Definition of GI sign

Transcription

1 Table Clinical signs of gastrointestinal disease Gastrointestinal sign Anorexia Borborygmus Constipation Diarrhea Dyschezia Dysphagia Flatulence Hematemesis Hematochezia Melena Obstipation Polyphagia Ptyalism Regurgitation Tenesmus Definition of GI sign Loss of appetite/not interested in eating Rumbling sound in the gut, caused by moving gas fluid interface, from stomach through intestines Dry, hard feces; difficulty and straining to defecate Passage of feces containing excessive amount of water, increasing daily fecal weight Difficulty or painful passing of feces Difficult or painful swallowing Presence of large amounts of intestinal air/gas, leading to distention of organs Vomiting of digested and/or fresh blood Bright red blood in feces Black, tarry stools as a result of digested blood Intractable constipation, typically with progressive enlargement and hardening of the feces Excessive eating or ingestion of food Excessive salivation Passive, upward movement of ingested material from the esophagus Ineffective and painful straining to pass stool

2 Table History-taking questions for patients presenting with diarrhea 1. Was the onset recent? 2. Was the onset acute? 3. Any other animals at home? If yes, are others showing signs of diarrhea? 4. Has the patient been to areas where there are large numbers of other animals? Obedience, dog parks, pet stores, pet shows, and so on? 5. Has there been access to drinking from a pond or streams? 6. What is the environment like where the pet spends its time? 7. What is the breed? Typical temperament of the pet? 8. Did the patient get into/ingest any of the following: trash, toxins, other pet foods, foods that have spoiled, and so on? 9. Have any drugs been prescribed or administered recently that could result in diarrhea, for example, antibiotics? 10. Have there been any changes in the pet s environment that may be stressful to the pet? New pet, change in family dynamics, alteration in home environment, boarding, day care, and so on. 11. Has there been any change in diet? Dry to can? Raw food? Treats? People foods? Added? Part of diet? 12. Describe the diarrhea. 13. What is the size and volume of the feces? 14. Consistency of the stool? Watery? Soft, formed? 15. Are there any normal stools passed during the day? 16. Frequency of stools? 17. Blood or mucus seen? 18. Timing? Increased defecation? Unable to make it outside? Increased during nighttime? Urgency? 19. If feline does the cat use litter box? Does it defecate near the box or away from the litter box? 20. Other symptoms present? Lethargy, fever, vomiting?

3 Table Etiology of weight loss Food Quantity Not enough multiple animals Quality Poor Low caloric density Inedible Anorexia Inflammatory disease Alimentary tract disease Metabolic disease Central nervous system disease Cachexia Psychological/behavioral disorders Dysphagia Oral pain Oral mass Oral trauma Neuromuscular disease Regurgitation/vomiting Maldigestive disease Exocrine pancreatic insufficiency Malabsorptive disease Small intestinal disease Organ failure Cardiac failure Hepatic failure Renal failure Adrenal failure Cachexia Cancer Cardiac Excessive utilization of calories Lactation Pregnancy Working Cold environment Fever/inflammation Increased catabolism Hyperthyroidism Increased loss of nutrients Diabetes mellitus Protein-losing neuropathy Protein-losing enteropathy Neuromuscular disease Lower motor neuron disease Source: Compiled from Willard MD. Clinical Manifestations of gastrointestinal disease. In: Small Animal Internal Medicine, 4th edition, pp St. Louis, MO: Mosby; 2009; Medinger TL. Clinical evaluation of patients with chronic weight loss. In: Small Animal Gastroenterology, ed. JM Steiner, pp Germany: Schlutersche; 2008.

4 Table Acute gastritis etiology Dietary Indiscretion Spoiled food Intolerance/sensitivity Foreign bodies Bones Toys Hair balls Drugs and toxins Non-steroidal anti-inflammatory drugs (NSAIDS) Corticosteroids Heavy metals Antibiotics Plants Cleaners Ethylene glycol Bleach Herbicides Fertilizers Petroleum distillates Organophosphates Systemic disease Uremia Liver disease Hypoadrenocorticism Parasites Ollulanus Physaloptera spp. Bacteria Bacterial toxins Helicobacter Viral Parvovirus Distemper Infectious hepatitis Coronavirus

