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Smallies 3 Flashcards

1
Q

What anti-emetics can be used for management of a parvo case?

A

Metoclopramide
Maropitant
Ondansetron/Dolasetron

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2
Q

Why are antacids and ulcer coating medications used in the management of parvo cases?

A

Severe gastritis can develop alone with reflux oesophagus and strictures

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3
Q

How can you prevent canine parvovirus

A

Vaccination

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4
Q

What are differentials for haemorrhagic gastroenteritis?

A

Parvovirus enteritis
Intussusception
Pancreatitis

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5
Q

What are clinical signs of haemorrhagic gastroenteritis?

A

Vomiting +/- blood
Foetid diarrhoea including protein loss
Depression
Anorexia

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6
Q

What are signs of haemorrhagic gastroenteris on haematology and biochemistry?

A

Haemoconcentration
Hypovolaemia (fluid shift into GIT) before dehydration becomes apparent
High PCV
No leucopaenia (cf parve)

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7
Q

What is the treatment for haemorrhagic gastroenteritis?

A

Aggressive fluid therapy
Colloid/plasma/whole blood
Antimicrobials (amoxiclav, metronidazole, fluoroquinolone)

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8
Q

What is the prognosis for haemorrhagic gastroenteritis?

A

Good in most cases however severe cases where proteins are low and systemic inflammatory response develops the prognosis is guarded

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9
Q

What is feline panleucopenia?

A

Feline parvovirus

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10
Q

How does coronavirus cause pathology?

A

Mild villus destruction - enterocytes at tips

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11
Q

Which dogs often get campylobacter bacterial enteritis?

A

Commensal
Young dogs
Immunocompromised
Ones with additional infectious agents (giarda, parvo etc)

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12
Q

What are clinical signs of Campylobacter?

A 
Diarrhoea +/- blood/mucus
Vomiting
Straining
Fever
Abdominal pain
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13
Q

How can campylobacter be diagnosed?

A

Faceal stain/culture
Fragile therefore best isolated from fresh faeces
Standard culture may be misleading as speciation is not performed –> need PCR

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14
Q

How is campylobacter treated?

A

4-fluoroquinolones (can use erythromycin but this can lead to vomiting)

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15
Q

What are the 4 scenarios of a salmonella infection?

A

Transient aymptomatic diarrhoea
Acute gasatroenteritis
Carrier state
Bacteraemia

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16
Q

What are features of severe Salmonella gastroenteritis?

A

Haemorrhagic diarrhoea
Pyrexia
Sepsis

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17
Q

What are negative prognostic indicators of a salmonella infectoin?

A

Hypoglycaemia
Temp >40
Degenerate left shift

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18
Q

What happens with ‘songbird’ fever in cats?

A

Caused by ingestion of birds that can lead to acute febrile illness with diarrhoea

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19
Q

Hoe does Clostridial enteritis generally cause diarrhoea?

A

Enterotoxin production

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20
Q

How is Clostrial enteritis treated?

A

Metronidazole

ampicillin and tylosin alternatives

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21
Q

What nematodes can cause diarrhoea in dogs?

A 
Toxocara canis
Toxascaris leonina
Uncinaria stenocephala
Ancylostoma canium
Trichuris vulpis
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22
Q

What nemetodes can cause diarrhoea in cats?

A

Toxocara cati
Toxascaris leonina
Ancylostoma tubaeforme

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23
Q

What are clinical signs of an Ascarid infection?

A

Fail to gain weight
Pot-bellied appearance
Vomiting and small bowel diarrhoea

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24
Q

What are clinical signs of a Hookworm infection?

A 
Diarrhoea
Weight loss
Anemia
Interdigital dermatitis
Perineal irritation
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25
Q

What dogs are often infected with Hookworm?

A

Kenneled dogs

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26
Q

What is the diagnosis of a Helminth infection based on?

A

Clinical signs
History
Faecal examination

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27
Q

How can you diagnose a Coccidia infection in dogs and cats?

A

Faecal exam - direct or floatation for oocysts

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28
Q

What is the treatment for a Coccidia infection?

A

Mild cases are self limiting
Removal of underlying cause
Sulphonamides or potenitated sulphonamides
Toltrauril and diclazuril can also be effective

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29
Q

How can you diagnose a Cryptosporidium infection in cats and dogs?

A

Faecal smear
IFA
PCR

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30
Q

What is the treatment for a Cryptosporidium infection in dogs and cats?

