which breeds are prone to histiocytic ulcerative colitis?
Boxers and French bulldog
HUC is a type of what dz?
what kinda diarrhea does HUC cause?
recurrent large bowel diarrhea (boxers, big intestine)
etiology of HUC?
unknown-- possibly infectious agents? E.coli,Mycobacteria, rickettsiae, mycoplasma?? (prolly e coli invasive, she said in class)
how do you tx HUC?
since theorized to be infectious agent... Enrofloxacin
what causes Inflammatory Bowel Disease IBD?
Idiopathic intestinal inflammation---- (diagnosis of exclusion) They think it might be a Exaggerated response to normal bacterial or dietary antigens
where is the GI affected with IBD?
Can affect any portion of GI tract
how is the GI tract affected by IBD?
(any portion can be affected) you will see Mucosal cellular infiltrates, Inflammatory mediators, Intestinal dysmotility
IBD can look like what other problem it must be differentiated from?
Can look like lymphoma
if you do histology, IBD and what other problem will look the same?
food allergy (hence think it might be exaggerated response to bacterial or dietary antigens)
how do you dx IBD?
DX OF EXCLUSION!! look at histopath (remember can look like food allergy) -- might also see a cobalamin deficiency
A clinical diagnosis of IBD (inflammatory bowel disease) is considered only if
(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.
Treatment of chronic diarrhea-- how can you try to do this with diet?
Hypo/low allergen diets
Treatment of chronic diarrhea-- you can try abx-- with that prob would you want to try abx, and which abx?
If you suspect ARD you can try tylosin or metronidazole
Treatment of chronic diarrhea-- you can suppliment cobalamin--- you never want to go below how much cobalamin?
Treatment of chronic diarrhea-- what can you give to try to have antiinflammatory/immunosuppressive effects?sp diffs? how should you admin? what are some additional immunosuppressive drugs you can try?
Prednisolone/prednisone-- cats might need more! Start with a strong dose and then Try and wean to lowest dose necessary (might need to be on long term esp if IBD or sthing like that).... additional drugs you can try= Cyclosporine, chlorambucil (cat only)
Dilation and leakage of lacteals (the terminal ends of the lymphatic vessels in the gut) (so will loose Protein, Lymph, Chylomicrons because lacteals usually pick these up)
which breeds are prone to Lymphangiectasia?
Yorkies (Wheaten Terriers, Lundehunds)
what kinda diarrhea would you see with this?
Diarrhea/Protein loosing enteropathy
*what lab values scream Lymphangiectasia?
low albumin/low TP (bc this causes PLE) --> Ascites/transudate from low iv oncotic pressure
what will Lymphangiectasia look like on US?
what bx method do you wanna do to dx LA?
Surgical biopsy superior to endoscopic Biopsy
how do you tx/provide therapy for LA?
(1) DIET: Ultra low fat diet (bc if lymph vessels can't absorb the fat/chylomicrons it just causes osmotic diarrhea) and high protein (since PLE) (she said inc fiber too, idk why). (2) Prednisone (dec inflammation) (3) +/- additional immunosuppressives
treatments and such, tenesmus/dyschezia, constipation, idiopathic megacolon
if there is diarrhea, do you wanna feed them or do NPO?
Feeding is better than NPO (feed small amounts of what the animal is used to eating. Need to supply nutrition to enterocytes for them to recover)
2 possible sources of fiber you can use to help tx diarrhea?
Metamucil, Canned pumpkin
what are some Antibiotics for intestines-- and which one shouldn't you use in cats?
Metronidazole, tylosin, Sulfasalazine – not in cats
when is giving an anti-diarrheal indicated? what are some examples of anti-diarrheals you could use?
Rarely indicated “But: first line vet has to do something… ” ??? so, can consider Loperamide (Imodium) 1 x …?, Buscopan 1x …?, Bismuth subsalicylate (NEPHROTOX!)
what is the diff between a pro-biotic and a pre-biotic? what should you know about these supplimentals?
PRO=are bact. PRE= help feed the bact. *no real proof of if these work tho
in order to try a HYPOALLERGENIC DIET, what do you and the owner need to do? (how long?)
New protein source, New carbohydrate source, *STRICT COMPLIANCE!!!, Slow transition from current diet, 2-8 weeks, some improvement within first 2 weeks
what are some things you can suppliment to help inc the fiber in a diet? be cautious of what?
can give Ispaghula granulate, Carob flour, formulated high fiber diets, metamucil (LOOK OUT FOR citrus flavored metamucil with cats)
sulfasalzine / salazosulfapyridine (same thing) are good for which part of the GI and who? why?
COLON* and RECTUM in DOGS. This is bc it is broken down into sulfapyrimidine (an abx) and 5-amino-salicylic acid (antiinflammatory)
Salazosulfapyridine / Sulfasalazine--> although this can give good abx and antiinflammatory actions, what are the adverse effects?
**CAUTION IN DOBIES! AND ******OH MY GOD DO NOT GIVE IN CATS EVER EVER EVER(anemia/vomiting/anorexia) Can cause... KCS keratoconjunctivitis sicca, Arthritis (Doberman), Cholestasis, Hemolytic anemia, Leukopenia, vomiting, dec Sperm production, allergic dermatitis
read case study
Differential diagnoses low MCV ?
Microcytosis= Iron deficiency absolute or relative: Congenital portosystemic shunt/Acquired shunting secondary to cirrhosis, Hepatic lipidosis (some cats), Lead toxicity, chronic gastrointestinal blood loss (chronic inflammation or neoplasia)