Small Animal Diarrhoea Flashcards
What are the different ways diarrhoea can be defined/refined?
Acute vs. chronic and small intestine vs. large intestine
What is important to note if the diarrhoea is acute?
The presence of other clinical signs that may indicate the presence of disease
What type of diarrhoea does melaena indicate?
Small intestinal or upper gi bleeding as it indicates digested blood.
When is diarhoea defined as chronic?
When it has lasted for 3 weeks or more
What are the ways in which small intestinal diarrhoea is differentiated from large intestinal and how is the diagnostic approach fundamentally different?
n.b. si diarrhoea can have GI or extra GI causes whereas LI diarrhoea is pretty much always confined to problems with the colon
What are the following diarrhoea types?
A) Large Intestinal
B) Most likely small but worth asking other questions at history to be certain. As it could be both!
What are the DDx for acute SI diarrhoea with no systemic signs?
What is a possible treatment protocol?
- Diet
- Helminths
- Protozoa
- Iatrogenic
Fasting is an appropriate method in dogs, cats can’t tolerate fasting for too long so bear this in mind.
List the DDx for acute SI diarrhoea with systemic signs. Describe the work up for each group.
- Bacterial
- Salmonella
- Campylobacter —–Faecal culture
- Viral
- Distemper
- Parvo ——Faecal Ag tests
- Fpv
- Toxins ——history?
- Heamorrhagic gastroenteritis (dogs) —-high PCV and dehydration signs
- Acute Pancreatitis —ultrasound and pancreatic lipase
What are the differentials for acute LI diarrhoea?
How would you work these up?
- Clostridia
- Whipworms
- Giardia
- Campylobacter
Faecal culture and examination
What are the most common extra-GI causes of chronic small intestinal diarrhoea?
- Metabolic
- Hepatic disease (Portosystemic shunts)
- Hyperthyroidism (cats)
- Addisons (dogs)
- Renal Insufficiency
- Pancreatic
- EPI
- Chronic Pancreatitis
What are the most common DDx for Primary small intestinal diarrhoea?
- Giardia
- Chronic partial obstruction
- Lymphangiectesia
- Neoplasia (Lymphosarcoma)
- Food-responsive disease
- IBD
- Will see lympho-plasmacellular inflammation
What are the DDx for chronic large intestinal diarrhoea?
- IBD
- Lympho-plasmacellular
- Ulcerative colitis
- Polyps
- Food responsive disease
- Neoplasia
- Chronic partial obstruction
- Tritrichomonan foetus (cats)
Outline the investigatic approach for chronic diarrhoea.
- Feacal exam
- Bloods and urinanalyis
- SI : consider serum tests e.g. TLI, PLI
- Abdominal ultrasound
- Elimination diet treatment
- Biopsies
Is a full thickness biopsy approach (i.e. ex lap) neccesary?
No, in fact it is a lot more dangerous than endoscopy and LI biopsies should not really be taken by this method. Cats don’t do well after this type of surgery.
How is food-responsive diarrhoea treated?
Elimination or hydrolysed diet for 6-8 weeks. The animal should respond within the first 2 weeks. Have to be very strict and not give treats!
When are you likely to see antibiotic responsive diarrhoea? Should ABs be administered?
In young German Shepherd Dogs. Metronidazole 15mg/kg po bid is the dosage for 4 weeks. However there is often relapse so it is likely ABs would be required long time which is not good in terms of AB resistance.
How is IBD diagnosed?
By clinical exclusion
What lesions are associated with IBD?
Lympho-plasmacellular
Eosinophilic (rare)
Ulcerative colitis
Outline the treatment protocol for IBD in dogs
Elimination diet
Metronidazole 10-15mg/kg bid 3-4 weeks
then if neccesary: prednisolone 2.2mg/kg/d for 10 days then taper dose
azathioprine or cyclosporine is prednisolone unsuccessful.
Outline the treatment protocol for IBD in cats.
Elimination diet (harder in cats)
prednisolone 2mg/kg/d for 10-14d then taper
chlorambucil if unsuccessful
Cobalmin supplementation is key to success.
Describe the clinical picture of a dog with protein losing enteropathy.
How is it diagnosed?
Diarrhoea, vomiting, annorexia and weight loss
Low TP both albumin and globulins
Third spacing
Biopsy is very important early on!