A

Self-limiting unless there is an underlying cause

Antibiotics are of limited benefit

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31
Q

How are protozoal infections transmitted?

A

Faeco-oral route

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32
Q

How is a Giardia infection diagnosed in dogs and cats?

A 
Faecal smear evalulatoin (direct or floatation)
SNAP test (ELISA) is available
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33
Q

What is the treatment for a Giardia infection?

A

Fenbedazole for 3-5 days (licensed)
Metronidazole, ronidazole, tinidazole
Dietary manipulation

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34
Q

How is a Tritichomonas infection diagnosed in dogs and cats?

A

Microscopy
Culture
PCR

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35
Q

What do you need to ask when collecting the general history for a SI disease case?

A 
Vaccination and worming status
Scavenging, diet, drugs
Contact with other animals and environment
Recent travel history
Health of owners - zoonoses
Previous illness/surgeries
Other body systems involved
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36
Q

What do you need to establish about the SI disease when asking the owner?

A

Duration, progression, severity, frequency
Continuous or intermittent plus length of intervening normality
Response to treatment and diet
Which arose first (V or D)

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37
Q

What characteristics about the V/D do you need to ask the owner about?

A 
Urgency/straining
Blood (melaena/digested or haematochezia/fresh)
Mucus
Frequency
Faecal volume
Weight loss
Steatorrhoea
Flatulence/borborygmi
Bloating
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38
Q

What might you be looking for on your clinical exam of a SI disease case?

A

Dehydration/CVS status
Evidence for oral ulceration/FB
Palpable thyroid in cats/dogs
Thoracic ascultation - dull with effusions
Cardiac - abnormalities if hypoadrenocorticsim/cardiac disease
Abdomen - pain, focal mass/intestinal bunching, fluid, faeces - may need dog to stand on hindlegs to get better access to abdomen
Rectal - foreign material, mucosal friability
Cutaneous exam - food sensitivity, poor coat condition

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39
Q

What are the 3 main outcomes from history/clinical exam findings? And what will you do?

A

Not worried - manage consequences of diarrhoea
Not sure - screen
Worried - investigate

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40
Q

What is hypertonic water loss characterised by?

A

Increased motility and secretion, with decreased absorption

Loss of sodium (often as bicarb)`

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41
Q

What symptomatic therapy can be given to patients with SI disorders?

A

Adsorbants e.g. Kaolin
Bulk forming agents e.g. Peridale
Pre and probiotics e.g. Lactulose (pre) or Canikur Pro (combined product - synbiotic)
Anti-motility e.g. Opiates or Spasmolytics
Prokinetics e.g. Metaclopromide
Antimicrobials

42
Q

How do adsorbants work?

A

Alter intestinal flora/bind flora
Coat or protect mucosa
Absorb toxins
Bind water and possible antisecretory

43
Q

How do bulk forming agents work?

A

Granules containing sterculia which take up as much as 60x its own volume of water, forming a gelatinous mass
Increases the bulk of the intestinal contents, promote peristalsis and help to ensure the easy passage of soft stool

44
Q

How do prokinetics work?

A

Coordinate motility

Reduce ileus if present

45
Q

When are antimicrobials indicated in SI disorders?

A

Helicobacter
Definitively diagnosed infectious diarrhoea
Loss of GI integrity
Neutropenia/immunosuppresion e.g. parvo cases

46
Q

What is the minimum database of information you need to obtain for SI disorders? And what are you looking for?

A

Biochemistry (including electrolytes)
- renal parameters (azotaemia or GI bleeding)
- liver parameters (bile acids, ammonia, low urea, bilirubin)
- proteins (low albumin/globulin)
- electrolytes (K, Na, Cl)
Haematology
- RBC (anaemia, polycythaemia, toxic change)
- WBC (lymphocytosis/paenia, neutrophilia/paenia, esinophilia)
Urinalysis
- USG (dehydration)
- bilirubin (liver dz)
- glucose (stress, endocrinopathies, tubular disease)
- cast (renal dz)
- proteinuria (systemic inflammation/GN)

47
Q

What are causes of chronic diarrhoea?

A 
SIBO/ARD
EPI
Food responsive diarrhoea
IBD
Lymphangiectasia
Neoplasia
48
Q

What is SIBO/ARD?

A

Small intestinal bacterial overgrowth/antibiotic resistance diarrhoea

49
Q

What are causes of SIBO/ARD?

