Gastro - Diseases of the Colon

Question 1

What is the normal function of the colon?

Answer 1

Fluid storage, motor function, mucus secretion, passive water flux, and bacteria flora

Question 2

Do anaerobes or aerobes prevail in the colon?

Answer 2

anaerobes

Question 3

What are clinical signs of colon disease?

Answer 3

LB diarrhea, hematochezia, mucus, tenesmus, frequent defecation, small volumes of stool, and there are rarely systemic signs

Question 4

What are the causes of chronic colitis?

Answer 4

Infectious (parasites, fungi), infiltrative disease, intussusception, and motility disturbances

Question 5

What infiltrative disease can cause chronic colitis?

Answer 5

IBD colitis, neoplasia, and mycotic colitits

Question 6

Where does Trichuris vulpis preside?

Answer 6

the cecum and the colon

Question 7

Is diarrhea due to Trichuris vulpis chronic or acute?

Answer 7

It can be acute, chronic, or intermittent

Question 8

What is the treatment of choice for Trichuris vulpis?

Answer 8

fenbendazole for 5 days

Question 9

What are the common causes of bacterial colitis?

Answer 9

Clostridial species (perfringens and difficile), Salmonellosis, E. coli, and C. jejuni

Question 10

What common etiologic agent of bacterial colitis is zoonotic?

Answer 10

Campylobacter jejuni

Question 11

Why is bacterial colitis tough to diagnose?

Answer 11

because the problem bacteria are commensals

Question 12

What is the etiologic agent of fungal/algal colitis?

Answer 12

Histoplasmosis

Question 13

What clinical signs are associated with fungal colitis?

Answer 13

Large bowel diarrhea +/- systemic signs

Question 14

How is fungal colitis diagnosed?

Answer 14

rectal scrapes/endoscopic biopsy; urine Ag

Question 15

What is the therapy of choice for fungal colitis?

Answer 15

itraconazole/fluconazole for long-term therapy of 4-6 months

Prednisone to reduce inflammation seen with fungal death for 1-2 weeks

Question 16

What is the prognosis for Prototheca colitis?

Answer 16

poor

Question 17

What causes the clinical signs of inflammatory bowel disease?

Answer 17

infiltrates and mediators

Question 18

How is inflammatory bowel disease diagnosed?

Answer 18

Diagnosis of exclusion and GIT biopsy

Question 19

How is Inflammatory Bowel Disease treated?

Answer 19

nutrition and drugs

Question 20

What are some structural causes of chronic GI disease?

Answer 20

intussusception and neoplasia

Question 21

What are some metabolic diseases that cause chronic GI disease?

Answer 21

Renal disease, liver disease, Addison’s disease, and hyperthyroidism

Question 22

What are some parasites that cause chronic GI disease?

Answer 22

Giardia, Cryptosporidia, T. felis, and Physaloptera

Question 23

What are some infectious diseases that cause chronic GI disease?

Answer 23

FeLV/FIV, Toxoplasmosis, and histoplasmosis

Question 24

How would you treat chronic enteropathy due to Giardia?

Answer 24

Fenbendazole

Question 25

If you have a dog or cat that comes into the clinic and has chronic enteropathy, what is the first therapy you should try? You have already ruled out parasites.

Answer 25

Try a food trail In cats - 7 day elimination trial In dogs - 14 day elimination trial

Question 26

If a food trial does not work to treat chronic enteropathy, what should your next therapy be?

Answer 26

Try antibiotics - Metronidazole is the most common | Others that could be used are Tylosin and Oxytetracycline

Question 27

What food additive should you use to try and treat for colitis?

Answer 27

Fermentable fiber (psyllium)

Question 28

What supplementation should be given to patients with chronic enteropathies?

Answer 28

Cobalamin

Question 29

How many biopsies should you take from the stomach when testing for IBD?

Answer 29

At least 8 gastric biopsies

Question 30

How many biopsies should you take from the duodenum when testing for IBD?

Answer 30

At least 15 duodenal biopsies

Question 31

Can you cure IBD?

