Gastrointestinal Disease 2

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Gastrointestinal Disease 2
2013-02-16 20:14:18
Animal Diseases Three

Animal Diseases
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  1. What things make up the small intestines?
    • microvilli
    • crypt cells
    • goblet cells
    • hormones
  2. What does microvilli do?
    brush border to absorb nutrients
  3. What do crypt cells do?
    produce new cells that replace old villus cells as they slough off the top
  4. What do goblet cells do?
    produce mucus
  5. What types of hormones are in the small intestines?
    • secretin
    • cholecystokinin
    • gastric inhibitory peptide
  6. What does secretin do?
    • causes biocarbonate to be released from the pancreas
    • causes bile production to increase in the liver
  7. What does cholecystokinin do?
    • causes digestive enzymes to be released in the pancreas
    • causes the gall bladder to empty
  8. What does gastric inhibitory peptide do?
    decreases activity of the stomach
  9. What are the different diseases of the small intestines?
    • impairment of the absorptive villous surface
    • malabsorption, diarrhea, weight loss
    • small intestinal neoplasia
  10. What is diarrhea?
    • increased frequency of defecation
    • increased fluidity of stool
    • increased volume of stool
  11. What is the most common type of diarrhea and what causes it?
    • acute diarrhea
    • diet change, drug therapy, stress
  12. What are the different causes of diarrhea?
    • parasitic
    • bacterial
    • viral
    • dietary intolerance/sensitivity
  13. What are the clinical signs of parasitic diarrhea?
    • diarrhea
    • maybe vomiting
    • maybe blood in the vomit or diarrhea
    • weight loss
    • poor hair coat
  14. How do we diagnose parasitic diarrhea?
    fecal exams
  15. How do we treat parasitic diarrhea?
    • anthelminitcs for hooks, whips, and rounds
    • antiprotozoals for giardia and coccidia
  16. What type of viruses cause viral diarrhea?
    • canine parvovirus
    • canine corona virus
    • feline corona virus (FIP)
    • feline panleukopenia (feline parvovirus)
  17. What part of the body is affected with canine parvovirus?
    intestinal villi are affected and they collapse
  18. Where is canine parvovirus shed?
    shed in feces, vomit, and saliva
  19. How is canine parvovirus spread?
  20. Can we find canine parvovirus in the environment?
  21. Which dogs are predisposed to canine parvovirus?
    • rottweilers
    • dobermans
    • black labs
  22. What are the clinical signs of canine parvovirus?
    • vomiting
    • depression
    • fever
    • bloody diarrhea
    • anorexia
    • lethargy
    • dehydration
  23. How do we diagnose canine parvovirus?
    • ELISA test for parvovirus
    • decreased WBC count
    • viral detection in stool
    • electron microscope
  24. How do we treat canine parvovirus?
    • NPO
    • fluid therapy with KCL, dextrose, B vitamins
    • plasma transfusion
    • antibiotics
    • antiemetics
    • isolation
  25. How do we treat canine parvovirus?
    • keep patient warm, dry, and clean
    • wear protective clothing when treating patient
    • food dip in isolation area
  26. What kind of client education do we need to provide for canine parvovirus?
    • the patient is contagious to other dogs - avoid parks, kennels, dog shows, obedience classes
