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Alimentary System > Vomiting And Diarrhea > Flashcards

Vomiting And Diarrhea Flashcards

1
Q

What are the stages of vomiting?

A

Nausea, Retching and Vomiting

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2
Q

Signs of nausea

A

Reduced gastric tone
Duodenal and proximal jejunal tone increased
Depression, hyper-salivation, repeated swallowing
Duodenal contents into stomach

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3
Q

Stages of vomiting

A 
Glottis closed
Soft palate pressed against nasopharynx
Abdominal muscles and diaphragm contract
Cardia opens, pylorus contracts
Reverse peristalsis
Cardiac rhythm disturbed
Changes in colonic motility
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4
Q

How do you tell the difference between regurgitation and vomiting?

A

Vomiting: abdominal effort, nausea, bile present, acidic pH, digested material, food if vomit quickly after eating

Regurgitating: effort from shoulders, food not digested, mucous present, cough

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5
Q

What organs/ systems are involved in primary GI diseases?

A

Stomach, small intestines, and colon

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6
Q

What organs/ systems/ factors are involved in secondary GI diseases?

A

Pancreas, kidney, liver, Primary CNS, electrolyte imbalances, toxins

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7
Q

What diagnostic tools are most useful for primary GI disease?

A

Radiology, ultrasound, endoscopy

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8
Q

What diagnostic tools are most useful for secondary GI disease?

A

Hematology, biochemistry, urinalysis, radiology, ultrasound, surgical exploration

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9
Q

What are the signs that vomiting is due to a primary GI disease?

A

Vomiting with often relate in time to eating, delayed

Occur at variable times after eating in lower bowel disorders

Foreign body vomiting may occurs despite not eating

Palpable on physical exam

Paired with significant diarrhea

Vomit occurred then showed malaise, depression, anorexia

May be normal is all other aspects historically

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10
Q

What the signs that Vomiting is due to a secondary GI disease?

A

Vomiting occurs subsequent to other signs, like depression/ inappetence

Other clinical signs present, like jaundice

Patients are usually metabolically ill

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11
Q 
Gastritis
Gastric foreign bodies
Gastric ulceration
Pyloric disorders
Abnormal motility
Enteritis
Intestinal obstruction
IBD
Neoplasia
Are all...
A

Common primary GI disease lesions

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12
Q

The most common primary GI causes of vomiting are:

A 
Gastritis
    Spoiled food, dietary indiscretion, food intolerance
Viral infection
    Parvovirus, corona, rota
Foreign body
GI neoplasm
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13
Q

Most common causes of secondary GI vomiting?

A 
Pancreatitis
Liver disease
Renal disease
Endocrine disease
   Diabetic ketoacidosis
  Hyperadrencorticism
  Hypercalcemia
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14
Q 
Cricopharyngeal disease
Hiatal hernia
Diverticula
Mega esophagus
Persistent right aortic arch
Mediastinal lymphoma
Thyroid tumors
Foreign body strictures
Esophagitis
Intramural lesions are all?
A

Lesions of esophageal disorders

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15
Q

Break down the steps of the diagnostic approach to vomiting

A

Vomiting vs regurgitation

If vomit, primary or secondary, can’t tell

Investigate secondary or eliminate if appropriate
Identify organ, underlying disease

Investigate primary
Imaging, exploratory

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16
Q

When is symptomatic therapy appropriate for vomiting?

A

Primary GI disease do to transient cause, toxin, or dietary indescretion

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17
Q

This major presenting sign almost always indicates a primary GI lesion

A

Overt large bowel diarrhea, and mixed bowel diarrhea

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18
Q

List the lesions of ACUTE small bowel diarrhea

A 
Overeating
Dietary change
Spoiled food
Garbage
Parasites
Protozoa
Infection bacterial and viral
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19
Q

List the primary and secondary lesions of CHRONIC small intestinal diarrhea

A 
Secondary lesions
Toxins
Parasites
Diet intolerances, hypersensitivities
Bacteria and Protozoa
Deep mycoses
IBD aka Chronic Enteropathy
Neoplasia
Lymphangiectasia
Brush border enzyme defects

Secondary lesions
Hypoadrenocorticism
Hyperthyroidism (cats)
Exocrine pancreatic insufficiency( dogs) pancreatitis (chronic)

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20
Q

Where do diet hypersensitivity skin lesions tend to appear in dogs vs cats?

A

Cats: ears and face

Dogs: auxiliary region and feet

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21
Q

List the lesion of both acute and chronic large bowel diarrhea

A 
Parasites
Protozoa
Bacteria
Diet related (toxin, fiber, intolerance, hypersensitivity)
Inflammatory (idiopathic, eosinophilic, granulomatous)
Neoplasia 
stress
Strictures
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22
Q

List the diagnostic tools for chronic small and large bowel diarrhea

A 
Fecal flotation and examination
Hematology and biochem ( secondary)
Fecal culture
Fecal panel
Serum trypsin like immunoreactivity ( TLI)
B12 and folate panels
Ultrasound
Biopsy
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23
Q

When is it appropriate to biopsy?