Answer 31

It is rarely curative; control is possible in most patients

Question 32

Will relapses occur in patients with IBD?

Answer 32

yes

Question 33

What therapy is important for treatment of IBD?

Answer 33

Nutrition therapy

Question 34

What type of diet would you want to give to a patient with IBD?

Answer 34

Hydrolized rations or novel single Ag

Question 35

What percentage of IBD patients respond to nutritional therapies?

Answer 35

50%

Question 36

What drugs would you want to give to patients with IBD?

Answer 36

Prednisone and other immunosuppressives to decrease mucosal inflammation

Question 37

What agents, in food therapy, will help with clinical recovery of IBD?

Answer 37

bulking agents (fermentable fiber)

Question 38

Why are bulking agents good?

Answer 38

They bind to irritants, promote motility, and provide short-chain fatty acids

Question 39

What effects do corticosteroids have?

Answer 39

anti-inflammatory/antiprostaglandin

Question 40

What is the first choice corticosteroid to use in cats and dogs?

Answer 40

Prednisone in dogs and prednisolone in cats at 1-2 mg/kg/day

Question 41

What do corticosteroids suppress (side effects)?

Answer 41

HPA supression

Question 42

Other immunosuppressives may need to be given for IBD therapy. What drugs may you want to use?

Answer 42

Cyclosporine or chlorambucil

Question 43

How will lymphopcytic-plasmacytic colitis look on biopsy?

Answer 43

Hyperplastic lymph nodes, multiple erosions, and no significant macrophage infiltrate

Question 44

What is granulomatous colitis a variant of?

Answer 44

It is a canine IBD variant

Question 45

What breed is granulomatous colitis common in? Age?

Answer 45

Boxers, <2 years

Question 46

What clinical signs are associated with granulomatous colitis?

Answer 46

LB diarrhea and systemic signs

Question 47

How will granulomatous colitis look like on biopsy?

Answer 47

Intense granulomatous infiltrate

Question 48

What is the etiologic agent of granulomatous colitis?

Answer 48

Attaching/invasive E. coli

Question 49

What is the drug therapy of choice for granulomatous colitis?

Answer 49

Fluoroquinilones | Recent data supports the use of enrofloxacin

Question 50

What is the prognosis for granulomatous colitis?

Answer 50

good

Question 51

What are the clinical signs for fiber-responsive colitis (FBD)?

Answer 51

Large bowel diarrhea +/- blood and mucus

Question 52

What type of disease is irritable bowel syndrome?

Answer 52

It is a functional disease - decreased motility

Question 53

What clinical signs are associated with irritable bowel syndrome?

Answer 53

Abdominal pain, diarrhea, and constipation

Question 54

How is FRD and IBS diagnosed?

Answer 54

Diagnosis of exclusion - marked resolution on high fiber diets, consider motility modifiers

Question 55

What colorectal neoplasias predominate?

Answer 55

Malignant tumors - Adenocarcinoma, lymphosarcoma, and leiomyoma/sarcoma

Question 56

Where do most colorectal neoplasias reside?

Answer 56

in the left colon

Question 57

Where are colorectal neoplasias commonly located in cats?

Answer 57

ileocolic area

Question 58

At what age are colorectal neoplasias commonly found?

Answer 58

Middle-aged or older animals

Question 59

What clinical signs are associated with colorectal neoplasias?

Answer 59

Large bowel diarrhea +/- systemic signs

Question 60

How are colorectal neoplasias diagnosed?

Answer 60

examination, imaging, and endoscopic biopsy

Question 61

What diagnostic tool is critical for determining colorectal neoplasia therapy?

Answer 61

histology

Question 62

What is the prognosis for lymphosarcoma?

Answer 62

8-12 months with UW-25 protocol

Question 63

What is the prognosis for colorectal adenocarcinomas?

Answer 63

good remission with surgery | 15-22 months in dogs and cats

Question 64

What is the prognosis for adenomatous polyps?

Answer 64

excellent