    • clean up fecal material for the next few weeks
    • use 10% clorox solution
    • vaccinate
  27. Where is the canine corona virus shed?
    in feces
  28. Which is more damaging to intestinal villi, corona virus or parvovirus?
  29. What are clinical signs of canine corona virus?
    • inapparent to severe gastroenteritis
    • anorexia, lethargy, dehydration
    • vomiting may have blood or mucus
    • yellow-green to orange malodorous diarrhea that may have blood or mucus
    • persistent or intermittent for 3 - 4 weeks
  30. How do we diagnose canine corona virus?
    • presumptive
    • electron microscope for viral identification
  31. How do we treat canine corona virus?
    • supportive
    • isolate patient
  32. How do we prevent canine corona virus?
  33. What are the different names of feline panleukopenia?
    • feline parvovirus
    • feline infectious enteritis
    • feline distemper
  34. Is feline panleukopenia contagious?
    highly contagious
  35. Is feline panleukopenia fatal?
  36. Which types of cats is panleukopenia the most severe in?
  37. Which cells does feline panleukopenia affect?
    affects rapidly growing and dividing cells in bone marrow, lymph tissue, intestinal epithelium, cerebellum and retinas of young animals
  38. What can feline panleukopenia cause in pregnant queens?
    • embryonic death
    • mummification
    • abortion
    • still birth
    • cerebellar hypoplasia of kittens - tremors, incoordination
  39. How is feline panleukopenia transmitted?
    • oronasal
    • virus in abundant in all secretions
    • virus can survive in the environment for over one year
  40. What are the clinical signs of feline panleukopenia?
    • most cases are subclinical
    • most patients that manifest illness are under one year old
    • fever
    • depression
    • anorexia
    • vomiting
    • diarrhea
    • extreme dehydration
    • abdominal pain - palpation may induce vomiting
    • thickened intestinal loops
    • cerebellar hypoplasia - normal mentation with incoordination and tremors
  41. How do we diagnose feline panleukopenia?
    • usually based on clinical signs
    • CBC - WBC count under 500 WBC/ul
  42. How do we treat feline panleukopenia?
    • vigorous fluid therapy
    • dextrose and KCL added to fluids if needed
    • antibiotics
    • plasma or whole blood transfusion
    • antiemetics
  43. What causes bacterial diarrhea?
    • bacteria invade and damage intestinal epithelium
    • release enterotoxins which stimulate secretions, attach to mucosal surfaces, and produce cytotoxins
  44. What types of bacteria cause bacterial diarrhea?
    • salmonella
    • campylobacter
    • escherichia coli
    • clostridium
    • staphylococcus
  45. What are the clinical signs of bacterial diarrhea?
    • diarrhea may be bloody
    • may have fever
    • anorexia
    • vomiting
    • dehydration
    • septicemia
  46. How do we diagnose bacterial diarrhea?
    • fecal exam
    • fresh saline smears
    • cytotoxin assay - titer for clostridium
    • fecal cultures
  47. How do we treat bacterial diarrhea?
    • antibiotics
    • fluid and electrolyte replacement
  48. What is the difference between dietary sensitivity and dietary intolerance?
    • dietary sensitivity:  immune mediated
    • dietary intolerance:  non-immunologic and can be a dietary indiscretion
  49. What can an endoscopic exam help determine with dietary intolerance/sensitivity diarrhea?
    help to determine the extent of mucosal damage
  50. Which dietary substance could animals potentially not be able to handle with dietary intolerance/sensitivity?
    • carbohydrates
    • fats
    • dairy products
  51. What are the clinical signs for dogs with dietary intolerance/sensitivity involving the skin
    • non-seasonal pruritis in ears, face, feet, hindquarters
    • urticaria, erythema
    • alopecia, scales, papules
    • epidermal collarettes, crusts, erosions, otitis
    • hyperpigmentation, lichenification, hot spots
  52. What are the clinical signs for cats with dietary intolerance/sensitivity involving the skin?
    • non-seasonal pruritis in pinnae, face, head, neck feet
    • alopecia, miliary dermatitis
    • eosinophilic complex
  53. What are the GI clinical signs of dietary intolerance/sensitivity diarrhea?
    • vomiting
    • diarrhea - mucus, blood
    • abdominal pain, discomfort
    • flatulence
    • weight loss
  54. Which types of animals are the most affected by dietary intolerance/sensitivity diarrhea?
    can affect any age, but most commonly in dogs under 1 year and cats from 2 - 5 years
