2. 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.
Stress due to environmental changes.
Drugs: Opioids can cause diarrhea/constipation.
Abnormal flora: use probiotic to help.

3. Signs Acute onset diarrhea ± vomiting Normal appearance otherwise
Besides diarrhea, they seem normal.

4. 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
Metronidazole- helps firms stool
Antibiotics for abnormal GI flora
Bland diet after 24 h
Hills I/D, Purina EN
Boiled chicken/rice
Fecal to check for parasites/giardia.
PCV to check hydration status. PCV will look high due to dehydration.
Treatment: easily managed. Antibiotics: broad spectrum. Also use Pepto.

5. 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
Enterotoxins: produced toxin that causes intestinal issues.(produced by bacteria)
Cytotoxins: a substance toxic to cells (example chemotherapy)
Produces pathogens that invade and damage the intestinal epithelium by releasing the enterotoxins.

6. Acute Diarrhea: Bacteria
Clinical signs:
Diarrhea with/without blood
Patients may have a fever
Anorexia
Diagnosis: R/O parasites with fecal, stained fecal smear to identify the type of bacteria
Treatment: antibiotics
Stained smear is not common

7. Acute Diarrhea: Parasites
Parasites may be one of the primary causes of diarrhea in small animals.
Clinical signs:
Diarrhea with/without blood
+/- vomiting
Weightloss
Poor hair coat
Anorexia

8. As a tech you should know the life cycles of common intestinal parasites
Toxocara cati
Toxocara canis
Toxocara canis/cati: round worm
Ancylostoma caninum: hook worm
Trichuris Vulpis: whip worm
Ancylostoma caninum
Trichuris vulpis

9. Acute Diarrhea: Parasites
Diagnostics: Fecal/ELISA for Giardia
Treatment for parasites
Anthelmintics (Anti-parasitic)
Fenbendazole (3 days)
pyrantel pamoate (10-14 days)
Antiprotozoal medication for Coccidia
Ponazuril
Sulfadimethoxine (Albon)
Giardia: Metronidazole or Ponazuril
Fecal would be a direct and float.
Giardia: metronidazole (antibiotic and antiprotozoal medication) and fenbendazole
Coccidia: Albon or ponazuril
Giardia snap test (DOVE)

10. Acute Diarrhea: Viruses
Causes:
Canine Parvovirus
Canine distemper virus
Coronavirus (self-limiting)
Feline panleukopenia virus (parvovirus)
Commonly seen in young unvaccinated animals
Seen in young animals who have usually not been vaccinated against common viruses.
Remember enteric corona virus

11. Acute Diarrhea: Viruses
Clinical signs:
Diarrhea with/without blood
Patient may have a fever
Anorexia
Depression
Diagnostics: Snap test/CBC
Treatment: Supportive care
Fever due to virus, hints infection.
Supportive care: IV fluids, antibiotics, antidiarrheals

12. Dietary Intolerance and Sensitivity
Dietary Intolerance is seen in animals that are unable to handle certain substances in their diet
Table scraps, garbage
May have a history of eating indiscriminate objects
Dietary Sensitivity is due to immune- mediated damage to the intestinal mucosa
Some p are more sensitive.
Indiscriminate: random
Dietary sensitivity: results from an inflammatory response within stomach to certain diets. Makes them very sensitive to certain foods.
These patients tend to be sensitive to carbohydrates, fats, or milk products (also seen in patients that are fed large amounts of table scraps).

13. 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
3-4 months
This condition can cause abdominal pain so r/o pancreatitis
Fecal to R/O parasites
Prednisone to decrease the immune response

14. 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
Treats would interfere with the trial.

16. Intestinal Neoplasia
Intestinal Adenocarcinoma and Lymphosarcoma are the most common malignant neoplasia’s seen in both cats and dogs
Clinical signs
Related to the location and growth rate of the tumor
Wt loss
Abdominal pain
Melena
Signs of GI obstruction
Anorexia
Adenocarcinoma(25% intestinal neoplasia’s in dogs/52% cats): seen in older animals. Lymphosarcoma(10% dogs/21% cats): seen in all ages, more common in middle aged.
GI obstruction: Loss of appetite, Constipation, Vomiting, Inability to have a bowel movement
Melena: dark feces with digested blood.
Cat story that could not defecate.

17. Intestinal Neoplasia Diagnosis
P.E. – mass may be palpated, intestinal lymph nodes may be enlarged
Radiography
Biopsy
Blood work
Treatment
Surgical removal of tumor
Chemotherapy
Supportive care
Dogs do not usually respond to the chemotherapy. I think it has to do with the type of cancer. Cats may do well with certain types of chemotherapy.
Blood work: leukocytosis with left shift (increased WBC’s with increased amounts of immature WBC’s)

18. Biopsy punch. Then they use foam to fill in the hole afterwards.

19. Intestinal Neoplasia Client Info Prognosis for adenocarcinoma is poor
Survival time from 7mths -2yrs w/treatment
Cats with lymphosarcoma undergoing chemotherapy may go into remission for up to 2 yrs
Remission: no more test showing cancer being present. This is due to them responding so well to chemotherapy. Does not mean that they cleared the cancer.

20. 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(proximal segment). Telescoping causes partial blockage, compromises blood supply and tissue necrosis. Intestines telescope into itself.
Can use radiographs or ultrasound to diagnose.

21. Intussusception

22. Intussusception Treatment
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
Can become necrotic and the surgeon might have to remove part of the intestine. R&A. Resection and anastomosis.
The “resection” refers to the removal of the abnormal tissue and the “anastomosis” is the procedure where the two parts are reconnected
Recurrence is not often.

23.
If they can pull it out, they would give medication to help with GI motility (reglan)

24. R & A
The “resection” refers to the removal of the abnormal tissue  

25. “anastomosis” is the procedure where the two parts are reconnected. 

26. Megacolon 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
Thought to be caused by hypothyroidism, hypokalemia(high blood potassium levels), pelvic deformities, severe colonic distension. Possible defect in neurostimulation (nerves that control the bowel) of colon to evacuate the feces.
It is believed that megacolon is the reason for cats with obstipation (sever constipation)- about 62% of these cases are due to idiopathic megacolon.

27. Megacolon
Diagnosis
Palpation of distended colon filled with hard, dry feces
Radiographs show colon full of feces
Rectal palpation assures adequate pelvic opening
They will have an adequate pelvic opening, but still won’t be passing stool like they should.

28. 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.

30. Megacolon Treatment Warm water enema Manual removal under anesthesia
Mucosal surface is delicate
Client info
Encourage water intake
High-fiber diet
Fiber will help make them poop. Enemas are very messy and could take multiple times to loosen stool up.
Medical and dietary management are usually unrewarding in long term use. Can add canned pumpkin to the diet as well.
Enema video (DOVE)

31. Surgery is needed for repeated cases
Surgery is needed for repeated cases. Actually remove the part of the colon that is stretched and then reattach the remaining pieces. Then they use stool softeners afterwards.
Subtotal because it is only removing part of the colon.
After sx cats often do well and pass normal stool within several months.
Subtotal Colectomy