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Gut Diseases - Coggle Diagram

- - - - LYMPOPLASMACYTIC
        
        hard to differentiate from lymphoma
      - EOSINOPHILIC
      - GRANULOMATOUS
  - - - Dogs (50%upper GI/50%lower GI)
    - - Cats (85% upper GI/15% lower)
    - - Weight loss
      - change in appetitie
      - vomiting
      - Diarrhea (small and/or large)
      - abdominal pain
      - excess flatulence/borborygmi
      - Often CHRONIC intermittent signs, and not all need to be present
  - - - Tier 2
        
        Abdominal ultrasound, GI panel, Contrast Upper GI (barium), Specific DDx tests like Bile acids and ACTH stim (addisons)
        
        Abdominal ultrasound
        
        Mucosal and submucosal thickening, wall layering, enlarged LNs but MAY BE NORMAL
        
        GI Panel
        
        LOW B12 = DISTAL SMALL INTESTINE DZ (EPI)
        
        HIGH Folate = bacterial overgrowth PROMIXMAL SI DZ
        LOW Folate = disease in proximal SI
        
        Abnormal levels indicates SI dz but is non specific, and there can be normal levels of B12/folate with IBD
        
        animal must be FASTED FOR 12 HOURS and the tube must be LIGHT PROTECTED
        
        LOW TLI = EPI
        
        HIGH PLI = suggestive of pancreatitis
      - Tier 3
        
        CT, Endoscopy, Abdominal explore
        
        Ultrasound is better in dogs than cats
        
        biopsy looks for inflitarte type and architectural changes
      - Tier 1
        
        bloodwork, fecal, UA, T4, cortisol (dogs if conserned about Addisons) and Abdominal x-rays
        
        GENERALLY A GOOD PLACE TO START WITH ANY CHRONIC GI CASES!!
        
        CBC
        
        Normal +/- Neutrophilia, Eosinophilia, Anemia (regenerative vs non)
        
        Chem
        
        Normal +/- Low albumin, globulins, cholesterol, or reactive hepatopathy
  - - - NOVEL PROTEIN/HYDROLIZED, LOW FAT (ESP IF LYMPHANGIECTASIA), HIGHLY DIGESTIBLE, NEW MICROBIOM DIET!!
    - - GOAL: SHORT TERM USE ONLY,PULSE THERAPY
        
        tylan vs. metrondiazonle
    - - Goal: immunosuppression
        
        Prednisone (1-2 mg/kg and no more than 40 mg/dog) (cats get prednisolone)
        
        Budesonide (pred alterative, locally active, 0.5-1mg/day/cat or 0.5-2mg/day/dog)
        
        Secondary immunosuppressants (cyclosporine, azathioprine, mycophenolate, chlorambucil)
        
        used when steriods arent enough
    - - supplement when B12 is low on GI panel
- - - - CBC/Chem
      - Symptoms
    - - symptoms
      - CBC/CHem
- - - - serum lipase
        
        Species specific and preferred test but sample must be taken while patient is CLINICAL
      - US
      - Fluid analysis/cytology
      - GI panel (LOW B12)
      - Bile acids and ACTH stim.
      - Alpha 1 protease inhibitor, COLLECT FRESH FECES ON 3 CONSECUTIVE DAYS
    - - CBC/Chem
      - UA
      - Fecal
      - baseline cortisol
      - Xrays (chest, abdomen)
    - - CT
      - ENDOSCOPY
      - LAPRACOSPY (RISKY DUE TO LOW ALBUMIN!!!)
  - - - lymphangiectasia (58%)
        
        marked dialation and dysfunction of intestinal lymphatics
        
        lacteals rupture and release lymph which his highly irritating to the mucosa resulting in more inflammation and granuloma formation
        
        Breeds: shar-pei, soft coated wheaten terrier, lundehund, yorkshitre terrier
      - lymphangitis
    - - IBD 68% (lymph form highest)
      - neoplastic inflitrate (lymphoma)
    - - hook wormss
    - - EXTREMELY RARE IN CATS!!!!
  - - - ANTITHROMBIN III IS LOST IN GI TRACT, THIS RESULTS IN CLOT FORMATION AND HYPERCOAGULABILITY!!!
  - - - immunosuppressant for IBD/lymphangiectasia, chemo for cancer, deworming, antifungals, surgery etc.
    - - LOW FAT FOR LYMPHANGIECTASIA
      - hydrolzed novel protein
    - - furosemide or spironolactone for ascities
      - centesis if indicated
    - - MEAN SURVIVAL? 1month - 2 years