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What things make up the small intestines?
- microvilli
- crypt cells
- goblet cells
- hormones
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What does microvilli do?
brush border to absorb nutrients
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What do crypt cells do?
produce new cells that replace old villus cells as they slough off the top
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What do goblet cells do?
produce mucus
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What types of hormones are in the small intestines?
- secretin
- cholecystokinin
- gastric inhibitory peptide
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What does secretin do?
- causes biocarbonate to be released from the pancreas
- causes bile production to increase in the liver
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What does cholecystokinin do?
- causes digestive enzymes to be released in the pancreas
- causes the gall bladder to empty
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What does gastric inhibitory peptide do?
decreases activity of the stomach
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What are the different diseases of the small intestines?
- impairment of the absorptive villous surface
- malabsorption, diarrhea, weight loss
- small intestinal neoplasia
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What is diarrhea?
- increased frequency of defecation
- increased fluidity of stool
- increased volume of stool
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What is the most common type of diarrhea and what causes it?
- acute diarrhea
- diet change, drug therapy, stress
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What are the different causes of diarrhea?
- parasitic
- bacterial
- viral
- dietary intolerance/sensitivity
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What are the clinical signs of parasitic diarrhea?
- diarrhea
- maybe vomiting
- maybe blood in the vomit or diarrhea
- weight loss
- poor hair coat
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How do we diagnose parasitic diarrhea?
fecal exams
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How do we treat parasitic diarrhea?
- anthelminitcs for hooks, whips, and rounds
- antiprotozoals for giardia and coccidia
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What type of viruses cause viral diarrhea?
- canine parvovirus
- canine corona virus
- feline corona virus (FIP)
- feline panleukopenia (feline parvovirus)
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What part of the body is affected with canine parvovirus?
intestinal villi are affected and they collapse
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Where is canine parvovirus shed?
shed in feces, vomit, and saliva
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How is canine parvovirus spread?
fomites
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Can we find canine parvovirus in the environment?
yes
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Which dogs are predisposed to canine parvovirus?
- rottweilers
- dobermans
- black labs
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What are the clinical signs of canine parvovirus?
- vomiting
- depression
- fever
- bloody diarrhea
- anorexia
- lethargy
- dehydration
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How do we diagnose canine parvovirus?
- ELISA test for parvovirus
- decreased WBC count
- viral detection in stool
- electron microscope
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How do we treat canine parvovirus?
- NPO
- fluid therapy with KCL, dextrose, B vitamins
- plasma transfusion
- antibiotics
- antiemetics
- isolation
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How do we treat canine parvovirus?
- keep patient warm, dry, and clean
- wear protective clothing when treating patient
- food dip in isolation area
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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
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Where is the canine corona virus shed?
in feces
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Which is more damaging to intestinal villi, corona virus or parvovirus?
parvovirus
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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
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How do we diagnose canine corona virus?
- presumptive
- electron microscope for viral identification
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How do we treat canine corona virus?
- supportive
- isolate patient
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How do we prevent canine corona virus?
vaccinate
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What are the different names of feline panleukopenia?
- feline parvovirus
- feline infectious enteritis
- feline distemper
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Is feline panleukopenia contagious?
highly contagious
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Is feline panleukopenia fatal?
yes
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Which types of cats is panleukopenia the most severe in?
kittens
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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
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What can feline panleukopenia cause in pregnant queens?
- embryonic death
- mummification
- abortion
- still birth
- cerebellar hypoplasia of kittens - tremors, incoordination
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How is feline panleukopenia transmitted?
- oronasal
- virus in abundant in all secretions
- virus can survive in the environment for over one year
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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
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How do we diagnose feline panleukopenia?
- usually based on clinical signs
- CBC - WBC count under 500 WBC/ul
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How do we treat feline panleukopenia?
- vigorous fluid therapy
- dextrose and KCL added to fluids if needed
- antibiotics
- plasma or whole blood transfusion
- antiemetics
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What causes bacterial diarrhea?
- bacteria invade and damage intestinal epithelium
- release enterotoxins which stimulate secretions, attach to mucosal surfaces, and produce cytotoxins
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What types of bacteria cause bacterial diarrhea?
- salmonella
- campylobacter
- escherichia coli
- clostridium
- staphylococcus
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What are the clinical signs of bacterial diarrhea?
- diarrhea may be bloody
- may have fever
- anorexia
- vomiting
- dehydration
- septicemia
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How do we diagnose bacterial diarrhea?
- fecal exam
- fresh saline smears
- cytotoxin assay - titer for clostridium
- fecal cultures
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How do we treat bacterial diarrhea?
- antibiotics
- fluid and electrolyte replacement
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What is the difference between dietary sensitivity and dietary intolerance?
- dietary sensitivity: immune mediated
- dietary intolerance: non-immunologic and can be a dietary indiscretion
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What can an endoscopic exam help determine with dietary intolerance/sensitivity diarrhea?
help to determine the extent of mucosal damage
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Which dietary substance could animals potentially not be able to handle with dietary intolerance/sensitivity?
- carbohydrates
- fats
- dairy products
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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
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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
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What are the GI clinical signs of dietary intolerance/sensitivity diarrhea?
- vomiting
- diarrhea - mucus, blood
- abdominal pain, discomfort
- flatulence
- weight loss
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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
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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
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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
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What are the most common food allergens in dogs?
- beef
- soy
- chicken
- milk
- corn
- wheat
- eggs
- any protein can be involved
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What are the most common food allergens in cats?
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What are the two types of intestinal neoplasia?
- adenocarcinoma - more common in older cats than dogs
- lymphosacroma - more common in cats than dogs
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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
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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
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What will we see on a contrast radiograph with intestinal neoplasia?
- mucosal irregularity
- thickened bowel walls
- abnormal lumen diameter
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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
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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
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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
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What are the most common signs of large bowel disease?
- diarrhea
- straining to defecate
- blood in the stool
- increased mucus in the stool
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What are the different types of large intestines diseases?
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What are the causes of intussesception?
- usually idiopathic
- parasites
- foreign body
- infections
- neoplasia
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Where does intussesception occur?
- smaller, proximal segment of the intestines
- invaginates in the larger portion of the large bowel
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What can intussesception cause?
- causes a partial to complete blockage
- ischemia, bowel necrosis
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What are the clinical signs of intussusception?
- vomiting
- anorexia
- depression
- diarrhea
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How do we diagnose intussusception?
- palpate a sausage-like mass in the cranial abdomen
- ultrasound - multilayered concentric rings
- contrast radiograph - barium
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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
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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
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What are the clinical sings of megacolon?
- straining to defecate
- vomiting
- weakness
- dehydration
- anorexia
- small, hard feces, or liquid feces with or without blood
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How do we diagnose megacolon?
- history and physical exam
- abdominal palpation
- rectal exam
- minimum data base
- radiographs - distended colon
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How do we treat megacolon?
- correct fluid and electrolyte abnormalities
- remove impacted feces
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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
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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
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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
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