Metabolism/ nutrition/ GI Flashcards
(135 cards)
1
Q
what is the significance of cholesterol on mortality rates in dogs and cats?
A
higher risk of mortality if hypocholesterolaemia (JSAP paper- he mortality rate of hypocholesteraemic dogs and cats was 12% in both species which was significantly higher than that of animals with normal serum cholesterol. The degree of hypocholesterolaemia was significantly associated with mortality. Disease of hepatic, gastrointestinal and lymphoreticular systems were most commonly associated with hypocholesterolaemia, and infectious and neoplastic disease were the most commonly associated pathophysiologic processes in both species. Lymphoma was over-represented in dogs with neoplasia.)
2
Q
concentrations of which minerals are likely to be significantly higher than declared in non-prescription commercial cat food?
A
calcium and phosphorus
3
Q
which amino acids could help modulate immune function when supplemented in feline diets?
A
arginine and ornithine
4
Q
which dietary supplement may reduce seizure frequency in dogs?
A
medium chain triglycerides
5
Q
senior feline diets have higher what than adult feline diets?
A
crude fiber
6
Q
what is the mechanism of action of bezafibrate?
A
Not fully understood but effects thoughts to be mediated by peroxisome proliferator activated receptor (PPAR) alpha and include reduction in hepatic triglyceride synthesis and increased activity of lipoprotein lipase.
7
Q
which form of 25OHD decreases postoperatively? (study looking at dogs undergoing CCL dz sx)
A
total 25OHD (whereas free 25OHD increased). Negative correlation between markers of inflammation and serum total 25(OH)D in people.
8
Q
what proportion of English Cocker Spaniels dx with DCM have low taurine?
A
81%
9
Q
which zoonotic pathogens of note have been documented to be increased in raw fed dogs?
A
MDR E.coli and salmonella
10
Q
A mutation in which gene may be implicated in vitamin D-dependent rickets type 1A in young pugs?
A
1a-hydrxylase gene (CYP27B1)
11
Q
receptors for which gastrointestinal hormone are aberrantly expressed in the adrenal cortex in food-dependent hypercortisolism?
A
GIP (gastric inhibitory peptide aka glucose-dependent insulinotropic peptide)- normal stimulation for secretion is protein, fat, FFAs and to lesser extent CHO. Normally produced by K cells in mucosa of duodenum and jejunum. Stimulates insulin release and mild effects on decreasing motor activity of stomach and therefore decrease gastric emptying if SI overloaded. Inhibits gastric acid secretion.
In food responsive hypercortisolism- abberant expression of receptors for GIP in adrenal cortex- food ingestion increases release of GIP from SI which binds to its R in the adrenal gland and causes excess cortisol secretion.
12
Q
dietary linoleic acid is required by dogs to form what? What are signs of linoleum acid deficiency?
A
to form arachidonic acid. Linoleic acid deficiency -> hyperkeratosis, water loss through skin, testicular degeneration
13
Q
a deletion mutation of what is linked to increased tendency for obesity in golden retrievers and labradors?
A
POMC (proopiomelanocortin)
14
Q
what is the recommended maximum amount of weight loss per week in dogs and cats being managed for obesity?
A
Shouldn’t exceed 2% per week, or if comorbidities shouldn’t exceed 0.5% per week
15
Q
what is the median time missing reported for cats diagnosed with refeeding syndrome? What factors were associated with non-survival?
A
6 weeks (range 3-104 weeks). increased risk non survival if AKI or higher total bilirubin.
16
Q
What is the median time that NE feeding tubes have been reported to be kept in situ at home?
A
6 days
17
Q
What percentage of dogs with uncontrolled chronic enteroapthy had a response to eating an elemental diet (amino acid based) kibble? What is the possible mechanism of action behind response?
A
70% response. Maybe due to shifts in faecal microbiome.
18
Q
What physical examination, clinical and biochemical parameters are supported by feeding of hydrolysed fish diets to dogs with PLE?
A
weight gain, serum albumin and recovery
19
Q
what melanocortin 4 antagonist may have potential efficacy in pet dogs with cachexia?
