Clinical Issues: Lappin Stuff

Question 1

Fluff, 5 yr, male castrated, DSH
* 2 day history
– Small bowel diarrhea and fever
* Hunter!
– Husband found bird feathers 5 days ago
* Well vaccinated for panleukopenia
* Complete blood cell count = neutrophilic leukocytosis
* FeLV/FIV negative
* Fecal negative
* Cytology = multiple neutrophils
what if he had recently eaten a bird?

Answer 1

Songbird Fever – Salmonella!
lethargy and anorexia, leukocytosis w left shift, fever, V+/D+

Question 2

can humans catch songbird fever?

Answer 2

YES!

Question 3

salmonellosis causes what type of D+

Answer 3

• mixed bowel diarrhea

Question 4

what do you do if your patient has a possible campylobacter exposure?

Answer 4

DX: culture or PCR to prove, as cytology is suggestive
treat: probiotic and diet trial first before abx because these are rapidly resistant!
tylosin or quinolone orally if probiotic fails, erythromycin causes vomiting

Question 4

salmonellosis

Answer 4

• mixed bowel D+
• fever and neutropenia
• fever and neutrophilia
• raw protein
• poultry exposure
• crowded cat environments
• songbirds

Question 5

when do you do antibiotics with salmonellosis?

Answer 5

only if bacteremic
ampicillin IV or add a quinolone parentally if septic
if D+ only, probiotics and diet! self-limited

Question 6

T/F: campylobacter upsalensis is not pathogenic

Answer 6

true

Question 7

exposure and symptoms of campylobacter jejuni, C. coli

Answer 7

• poultry exposure, crowded environments
• kittens
• mixed bowel diarrhea

Question 8

salmonella and campylobacter both present with what type of D+?

Answer 8

mixed bowel

Question 9

a 5 y/o boxer presents with large bowel diarrhea, with red blood and white stringy mucous. what are you suspecting?

Answer 9

boxer colitis! e.coli, not immune
diagnose at cornell
enrofloxacin at 5 mg.kg/daily
minimum of 6-8 weeks

Question 10

are spore-forming rods diagnostic proof of clostridium sp diarrhea?

Answer 10

no!

Question 11

what is the #1 bacterial D+ we see in small animals?

Answer 11

clostridium spp

Question 12

clostridium perfringens

Answer 12

nosocomial or overgrowth?
acute large bowel D+
stressful situations

Question 13

acute hemorrhagic diarrhea syndrome in dogs is likely caused by

Answer 13

clostridium perfringens
usually elevated packed cell volume
acute onset
exclude hypoadrenocorticism with a screening cortisol!

Question 14

what disease should you rule out with a dog that has acute hemorrhagic diarrhea syndrome?

Answer 14

ADDISON’S!

Question 15

what are common co-infections with giardia?

Answer 15

tritrichomonas, cryptosporidium

Question 16

what do you treat tritrichomonas with?

Answer 16

RONIDAZOLE!
once daily for 14 days because it crosses the BBB so use ONCE DAILY

Question 17

does giardia induce a sterilizing immunity?

Answer 17

no bc you can be infected and shedding in 9 days, a neg test is only good for 9 days

Question 18

can you catch giardia from a healthy pet?

Answer 18

no bc there are host specific genotypes

Question 19

giardia protocol

Answer 19

• febantel for 3 days, fenbendazole as alternate for 5 days
• EN Fiber balance or other fiber diet
• fortiflora to help with microbiome sid x 1 4

Question 20

when should follow-up testing for giardia be done

Answer 20

24-48 hours AFTER completion of therapy, this is when theyre most likely to be negative !
perform fecal with centrifuge for detection of cysts
ELISA may remain positive even after treatment; don’t use it as guide for treatment

Question 21

what kind of diarrhea does giardia cause?

Answer 21

small bowel

Question 22

what kind of diarrhea does tritrichomonas foetus cause?

Answer 22

large bowel
can be up to 9 months in cats!

Question 23

a male vet student is on necropsy rotation and had seen a holstein calf. he presents with intense small bowel diarrhea. what are you suspecting

Answer 23

cryptosporidium PARVUM!!
really teeny
crypto hominus is what is found in nursing homes, daycares etc

Question 24

what drug eliminates crypto?

