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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
What are the differential diagnoses for **chronic large intestinal diarrhoea**?
IBD Polyps Food-responsive disease Neoplasia Chronic partial obstruction Tritrichomonas foetus
26
What are the various investigations for chronic diarrhoea?
Faecal exam Haematology, biochemistry, UA Serum tests (TLI, LPI cobalamin) Abdominal ultrasound Empiric treatment with elimination diet Biopses
27
Describe how biopsies are done via endoscopy
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
Describe biopsies taken via exploratory laparotomy
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
What are the four main causes for **chronic small intestinal diarrhoea** in the dog?
Food-responsive disease Antibiotic-responsive diarrhoea Inflammatory Bowel Disease Neoplasia
30
How is food-responsive disease treated?
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
What breed is antibiotic responsive diarrhoea most commonly seen in?
German Shepherd Dogs
32
What is the treatment for antibiotic responsive diarrhoea?
Metronidazole 15mg/kg orally twice daily for 4 weeks Usually relapse though
33
How is IBD diagnosed?
Clinical exclusion
34
What is the most common chronic enteropathy in dogs?
Inflammatory bowel disease
35
What are the three histopathologys of IBD?
Lymphoplasmacellular - most common Eosinophilic - rare Ulcerative colitis - only large intestine, rare in Boxers
36
What is the therapy for chronic enteropathies in dogs?
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
What is the terapy for IBD in cats?
Elimination diet Prednisolone 2mg/kg/day for 10-14 days then slow Chlorambucil if no response Supplementation with cobalamin
38
Define protein losing enteropathy and its causes
Syndrome of intestinal diseases with non-selective protein loss - low albumin and globulins Causes are IBD, lymphangiectasia and neoplasia
39
What can rabbits and rodents not do in regards to the GI tract?
Vomit
40
What is a vital dietary component of normal digestion of small furries?
**Indigestible fibre** * Stimulate gut motility and dental wear **Digestible fibre** * Fermented by GI bacteria to produce fatty acids
41
What controls the large intestinal motility of rabbits?
**Fusus coli** * Distal part of proximal colon
42
What happens to indigestible fibre and digestible fibre in rabbits?
Contractions separate indigestible fibre which is passed to produce pellets Digestible fibre washed back to caecum for fermentation
43
Describe caecotrophy
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
What do rodents still need even if eating caecotrophs?
B vitamins
45
What will some oral antibiotics cause in rabbits/rodents?
Death due to reduction in intestinal bacteria allowing overgrowth of others
46
What is gut stasis usually associated with in small furries?
Anorexia - can be potentially fatal
47
What are some common causes of gut stasis?
Stress Dehydration Anorexia Pain Primary GI disease Toxin ingestion Insufficient Fibre
48
When should primary GI disease be suspected with gut stasis in small furries?
History of poor diet Dietary change Abnormality palpable in gut Onset preceded any development Depression Anorexia
49
When should secondary GI disease be suspected with gut stasis in small furries?
History of stress Obvious source of pain
50
What should be done when a small furry presents with gut stasis after refining the problem?
Admit for supportive care and diagnostics
51
What five things need to be provided when stabilizing the rabbit with gut stasis?
Warmth Fluids Nutrition Gut stimulants Analgesia
52
What is the normal temperature for a rabbit?
38-39.5 ºC
53
What is the maintenance fluids for a rabbit?
\<100ml/kg/day
54
How is fluid therapy often divided with rabbits?
Between IV and SC to reduce frequency
55
What fluid therapy is provided for rabbits with gut stasis?
Warm subcutaneous fluids with added hyaluronidase
56
Describe rabbit nutrition when supplied with gut stasis
50ml/kg/day split between 3-5 feeds if completely anorexic Time and patience required Nasogastric tube placement sometimes necessary
57
Describe cisapride use
Works on serotonin receptors Indirectly stimulates Ach release Works on: * Oesophagus * Stomach * Small intestine * Colon More potent than metoclopramide
58
Why is gut stasis always a risk?
Gut stasis causes pain which causes gut stasis which causes pain etc.
59
What analgesia should be provided to rabbits with gut stasis?
NSAIDs (meloxicam) - \<0.6mg/kg q12 hrs, ensure well hydrated and consider gastro-protectants Opiods (buprenorphine) - \<0.05mg/kg q6-8 hrs
60
When is surgery required with gut stasis?
Obstruction indicated by: * Visualised foreign body * Gastric dilation * Gas shadows in small intestine * Serial radiographs to see gas movement
61
When are blood tests indicated with rabbits?
If systemic disease suspected (renal failure, hepatic disease etc.)
62
What can indicate the severity of a condition on blood tests in rabbits?
Elevated glucose levels
63
What are some common causes of diarrhoea in rabbits?
Coccidiosis Diet Antibiotics Post-weaning Bacterial enteritis Viral enteritis
64
What things can be used to diagnose the cause of diarrhoea in rabbits?
Faecal parasitology Faecal microbiology Abdominal imagining Bloods
65
What four things should be provided to a rabbit with diarrhoea?
Warmth Fluids Nutrition Analgesia
66
Describe large bowel diarrhoea
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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