A
TCMCB07
20
Q
Feeding what diet, with potential efficacy at promoting urine dilution and decreasing urolithiasis risk, has been deemed safe for up to 5 years with regards to renal and cardiac health in healthy aged cats?
A
high salt diet
21
Q
Which interleukins are decreased in duodenal mucosa in GSD with chronic enteropathy?
A
IL-13 and IL-33
22
Q
Increased villous lacteal width and proprial mucosal lacteal width correlates with which biochemical finding in dogs with chronic inflammatory enteropathy?
A
Hypoalbuminemia
23
Q
Lymphatic endothelial cell IHC identified what finding in some dogs that was not recognised with routine H&E staining?
A
proprial mucosal lymphangiectasia
24
Q
Which skull type of dog is associated with esophageal dysmotility?
A
brachycephalic
25
what percentage of healthy research dogs receiving enrofloxacin and metronidazole experienced diarrhoea?
100%
26
What proportion of O tube placements are associated with complications, and what proportion are associated with infection?
44.4% complication rate; 16% infection overall
27
Administration of famotidine in which modality results in higher time with gastric pH >3?
CRI
28
what is the median time for albumin >20g/L in dogs with PLE treated with immunosuppression?
13 days (no difference between pred vs pred + second agent)
29
Which fluoroscopic swallow study features are suggestive of LES achalasia?
Bird beak sign and baseline oesophageal fluid line
30
Treatment with which combination of medications for IMHA in dogs results in 31.5x higher odds of endoscopic mucosal lesions?
prednisolone + aspirin (31.5 times higher odds in comparison to placebo, vs dogs on pred alone were 11.1 times higher odds in comparison to placebo)
31
list the types of hiatal hernia?
Type I - sliding hiatal hernia (abdominal segment of oesophagus and parts of the stomach displaced cranially through oesophageal hiatus)
Type II- paraesophageal hiatal hernia; abdominal segment of oesophagus and LES remain in a fixed position but a portion of the stomach herniates into the mediastinum alongside the thoracic oesophagus)
Type III - combination of types I and II (characterised by herniation of the greater curvature of the stomach as well as the gastroesophageal junction into the thorax)
Type IV- one case reported- liver, stomach and small intestine displaced into thorax
32
What type of hiatal hernia is most common in cats? What is commonly seen alongside HH in cats?
type I most common. Many cats have comorbidity including upper airway obstruction.
33
what proportion of brachycephalics with BOAS have GI signs?
76.7%
34
dogs with chronic inflammatory enteropathy and low calcidiol had what clinicopathological findings in comparison to CIE dogs with normal calcidiol?
Higher CCECAI scores, lower serum alpha-tocopherol, cholesterol and albumin and higher CRP. Vitamin D binding protein didn't' differ between groups. Duodenal morphologic and inflammatory histopathological scores and total histopath score in duodenum and combined duodenum and ileum negatively correlated with calcidiol concentration (ie more inflammation, lower calcidiol)
35
which dyslipidemias may be seen in dogs administered probiotic e. faecium SF68?
increased triglycerides and decreased cholesterol (but not clinically relevant, also no sig changes in ALT/ALP)
36
what effect does administration of pred, clopidogrel and pred/clopidogrel have on GI tract compared to placebo in healthy dogs?
Odds of endoscopic mucosal lesions> 4 were 7x higher in dogs in pred and pred/clopidogrel group than placebo, not associated with clinical signs. Conversely, no increases in GI ulceration with clopidogrel mono therapy
37
what is the long term impact of 7 days tylosin on fecal microbiota and fecal bile acids in healthy dogs?
Fecal scores unchanged between placebo and tylosin administration but tylosin dogs had decreased bacterial diversity and increased primary unconjugated bile acids in faeces. Changes did not uniformly resolve after discontinuation tylosin.
38
what complications of feline endoscopic removal of esophageal FB are recognised?
stricture, pleural effusion, CPA, unsuccessful removal,aspiration pneumonia
39
By what number of days can administration of metronidazole shorten duration of acute diarrhoea?
