Diarrhoea - Cat and Dog Flashcards Preview

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Flashcards in Diarrhoea - Cat and Dog Deck (34):
1

diarrhoea - define

incr freq, volume or fluidity

2

melaena - define

dark, tarry

3

flatulence - define

excess gas

4

dyscezia - define

difficult/painful defacation

5

haematochezia - define

fresh blood in stool

6

tenesmus - define

ineffectual straining

7

Differentiation small/ large bowel diarrhoea - small

volume +++
mucus -
freq +
tenesmus -
dyschezia -
weight loss ++
vomiting +
general condition +

8

Differentiation small/ large bowel diarrhoea - large

volume +
mucus +++
freq +++
tenesmus +++
dyschezia +
weight loss +
vomiting +
general condition -

9

Differential Diagnoses acute small intestinal diarrhoea - No systemic signs

Diet
helminths
Protozoa (Giardia)
Iatrogenic (drugs)

10

Differential Diagnoses acute small intestinal diarrhoea - systemic signs - bacterial

Salmonella
Campylobacter
faecal culture needed

11

Differential Diagnoses acute small intestinal diarrhoea - systemic signs - viral

Distemper (dogs)
Parvovirosis (dogs)
Panleukopenia (cats)
faecal antigen test

12

Differential Diagnoses acute small intestinal diarrhoea - systemic signs - other

Toxins
Hemorrhagic Gastroenteritis (dogs)
Acute pancreatitis

13

Differential Diagnoses acute large intestinal diarrhoea

Whipworms
Clostridia
Giardia
Campylobacter
faecal examination, culture

14

DDx chronic small intestinal diarrhoea - metabolic

Hepatic disease (Portosystemic Shunt!)
Hyperthyroidism (cats)
Addison’s disease (dogs)
Renal insufficiency

15

DDx chronic small intestinal diarrhoea - pancreatic

exocrine pancreatic insufficiency
chronic pancreatitis

16

DDx chronic small intestinal diarrhoea - intestinal

Giardia infection
Chronic partial obstruction
Lymphangiectasia
Neoplasia: Lymphosarcoma
food-responsive disease
Inflammatory Bowel Disease - Lympho-plasmacellular

17

DDx chronic large intestinal diarrhoea - Colon

Inflammatory Bowel Disease - Lympho-plasmacellular, Ulcerative Colitis (Boxer)
Polyps
Food-responsive disease
Neoplasia
Chronic partial obstruction
Cats: Tritrichomonas foetus!

18

Investigations for chronic diarrhoea

Faecal exam
Haematology, Biochemistry, UA
If small intestinal diarrhoea: consider serum tests
Abdominal ultrasound
Empiric treatment with elimination diet
If no response: Biopsies

19

faecal exam

flotation, culture
exclude Parasites, bacterial infection

20

Haematology, Biochemistry, UA

exclude renal failure, hepatic disease

21

serum tests

Trypsin-like Immunoreactivity (TLI), Pancreatic
lipase (PLI), cobalamin

22

Empiric treatment with elimination diet

Food-responsive disease

23

biopsy

endoscopy
exploratory laparotomy
Food-responsive disease

24

biopsy via endoscopy

Multiple biopsies from stomach, proximal small intestine, ileum and colon possible
Non-invasive (except for anaesthesia)
Direct visualization of mucosa possible
Gives diagnosis in majority of cases
Difficulty: Intestinal lymphoma, lymphangiectasia
dont sample from peyers patch - looks like lymphoma

25

biopsy via ex lap

Invasive - Caution in sick animals, cats, animals with decreased albumin levels
Only yields 2-3 biopsies from stomach and small intestine, not for colonic biopsies!
More expensive and painful for the animal
20% mortality vs 2% mortality for endoscopy

26

main causes for chronic SI diarrhoea in dogs

Food-responsive disease
Antibiotic-responsive diarrhoea
Inflammatory Bowel Disease - lympho-plasmacellular Enteritis/Colitis
Neoplasia

27

food-responsive disease

Diarrhoea gets better when given elimination diet = protein that the animal has never eaten before:
Better within first 2 weeks
Keep on diet for at least 6-8 weeks

28

antibiotic responsive diarrhoea (ARD)

Former Small intestinal bacterial overgrowth = SIBO
Most commonly seen in young German Shepherd Dogs
Chronic small intestinal or mixed diarrhoea
Treatment - Metronidazole For 4 weeks
But: usually relapse!

29

IBD - inflammatory bowel disease

Diagnosis by clinical exclusion!
Most common chronic enteropathy in dogs
Histopathology - Lympho-plasmacellular (most common!), Eosinophilic (rare), Ulcerative colitis

30

Therapy of chronic enteropathies/IBD in dogs: Sequential treatment protocol

Elimination diet
Metronidazole for 3-4 weeks
If inadequate response - prednisolone for at
least 10 days, then taper dose to e.o.d.
azathioprine or cyclosporine if steroids poorly tolerated or unsuccessful

31

therapy of IBD in cats

Elimination diet
Prednisolone for 10-14 days, then slow taper
if no response: Chlorambucil
Cobalamin supplementation

32

Protein losing enteropathy - define

Syndrome of intestinal diseases
Non-selective protein loss:
Albumin low, +/- Globulins low

33

Protein losing enteropathy - causes

IBD
Lymphangiectasia
Neoplasia (Lymphoma)

34

clinical picture

Diarrhoea
vomiting, anorexia
Weight loss
Ascites, pleural effusion, peripheral oedema
Usually albumin and globulin serum concentrations low
Important to biopsy early on in workup