Small animal GI Learning objectives (6: acute diarrhea; 7: clin app to diarrhea; 8/9: chron diarrhea dx) Flashcards
1
Q
Classification of acute diarrhea
A
- self-resolving small bowel diarrhea
- life-threatening small bowel diarrhea
- self-resolving large bowel diarrhea
- life-threatening large bowel diarrhea - rare
* Do a fecal in all cases
2
Q
Infectious causes of acute diarrhea
A
Parasites, bacteria, virus
- whipworms - large bowel diarrhea
- tritrichomonas - large bowel diarrhea in cats
- hookworms
- more severe diarrhea + anemia
- Salmonella and Campylobacter
- salmonella considered when on raw food diet
- Clostridium
3
Q
Causes of Acute diarrhea
A
- infectious
- hemorrhagic gastroenteritis
- obstructive
- toxin and drug-induced
- dietary
- extraintestinal
4
Q
Pathogenesis of canine parvovirus
A
- very contagious (dogs and cats)
- attacks rapidly dividing cells
- some breeds more susceptible: dobies, rotties
- caused by epitheliotropic enterovirus
- Type 1 parvo: abortion
- Type 2 parvo: severe enteritis, FeLeuk
- four evolving subtypes
- tx fecal-oral, hard to kill
- subclinical infections with shedding possible
- Morbidity: 20-90%; mortality: 0-50%
5
Q
Clinical signs of parvo
A
- leukopenia
- dehydration
- diarrhea
- vomit
- fever
- abd pain
- anorexia
- lethargy
6
Q
DX parvo
A
- EM of fresh feces
- histopath of intestines
- Tissue immunofluorescence
- Fecal ELISA
- viral load may be too low if clinical signs are very advanced
- recently vaccinated patient (with mod live vacc) will test positive
7
Q
TX parvo
A
- isolate
- replacement fluid therapy
- plasma for coag issues or anemia
- parenteral abx
- cephalosporin or aminoglycoside
- anti-emetics
- tamiflue
- NPO till zero puke for 24 hours
- liquid diet during vx/diarrhea
- control parasites
8
Q
Prevention parvo
A
- immunity for 20mo to 1 yr post infection
- VACCINATION
9
Q
Clinical signs HGE
A
- common in 2-4 yr olds, minis and toys
- depression, vx +/- blood, diarrhea (dysentary)
- dehydration, tachycardia, +/- N skin turgor
- severely inc PCV > 60%, normal TP
- thrombocytopenia and metabolic acidosis
- usually a one-time episode
10
Q
TX HGE
A
- Fluids and electrolytes
- antiemetics
- +/- abx
- stop food and water
- feed 12-24 hours after resolution clin signs
- recovery usually in 1-2 days
11
Q
eleven aspects to eval in chronic diarrhea patient
A
- duration
- diet
- progression
- appetite (inc, ravenous, pica)
- weight loss: SI
- appearance of feces
- large volume: SI
- small volume: LI
- frequency of defecation
- near normal: SI
- inc: LI
- urgen: LI
- presence of vomiting: usually upper, can be any
- tenesmus: involvement of distal rectum, colon or anus
- environment animal stays in
- parasites, working animals, indoor/outdoor, recent change, boarding, travel
- animals breed and character
- GSD and EPI
12
Q
Small bowel dz
Feces
Defecation
Other
A
- Feces
- normal to inc volume
- mucus rare
- melena rare
- Defecation
- urgency uncommon
- tenesmus absent
- frequency normal to mild inc
- dyschezia increased (2-3x)
- Other
- weight loss common
- vomiting can occur
- flatulence can occur
- halitosis can occur
13
Q
Large bowel dz
Feces
Defecation
Other
A
- Feces
- normal or decreased
- mucus common
- hematochezia common
- Defecation
- urgency common
- tenesmus common
- frequency moderately to severely increased
- dyschezia increarsed (> 3x)
- Other
- weight loss rare
- vomiting uncommon
- flatulence absent
- halitosis absent
14
Q
Diagnostic approach to chronic diarrhea patient
A
- Complete fecal exam (macro and micro)
- cobalamin/folate
- imaging
- biopsy
- diet trial
15
Q
comp of complete fecal exam
A
- centrifugation
- saline smear (mobile things)
- cytology
- culture (not great)
- check for C. Perfringens (can be normal)
- Giardia and Tritrichomonas (ELISA)
- IDEXX PCR panel
