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ACVN - MEDICAL NURSING > Dietary Sensitivity and Chronic Inflmmation Enteropathies > Flashcards

Dietary Sensitivity and Chronic Inflmmation Enteropathies Flashcards

1
Q

What is a food intolerance ?

A

something that occurs repeatedly

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2
Q

What is a non-repeatable diet sensitivity?

A

dietary indiscretion, intoxication or poisoning

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3
Q

What are repeatable and non-repeatable sensitivies?

A

non-immunologically mediaated

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4
Q

What are immunlogically mediated diet sensitivites?

A

food allergies

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5
Q

Are food allergies repeatable or non-repeatable?

A

repeatable

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6
Q

What are the most common food allergies in dogs?

A

beef, dairy products and wheat

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7
Q

What are the most common food allergies in cats?

A

beef, dairy and fish

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8
Q

What is ARF?

A

adverse food reactions

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9
Q

What are immunologically mediated food sensntivites usually?

A

a protein component

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10
Q

What are the cutaneous signs of a food allergy?

A
  • pruritis/erythema
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11
Q

What are the gastrointestinal signs of a food allergy?

A

vomiting, diarrhoea

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12
Q

What is the most common food allergy reaction?

A

cutaneous - pruritis

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13
Q

Are gastrointestinal signs non-specific or specific?

A

non-specifc

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14
Q

What are the systemic signs of a food allergy?

A

anaphylaxis

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15
Q

What age do food allergies usually present in?

A

younger pets however any age is possible

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16
Q

What does dysorexia mean?

A

abnormal appetite

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17
Q

What are chronic inflammatory enteropathies?

A

A ground of diseases with chronic gasto intestinal inflammation

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18
Q

What symptoms would you see with chronic inflammatory enteropathies?

A

vomiting, diarrhoea, dysorexia, weight loss

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19
Q

How long does it occur if it is a chronic inflammatory enteropathy?

A

more than >3 weeks

20
Q

What other causes must be involved for it to be a chronic inflammtory enteropathy?

A

exocrine, local abdonimal inflammtion, metabolic

21
Q

What exclusion testing would you do for CIE?

A

faecal, bloods, imaging (abdominal ultrasound)

22
Q

What are the causes of CIE?

A

food responsive disease, antibiotic responsive disease, idiopathic disease

23
Q

What would you recommend if a patient comes in with food responsive disease?

A

a diet trial

24
Q

What is another term for CIE?

A

Inflammatory Bowel Disease

25
Q

What type of disorder is idiopathic CIE?

A

immunological

26
Q

What causes gastrointestinal inflammation?

A

a shift in floral, causing loss of tolerance to mucosal flora

27
Q

How would you diagnose CIE?

A

biopsies

28
Q

What are the advatnages and disadvantages of doing an endoscope based approach to intestinal biopsies?

A
  • minimally invasive
  • small mucosal biopsies
  • may not reflect jejunal disease
29
Q

What are the advantages and disadvatnages of doing a laparotomy aproach for intestinal biopsies?

A
  • enables multiple full thickness biopsies
  • enables full exploration of other organs
  • surgical risk of dehiscence (~10%)
30
Q

What are the standard supportive therapies for CIEs?

A
  • fluid balance - hydration, volaemia
  • nutritional balance - dietary modification; exclusion diet, tube feeding intitially in severely affected animals; dietary suitability
  • various anti-emetics, appetite stimulants, as required
31
Q

What are the principles for dietary trials?

A
  • feed with water for minimum 3-10 weeks
  • NOT a sensitivity diet like Hill’s I/D
  • other diseases may respond to dietary trials
  • dermatology signs respond in 10 weeks
  • GI responds in 3 weeks
32
Q

What are the dietary options for food intolerance/sensitivity trials?

A
  • novel protein/carbohydrate (home cooked vs commercial)
  • hydrolysed protein
33
Q

Why might a patient need to have nutrtional support?

A
  • less than 80% RER voluntary intake
  • more than 10% BW loss (after fluid balance)
  • more than 3 days hyporexia
  • severe underlying disease (trauma, sepsis, severe burns)
34
Q

What are other forms of dietary manipulation?

A
  • feeding frequently/posutre
  • low fat
  • supplemented fibre
35
Q

What is a low fat diet good for?

A
  • facilitates gastric emptying
  • good for reflux/regurgitation
36
Q

What drug you give if a patient is experiencing gastro-intestinal dilation?

A

omeprazole

37
Q

What drug can you give if a patient is experiencing gastro-intestinal ulceration?

A

sucralfate

38
Q

What can you do if a patient is experiencing reflux pain?

A
  • manage oesophagitis
  • postural feeding
39
Q

What might opioids do if a patient is having abdominal discomfort?

A

may exacerbate/cause ileus

40
Q

What other medication can you give if a patient has abdomonial discomfort?

A

buscopan/spasmolytic

41
Q

What does a spasmolytic do?

A

relieves spasms of smooth muscle

42
Q

What per-anal management would you do for diarrhoea/faceal scald?

A
  • keep bottom clean and dry
  • topical barrier such as cavilon spray or no sting barrier film +/- vaseline for extra barrier
43
Q

How would you manage the patient with diarrhoea/faecal scald?

A
  • avoid patient grroming (provide distractions or use buster collar)
  • tail bandage
  • absorbent bedding (layers of inco sheets)
  • avoid vet beds as can be scratchy, use soft fleecy bedding
44
Q

Write down the consequences and considerations of CIEs

A
  • dehydration
  • protein malabsorption ‘protein losing enteropathy’ - hypobilirubinaemia
    -effisions (pleural, respiratory comrpmise; peritoneal
    -oedema
    - throboemolic events
  • hypocobalminaemia
  • GI haemorrhage +/- anaemia
  • GI perforation
45
Q

Write down the standard therpies for CIEs

A
  • immunosuppression - prednisolone (minimum effective dose) +/- adjuncts (handling care required)
    -+/- fenbendazole
    +/- metronidazole
    +/- vitamin B12
    +/- anti-platelet drugs
46
Q

Write down the nursing considerations for CIE patient

A
  • hydration status (replace deficits/ongoing losses)
  • inappetance/nausea
  • nutriton/malnutrtion status (tube feeding, B12/potassium
  • abdominal discomfort
  • hypoproteinaemia
  • diarrhoea/faecal scald
  • body/muscle condition score
47
Q

Write down the monitoring considerations for the CIE patient

A
  • weight
  • appetite
  • demeanour
  • vomiting/diarrhoea (record nature, vomit/regurge vs small/large intestinal diarrhoea; try to quantify)
  • hydration/volaemic status
  • HR/ RR
  • comfort levels
  • bloods; electrolytes, proteins

ACVN - MEDICAL NURSING (22 decks)

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