

What is the normal temperature for a rabbit?

A

38-39.5 ºC

53
Q

What is the maintenance fluids for a rabbit?

A

<100ml/kg/day

54
Q

How is fluid therapy often divided with rabbits?

A

Between IV and SC to reduce frequency

55
Q

What fluid therapy is provided for rabbits with gut stasis?

A

Warm subcutaneous fluids with added hyaluronidase

56
Q

Describe rabbit nutrition when supplied with gut stasis

A

50ml/kg/day split between 3-5 feeds if completely anorexic

Time and patience required

Nasogastric tube placement sometimes necessary

57
Q

Describe cisapride use

A

Works on serotonin receptors

Indirectly stimulates Ach release

Works on:

  • Oesophagus
  • Stomach
  • Small intestine
  • Colon

More potent than metoclopramide

58
Q

Why is gut stasis always a risk?

A

Gut stasis causes pain which causes gut stasis which causes pain etc.

59
Q

What analgesia should be provided to rabbits with gut stasis?

A

NSAIDs (meloxicam) - <0.6mg/kg q12 hrs, ensure well hydrated and consider gastro-protectants

Opiods (buprenorphine) - <0.05mg/kg q6-8 hrs

60
Q

When is surgery required with gut stasis?

A

Obstruction indicated by:

  • Visualised foreign body
  • Gastric dilation
  • Gas shadows in small intestine
  • Serial radiographs to see gas movement
61
Q

When are blood tests indicated with rabbits?

A

If systemic disease suspected (renal failure, hepatic disease etc.)

62
Q

What can indicate the severity of a condition on blood tests in rabbits?

A

Elevated glucose levels

63
Q

What are some common causes of diarrhoea in rabbits?

A

Coccidiosis

Diet

Antibiotics

Post-weaning

Bacterial enteritis

Viral enteritis

64
Q

What things can be used to diagnose the cause of diarrhoea in rabbits?

A

Faecal parasitology

Faecal microbiology

Abdominal imagining

Bloods

65
Q

What four things should be provided to a rabbit with diarrhoea?

A

Warmth

Fluids

Nutrition

Analgesia

66
Q

Describe large bowel diarrhoea

A

Small volume

Lots of mucus

Frequent

Tenesmus

Dyschezia

Little weight loss

Little vomiting

No change in general condition

Alimentary - Diarrhoea (3 decks)

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