~1.5 days (mean time to resolution d+ 2.1 days in metronidazole tx dogs vs 3.6 in controls) (23.1% metro dogs and persistent c. perfringens at d 7 vs 78.6% controls)
40
how may CD3/Ki67 ratio aid diagnosis of CIE dogs and In which region are CD3/KI67 double positive labelling cells present in dogs with chronic inflammatory enteropathy?
dogs with CIE had sig higher Ki67/CD3 ratio than controls and sig correlation with CCECAI. Ki67 and CD3 positive cells found in sig increased numbers in laminate propria of crypts
41
Which biochemical and clinical scoring findings are predictive of increased risk death at time of dx in dogs with PLE?
CCEAI >8 and increased urea <7 mmol/L
42
D-lactate has been shown to be increased in which infectious enteritis?
canine parvovirus
43
What may procalcitonin be a useful marker of and when would it be expected to normalise?
sepsis/ endotoxaemia - expected to normalise after 48 hours
44
Which H2RA is of similar efficacy to esomeprazole and superior to pantoprazole when administered as a CRI for increasing gastric pH?
famotidine
45
which CCECAI cut off may help differentiate dogs with food-response PLE from immunosuppressant-responsive PLE or non-responsive PLE?
8
46
Clinical deterioration after endoscopy should raise concern for which complication, and what is the survival to discharge rate?
perforation, 93% survive
47
Which technique other than IHC, PARR and histo may be used to differentiate feline IBD from SCL on duodenal tissue samples?
histology guided mass spectrometry
48
what signalment features are more likely in dogs with chronic gastritis compared to controls?
Compared with controls, cases were significantly younger and more likely to be of a brachycephalic phenotype. Inspiratory dyspnea, gastric mucosal hyperemia, and gastritis severity were positively associated, whereas poor body condition was negatively associated, with CG with concurrent lymphofollicular hyperplasia on multivariable logistic regression.
49
what breed is most common for gastroeosophageal intussusception? What complication is most common after successful treatment, but can typically be managed medically?
German Shepherd most common, r+ most common complication post correction
50
how did time to recovery and faecal flora compare between amoxiclav tx and placebo in dogs with uncomplicated acute d+?
No difference in time to recovery. Higher proportion of resistant E.coli in the amoxiclav tx dogs which persisted at least 3 weeks post tx.
51
what effects do exenatide, metoclopramide and erythromycin have on gastric emptying in cats?
exenatide slows down gastric emptying, metoclop and erythromycin speed up (ie shorten gastric emptying times)
52
silent reflux episodes may be seen in what percentage of clinically healthy dogs?
100%
53
which ultrasonographic gastric wall changes may be seen in dogs with hypoalbuminemia?
edema in 21%, with preserved mucosa but thickened submucosa. Dogs with gastric edema also had peritoneal effusion. Albumin did not correlate with wall thickness.
54
What proportion of dogs with chronic LP rhinitis have endoscopic gastrointestinal lesions? What percentage of dogs with chronic LP rhinitis have GI signs? What impact does treating gastrointestinal disease have on LP rhinitis?
22/25 (88%) cases had concurrent GI endoscopic lesions, 13/25 (52%) had GI signs, in cases where GI signs tx the resp signs seemed to resolve or markedly improved up to 12 months post endoscopy
55
which method of parenteral hydroxycobalamin is efficiaceous in cats where owners cannot come weekly to the clinic?
IM hydroxocobalamin q2wks for 4 injections - cobalamin increased (normalised) at 4 weeks and MMA decreased significantly (normalised) at 4 weeks post the final injection
56
administration of metronidazole for 2 weeks may result in what alterations of fecal secondary bile acids, lactate, microbiome and meetabolome?
decreases in reichness and in key bacteria such as fusobacteria (that did not resolve 4 weeks after discontinuation), fecal dysbiosis index sig increased with increases in fecal total lactate and decreases sedondary BAs deoxycholic acid and lithocholic acid
57
Which PPI is superior in cats when orally administered, esomeprazole, lansoprazole and dexlansoprazole?
esomeprazole
58
What effect would you expect to see in a dysbiosis index when a dog is administered concurrent omeprazole and carprofen, versus carprofen alone?
increased dysbiosis index and fecal calprotectin
59
60
which microbe correlates with fecal secondary bile acid abundance? And which life stage is this lower in?
c. hiranosis, lower in puppies
61
How does increased MMA correlate with total iron binding capacity in cats with GI disease?
iron binding capacity lower in cats with higher MMA.
