Smallies GI Flashcards

1
Q

How does intestinal transit time of small herbivores differ to other hidgut fermenters?

A

Faster GI transit time to stay light and escape predators more efficiently

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2
Q

Can rabbits and rodents vomit?

A

No

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3
Q

What are the 2 forms of fibre?

A

Indigestible (stimulates gut, dental wear)

Digestable (fermented by bacteria to produce fatty acids)

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4
Q

How does the size of the thorax in small herbbivores compare with dogs and cats?

A

Much smaller - almost entire abdomen is gut contents

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5
Q

Why may the stomach be difficult to visualise on endoscopy?

A

Always food in the stomach

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6
Q

Where is the “pacemaker of the gut”?

A

Fusus coli - between proximal and distal colon junction

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7
Q

What to colonic contractions function to do?

A

Separate indigestible fibre -> produce >150 pellets per day, while digestable fibre washed back to ceacum for fermentation

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8
Q

When and how are ceacotrophs produced? What nutrients do they provide second time round? `

A

3-8 hours after eating, ceacum contracts, ceacotrophs produced coated in mucus
- provide microbial protein, B and K vits, FAs

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9
Q

Which animals still require external sources of B vitamins even if eating ceacotrophs?

A

Rodents

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10
Q

What may owners confuse ceacotrophs for?

A

Diarrhoea

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11
Q

Why are some antibiotics so dangerous to give to small herbivores?

A
  • reduce some intestinal bacteria, allow overgrowth of others eg. Clostridium -> toxin production and death
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12
Q

Which antibiotics should NEVER be given to small herbivores

A

PLACE

  • Penicillins
  • Lincosamides
  • Aminoglycosides
  • Cephalosporins
  • Erythromycin
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13
Q

What eception may PLACE antibiotics be given to small furries?

A

If given as injectables not orall y

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14
Q

Is gut stasis a disease?

A

No, clinical sign

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15
Q

What is gut stasis usually associated with?

A

Anorexia and dehydration - either as a cause or consequence

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16
Q

Give 7 causes of gut stasis

A
  1. Stress
  2. Pain
  3. Anorexia
  4. 1* GI disease
  5. Toxin ingestion
  6. Insufficient fibre
  7. Dehydration `
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17
Q

How is the problem of gut stasis defined, refined etc.?

A

Problem: complete or partial obstruction? +- anorexia?
System - 1* or 2* GI ?
Location: Proximal or distal GI ?
Lesion:? May not be investigated fully

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18
Q

What 3 aspects of the history are of particular importance when defining the problem of gut stasis?

A
  1. Husbandry history (Indoor/outdoor -toxins, predators, weather, FBs?)
  2. Diet (Probe! Owners will say what you want to hear)
  3. Medical history (DUDE?)
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19
Q

What 2 aspects of the physical exam may be slightly modified for small herbivores cf. dogs/cats

A

Otoscope for thorough oral exam

Listen to gut sounds like a horse

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20
Q

When would 1* GI disease be suspected?

A
  • history of poor diet/change
  • abnormality palpated in gut
  • onset of gut stasis PREceded by signs of malaise (depression/anorexia etc.)
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21
Q

When would 2* GI disease be suspected

A
  • history of stress

- obvious source of pain

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22
Q

What is the usual plan of action for an animal with gut stasis?

A

Admit for supportive care and diagnostics

  • euthanasia may have to be considered
  • ex lap if FB suspected
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23
Q

What are the 5 stages of stabilising a rabbit with gut stasis?

A
  1. warmth
  2. fluids
  3. nutrition
  4. gut stimulants
  5. analgesia
24
Q

How can stress be decreased in the hospital setting?

A

Make as homely as possible - admit companion, bring in bedding etc.

25
Q

What is the normal temperature of the rabbit?

A

~38-39.5c

26
Q

Why can rabbit temperatures fluctuate so rapidly?

A

High surface area to volume ratio

27
Q

What are maintainence fluid doses for a rabbit? How are these usually given?

A

<100ml/kg/day (high due to high metabolic rate)

  • given IV/SC to reduce frequency
  • if given SC: warm and add hyaluronidase (1500 IU/L) to decrease absorption/ distribution time
28
Q

Where are IV catheters placed in the rabbit?

A

Marginal ear vein

29
Q

After how long does anorexia present a problem/worrying situation?

A

12 hours

30
Q

How much nutrition supplement is required to be syringe fed if completely anorexic?

