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VET433: Gastroenterology > Diarrhea > Flashcards

Diarrhea Flashcards

(54 cards)

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1
Q

fecal scoring

A

1: dry – constipation
2-3: normal
4-7: wet – diarrhea

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2
Q

activity index

A

scoring of characteristics of diarrhea on a scale of 0-3 based on normal, mild, moderate, or severe change

  • activity/attitude (mentation)
  • vomiting
  • stool consistency
  • stool frequency
  • weight loss
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3
Q

what history questions should be asked for a diarrhetic patient

A
  1. fecal scoring
  2. activity index (mentation, vomiting, stool frequency, consistency, weight loss)
  3. blood, mucus, tenesmus, urgency
  4. first event or recurrence
  5. deworming history
  6. drug history
  7. vaccination history
  8. vomiting or regurgitation
  9. lifestyle
  10. travel history
  11. appetite
  12. weight loss
  13. diet history
  14. pruritic behaviors
  15. environmental stress
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4
Q

characteristics of small bowel diarrhea

A
  • normal/increased frequency
  • normal/increased volume
  • melena
  • no mucus or tenesmus
  • normal urgency
  • vomiting + weight loss possible
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5
Q

characteristics of large bowel diarrhea

A
  • markedly increased frequency
  • decreased volume
  • hematochezia
  • mucus + tenesmus present
  • increased urgency
  • no vomiting or weight loss
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6
Q

what are diagnostics for GI parasites

A
  • centrifugation floatation
  • antech KeyScreen GI PCR
  • direct wet prep
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7
Q

antech key screen GI PCR

A
  • determines if giardia is zoonotic (strain A or B)
  • determines if ancylostoma (hookworms) are benzimidazole resistant
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8
Q

what can be identified on a direct wet prep

A

giardia
tritrichomonas

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9
Q

stages of giardia

A

cyst
trophozoite

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10
Q

what are the zoonotic strains of giardia

A

A & B

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11
Q

what type of diarrhea is usually caused by giardia

A

small bowel
OR
asymptomatic

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12
Q

ideal diagnostics for giardia

A
  • fecal float + ELISA
    OR
  • PCR
  • DFA
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13
Q

what does the giardia ELISA detect

A

cyst wall protein 1

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14
Q

giardia treatment

A

fenbendazole

can also do drontal plus - the febantel gets metabolized to fenbendazole

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15
Q

stages of tritrichomonas

A

trophozoite only

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16
Q

what species does tritrichomonas foetus affect

A

cats

usually young, purebred

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17
Q

what type of diarrhea does tritrichomonas cause

A

large bowel diarrhea, chronic

malodorous, dribbling feces with a red, swollen, painful anus from colitis

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18
Q

tritrichomonas diagnostics

A
  • direct wet prep
  • inpouch fecal culture
  • PCR
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19
Q

tritrichomonas treatment

A

ronidazole

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20
Q

what are the common enteropathogenic bacteria

A
  • C. perfringens
  • C. difficile
  • Campylobacter jejuni
  • Salmonella
  • E. coli
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21
Q

what C. perf toxins cause disease and what type of disease

A

netE and netF

acute hemorrhagic diarrhea syndrome

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22
Q

how to diagnose enteropathogenic bacteria

Study These Flashcards
A

fecal culture or PCR

NOT ALWAYS INDICATED

23
Q

when is fecal culture/PCR indicated

Study These Flashcards
A
  1. hematemesis or bloody diarrhea w/ sepsis
  2. zoonotic risk to immunocompromised owner
  3. hemorrhagic diarrhea in immunocompromised patients
  4. multipet diarrhea
  5. increased neutrophils on fecal smear
24
Q

treatment for each enteropathogenic bacteria

Study These Flashcards
A

C. perfringens: metronidazole, amoxicillin, tylosin

C. difficile: metronidazole

Campylobacter: macrolides (azithromycin)

Salmonella: fluoroquinolones (enrofloxacin)