A

Hypoproteinemia
Thicken intestinal wall or loss of layering
Significant weight loss
Hypercalcemia
Hypocobalaminemia
Neoplasia strongly suspected
O unable/ unwilling to follow diagnostic plan

Rule out parasites, dietary trials, secondary GI and treatment trial before considering

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24
Q

List 3 factors that contribute to the seriousness of diarrhea in farm animals

A

Major Economic loss

Welfare

Environmental cost

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25
Q

What pathogens are associated with acute diarrhea in calves?

What age are calves most affected by each and the mortality rate?

A

E.coli- <5days- zoonotic, enterotoxigenic can cause death
Cryptosporidia- 5-14 days- villus atrophy, often concurrent,
Rotavirus- 7-14 days( max 3 weeks)- high morbidity low mortality
Coronavirus-7-22 days- higher mortality
Coccidia-> 3 weeks- poor growth rates, colitis
Salmonella- all ages- always significant

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26
Q

List the caused of acute and chronic diarrhea in adult cows

A 
acute
Salmonellosis
Winter dysentery ( corona virus)
Acidosis ( SARA)
Malignant catarrhall fever
Poison
Mucosal disease
BVD- RARELY

Chronic
Johnes
Ostertagiasis
Fluke

27
Q

List the causes of acute and chronic diarrhea in lambs under 3 weeks

A

Acute
Watery mouth
Poor milk production

Chronic
Rotavirus
Corona virus
E.coli
Salmonella
Lamb dysentery
28
Q

Most common causes of diarrhea in lambs 3-12 weeks old

A

Coccidiosis

Nematodirosis - sudden death

29
Q

List the key factors to look into when investigating diarrhea on a farm?

A 
Herd vs individual?
Colostrum quality and time given
Environment - cleaned regularly
Regularly feeding (for calves)
Vaccines
Deworming
Preventatives/ supplements
30
Q

Define Johnes Disease and list the key clinical signs, and solution

A

Is a chronic enteritis wasting diseases caused by MAP (Mycobacterium avium subspecies Paratuberculosis). Is zoonotic and is implicated in IBD and Crohns diseases in humans. Has no treatment

Key signs
Profuse hose type diarrhea
Weight loss severe

Solution
All affected animals must be culled

31
Q

What are key steps to take to diagnose and control Johne’s Disease?

A

Prevent young animals from getting infected
Do not house old and young animals
Do not give infected colostrum
Do not give pooled colostrum

To diagnose
Blood test ELISA ( low sensitivity, but high specificity )
Positive test is reliable

32
Q

What is the most common diarrhea in horses?

A

Primary GI, Secondary is very rare

33
Q

What are the most common causes of diarrhea in neonate foals?

A 
Foal heat diarrhea
Rotavirus
Salmonella
Clostridia
Sepsis
34
Q

Most common causes of Diarrhea in older foals (10-12months)?

A

Proliferation enteropathy
Rhodococcus equi colitis
Parasitic diarrhea

35
Q

What are the most common causes of diarrhea in adult horses?

A

Salmonellosis
Clostridium is
Parasites
Antimicrobial diarrhea

Chronic
IBD
Undiagnosed

NSAID toxicity should be noted

36
Q

Acute diarrhea in horses is a…

A

Life threatening medical emergency!!!

37
Q

Diarrhea is considered chronic when…

A

It as persisted for at least 2 weeks

38
Q

List the causes of acute diarrhea in horses?

A 
Salmonellosis
Parasitism ( cyanthostominosis, strongylosis)
Clostridiosis 
Antimicrobial- associated diarrhea
NSAID toxicity
Sand enteropathy
Carbohydrate overload
39
Q

List the causes of chronic diarrhea in horses

A 
Salmonellosis
Parasites
Sand enteropathy
NSAID toxicity
IBD
Abnormal fermentation
Neoplasia
Peritonitis
Abdominal abscession
40
Q

What are the factors that predispose horses for diarrhea?

A 
Young performance horses
Antimicrobial or NSAID administration
Stress
Concurrent illness
Recent deworming
Exposure to other horses
Poor foal hygiene
41
Q

What are the main diagnostic tools for equine diarrhea?

A

Fecal PCR
Fecal Culture
ELISA for viruses

Mainly treat diarrhea supportively, try to find a diagnosis to rule out zoonoses

42
Q

When treating diarrhea in horses what are the main aspects we should address?

A

Prevention of spread

Fluid and electrolyte therapy

Control endotoxemia and sepsis

Control enteric inflammation

Re establish GI flora

Specific Treatments

43
Q

What steps should be taken for biosecurity in horses with diarrhea?

