“Winning (success) takes work!” “The will to win is not nearly as important as the will to prepare to win.” -Bobby Knight

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

◦ Signs  Acute onset diarrhea  ± vomiting  Normal appearance otherwise

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

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

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

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

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

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  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

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

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

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

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

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

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

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

YOUR LIFE FOLLOWS YOUR THOUGHTS “If it is to be it’s up to me.”

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

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

Inflammatory Bowel Disease  Treatment  Sulfasalazine—a sulfa drug with anti-inflammatory effects  Most effective against colitis  Prednisone  Metronidazole, Tylosin  Mesalamine—a metabolite of Sulfasalazine in LI (actions unknown)  Hypoallergenic diet  Hill’s 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 BM’s

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

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

Intussuception

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

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

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