62
which fecal test is not useful for discriminating dogs in health and with chronic diarrhoea?
fecal culture
63
which noninvasive visualisation method correlates with duodenal histology in dogs? how about colonic histology?
duodenal - Storz Professional Image Enhancement System (SPIES) endoscopy , colonic- CEUS
64
What is the prevalence of fluoroquinolone-resistant granolumatous colitis in dogs?
15/24 (62.5%)
65
integration of what diagnostic testing increases numbers of cats diagnosed with lymphoma from GI histopathology? What percentage of cats are diagnosed with lymphoma on lower GI samples alone?
combine IHC and clonality testing. 1/44 (2%) dx from lower GI alone
66
which peptide that decreases food intake is decreased in obese dogs?
spexin
67
what is the utility of 2-dimensional fluorescence difference gel electrophoresis (2D DIGE) for differentiating cats with SCL from IBD?
not helpful
68
global clot strength as measured by TEG, is positively correlated with what feature of dogs with chronic enteropathy? what percentage of dogs with chronic enteropathy are hyper coagulable on TEG?
positive correlation with age, negative with albumin, HCT and duration of signs. 44.7% CE dogs hyper coagulable.
69
which is the best patient preparation to collect samples for uremic toxins?
be consistent with fasting status and time of sampling if monitoring values (serum indoxyl sulfate (IS), p-cresol sulfate (pCS), and trimethylamine-n-oxide (TMAO) sig lower if fed vs not fed )
70
what proportion of dogs receiving chronic NSAID therapy have gastric erosions?
83.30%
71
What surgical technique can be useful for removal of distal oesopahgeal foreign bodies?
transdiaphragmatic gastrotomy
72
what may be effective as a monotherapy in some dogs with PLE and US evidence of lymphangiectasia?
low fat diet
73
the use of what non-conventional equipment might aid removal of hard to grasp or sharp gastric foreign bodies via endoscopy?
bottle liner
74
what may be predisposing causes of sclerosins encapsulating peritonitis?
Previous surgery, pregnancy, presence of a perforating FB
75
Intravenous application of 10% amino acid solution in hypoalbuminemic dogs can improve albumin concentration after 2 days, but does not influence outcome.
IV 10% amino acid solution
76
which oral formulation of omeprazole is effective for increasing pH >3?
enteric coated (as non coated interfered with by stomach acid).
77
what proportion of dogs with non-gravity depending biliary sludge have concurrent enteropathy?
81% (13/16)
78
which treatment modality reduces SIRS criteria in dogs with acute haemorrhagic diarrhoea syndrome?
rehydration
79
what is the most appropriate next step for a patient with granulomatous ileocolitis who is refractory to treatment with fluoroquinolones?
repeat biopsy for c&s and treatment based on susceptibility
80
What is the expected coagulation status of dogs with chronic inflammatory enteropathy?
hypercoagulable, with hypofibrinolysis
81
How does prevalence of C perfrigents alpha toxin and enterotoxin compare between dogs with AHDS, dogs with haemorrhage diarrhoea of another cause and dogs without haemorrhoagic diarrhoea/
no difference
82
what proportion of dogs with PLE resistant to immunosuppressive treatment may respond to change in diet within 14-30 days?
80%
83
Which form of feeding is associated with improved outcome in PLE dogs on concurrent immunosuppressive treatment?
assisted enteral (feeding tube) (management with diet alone and use of enteral feeding tube generally associated better outcomes, feeding tube use assoc better outcome when in dogs on immunosuppression, benefit not shown in dogs on diet alone)
84
expression of pSTAT3 in dogs with chronic enteropathy in which regions correlates with CCECAI?
epithelial and crypt regions
85
what are risk factors for incomplete study when using video capsule endoscopy?
transit time >6h, opioids, simethicone, chronic enteropathy
86
micronised nanocrystal fenofibrate may cause significant reduction in which hepatobiliary enzyme activity?
