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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
What dogs are often infected with Hookworm?
Kenneled dogs
26
What is the diagnosis of a Helminth infection based on?
Clinical signs History Faecal examination
27
How can you diagnose a Coccidia infection in dogs and cats?
Faecal exam - direct or floatation for oocysts
28
What is the treatment for a Coccidia infection?
Mild cases are self limiting Removal of underlying cause Sulphonamides or potenitated sulphonamides Toltrauril and diclazuril can also be effective
29
How can you diagnose a Cryptosporidium infection in cats and dogs?
Faecal smear IFA PCR
30
What is the treatment for a Cryptosporidium infection in dogs and cats?
Self-limiting unless there is an underlying cause | Antibiotics are of limited benefit
31
How are protozoal infections transmitted?
Faeco-oral route
32
How is a Giardia infection diagnosed in dogs and cats?
``` Faecal smear evalulatoin (direct or floatation) SNAP test (ELISA) is available ```
33
What is the treatment for a Giardia infection?
Fenbedazole for 3-5 days (licensed) Metronidazole, ronidazole, tinidazole Dietary manipulation
34
How is a Tritichomonas infection diagnosed in dogs and cats?
Microscopy Culture PCR
35
What do you need to ask when collecting the general history for a SI disease case?
``` 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 ```
36
What do you need to establish about the SI disease when asking the owner?
Duration, progression, severity, frequency Continuous or intermittent plus length of intervening normality Response to treatment and diet Which arose first (V or D)
37
What characteristics about the V/D do you need to ask the owner about?
``` Urgency/straining Blood (melaena/digested or haematochezia/fresh) Mucus Frequency Faecal volume Weight loss Steatorrhoea Flatulence/borborygmi Bloating ```
38
What might you be looking for on your clinical exam of a SI disease case?
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
39
What are the 3 main outcomes from history/clinical exam findings? And what will you do?
Not worried - manage consequences of diarrhoea Not sure - screen Worried - investigate
40
What is hypertonic water loss characterised by?
Increased motility and secretion, with decreased absorption | Loss of sodium (often as bicarb)`
41
What symptomatic therapy can be given to patients with SI disorders?
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
How do adsorbants work?
Alter intestinal flora/bind flora Coat or protect mucosa Absorb toxins Bind water and possible antisecretory
43
How do bulk forming agents work?
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
How do prokinetics work?
Coordinate motility | Reduce ileus if present
45
When are antimicrobials indicated in SI disorders?
Helicobacter Definitively diagnosed infectious diarrhoea Loss of GI integrity Neutropenia/immunosuppresion e.g. parvo cases
46
What is the minimum database of information you need to obtain for SI disorders? And what are you looking for?
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
What are causes of chronic diarrhoea?
``` SIBO/ARD EPI Food responsive diarrhoea IBD Lymphangiectasia Neoplasia ```
48
What is SIBO/ARD?
Small intestinal bacterial overgrowth/antibiotic resistance diarrhoea
49
What are causes of SIBO/ARD?
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
What are the consequences of secondary bacterial overgrowth?
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
What are clinical signs of ARD/SIBO?
``` Chronic small bowel diarrhoea Weight loss/failure to thrive Vomiting Borborygmus Appetite changes ```
52
How is SIBO/ARD diagnosed?
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
How is SIBO/ARD treated?
Treatment of primary cause | Antibiotics for 4-6 weeks, review after 2 weeks as you may need to change the type
54
What are ancillary treatment approaches used for SIBO/ARD?
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
What is the aetiology of food responsive diarrhoea?
Adverse reaction to food category | Sub-category of IBD
56
How is food response diarrhoea diagnosed?
Response to food trial | Inflammation can be determined with biopsy
57
What is IBD?
Inflammatory bowel disease is an idiopathic condition that is not responsive to diet or antibiotics
58
What is the typical signalment and clinical signs of IBD?
``` Mainly middle aged animals Vomiting - more common in cats - can be haemorrhagic Weight loss Variable appetite Abdominal discomfort ```
59
How is IBD diagnosed?
``` History Clinical signs Physical exam Rule out other DDx Diagnostic imaging Biopsy ```
60
Discuss use of biopsy in the diagnosis of IBD?
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
What are DDx of eosinophilic enteritis?
``` Endoparasitism Hypersensitivity disorders MCT/paraneoplastic disease Hypoadrenocorticism Hypereosinophilic syndrome in Rottweilers or cats ```
62
What is the feline triaditis complex?
IBD, pancreatitis, and cholangiohepatitis
63
What are baseline tests fo triaditis?