5 Table Inflammatory bowel disease signs Vomiting Bile Food Cats with or without hair Dogs with or without grass Hematemesis Small intestinal-type diarrhea Large volume Watery Melena Large intestinal-type diarrhea Hematochezia Mucoid Frequency Tenesmus Thickened bowel loops Abdominal discomfort/abdominal pain Excessive borborygmus and flatulence Weight loss Alterations in appetite Polyphagia Decreased appetite/anorexia Eating grass Pica Hypoproteinemia Ascites Subcutaneous edema Hydrothorax Source: Hall EJ, German AJ. Diseases of the small intestine. In: Textbook of Veterinary Internal Medicine, 7th edition, eds. SJ Ettinger, EC Feldman, pp St. Louis, MO: Elsevier; Hall EJ, German AJ. Inflammatory bowel disease. In: Small Animal Gastroenterology, ed. JM Steiner, pp Germany: Schlutersche; 2008.

6 Table Acute and chronic diarrhea tables Acute causes Dietary Dietary indiscretion Foreign bodies Garbage/compost toxicity Contaminated raw food diets Infectious agents Bacteria Parasites Rickettsia Virus Miscellaneous Hemorrhagic gastroenteritis Toxin or drug induced Chemotherapeutic agents Laxatives NSAIDs in dogs Chronic causes Dietary Adverse reaction to food Carbohydrate intolerance in cats Infectious agents Bacteria and small intestinal bacterial overgrowth Fungi Parasites Miscellaneous Juvenile diarrhea of cats Pancreatic exocrine insufficiency IBD Lymphoplasmacytic eosinophilic, lymphocytic, suppurative gastroenteritis/enteritis Neoplasia Lymphosarcoma Mast cell tumor Source: Davenport DJ, Remillard RL, Carroll M. Large bowel diarrhea: colitis. In: Small Animal Clinical Nutrition, 5th edition, eds. MS Hand, CD Thatcher, RL Remilliard, P Roudebush, BJ Novotny, pp Marceline, MO: Walsworth Publishing; 2010.

7 Table Protein energy source comparison Protein type Biological value Percentage of protein (%) Protein quality Egg Excellent Casein Good Beef, lamb, pork, chicken Good Soybean meal Good Rice (white) 64 7 Adequate Collagen 0 88 Poor Source: Gross KL, Jewell DE, Yamka RM, et al. Macronutrients. In: Small Animal Clinical Nutrition, 5th edition, eds. MS Hand, CD Thatcher, RL Remilliard, P Roudebush, BJ Novotny, pp Marceline, MO: Walsworth Publishing; 2010.

8 Table Tube feeding comparisons Type of tube Condition Disease ICU costs Food type used Length of time Nasoesophageal or nasogastric Not recommended for patients that are vomiting or those with respiratory disease Short-term anorexia, supplement oral intake $ Liquid ± thinning required, CRI, or bolus Short term, in-hospital use only (3 7 days) Esophagostomy Not recommended for patients that are vomiting or those with respiratory disease Hepatic lipidosis, anorexia, oral surgery or trauma, cancer $$ Liquid, recovery diet, or gruel commercial diet based on tube size, CRI, or bolus Long term, in-hospital and at-home use, (1 20 weeks, depending on tube type used) Gastrostomy Can be used on patients that are vomiting or that have respiratory diseases Pancreatitis, hepatic lipidosis, anorexia, esophageal strictures, oral surgery or trauma, cancer $$$ Liquid, recovery diet, or gruel commercial diet based on tube size; CRI or bolus Long-term use, can be permanent, depending on tube type used Jejunostomy Can be used on patients that are vomiting or that have respiratory disease Pancreatitis, intestinal anastomosis, coma $$$$ Liquid diet, CRI or bolus Short term, in-hospital use only (3 10 days)

9 Table Primary dermatologic responses Severe generalized pruritus without lesions Military dermatitis Pruritus with self-trauma centered around head, neck, ears Traumatic alopecia Moist dermatitis Scaling dermatitis Source: Roudebush P, Guilford WG, Shanley KJ. Adverse reactions to food. In: Small Animal Clinical Nutrition, 4th edition, eds. MS Hand, CD Thatcher, RL Remillard, P Roudebush, pp Topeka, KS: Mark Morris Institute; 2000.

10 Table Intestinal bacteria Beneficial Lactobacilli Eubacteria Bifidobacteria Enterococci Pathogenic Pseudomonas aeruginosa Proteus species Staphylococci Clostridia Veillonella Source: Kelly M. The Role of Probiotics in GI Tract Health. St. Louis, MO: Nestle Purina Pet Care;2006.