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