Answer 24

no drug eliminates the infection, the goal is just to resolve D+ and lessen oocyst shedding

Question 25

how do you test for cryptosporidium?

Answer 25

CSU and lappin does IFA likely in practice you will do PCR- genotypes only ELISA for antigen is inaccurate

Question 26

a 12 week intact DLH from a pet store presents with small bowel diarrhea with some blood. .what is the most likely parasite?

Answer 26

regular isospera diarrhea usually only in kittens not adults

Question 27

what type of drug do you want to use with cystoisospera?

Answer 27

a bacteriocidal drug. in practice, often was albon

Question 28

what are the only known definitive host for toxoplasma?

Answer 28

cats

Question 29

what drug do you use with cystoisospera?

Answer 29

PONAZURIL (TOLTRAZURIL)!!! it is bactericidal!!! daily for 3 days

Question 30

cystoisospera is also called

Answer 30

coccidia

Question 31

is toxoplasma zoonotic?

Answer 31

YES- INCREDIBLY TRANSMISSIBLE TO HUMANS, crosses placenta during 1st trimester!

Question 32

what is the definitive host for neospora caninum?

Answer 32

dogs! only known definitive host for neospora.

Question 33

is neospora caninum zoonotic?

Answer 33

less likely to be zoonotic than toxoplasma but unsure; dogs are the only known definitive host. rarely have D+

Question 34

a 3 yr old cat presents with "rice grains on his butt". he is a hunter and murderer. what are you suspecting?

Answer 34

taenia spp hunter = taenia if he had fleas, would suspect dipyllidium. have to eat the flea to make it

Question 35

what are the 3 types of tapeworms to know?

Answer 35

1. taenia: hunting 2. dipylidium: fleas 3. echinococcus: only zoonotic tapeworm! present in colorado

Question 36

what is the only zoonotic tapeworm?

Answer 36

echinococcus!

Question 37

where can a pet get echinococcus from?

Answer 37

E. granulosa: sheep - tends to be one big cysts E. multiocularis: rodets: makes "multi"ple cysts in lover

Question 38

how do you diagnose tapeworms?

Answer 38

PCRs! have for all of them see segments with Dip and Taenia

Question 39

what medication do you use to treat cat or dog tapeworms?

Answer 39

praziquantel

Question 40

what do you use for dog or cat flukes?

Answer 40

praziquantel

Question 41

what is entamoeba histolytica?

Answer 41

an amoeba affecting small animals. gi protozoan rare in USA, potentially zoonotic, large bowel diarrhea likely, metronidazole should be effective

Question 42

what is balantidium coli?

Answer 42

the only pathologic ciliate in small animal rare in USA, potentially zoonotic, large bowel diarrhea likely, metronidazole should be effective

Question 43

why do you want to be really cautious with diarrhea + fever cases?

Answer 43

because the fact that there is a fever means that the bacteria are getting into bloodstream. start to become suspicious of salmonella or campylobacter, which humans can get!

Question 44

what is the #1 bacterial D+ seen in small animals?

Answer 44

clostridium

Question 44

T/F: there is no such thing as a CHRONIC costridial carrier

Answer 44

true: likely is a recurring D+ or something else going on

Question 45

if treatment for clostridium fails, what should you do next?

Answer 45

complete the workup; may have other problems going on like IBD

Question 46

primary GI causes

Answer 46

infectious parasitic garbage gut inflammatory neoplasia obstruction

Question 47

secondary GI causes

Answer 47

renal hepatic pancreas endocrine CNS right heart failure

Question 48

what are the nematodes that can cause GI infections?

Answer 48

rounds, hooks, whips, heartworm

Question 49

what are the flagellates that can cause GI infections?

Answer 49

tritrichomonas, giardia

Question 50

what are the cestodes that can cause GI infections?

Answer 50

taenia, dipylidium, echinococcus

Question 51

what are the coccidians that can cause GI infections?

Answer 51

cystoisospora cryptosporidium toxoplasma neospora