A

Isolate

Disinfect all personal equipment that comes in contact with affected animals

PPE

44
Q

List the signs of dehydration and explain how it is measured?

A

Tachycardia, increased jugular refill time, pale mm, Increased CRT, decreased skin turgid, cool extremities, decreased urine output.

<5% = clinically normal

8-10% = moderate, CRT 3-4 sec, hypovolemic signs

> 10%= severe >4-5sec, severe hypovolemic signs

45
Q

What type of fluids should be administered to horses and foals with diarrhea?

A

Polyionic fluids, hartmanns

10-20mls/kg horses

4-5mls/kg/hr in foals

Administer bolus’ for shock

46
Q

Define endotoxemia and the clinical signs

A

Breakdown of physical barriers to endotoxins in intestine cause LPS to enter systemic circulation

Clinical signs
Fever,depression, pale mm, cold extremities, congested, toxic mm, prolonged CRT.

Advanced clinical signs
Edema
Tachycardia, low BP, prolonged CRT
Lethargy, altered mentation
Diarrhea
Metabolic acidosis
Thrombosis, and Petechial hemorrhages
47
Q

List the steps of endotoxemia treatment in horses

A 
Remove the cause
Neutralize the circulating LPS
Inhibition of LPS induced Inflammation
Modulate coagulation system
Circulatory support
48
Q

Name the treatment for the following conditions

Cyathostomiasis

Clostridiosis

Sand enteropathy

Right coral enteropathy

IBD.

A

Cyathostomiasis- moxidectin, dexamethasone, prednisolone

Clostridiosis- metronidazole

Sand enteropthy- psyllium mucilloid and magnesium sulfate

Right dorsal colitis- misoprostal

IBD- dexamethasone, prednisolone

49
Q

When doing a problem based approach to diarrhea in small animals what are the steps?

A

Define the: problem, location, system then lesion

50
Q

The most important tool in classifying the type of diarrhea present is what?

A

History

51
Q

How do you approach acute vs chronic diarrhea?

A

Acute: treat symptomatically

Chronic: investigate fully

52
Q

List the characteristics of small bowel diarrhea

A 
Consistency:Cow pie to watery
Pattern: large volume and normal frequency
Blood: not bright or fresh
Color: ranges
Weight loss if chronic
Dehydration/pd
Physical exam often unremarkable
53
Q

What are the characteristics of large bowel diarrhea?

A 
Small amounts and often
Mucous present
Fresh blood on surface
Tenesmus: straining
No weight loss
PE often unremarkable
54
Q

What are some of the secondary GI disorders that can cause small bowel diarrhea?

A 
Hepatic disease
Pancreatic insufficiency
Pancreatitis
Hyperthyroidism
Hypoadrenocorticism ( Addison’s disease)
Renal disease
55
Q

What does overt large bowel diarrhea as the major presenting signs almost always indicate?

A

A primary GI lesion

56
Q

Mixed bowel diarrhea as the major presenting sign usually is due to?

A

Primary GI disease

57
Q

Large bowel diarrhea associated with secondary GI disease usually…

A

Is not the presenting complaint, and has small bowel characteristics

58
Q

List the diet relates lesions that can cause acute small bowel diarrhea

A

Overeating
Dietary changes
Spoiled food
Garbage

59
Q

List the parasites and Protozoa that can cause acute small bowel diarrhea

A

As raids
Hookworms

Giardia
Coccidia

60
Q

List the viral and bacterial lesions that can cause acute small bowel diarrhea

A

Viral
Parvovirus
Coronavirus
Rotavirus

Bacteria
  Campylobacter
  Salmonella
  Clostridium
   E.coli
61
Q

What are the possible primary GI lesions of chronic small bowel diarrhea?

A 
Toxins
Parasites
Diet intolerances
Diet hypersensitivity
Bacteria and Protozoa
Deep mycoses
Chronic Enteropathy ( IBD)
Neoplasm
62
Q

What are the possible secondary GI lesions of chronic small bowel diarrhea in small animals?

A 
Hypoadrenocorticism
Hyperthyroidism
Exocrine pancreatic insufficiency
Chronic pancreatitis
Liver disease
63
Q

List the possible primary lesions of acute and chronic large bowel diarrhea

A 
Parasites
  Trichuris culpis
  Anclostoma caninum
Protozoa
  Giardia
  Entamoeba sp
  Tritrichomonas
Bacteria
 Campylobacter, clostridium, salmonella, granulomatous collision
Diet related
Inflammatory
Neoplasia
Stress
Stricture
64
Q

List the possible diagnostic tools for working up diarrhea

A 
Fecal flotation
Fecal examination
Fecal culture/ panels
Ultrasound
Serum trypsin like immunoreactivity (TLI)
Biopsy( rule out secondary before doing)
B12 and folate to determine if supplements are needed
Proper dietary trial

Alimentary System (6 decks)

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