``` CBC Biochemistry Urinalysis Serum T4 concentrations FeLV/FIV test ```
64
What is the standard management of IBD cases?
``` Dietary manipulation Antiparasiticides e.g. Fenbendazole Vitamin supplementations e.g. Cobalamin Antibiotics e.g. Oxytetracycline Immunosuppressive therapies e.g. Prednisolone Pre/pro biotics ```
65
What is lymphangiectasia?
Pathologic dilation of lymph vessels in the intestine
66
What can lymphangiectasia be secondary to?
Generalised primary conditions of lymphatics e.g. breed predispositions or lipogranulomatous changes Blocked C. chyli/thoracic duct
67
what is the outcome of lymphangiectasia?
Lipid malabsorption - chronic small bowel diarrhoea - PLE - dramatic weight loss - protein-rich ascites
68
What is the diagnostic approach to lymphangiectasia?
Bloods - low albumin/globulin/cholesterol/WBC/Ca/Mg Ultrasound - mucosal striations Endoscopy - white spots on villus tips, white nodules or plaques Biopsy
69
What is the treatment for lymphangectasia?
``` Treat primary cause e.g. neoplasia, IBD Ultra low-fat diet Fluid therapy Albumin/colloid for hypoproteinaemia Diuretic for effusions ```
70
What are examples of intestinal tumours?
``` Lymphoma Adenocarcinoma Leiomyoma/leiomyosarcoma MCT Fibrosarcoma Haemangiosarcoma ```
71
What are risks of focal intestinal tumours?
Obstructions
72
What are the clinical signs of gapeworm in chickens?
Coughing Emaciation Weakness Gaping
73
What is the diagnosis of gapeworm?
PM examination Faecal egg cout Clinical signs
74
What are DDx for gapeworm?
Mycoplasmosis | Aspergillosis
75
What is the treatment and management for gapeworm?
Flubendazole, levamisole, piperazine salts
76
How can gapeworm be prevented?
Prevent contaminatino of feeders and drinkers with faeces Pasture rotation Regular treatment
77
Where is Heterakis gallinarum found?
Caecum in the chicken
78
What clinical signs are seen with caecal worms?
``` Usually harmless with no clinical signs but it can carry black head (histomonus meleagridis) Bright yellow diarrhoea Dullness Sudden death Black head ```
79
What is the diagnosis of caecal worm?
Adults seen in caecal contents at PM Eggs seen in faeces Clinical signs
80
How are caecal worms treated?
Flubendazole | Levamisole
81
How aare caecal worms prevented?
Never keep chickens and turkeys together | Worm flock every 3 months
82
What species and organs are affected by hairworm (capillaria spp)
Chickens, turkeys, pigeons, wild birds | SI, crop, oesophagus
83
How is hairworm transmitted?
Bird to bird | Earthworms can be intermediate hosts
84
What are clinical signs of hairworm in birds?
``` Diarrhoea Anaemia Hunched Dull Weight loss Regurgitation Oral necrotic plaques Preduced egg production ```
85
How is diagnosis of hairworm done?
Faecal floatation for eggs | PM to idenfiy GI epithelium enteritis
86
When can fenbendazole be given to a pregnant bitch?
Used from day 40 til day 2 after whelping
87
When is fenbendazole given to puppies?
2 weeks, 5 weeks at at weaning | Then monthly
88
What is the function of the LI?
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
Is weight loss a clinical feature of SI and LI disease?
SI - common | LI - rare
90
What is faecal consistency like in SI and LI disease?
SI - watery, soft, bulky, undigested food, variable colour | LI - variable, colour unchanged
91
What is the faecal volume like in SI and LI disease?
SI - increased | LI - normal or decreased
92
Is borborygmi/flatulence a clinical feature of SI and LI disease?
SI - common | LI - absent
93
What is the frequency of defaecation in SI and LI disease?
SI - 1-3x a day, increased urgency if severe or acute | LI - >6x a day with increased urgency
94
Is tenesemus a clinical feature of SI and LI disease?
SI - aabsent | LI - present
95
Is mucus a clinical feature of SI and LI disease?
SI - absent | LI - present
96
IS blood a clinical feature of SI and LI disease?
SI - melaena | LI - fresh blood
97
What are DDx for LI diarrhoea?
``` 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
What do you need to establish from the history of a LI disease case?
``` Vaccination and worming history Diet - changes, scavenging Medication In contacts affected Previous or concurrent illness ```
99
What should you llook for in a perineal exam?
``` Perineal rupture Wounds/swelling/mass Faecal incontinence Anal sac disease Self trauma Anal furunculosis ```
100
What are you feeling for in a rectal exam?
``` 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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