A

Decreased gastric acid production (atrophic gastritis/antacids)
Increased SI substrates (EPI/malabsorptive dz)
Partial obstructions (strictures/neoplasia)
Anatomic disorders (resection of ileal valve/blind loops)
Motility disease
Hypothyroidism

50
Q

What are the consequences of secondary bacterial overgrowth?

A

Utilise nutrients/interfere with absorption
Damage epithelium and microvillar enzyme dysfunction
Increase mucosal permeability/fluid loss
Deconjugate bile acids
Hydroxylate fatty acids
Stimulate colonocyte secretion

51
Q

What are clinical signs of ARD/SIBO?

A 
Chronic small bowel diarrhoea
Weight loss/failure to thrive
Vomiting
Borborygmus
Appetite changes
52
Q

How is SIBO/ARD diagnosed?

A

History
Response to antibiotics if ruled out other underlying causes
Serum folate/B12 (cobalamin) to localise disease
- folate absorbed in proximal SI
- B12 absorbed in distal SI
Bacteria synthesis folate and bind B12
Breath hydrogen testing
Circulating unconjugated bile acids (no longer recommended)

53
Q

How is SIBO/ARD treated?

A

Treatment of primary cause

Antibiotics for 4-6 weeks, review after 2 weeks as you may need to change the type

54
Q

What are ancillary treatment approaches used for SIBO/ARD?

A

Dietary manipulation - highly digestable diet and low fat
Prebiotics - alter colonic flora (cats not dogs)
Probiotics - unsure of benefit
Cobalamin supplementation - essential to improve recovery rates

55
Q

What is the aetiology of food responsive diarrhoea?

A

Adverse reaction to food category

Sub-category of IBD

56
Q

How is food response diarrhoea diagnosed?

A

Response to food trial

Inflammation can be determined with biopsy

57
Q

What is IBD?

A

Inflammatory bowel disease is an idiopathic condition that is not responsive to diet or antibiotics

58
Q

What is the typical signalment and clinical signs of IBD?

A 
Mainly middle aged animals
Vomiting
- more common in cats
- can be haemorrhagic
Weight loss
Variable appetite
Abdominal discomfort
59
Q

How is IBD diagnosed?

A 
History
Clinical signs
Physical exam 
Rule out other DDx
Diagnostic imaging
Biopsy
60
Q

Discuss use of biopsy in the diagnosis of IBD?

A

Can be done before or after treatment
Duodenum often has significant changes in 30% of cases
Ileum has significant changes in 30% of cases

61
Q

What are DDx of eosinophilic enteritis?

A 
Endoparasitism
Hypersensitivity disorders
MCT/paraneoplastic disease
Hypoadrenocorticism
Hypereosinophilic syndrome in Rottweilers or cats
62
Q

What is the feline triaditis complex?

A

IBD, pancreatitis, and cholangiohepatitis

63
Q

What are baseline tests fo triaditis?

A 
CBC 
Biochemistry
Urinalysis
Serum T4 concentrations
FeLV/FIV test
64
Q

What is the standard management of IBD cases?

A 
Dietary manipulation
Antiparasiticides e.g. Fenbendazole
Vitamin supplementations e.g. Cobalamin
Antibiotics e.g. Oxytetracycline
Immunosuppressive therapies e.g. Prednisolone
Pre/pro biotics
65
Q

What is lymphangiectasia?

A

Pathologic dilation of lymph vessels in the intestine

66
Q

What can lymphangiectasia be secondary to?

A

Generalised primary conditions of lymphatics e.g. breed predispositions or lipogranulomatous changes
Blocked C. chyli/thoracic duct

67
Q

what is the outcome of lymphangiectasia?

A

Lipid malabsorption - chronic small bowel diarrhoea

  • PLE
  • dramatic weight loss
  • protein-rich ascites
68
Q

What is the diagnostic approach to lymphangiectasia?

A

Bloods - low albumin/globulin/cholesterol/WBC/Ca/Mg
Ultrasound - mucosal striations
Endoscopy - white spots on villus tips, white nodules or plaques
Biopsy

69
Q

What is the treatment for lymphangectasia?

A 
Treat primary cause e.g. neoplasia, IBD
Ultra low-fat diet
Fluid therapy
Albumin/colloid for hypoproteinaemia
Diuretic for effusions
70
Q

What are examples of intestinal tumours?

