15. Non-infective diseases of the small intestines in dogs and cats. Protein loosing enteropathies

Question 1

acute small intestinal disorders

Answer 1

AHDS

Question 2

Chronic small intestinal disorders

Answer 2

food responsive enteropathy
antibiotic responsive enteropathy
immuneosuppressant responsive enteropathy
non responsive enteropathy

Question 3

AHDS

Answer 3

acute haemorrhagic diarrhoea syndrome
used to be called haemorrhagic gastroenteritis

Question 4

possible causes of AHDS

Answer 4

Dietary indiscretion
Toxins
Immune-mediated
Pancreatitis
Anxiety
Hyperreactivity
Stress
Intestinal bacteria
Intestinal parasites
Infection
Trauma
Intestinal ulcer
Foreign body
GI tumour, ulcer
Coagulation disorder

Question 5

predisposition of AHDS

Answer 5

young - middle aged
small & toy breeds
in winter

Question 6

Clinical signs of AHDS

Answer 6

acute onset of vomiting
profuse haemorrhagic diarrhoea –> hypovolemic shock
anorexia
lethargy
abdo pain
fever

Question 7

diagnosis of AHDS

Answer 7

increased PCV
neutrophilic leucocytosis
normal / decreased TP
hypoglycaemia
electrolyte imbalances

Question 8

treatment of AHDS

Answer 8

IVFT
parenteral AB
symtptomatic treatment
intestinal diet

Question 9

Food Responsive Enteropathy

Answer 9

enteropathy that improves by alteration of the diet

Question 10

causes of Food Responsive Enteropathy

Answer 10

food allergy
food intolerance

Question 11

difference between food allergy and intolerance

Answer 11

allergy - immune related. can be due to genetics
intolerance - non immune related

Question 12

most common allergens

Answer 12

dog - beef, chicken, wheat, milk
cat - beef, chicken, wheat, fish, corn

Question 13

clinical signs of Food Responsive Enteropathy

Answer 13

pruritis
recurrent chronic diarrhoea

Question 14

diagnosis and treatment of Food Responsive Enteropathy

Answer 14

work together
diagnosis by exclusion
prescription diet
homemade diet
avoid hidden allergens

Question 15

how to do trial diets

Answer 15

Pruritis - trial for 8-12 weeks
Diarrhoea - trial for 3 weeks
No more than 1 therapeutic change every 2-3 weeks

Question 16

Antiobiotic Responsive Enteropathy

Answer 16

enteropathy that improves by administration of antibiotics

Question 17

Primary Antiobiotic Responsive Enteropathy

Answer 17

Loss of tolerance by local immune system

Question 18

secondary Antiobiotic Responsive Enteropathy

Answer 18

damage of microbiome
dysbiosis

Question 19

consequences of Antiobiotic Responsive Enteropathy

Answer 19

endotoxin secretion
Brush border enzymes become damaged
competition for nutrients

Question 20

Clinical signs of Antiobiotic Responsive Enteropathy

Answer 20

chronic s. intestinal diarrhoes
gas production
fat malabsorption
weight loss
womiting

Question 21

diagnosis of Antiobiotic Responsive Enteropathy

Answer 21

no specific tests
microbiota dysbiosis index

Question 22

treatment of Antiobiotic Responsive Enteropathy

Answer 22

aim is to decrease the microbioma and dysbiosis
metronidazole but withdra if there is any relapse

Question 23

Immunosuppresant Responsive Enteropathy

Answer 23

enteropathy that improves with immunosuppressive treatment
aka IBS in humans

Question 24

predisposed to Immunosuppresant Responsive Enteropathy

Answer 24

middle aged animals,
g. shepherd, terriers, sharpei

Question 25

Histopath types of Immunosuppresant Responsive Enteropathy

Answer 25

LPE EGE Neutrophilic gastroenteritis granulomatous gastroenteritis

Question 26

pathophys of Immunosuppresant Responsive Enteropathy

Answer 26

diffuse cellular infulatration mucosal inflammation oedema

Question 27

clinical signs of Immunosuppresant Responsive Enteropathy

Answer 27

chronic diarrhoea abdominal discomfort flatulence weight loss inappetence vomiting

Question 28

what may occur in case of severe Immunosuppresant Responsive Enteropathy

Answer 28

protein losing enteropathy

Question 29

diagnosis of Immunosuppresant Responsive Enteropathy

Answer 29

non specific - hypoproteinaemia, leucocytosis, eosiniphilia specific - intestinal biopsy

Question 30

treatment of Immunosuppresant Responsive Enteropathy

Answer 30

immunosuppressive drugs - pred, azathioprine (not for cats), budesonide, cyclosporine

Question 31

non Responsive Enteropathy

Answer 31

enteropathy that doesnt respond to any treatment idiopathic

Question 32

possible choices of treatment

Answer 32

pre & pro biotics faecal transplantation Mesenchymal stem cell treatment intestinal biopsy

Question 33

types of Intestinal Neoplasia

Answer 33

Alimentary lymphoma lymphosarcoma intestinal adenosarcoma intestinal leiomyoma/ leiomyosarcoma

Question 34

clinical signs of Intestinal Neoplasia

Answer 34

Chronic diarrhoea Excess weight loss haematemesis anorexia melaena vomitting

Question 35

Protein Losing enteropathies

Answer 35

any gi condition resulting in a net loss of protein from the body

Question 36

causes of Protein Losing enteropathies

Answer 36

lymphangiectasia IBD intestinal neoplasia / lymphoma gi haemorrhage

Question 37

general clinical signs of Protein Losing enteropathies

Answer 37

chronic diarrhoea intestinal protein loss ascites oedema cachexia

Question 38

lymphangiectasia

Answer 38

abnormal dilation & dysfunction of lymphatic vessels

Question 39

Predisposition to lymphangiectasia

Answer 39

yorkie rottweiler

Question 40

classification of lymphangiectasia

Answer 40

Primary - idiopathiclymphatic abnormality Secondary - infiltration of lymphatics by; inflammation, fibrosis, neoplasia, infection

Question 41

Clinical signs of lymphangiectasia

Answer 41

prolonged protein loss decreased oncotic pressure ascites hydrothorax fat malabsorption protein loss weight loss chronic diarrhoea

Question 42

diagnosis of PLE

Answer 42

intestinal biopsy Hypoproteinaemia, hypocholesterolaemia, lymphopenia, hypocalcaemia, hypomagnesaemia endoscop - mucosal oedema, rice grain nodules Abdo US - streaks in submucosa

Question 43

Treatment of PLE

Answer 43

protein loss with ultra low fat diet with high bioavailability inflammation with - cyclosporin or corticosteroids Antithrombin III Weekly monitoring of albumin