  55. How do we diagnose and treat dietary intolerance/sensitivity diarrhea?
    • dietary trial
    • avoid treats, flavored treats, flavored medication, vitamins, coprophagia
    • treat and resolve concurrent skin and ear infections
    • serum allergy testing
  56. How do we do a dietary trial for intolerance/sensitivity diarrhea?
    • exclusion, elimination diet
    • protein source not usually eaten by the pet
    • need a trail of at least 12 weeks
    • can try oral prednisone
  57. What are the most common food allergens in dogs?
    • beef
    • soy
    • chicken
    • milk
    • corn
    • wheat
    • eggs
    • any protein can be involved
  58. What are the most common food allergens in cats?
    • fish
    • beef
    • dairy
  59. What are the two types of intestinal neoplasia?
    • adenocarcinoma - more common in older cats than dogs
    • lymphosacroma - more common in cats than dogs
  60. What are the clinical signs of intestinal neoplasia?
    • clinical signs are progressive
    • signs related tot he location and growth of the tumor
    • metastasis can occur
    • weight loss
    • signs of partial GI obstruction
    • may have melena
    • malabsorption/maldigestion
    • may have diarrhea, vomiting
    • abdominal discomfort
    • anorexia
  61. How do we diagnose intestinal neoplasia?
    • palpate abdominal mass
    • intestinal wall thickens
    • contrast radiographs
    • obstruction
    • endoscopy for biopsy of upper GI tract
    • minimum data base - anemia, hypoproteinemia
  62. What will we see on a contrast radiograph with intestinal neoplasia?
    • mucosal irregularity
    • thickened bowel walls
    • abnormal lumen diameter
  63. How do we treat intestinal neoplasia?
    • surgical removal if possible
    • chemotherapy - cats respond better than dogs
    • supportive care
    • nutritional management
    • antibiotics if bacterial overgrowth
    • cotricosteroids
  64. What kind of client education do we need to provide for intestinal neoplasia?
    • prognosis for adenocarcinoma is poor
    • may survive 7 months to 2 years with treatment
    • cats with lymphosarcoma respond well to chemotherapy - remission up to 2 years
    • supportive and nutritional care is critical
    • new cancer diets are available through Hills
  65. What is the function of the colon?
    • reabsorption of water and electrolytes
    • store feces
    • microbial fermentation of undigested material
    • production of vitamins K and B
  66. What are the most common signs of large bowel disease?
    • diarrhea
    • straining to defecate
    • blood in the stool
    • increased mucus in the stool
  67. What are the different types of large intestines diseases?
    • intussusception
    • megacolon
  68. What are the causes of intussesception?
    • usually idiopathic
    • parasites
    • foreign body
    • infections
    • neoplasia
  69. Where does intussesception occur?
    • smaller, proximal segment of the intestines
    • invaginates in the larger portion of the large bowel
  70. What can intussesception cause?
    • causes a partial to complete blockage
    • ischemia, bowel necrosis
  71. What are the clinical signs of intussusception?
    • vomiting
    • anorexia
    • depression
    • diarrhea
  72. How do we diagnose intussusception?
    • palpate a sausage-like mass in the cranial abdomen
    • ultrasound - multilayered concentric rings
    • contrast radiograph - barium
  73. How do we treat intussusception?
    • surgical reduction
    • fluid therapy
    • antibiotics
    • restrict sold food for 24 hours post-op, then begin bland food
    • recurrence is infrequent
    • puppies should be dewormed on a proper schedule to prevent bowel irritation and intussusception
  74. What can cause megacolon?
    • loss of normal colonic function
    • usually dysfunction of colonic smooth muscle
    • severe fecal impaction
    • colonic distension
    • middle aged to older cat
    • obese
    • persistent distension leads to loss of colonic motility
    • muscle hypotony
    • water continues to be resorbed from the feces
    • feces becomes like concrete
    • unable to pass feces
    • mucosal injury from intraluminal pressure
  75. What are the clinical sings of megacolon?
    • straining to defecate
    • vomiting
    • weakness
    • dehydration
    • anorexia
    • small, hard feces, or liquid feces with or without blood
  76. How do we diagnose megacolon?
    • history and physical exam
    • abdominal palpation
    • rectal exam
    • minimum data base
    • radiographs - distended colon
  77. How do we treat megacolon?
    • correct fluid and electrolyte abnormalities
    • remove impacted feces
  78. How do we remove impacted feces?
    • warm water enemas, lubricants 
    • do not use sodium phosphate enemas in small dogs or cats - electrolyte disturbance
    • sedation
    • may need forceps
  79. What is the long term maintenance for megacolon?
    • dietary fiber - psyllium, oat bran, canned pumpkin
    • laxative - DSS (dioctyl sodium sulfosuccinate), lactulose
    • prokinetic agent - Propulsid (cisapride), nizatidine or ranitidine
    • colectomy
  80. What kind of client education do we need to provide for megacolon?
    • recurring problem
    • medical treatment for the life of the cat
    • may be solved with surgery