ALP
87
what type of atresia ani is associated with a worse prognosis?
type III (rectum as a blind pouch) (vs better px with sx for types I - distal stenosis- and II - imperforate anus- , MST 41 months)
88
which scoring systemi is positively correlated with cPLI, CRP and negatively correlated with survival to discharge in dogs with pancreatitis?
modified canine activity index
89
which puppyhood diet may be associated with reduced atopic skin disease? (in dogs in Finland)
raw meat
90
what percentage of cases of oesophageal stricture undergoing ballooning as a first line therapy or stenting as a rescue therapy have a good long term outcome?
Baloon - 59% cases good long term outcome
Cases having stenting as rescue (due to stricture recurrence) - 88% good long term outcome
91
which route of apomorphine administration is fastest at inducing emesis?
IV (2 mins median vs 13.5 mins median for SC) (80% dogs receiving sc and 82% receiving IV , no sig diff, had induction emesis)
92
what proportion of cats with LPE have monoclonality on clonal testing of histologic intestinal biopsy?
70% (40% monoclonality, 30% monoclonality on a polyclonal background)
93
what effects would you expect to see in gastrin in dogs with NSAID-related gastric ulcers?
increased
94
which serum biomarker may be indicative of histopathologic severity of canine IBD and also correlates (along with CRP) with CCECAI ?
high mobility box group protein (HMBGP1)
95
which factors are associated with gastroduodenal ulceration in dogs?
NSAIDs, glucocorticoids, GI neoplasia, GI mechanical disease and working breed dogs
96
Which clinical and imaging features may help differentiate cats with LPE from LGITL?
male sex, longer duration clinical signs, polyphagia; rounded jejunal LN and peritoneal effusion
97
What long term effects could acute haemorrhagic diarrhoea result in?
higher risk of chronic GI signs
98
Which conditions do esophageal varices typically occur in conjunction with in dogs?
abdominal- portal hypertension, thoracic- pulmonary, caval or systemic hypertension
99
which macrolides may be effective for improved gastric emptying in healthy cats when compared to placebo?
azithromycin and erythromycin
100
which features of esophageal foreign bodies are associated with esophageal erosions?
longer duration and distal entrapment
101
what technique should be considered for oesophageal bone foreign bodies if oral removal is not possible?
gastric advancement for dissolution
102
which diet may be useful in acute large bowel diarrhoea?
high fibre diet
103
which bacteria is associated with gastric lymphoid follicular hyperplasia and in what age group?
helicobacter-like organisms, young dogs
104
in dogs with pancreatitis, what is the most common ultrasonographic site of GI wall changes?
duodenum
105
what factors increase likelihood of ultrasonographic diagnosis of pancreatitis?
increased lipase, previous episodes of pancreatitis and imager told 'suspicion of pancreatitis'
106
which histologic changes are more likely in dogs with severe hypocobalaminemia than normal b12?
crypt dilatation, villus atrophy, epithelial injury and intraepithelial lymphocytes
107
what effect does tylosin have on the gi microbiota?
decreased diversity and richness
108
which metabolites are decreased in dogs with CIE?
total fatty acids, glycine
109
which mode of adminstration of cobalamin is superior for dogs with EPI?
oral (based on MMA only decreasing in dogs given oral b12 , not injectable if had EPI - but b12 incr in both groups)
110
which fecal miRNA are highly sensitive and specific for detection of GI neoplasia?
miRNA 451 and miRNA 223
111
which treatment for acute diarrhoea produces a faster resolution of time than when metronidazole is added?
diet alone (easily digestible +/- fibre )
112
What proportion of dogs with PLE in remission relapse within 2 years, and what is a risk factor for this?
