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Winning (success) takes work!

• The will to win is not nearly as important as
  the will to
• prepare to win.
• -Bobby Knight

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Diseases of Small Intestine

• Acute Diarrheaone of the most commonly seen
  types of diarrhea
• Often involves impairment of absorptive surface
  of small intestine
• Often accompanies acute gastritis
• Causes
• Diet change
• Stressful situations
• Drug therapy

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• Signs
• Acute onset diarrhea
• vomiting
• Normal appearance otherwise

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Acute Diarrhea

• Diagnosis
• Fecal sample
• HCT
• Treatment
• Fluids for dehydration, electrolyte imbalance
• NPO x 24 h water OK if no vomiting
• Intestinal absorbants/coating agents
• Loperamide - slows gut motility
• /-Antibiotics
• Bland diet after 24 h
• Hills I/D
• Boiled chicken/rice

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Parasite Diarrhea

• Signs
• Diarrhea
• Wt loss
• Poor hair coat
• Listlessness
• Diagnosis
• Fecal exam
• Treatment
• Anthelmintics Fenbendazole, pyrantel pamoate
• Antiprotozoal medication for Giardia, Coccidia

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Viral Diarrhea

• Causes
• Canine Parvovirus
• Canine distemper virus
• Coronavirus (self-limiting)
• Feline panleukopenia virus (parvovirus)

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Bacterial Diarrhea

• Pathogenic bacteria produce intestinal disease
  by
• Releasing enterotoxins
• Attaching to the mucosal surface and produce
  cytotoxins
• Bacteria Salmonella, Shigella, Campylobacter, E.
  Coli, Clostridium, Staphylococcus
• Clinical signs
• Diarrhea with or without blood
• /- fever
• anorexia

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Bacterial Diarrhea

• Diagnosis
• Fecal
• Rule out parasites
• Observe for gram (-) bacteria
• Treatment
• Oral antibiotics
• Fluid therapy

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Dietary Intolerance and Sensitivity

• Dietary Intolerance is seen in animals that are
  unable to handle certain substances in their diet
  
• Table scrabs, garbage
• May have a history of eating indiscriminate
  objects
• Dietary Sensitivity is due to immune-mediated
  damage to the intestinal mucosa

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Dietary Intolerance and Sensitivity

• Diagnosis
• Hx of sensitivity to specific foods or recent
  diet change
• Fecal
• Radiographs
• Bloodwork to rule out other diseases
• Check for pancreatitis
• Treatment
• Diet trial for at least 6 weeks (may take 3
  months to see response)
• Oral Prednisone to decrease immune response

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Dietary Intolerance and Sensitivity

• Client Info
• Prevent pets from eating trash and indiscriminate
  objects
• Be patient It may take trial and error
• Pets on a food trial should not eat treats or
  flavored medications

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Chronic Inflammatory Bowel Disease

• Common disease seen in dogs and cats
• Chronic antigenic stimulation results in
  lymphocytes and plasma cells infiltrating the
  intestinal tissue
• Causes are variable
• Damage results in abnormal intestinal absorption
• Clinical signs
• Vomiting /- diarrhea
• Wt loss
• Borborygmus
• Halitosis
• flatulence

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Treatment

• Diagnosis
• History , Physical exam
• BIOPSY to identify the lymphocytes and plasma
  cells
• Treatment
• Eliminate the antigen and decrease immune
  response
• Immunosuppressants and/or immune modulating drugs
• Prednisone, azathioprine, metronidazole
• Intestinal protectants

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Intestinal Lymphangiectasia

• A protein-losing intestinal disease due to
  abnormal lymphatic drainage.
• Fluid is released into the intestinal lumen,
  causing loss of lipids, proteins, and lymphocytes
• Clinical signs
• Edema and effusion
• Ascites, hydrothorax
• Diarrhea
• Wt loss

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Intestinal Lymphangiectasia

• Diagnosis
• Bloodwork
• Biopsy
• Treatment
• Decrease loss of protein
• Choose food with minimal fat and high quality
  protein
• Drugs prednisolone, metronidazole
• No cure most dogs will finally succumb to
  protein depletion, diarrhea, or severe effusions

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Intestinal Neoplasia

• Intestinal Adenocarcinoma
• Most commonly found in older animals
• Lymphosarcoma
• Middle-aged to older animals are most commonly
  affected
• Clinical signs
• Related to the location and growth rate of the
  tumor
• Wt loss
• Abdominal pain
• Melena
• Signs of GI obstruction

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Intestinal Neoplasia

• Diagnosis
• P.E. mass may be palpated, intestinal lymph
  nodes may be enlarged
• Radiography- contrast studies
• Biopsy
• Blood work
• Treatment
• Surgical removal of tumor
• Chemotherapy cats do better than dogs
• Supportive care

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YOUR LIFE FOLLOWS YOUR THOUGHTS

• If it is to be its up to me.

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Intestinal Neoplasia

• Client Info
• Prognosis for adenocarcinoma is poor
• Survival times from 7mths -2yrs w/treatment
• Cats with lymphosarcoma undergoing chemotherapy
  may go into remission for up to 2 yrs

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Diseases of Large Intestine

• Function is to reabsorb water, electrolytes and
  store feces
• Inflammatory Bowel Disease (IBD)
• Clinical Signs
• Diarrhea with wt loss
• ? frequency of defecations, ? volume
• Tenesmus
• ? mucus
• Diagnosis
• Fecal to r/o parasites
• Bloodwork r/o metabolic causes
• Biopsy of LI wall
• ? lymphocytes and plasma cells

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Inflammatory Bowel Disease

• Treatment
• Sulfasalazinea sulfa drug with anti-inflammatory
  effects
• Most effective against colitis
• Prednisone
• Metronidazole, Tylosin
• Mesalaminea metabolite of Sulfasalazine in LI
  (actions unknown)
• Hypoallergenic diet
• Hills d/d, z/d, i/d
• Homemade diets
• Client info
• Treatment is often prolonged
• Goal of Rx is to control symptoms, not cure
  disease
• Animals with IBD need to be taken outside
  frequently for BMs

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Intussusception

• Cause usually unknown can result from parasites,
  FB, infection, neoplasia
• Signs
• Vom/diarrhea with or without blood
• Anorexia, depression
• Diagnosis
• Palpation of sausage-like mass in cranial abdomen

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Intussusception

• Treatment
• Surgical reduction/resection of necrotic bowel
• Restore fluid/electrolyte balance
• Restrict solid food x 24 h after Sx then bland
  diet
• x 10-24 d
• Client info
• Recurrence is infrequent
• Prognosis depends on amt of bowel removed
• Puppies should be treated for parasites to
  prevent intussusception

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Intussuception
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Megacolon

• Uncommon in dogs, more common in cats (mostly
  idiopathic)
• Associated with Obstipation (intestinal
  obstruction, severe constipation)
• Clinical Signs
• Straining to defecate
• Must be distinguished from straining to urinate
  in male cats
• vomiting
• Weakness, dehydration, anorexia
• Small, hard feces or liquid feces
• With or without blood, mucus

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Megacolon
The width of the colon is greater than length of
lumbar vertebrae
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Megacolon

• Diagnosis
• Palpation of distended colon filled with hard,
  dry feces
• Radiographs show colon full of feces
• Rectal palpation assures adequate pelvic opening
• Treatment
• Warm water enema
• Manual removal under anesthesia
• Mucosal surface is delicate
• Client info
• Encourage water intake
• Salt food
• Always provide adequate supply
• High-fiber diet