Externships Flashcards

Question

early herbivore enterotoxemias

Answer 1

Fairly alert, normal, but with diarrhea and a temperature of less than 100F (chinchillas less than 99). High carb diet, lethargy. there may be very mild lethargy and pallor CBC/CHEM- normal liver values can rule out liver torsion radiographs treatment with LRS at 100 to 150 mL/Kg per day divided TID, buprenex- 0.03 mg/Kg BID, 0.01-0.05 mg/Kg. Prokinetics like cisapride or metoclopramide0.5 mg/kg PO or SQ B-Syringe-feeding (Critical Care Herbivore- rabbits- 12-24cc QID, chin or GP 6-12cc QID) *Antibiotics (metronidazole @ 10 mg/kg, chloramphenical at 50 mg/kg, or in rabbits only Procaine penicillin G- 70,000 IU/kg SQ q48 hr) *Toxin chelation (cholestyramine- mix 1 packet to 40mL tap water, syringe-feed rabbits 12cc , chin or GP 6cc S-BID) Heat therapy until T > 100. (Monitor closely, these species are susceptible to heat stress!) prognosis is guarded as decompensation is fatal)

Answer 2

Weak, lethargic, pale and/or increased respiratory effort with T < 100 Can be rapidly fatal Signalment Any small herbivore, any age, either sex History Same history as GI stasis and enterotoxemia Physical Examination **Temperature <100 (axillary +1 degree is acceptable to avoid stress or injury) Chinchillas <99 Abdominal palpation same as GI stasis Lethargy or pallor may occur (**adrenaline won’t mask for very long) Incr. respiratory effort Diagnostics- BP <40 mm Hg No additional! Stabilize patient! Treatment IVC will be invaluable here. If IV access cannot be obtained without undue stress to patient, give warmed SQ fluids (LRS @ 100 mL/kg) and place on heat, +/- cover with warm blanket. As fluid is absorbed, consider reattempt IVC; intraosseus in femur is also acceptable (as in puppies) 1) Crystalloids- 10-15 mL/kg IV Hetastarch- 15 mL/kg IV over 15 min. Recheck BP. If <40 mm Hg, repeat. If still <40mm Hg, go to step 2. If >40 mm Hg, go to step 3. 2) Hypertonic Saline- 3 mL/kg over 10 minutes Hetastarch- 3 mL/kg IV over 15 min. Crystalloids- 4 mL/kg/hr IV Recheck BP. If <40 mm Hg, rule-out hypoglycemia or heart disease (rads) If >40 mm Hg, go to step 3. 3) Warm aggressively including IV crystalloids until BP > 90 mm Hg If BP drops below 40 mm Hg, return to step 1. Once stable, administer treatments as per enterotoxemia. Treatments may need to be given slowly due to stress. **Therefore, first treatment should be toxin chelation (cholestyramine- mix 1 packet to 40mL tap water, syringe-feed 12cc S-BID, chin and GP 6cc S-BID) CBC/chem. and possibly rads may be warranted if patient is stable. Additional diagnostics should be deferred. Prognosis Guarded-grave unless recovers completely and quickly following above treatment.

Answer 3

Signalment: ferrets <1 year old more likely to be infectious (non-Helicobacter) or GI FB ferrets > 1 year more likely to be Helicobacter or GI FB diarrhea will be reported as being soft or seedy, green or malena, vomiting, nausea, gagging , pytalaism pawing and mouth, pain, anorexia, hsitory of eating something

Answer 4

: +/- debilitated (dehydration by CRT, lethargy), abd. Palpation may have focal thickening/discomfort (incr. suspicion for GI FB), or just generalized SI thickening, gas, fluid. Abd. LN enlargement can occur (not pathognomonic for LSA).

Answer 5

Helicobacter gastroenteritis +/- ulcerative gastritis, GI FB (including trichobezoars), LSA, IBD, eosinophilic gastroenteritis, ECE (epizootic catarrhal enteritis)- usually older ferret exposed to new or young ferret, proliferative bowel disease (younger), metabolic derangement

Answer 6

ATH if debilitated, many times tx for Helicobacter with further work-up if young or poor response to tx. Amoxicillin – 20 mg/kg PO BID Metronidazole- 15-20 mg/kg PO BID Sucralfate- 100 mg/kg PO B-TID 20 min. before meals or meds. Famotidine- 0.5 mg/kg PO/SQ/IV S-BID

Answer 7

Can be acute (<24 hours) or chronic (2-7 days) Inappetance, anorexia, or normal appetite (usually early) Small, dry, sparse droppings May have dysphagia Emotional stress (travel, owner away, construction or new pet or family member in home) Physiological stress (underlying disease, typically dental, infectious, renal, hepatic, or cardiac, or heavy metal toxicity) Dietary issues (low fiber or high protein or high carbohydrate diet)

Answer 8

Temperature >100 (axillary +1 degree is acceptable to avoid stress or injury) Chinchilla >99 Abdominal palpation may or may not reveal: Splint, vocalizations Full firm stomach Tympany (stomach or cecum) Empty cecum Liquidy or gassy cecum Lack of feces in colon Decreased borborygmus (almost always decreased or absent unless very early in process)

Answer 9

CBC/chem.- normal liver enzymes can help rule-out life-threatening liver torsion E. cuniculi titer- ideal to always check, but especially when nothing in history or PE suggests underlying problem Lead level- particularly for known chewers allowed loose in homes >35 years old. (Has been seen in pets from “certified lead free” homes in our area) Imaging- Radiographs- ideal to always check, but especially important in severely debilitated (if not outweighed by risk of stress), severely painful, if PE is equivocal, or if looking for radiographic signs of underlying disease. U/S- recommended especially if liver torsion or FB suspected.

Answer 10

Rehydration (SQ fluids- Maintenance is LRS @ 100-150 mL/kg per day, divided TID) Analgesia (buprenex- 0.03 mg/kg BID) (range 0.01-0.05 mg/kg) Prokinetics (cisapride when available, metoclopramide 0.5 mg/kg PO or SQ B-TID) Syringe-feeding (Critical Care Herbivore- rabbits 12-24cc QID, chin or GP 6-12cc QID) Prognosis Good if not debilitated, not too painful and no underlying disease; unfortunately, decompensation due to any of these can be rapid and fatal.

Externships Flashcards

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