25%, poor dietary compliance
113
Derangements in which electrolyte may contribute to abnormalities in iCa and PTH in dogs with CIE?
ionised magnesium
114
Name 2 biochemical parameters that do not appear to be influenced by feeding?
cholesterol and albumin
115
which method is most effective to detect angiodysplasia in dogs?
Video capsule endoscopy (retrospective of cases dx on VCE - 15 cases total- 12 had overt GI bleeding (80%), 73% haematochezia, 40% microcytic hypo chromic anaemia. AGD had been missed by conventional endoscopy in 9/9 dogs and ex-lap in 3/3 dogs. 13 capsules given by mouth (1 incomplete study) and 2 into duodenum with endoscopy. AGD visualised in stomach of 3 dogs, SI of 4 and colon of 13
116
which positive stains for intestinal fibrosis are associated with decreased likelihood of remission and increased risk of death when present in the colon of cats with CE?
vimentin and massons trichrome
117
which B vitamin is associated with albumin and cholesterol levels in dogs with CIE?
B12
118
what effects on B12 and MMA would you expect to observe in dogs with parvoviral enteritis?
decreased b12 cf normal dog (but typically within RI) and normal MMA
119
which serum proteomic biomarker is greatly increased (50 fold) in cats with chronic enteropathy?
thrombospondin-1
120
which fecal acute phase protein may be of use for differentiating cats wth chronic enteropathy from small cell lymphoma?
fecal a1-acid-glycoprotein lower in CE
121
what are the most common causes of peripheral oedema in dogs?
vasculitis (37%), lymphatic/ venous obstruction (22%), hypoalbuminaemia (18%). Hypoalbuminaemia more likely if generalised peripheral oedema , abdominal and pleural ff with hypo alb more than vasculitis or lymphatic obstruction
122
which features of undernutrition score are most useful for predicting PLE remission?
epaxial muscle wastage and coat condition.
123
which miRNA may be of use for differentiating CATS with gastrointestinal neoplasia from healthy cats?
serum miRNA 223-3p
124
what DAMP is higher in faeces of cats with lymphoma and CIE compared to healthy cats but doesn't help differentiate between the two ?
Fecal S100A12
125
an increase in canine mycrobial disbiosis index may be documented when what is administered concurrently with esomeprazole?
A probiotic
126
what percentage of dogs with PLE and suspected or confirmed intestinal lymphangiectasia show an improvement in clinical signs while receiving octreotide?
50%
127
what percentage of cats with gastrointestinal eosinophilic sclerosing fibroplasia have peripheral eosinophilia?
50%
128
aerophagia is more likely in which patients?
Brachycephalic, mixed GI and resp signs, upper airway obstruction
129
Feeding prior to sampling changes interpretation when measuring B12 in what percentage of dogs?
27% (folate, cTLI and cPLI also affected in some dogs)
130
What histological diagnosis is present commonly in cats with short colon?
Lymphoplasmacytic colitis
131
what factors are associated with mortality during hospitalisation in dogs with PLE?
Longer duration of hospitalisation, longer duration of clinical signs, an increase in CRP after 1-3 days in hosp, being a pug (and if so risk of aspiration pneumonia)
132
what endoscopic technique might be considered for removal of difficult to visualise or multiple metallic gastric FBs?
use of a magnet contained within a roth net introduced endoscopically.
133
how do number of abnormalities documented on video capsule endoscopy with ALICAM differ between dogs with chronic enteropathy and healthy controls?
they don't
134
what protein content should be aimed for in patients with hepatic encephalopathy?
Dog- 18-22%
Cat - 30-35% (dry matter basis)
Avoid excessive protein restriction
Diet sixth milk and veg (e.g. soya) proteins lower in aromatic AAs (tyrosine and phenylalanine) and higher in branched chain AAs (eg valine, leucine and isoleucine) - less likely to precipitate HE
135
is fecal s100a12 (calgranulin C) helpful to differentiate CIE and LSA in cats?
no (but higher in both conditions than healthy cats)
vs in dogs - may help differentiate dogs needing immunosuppression from FRE and isn't impacted by steroids whereas calprotectin is
