GI 3

Question 1

What are the clinical signs of IBD?

Answer 1

• Chronic vomiting
• Chronic diarrhea
• Borborygmi and flatulence
• Abdominal discomfort
• Altered appetite
• Weight loss

Question 2

What is the most common type of IBD?

Answer 2

Lymphoplasmacytic IBD (second most common is eosinophilic)

Question 3

What is the first line treatment for IBD?

Answer 3

1. Hypoallergenic or novel protein diet
2. Prednisone 2 mg/kg/day (prednisolone or budesonide if too many side effects). Taper 25%/month (if sole agent)
3. Consider cobalamin, probiotics, tylosin, metronidazole long term)

Question 4

What is the second line treatment for IBD?

Answer 4

1. Add another agent such as cyclosporine, azathioprine (not cats), mycophenolate, chlorambucil
2. Different diet

Question 5

What is the third line treatment for IBD?

Answer 5

• Injectable immunosuppressant agents
• Fecal transplant (no strong evidence thus far)

Question 6

Which vitamin is cyanocobalamin?

Answer 6

Vitamin B12

Question 7

What is the prognosis of IBD?

Answer 7

Good to guarded (70-80%) (relapse common when medication is tapered)

Question 8

Which species has a better outcome after IBD treatment, cats or dogs?

Answer 8

Cats have a better outcome

Question 9

What condition can severe IBD lead to?

Answer 9

Protein losing enteropathy (PLE)

Question 10

What is the most common cause of PLE?

Answer 10

Lymphangiectasia

Question 11

What is lymphangiectasia?

Answer 11

A marked dilation and dysfunction of intestinal lymphatics that causes the leakage of protein-rich lymph into intestines (whereas IBD is usually just mild lacteal dilation)

Question 12

True or False: Primary PLE is more common than secondary PLE

Answer 12

True

Question 13

What are the clinical signs of PLE?

Answer 13

• Ascites
• Diarrhea (small and large bowel)
• Weight loss

Question 14

How can PLE be diagnosed?

Answer 14

• Panhypoproteinemia (albumin > globulin) (decreased total solids)
• Hypocholesterolemia
• Lymphopenia
• Hypocalcemia
• Protein poor transudate (ultrasound)
• GI biopsy

Question 15

How can lymphangiectasia be treated (three)?

Answer 15

• Marked fat restriction (+/- hypoallergenic diet)
• Immunosuppressive therapy (prednisone)
• Cobalamin supplementation

Question 16

What is the prognosis of lymphangiectasia?

Answer 16

Poor to fair (60% remission)

Question 17

What are some types of intestinal neoplasias?

Answer 17

• Lymphoma (better prognosis in cats)
• Adenocarcinoma
  -Leiomyoma/leiomyosarcoma
• Gastrointestinal stromal tumor (GIST)
• Interstitial cells of Cajal
• Mast Cell Tumor

Question 18

What causes histiocytic ulcerative colitis in young boxers?

Answer 18

E. coli in macrophages

Question 19

How can histiocytic ulcerative colitis be diagnosed?

Answer 19

Colonic biopsies by endoscopy for submission for fluorescent in situ hybridization (FISH)

Question 20

How can histiocytic ulcerative colitis be treated?

Answer 20

Enrofloxacin

Question 21

What is the prognosis of histiocytic ulcerative colitis?

Answer 21

Good

Question 22

True or False: Constipation is rare in dogs

Answer 22

True. It’s mostly cats that get it.

Question 23

True or False: Megacolon in cats is common

Answer 23

False. It is rarer than you think.

Question 24

How can megacolon be treated?

Answer 24

• Enema if acute
• Weight loss if overweight
• Chronic laxative therapy (lactulose)
• Low fat and low residue diets (the less stools and less fiber the better)
• Prokinetics
• Surgery

Question 25

What does Tritrichomonas fetus cause in cats?

Answer 25

Chronic large or small bowel diarrhea

Question 26

How can Tritrichomonas fetus be diagnosed?

Answer 26

PCR

Question 27

How can Tritrichomonas fetus be treated?

Answer 27

Ronidazole (resolution usually within 9 months)

Question 28

True or False: Anal gland impactions are a lot more common in dogs than cats

Answer 28

True

Question 29

What are the two main rectoanal disorders?

Answer 29

Perineal hernias and perianal fistulas

Question 30

What are perineal hernias?

Answer 30

The protusion of rectal wall and other pelvic organs through a weakened portion of pelvic diaphragm into the ischiorectal fossa

Question 31

How can perineal hernias be treated?

Answer 31

Surgery

Question 32

What are perianal fistulas?

Answer 32

A chronic, progressive immune disease of the perineal region of older German shepherds

Question 33

What are perianal fistulas usually caused by?

Answer 33

Immune dysfunction

Question 34

How can perineal fistulas be treated?

Answer 34

- Cyclosporine - Tacrolimus