A 
Lymphoma
Adenocarcinoma
Leiomyoma/leiomyosarcoma
MCT
Fibrosarcoma
Haemangiosarcoma
71
Q

What are risks of focal intestinal tumours?

A

Obstructions

72
Q

What are the clinical signs of gapeworm in chickens?

A

Coughing
Emaciation
Weakness
Gaping

73
Q

What is the diagnosis of gapeworm?

A

PM examination
Faecal egg cout
Clinical signs

74
Q

What are DDx for gapeworm?

A

Mycoplasmosis

Aspergillosis

75
Q

What is the treatment and management for gapeworm?

A

Flubendazole, levamisole, piperazine salts

76
Q

How can gapeworm be prevented?

A

Prevent contaminatino of feeders and drinkers with faeces
Pasture rotation
Regular treatment

77
Q

Where is Heterakis gallinarum found?

A

Caecum in the chicken

78
Q

What clinical signs are seen with caecal worms?

A 
Usually harmless with no clinical signs but it can carry black head (histomonus meleagridis)
Bright yellow diarrhoea
Dullness
Sudden death
Black head
79
Q

What is the diagnosis of caecal worm?

A

Adults seen in caecal contents at PM
Eggs seen in faeces
Clinical signs

80
Q

How are caecal worms treated?

A

Flubendazole

Levamisole

81
Q

How aare caecal worms prevented?

A

Never keep chickens and turkeys together

Worm flock every 3 months

82
Q

What species and organs are affected by hairworm (capillaria spp)

A

Chickens, turkeys, pigeons, wild birds

SI, crop, oesophagus

83
Q

How is hairworm transmitted?

A

Bird to bird

Earthworms can be intermediate hosts

84
Q

What are clinical signs of hairworm in birds?

A 
Diarrhoea
Anaemia
Hunched
Dull
Weight loss
Regurgitation
Oral necrotic plaques
Preduced egg production
85
Q

How is diagnosis of hairworm done?

A

Faecal floatation for eggs

PM to idenfiy GI epithelium enteritis

86
Q

When can fenbendazole be given to a pregnant bitch?

A

Used from day 40 til day 2 after whelping

87
Q

When is fenbendazole given to puppies?

A

2 weeks, 5 weeks at at weaning

Then monthly

88
Q

What is the function of the LI?

A

Fluid and electrolyte balance
Hosts a large population of bacteria
Faecal storage
No role in the absorption of nutrients (no villi)
Goblet cells prodcue mucis for lubrication

89
Q

Is weight loss a clinical feature of SI and LI disease?

A

SI - common

LI - rare

90
Q

What is faecal consistency like in SI and LI disease?

A

SI - watery, soft, bulky, undigested food, variable colour

LI - variable, colour unchanged

91
Q

What is the faecal volume like in SI and LI disease?

A

SI - increased

LI - normal or decreased

92
Q

Is borborygmi/flatulence a clinical feature of SI and LI disease?

A

SI - common

LI - absent

93
Q

What is the frequency of defaecation in SI and LI disease?

A

SI - 1-3x a day, increased urgency if severe or acute

LI - >6x a day with increased urgency

94
Q

Is tenesemus a clinical feature of SI and LI disease?

A

SI - aabsent

LI - present

95
Q

Is mucus a clinical feature of SI and LI disease?

A

SI - absent

LI - present

96
Q

IS blood a clinical feature of SI and LI disease?

A

SI - melaena

LI - fresh blood

97
Q

What are DDx for LI diarrhoea?

A 
Dietary indiscretion 
Inflammatory/colitis (IBD)
Infections
Secondary to fat maldigestion in the SI
Secondary to portal hypertension
Local irritation e.g. pancreatitis, mass, FB
Colonis polyps
Colonic neoplasia
Motility disorder
98
Q

What do you need to establish from the history of a LI disease case?

A 
Vaccination and worming history
Diet - changes, scavenging
Medication
In contacts affected
Previous or concurrent illness
99
Q

What should you llook for in a perineal exam?

A 
Perineal rupture
Wounds/swelling/mass
Faecal incontinence
Anal sac disease
Self trauma
Anal furunculosis
100
Q

What are you feeling for in a rectal exam?

A 
Rectal mucosa - smooth/rough or masses
Evidence of a stricture
Lumbar (medial iliac) LN
Prostate in males
Pelvic urethra (urethral calculs)

GI2 (27 decks)

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