Vomiting stuff is same slides as in stomach powerpoint
what is the definition of diarrhea? (3 things)
(1) low consistency (2) increased frequency (3) increased quantity
Diarrhea means intestinal disease BUT lack of diarrhea does NOT..
exclude small intestinal disease
in diarrhea, the excess fecal water can result from what two processes?
(1) Decreased absorption (2) inc secretion
classifying diarrhea: Options for duration, location, pathophys, and pathology? (list)
(1) Acute vs chronic. (2) Small vs large intestine. (3) pathophys: osmotic vs secretory vs permeability vs motility. (4) path: inflammation vs hypersensitivity vs infection vs neoplasia
Acute diarrhea cause? How long does acute diarrhea last?
Usually idiopathic (often garbage ingestion or something of the like). and self limiting within 3-5 days.
why is 3 days like the magic number for intestinal problems?
takes about 3 days for vili to recover or regenerate
If you have an acute diarrhea case, you should do what test for sure, and **what two things do you def wanna exclude?
Do a FECAL EXAM to look for parasites, parvo, etc.... and then make sure to exclude sepsis and ileus!
what is therapy for acute diarrhea? (4 things)
IV FLUIDS, electrolyte balance, fenbendazole, metronidazole
Should you withhold food with acute diarrhea? why?
NO!!!! because withholding food leads to loss of semipermeability, resulting in an inc of bacterial toxins. If possible, try to feed small meals consistantly throughout the day
if you have acute diarrhea, should you giv abx? why?
NO!! This will lead to dysbacteriosis (she said dont use the big ones unless you have a specific indication or pt is septic). there are EXCEPTIONS THO: sepsis, leukopenia, bacterial overgrowth--> metronidazole, tylosin
should you give motility inhibitors to an acute diarrhea pt? why?
maybe if fluid loss too high
how does a motility inhibitor work and what is an example?
Whipworms-- where do they live? Do they make large or small bowel diarrhea?
Live in Caecum, Chronic large > small bowel diarrhea (a large whip is a big problem)
which intestinal worm did she emphasize caused a protein losing enteropathy?
which intestinal worm can mimic what an addisonian dog might look like?
what are the CSs of a whipworm infxn, and how do you tx?
will see a protein losing enteropathy, Hematochezia, Pseudoaddisonian (hyperkalemia, hyponatremia). Tx with Fenbendazole.
Do roundowrms cause small or large bowel diarrhea? what are possible clinical signs and how do you tx?
SMALL BOWEL. you will see Inflammatory SI infiltrates, Ileus possible in puppies. tx: Fenbendazole or pyrantel
which worms live in the cecum?
which worms cause sever anemia?
where do hookworms live? CSs? tx?
SMALL intestine, Severe anemia, Fenbendazole or pyrantel
What do you treat tapeworms with?
PRAZIQUANTEL! (diff from others!!)
how do you tx Strongyloides?
*which intestinal parasite is a human health risk?
Coccidiosis is aka? how do you tx it?
aka Cystoisospora, +/- clinical relevance. Can treat with Sulfadimethoxine, but CAUTION IN DOBIES WITH SULFAS
how do you tx Cryptosporidia?
Spontaneous elimination? No proven therapy. Some success with tylosin, etc…
how can you treat giardia?
Fenbendazole +/- metronidazole
+/- Ronidazole, +/- tylosin, +/- metronidazole
how do you tx Heterobilharzia?
(Canine Schistosomiasis, flatworm) Fenbendazole plus praziquantel
**what are the 4 tests on the GI panel?
PLI, TLI, cobalamin, folate
when is cobalamin low?
when is folate high?
intestinal bacterial overgrowth
what does Serum trypsin-like immunoreactivity (TLI) tell us?
sensitive and specific test for exocrine pancreatic insufficiency (EPI). These assays quantify trypsinogen that normally leaks from the pancreas into the blood, and hence provide an indirect assessment of functional pancreatic tissue. In animals with EPI, functional exocrine tissue is severely depleted and hence serum TLI concentrations are extremely low.
who do we esp. care about if their cobalamin (B12) is low in?
how does bacterial overgrowth affect cobalamin? folate?
inc folate (bact make this) and dec cobalamin (bact use this to make the folate)
dec folate indicates..
PROXIMAL sm int damage
dec cobalamin indicates...
DISTAL SI damage/ malabsorptive dzs (lymphosarcoma in cat)
explain the relationship between cobalamin, intrinsic factor (IF) and receptors
Cobalamin is a very large molecule that cannot cross the intestinal epithelial barrier without help from a specific cobalamin-binding protein called “intrinsic factor” (IF). A second site on intrinsic factor subsequently binds to specific receptors present only on the surface of ileal epithelial cells. This binding induces cell-mediated endocytosis of the IF-cobalamin complex and hence transport of cobalamin into the blood. IF is synthesised by the stomach in most mammals including humans. However, the pancreas is an important site of IF synthesis in the dog, and is the sole site of IF synthesis in the cat. Pancreatic proteases also degrade non-specific R proteins (glycoprotein produced by the salivary glands of the mouth. It primarily serves to protect cobalamin (Vitamin B12) from acid degradation in the stomach by producing a Haptocorrin-Vitamin B12 complex.) from the stomach which would otherwise bind cobalamin and prevent binding to IF. Interference with production of pancreatic IF and pancreatic proteases in EPI can therefore result in cobalamin deficiency in dogs and particularly severe cobalamin deficiency in cats.
how do you exclude possibility of ileus?
A clinical diagnosis of IBD (inflammatory bowel disease) is considered only if there are what 4 things?
(1) persistent (**>3 weeks in duration) gastrointestinal signs (2) failure to respond to symptomatic therapies (3) failure to document other causes of gastroenterocolitis by thorough diagnostic evaluation (4) histologic diagnosis of benign intestinal inflammation
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