Small Mammal GI Disease Flashcards
What kind of digestive system do small herbivores have?
How does their GI transit time differ to monogastrics?
Hindgut fermentation
Faster GI transit time
Can rabbits and rodents vomit?
No
What dietary component is essential for small herbivore gut motility?
Fiber
How do small herbivores process food “twice”? What benefit does this have?
Cecotrophy - eat droppings to process them again to gain maximal nutritional value
What is the PLACE rule? List these medications
Antibiotics that you should never give orally to small herbivores because they come with VERY high risk
- Penicillins
- Lincosamides
- Aminoglycosides
- Cephalosporins
- Erythromycins
How can aminoglycosides be used safely in small mammals?
can be used topically (not absorbed that way) - never orally
How can you remember which Medications are appropriate to use For Treating Small Mammals?
Medications For Treating Small Mammals?
Metronidazole
Fluoroquinolones
Tetracyclines
Sulphonamides
Macrolides
Which macrolide is not appropriate for use in small mammals?
Erythromycin
Which group of antibiotics is commonly used in small mammals?
Fluoroquinolones
What are the factors which can cause gut stasis in small mammals?
What are the factors which can cause diarrhea in small mammals?
What is gut stasis in small mammals?
inadequate digestion - not a diagnosis
Usually associated with anorexia
Can have potentially fatal consequences if left untreated
What is very important to note on physical exam of a patient experiencing gut stasis?
Mouth/teeth/gums - look for evidence of overgrowth or issues with conformation
Watch animal from a distance and see how they act naturally
Listen to gut sounds
List primary vs secondary GI disease signs associated with gut stasis in small mammals?
Primary GI Disease should be strongly suspected if:
- Hx of poor diet/recent dietary change
- An abnormality is palpable in the gut (Ex. foreign body)
- The onset of gut stasis preceded any development of signs of
malaise (depression and/or anorexia)
Secondary GI Disease may be suspected if:
- History of stress
- Obvious source of pain (Ex. dental disease)
Why might an animal in severe pain look bright and alert in the clinic?
Prey animals - need to look ok in order to survive
What are the steps of stabilizing an animal with gut stasis?
- Oxygen
- Warmth
- Fluids
- Nutrition
- Analgesia
+/- Prokinetics? (Stimulate gut to move more)
- If first 5 steps are done properly, not necessary to give prokinetics!
What is the normal temperature range for a rabbit?
38-39.5C
Do rabbits have a lower or higher BMR compared to dogs and cats? How should you adjust the fluid rate to compensate for this?
Higher MBR in rabbits
Need to double fluid rate
What is the typical maintenance fluid rate for rabbits with gut stasis? What kind of fluids should you give (plus what additive and why)?
100 ml/kg/day
Warm SQ fluids + hyaluronidase 1500IU/L
Hyaluronidase aids distribution/absorption of fluids throughout the body
Why is nutrition so important for rabbits with gut stasis? How much should you feed a patient if completely anorexic? What should the entire team know how to do in terms of feeding the patient?
Important because the patient needs to be getting nutrition and encouraging gut motility
Feed patient 50 ml/kg/day split between 3-5 feeds
- NG tube placement occasionally necessary
Important that whole team is aware of how to feed the patient properly
What are the pharmacological options for analgesia in small mammals with GI disease?
NSAIDs - Meloxicam
Opioids - Buprenorphine
Metoclopramide
Ranitidine
Cisapride
What kind of medication is Meloxicam?
What is the dosing? What other medication should you consider giving in conjunction?
NSAIDs - Meloxicam
- < 0.6mg/kg q12hrs, Ensure well-hydrated
- Consider gastroprotectant
What kind of medication is Buprenorphine?
What is the dosing?
What does this medication do to gut motility and why is it still ok to give in these patients?
Opioids - Buprenorphine
- < 0.05 mg/kg q6-8hrs
- Normally slows down guts, but if animal is in pain it treats the pain
rather than only slowing down guts
- Important to use for pain reduction (fewer side effects when
medication is actually doing its job)
What kind of medication is Metoclopramide?
Where does it work?
What effect does this medication have on gut motility?
- Anti-emetic
- Prokinetic + effects on Ach release, dopamine/serotonin receptors
- Works on esophagus, stomach and small intestine
- Little or no effect on colonic motility
What kind of medication is Ranitidine?
What is it used to treat?
Which receptors does it work on?
Where does it work and what effect does it have on colonic motility?
- Used for treatment of GI ulcers
- Works on histamine H2 receptors but also prokinetic due to effects
on acetylcholinesterase inhibition - Works on proximal GI tract but may stimulate colonic motility
What kind of medication is cisapride? Where does this medication work?
Is this medication more or less potent than metoclopramide?
- Prokinetic agent
- Works on serotonin receptors to indirectly stimulate Ach release
- Works on esophagus, stomach and small intestine
- More potent than metoclopramide
When is surgery required for gut stasis patients?
When obstruction is present
What are the indications that an obstruction is present?
- Visualization of foreign body
- Gastric dilation
- Gas shadows in the SI cranial to an obstruction
- Serial radiographs to check if gas is moving through to hindgut
Are blood tests indicated in gut stasis patients?
May be indicated if systemic disease suspected (renal, hepatic, lead/zinc levels)
Elevated glucose levels can indicate severity of condition
Can you define the lesion in every case of gut stasis? How do most cases resolve?
No - Most cases resolve with symptomatic treatment
When should GA be considered?
Consider GA for full oral exam and further imaging
How do you approach diarrhea in small mammals?
Same as in cats and dogs
What is important to distinguish from diarrhea in rabbits? How do you do this?
Cecotrophs - get a really good history, do a really good oral exam (teeth may be overgrown and rabbit might not be able to pick up cecotrophs to eat them)
How do you stabilize a rabbit with diarrhea?
Oxygen
Warmth
Fluids
Nutrition
Analgesia
How do you treat coccidia in rabbits?
Trimethoprim-sulphonamide
Toltrazuril
What is cholestyramine and how is it used for diarrhea?
binds enterotoxins
Are antibiotics indicated? Probiotics?
Abx only indicated for bacterial enteritis (metronidazole)
Probiotics do no harm