25
when is antibiotic treatment indicated for enteropathogenic bacteria
- signs of sepsis - immunosuppressed animals
26
what are the differentials for chronic diarrhea
1. food responsive enteropathy 2. antibiotic responsive enteropathy 3. immunosuppressant responsive enteropathy 4. non-responsive enteropathy
27
food responsive enteropathy signalment
young adults (~3 years)
28
clinical signs of FRE
large or mixed bowel diarrhea
29
FRE treatment
diet trial - elimination (limited ingredient vs hydrolyzed) - fiber enriched - fat restricted - highly digestible expect response within 10-14 days must maintain trial for 3 months
30
negative prognostic indicators for chronic colitis
- high clinical activity index - hypocobalaminemia - hypoalbuminemia - hypovitaminosis D
31
antibiotic responsive enteropathy signalment
young to middle aged large and giant breed esp. GSDs
32
clinical signs of ARE
small, large or mixed bowel diarrhea
33
treatment for ARE
AVOID ANTIBIOTICS 1. diet trial - fiber enhanced 2. probiotics 3. fecal microbiota transplant
34
immunosuppressant responsive enteropathy
clinical IBD involves microbiome, host, and environmental factors
35
what 4 criteria must be met to make a clinical diagnosis of IBD
1. persistent GI signs (>3 weeks) 2. failure to respond to symptomatic therapy 3. failure to document other causes of gastroenteritis 4. histologic dx of benign intestinal neoplasia MUST get an intestinal biopsy in order to definitively diagnose IBD
36
diagnostics for IBD
1. elimination or fiber enrich diet trial (failed) 2. minimum database 3. serum total T4 4. fecal float, ELISA, DFA, or PCR 5. serum TLI 6. serum PLI 7. serum B12/folate 8. abdominal radiographs and ultrasound 9. GI biopsy
37
where is B12 absorbed
ileum
38
where is folate absorbed
jejunum
39
is B12/folate a good diagnostic for dysbiosis
NO because can get a high folate with low B12 in patients with dysbiosis (bacteria consume B12 and produce folate)
40
what would you expect to see on ultrasound for IBD
thickened muscularis and submucosa
41
what two diagnostics should be performed in all chronic enteropathy patients
B12/folate abdominal imaging
42
what are the two main types of IBD
- lymphoplasmacytic - granulomatous
43
lymphocytic, plasmacytic IBD treatment
most common and easiest to treat 1. diet trial - elimination or fiber enriched 2. immunomodulators 3. vitamin B12 can use probiotics or FMT
44
probiotic considerations
- there is not a regulatory agency - want to use products that have published research - visbiome, nutramax, purina - may contain single or multiple strains
45
what causes granulomatous IBD
"boxer colitis" caused by a highly adherent and invasive strain of E. coli
46
what can be seen on histo of a dog with granulomatous IBD
PAS positive macrophages
47
granulomatous IBD treatment
fluoroquinolones (Baytril) for 6-8 weeks MUST use antibiotics due to highly pathogenic strain
48
signalment for protein losing enteropathies
dogs with small bowel diarrhea RARE to se it in cats
49
intestinal lymphangiectasia
leakage of the lymphatics attahed to the GIT
50
lymphangiectasia signalment
small breed dogs (yorkies, maltese)
51
lymphangiectasia clinical signs
small bowel diarrhea panhypoproteinemia hypocholesterolemia hypocalcemia + hypimagenesemia
52
diagnostis of lymphangiectasia
abdominal US ID tiger striping
53
lymphangiectasia treatment
1. diet trial - low fat (<20% ME bases) 2. vitamin B12 3. thrombolytics 4. prednisone (if refractory) 5.Mg supplementation
54
what are 4 indications for using antibiotics in patients with Gi disease
1. hemorrhagic diarrea + sepsis 2. zoonotic in immunocompromised patients 3. managing ARE 4. managing specific (if not responsive to fiber fiet) 5. management of granulomatous colitis

VET433: Gastroenterology (16 decks)

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