A

50ml/kg/day

31
Q

When may nasogastric tube placement be necessary?

A

Facial damage

32
Q

Give 3 prokinetic drugs used to manage gut stasis. What are their dose rates?

A
  • Metoclopramide 0.5mg/kg PO TID (or injectable)
  • Ranitide 4mg/kg PO BID (or injectable)
  • Cisapride 0.5mg/kg PO BID/TID
33
Q

What is metoclopramide’s mechanism of action?

A
  • Prokinetic due to Ach release, DA and 5HT Rs
  • Works of oesophagus, stomach and SI
  • Little/no effect on colonic motility
34
Q

What is ranitidine’s mechanism of action? What is it most commonly used for?

A
  • H2-Rs, also prokinetic due to Ach-esterase inhibition
  • works on prox GI, MAY stimulate colonic motility too
    > commonly used for ulcers
35
Q

What is cisapride’s mechanism of action? How does it’s potency compare to metoclopramide and rinitide efficacy?

A
  • works on 5HT-Rs to indirectly stimulate acetylcholine release
  • works on oesophagus, stomach, SI and colon
  • efficacy > metoclopramide, roughly = rinitidine
36
Q

Should these drugs ever be used in combination?

A

Yes!

37
Q

Why is gut stasis a potentially devastating problem?

A

Vicious cycle - pain -> gut stasis -> pain -> gut stasis…

38
Q

Give 2 common analgesics used in small furries with dose rates

A
  • NSAIDs - meloxicam <0.05mg/kg q6-8hrs
39
Q

How do dose rates of common analgesics differ in small furries?

A

Higher doses /kg due to ^ metabolism

40
Q

How do the side effects of analgesics measure up to the benefits?

A

Usually benefits outweigh the side effects BUT be aware of potential side effects (GI disturbance etc.)
- with NSAIDs ensure well hydrated and consider gastro-protectants

41
Q

What should a normal survey radiograph of the GI tract in a rabbit look like?

A
  • Food everywhere! normal

- Stomach should NOT reach caudal to last rib

42
Q

How are initial radiographs of small furries carried out?

A

Concious - restrain with sandbags. If stressed retry later as can kick out and break back.

43
Q

When would surgery be indicated in a small furry?

A

Obstruction: indicated by -

  • visualisation of FB (May be soft carpet etc. so potentially not)
  • gastric dilation
  • gas shadows in SI cranial to obstructin
  • serial radiographs show stationary gas bubble/obstruction
44
Q

When are blood tests indicated?

A
Systemic disease suspected 
- renal failure
- hepatic disease 
- Pb/Zn levels 
Glucose levels to indicate severity of condition
45
Q

What should be considered before carrying out full oral exam and further imaging?

A

GA

46
Q

Why may the “define the lesion” part of the logical approach not be completed in a gut stasis work up? WHen should it be investigated more thoroughly?

A
  • GA may be contraindicated or not desirable
  • Gastroscopy limited by permenantly full stomach
  • Intestinal biopsies risk dihiscence and infection
    > many cases resolve with symptomatic treatment only
    > if recurrent episodes occour then investigate/work up further
47
Q

What is the clinical workup approach to D+ in small furries?

A

Same as cats/dogs

  • acute or chronic?
  • if acute, with/without systemic signs?
  • SI/LI/mixed?
48
Q

What may owners confuse for diarrhoea?

A

Ceotrophs stuck to bum

49
Q

Give 6 common causes of D+ in rabbits

A
  • diet (new veg, too much fruit etc)
  • antibiotics (just prior to death!)
  • post weaning
  • bacterial enteritis
  • viral enteritis
  • coccidiosis
50
Q

Give 4 diagnositc tests to assess the casue of diarrhoea

A
  • feacal parasitology
  • feacal microbiology
  • abdo imaging
  • bloods
51
Q

How does the stabilisation of a rabbit with diarrhoea differ to a rabbit with gut stasis?

A

Same steps but NO gut stimulants

  1. warmth
  2. fluids
  3. nutrition
  4. analgesia
52
Q

How is D+ due to coccidiosis treated?

A

Toltrazil (3mg/kg PD SID for 2 days, repeat after 14d)

TMPS 30mg/kg PO BID

53
Q

What can be given to bind enterotoxins?

A

Colestyramine

54
Q

When would ABs be indicated?

A

Only in bacterial enteritis

- metronidazole 20mg/kg PO BID

55
Q

Are probiotics advocated?

A

No evidence for but do no harm