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Diseases of Small Intestine Acute Diarrhea—one 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 Parasites, viruses, abnormal GI flora Diarrhea: increase in frequency, fluidity and volume of defecation.

Signs Acute onset diarrhea ± vomiting Normal appearance otherwise

Acute Diarrhea Diagnosis History and clinical signs Treatment Fecal sample PCV Treatment Fluids for dehydration NPO x 24 hrs; water OK if no vomiting Anti-diarrheals Loperamide –slows GI motility Antibiotics for abnormal GI flora Bland diet after 24 h Hills I/D, Purina EN Boiled chicken/rice

Acute Diarrhea: Bacteria Pathogenic bacteria produce intestinal disease by: Releasing enterotoxins Attaching to the mucosal surface and produce cytotoxins Bacteria: Salmonella, Shigella, Campylobacter, E. Coli, Clostridium, Staphylococcus

Acute Diarrhea: Parasites Treatment for parasites Anthelmintics Fenbendazole pyrantel pamoate Antiprotozoal medication for Giardia, Coccidia Ponazuril Sulfadimethoxine (Albon) Giardia: metronidazole and fenbendazole coccidia: Albon or ponazuril

Acute Diarrhea: Viruses Causes: Canine Parvovirus Canine distemper virus Coronavirus (self-limiting) Feline panleukopenia virus (parvovirus)

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

Dietary Intolerance and Sensitivity Diagnosis Hx of sensitivity to specific foods or recent diet change Fecal Radiographs Rule out foreign body Bloodwork to rule out other diseases Ex: Pancreatitis Treatment Diet trial for at least 6 weeks (may take 3 months to see response) Oral Prednisone to decrease immune response in dietary sensitivity

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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Intestinal Neoplasia Intestinal Adenocarcinoma and Lymphosarcoma are the most common Clinical signs Related to the location and growth rate of the tumor Wt loss Abdominal pain Melena Signs of GI obstruction

Intestinal Neoplasia Diagnosis Treatment P.E. – mass may be palpated, intestinal lymph nodes may be enlarged Radiography Biopsy Blood work Treatment Surgical removal of tumor Chemotherapy Supportive care

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

Intestinal Diseases: 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 Commonly at ileocolic junction. Telescoping causes partial blockage, compromises blood supply and nissue necrosis.

Intussuception

Intussusception Treatment Client info Surgical reduction/resection of necrotic bowel IV fluids Restrict solid food x 24 hr after Surgery; then bland diet for 2-3 weeks Client info Recurrence is infrequent Prognosis depends on amount of bowel removed Puppies should be treated for parasites to prevent intussusception Commonly at ileocolic junction. Telescoping causes partial blockage, compromises blood supply and nissue necrosis.

Megacolon Clinical Signs Straining to defecate vomiting Uncommon in dogs, more common in cats (mostly idiopathic) Caused by a possible defect in the neurostimulation of colon 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 Relates with hypothyroidism, pelvic deformities. Possible defect in neurostimulation of colon to evacuate the feces.

Megacolon The width of the colon is greater than length of lumbar vertebrae Relates with hypothyroidism, pelvic deformities. Possible defect in neurostimulation of colon to evacuate the feces.

Megacolon Diagnosis Treatment Client info 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 High-fiber diet