Difference between revisions of "Gastroenteritis, Haemorrhagic"
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{{dog}} | {{dog}} | ||
− | |||
==Signalment== | ==Signalment== | ||
− | + | Middle-aged, small-breed dogs such as: | |
*Toy and Miniature Poodles | *Toy and Miniature Poodles | ||
*Miniature Schnauzers | *Miniature Schnauzers | ||
+ | *Yorkshire Terrier | ||
+ | *Dachshunds | ||
==Description== | ==Description== | ||
− | Haemorrhagic gastroenteritis is characterised by acute vomiting and diarrhoea. | + | Haemorrhagic gastroenteritis is characterised by acute vomiting and diarrhoea. Gastrointestinal integrity is loss, resulting in a rapid movement of blood, fluid and electriolytes into the intestinal lumen. The aetiology is unknown but it may relate to ''Clostridium perfringes'' enterotoxicosis or an immune-mediated reaction. There is usually no history of garbage, chemical or foreign body ingestion. |
− | + | ||
==Diagnosis== | ==Diagnosis== | ||
===Clinical Signs=== | ===Clinical Signs=== | ||
− | *Acute and progressive | + | *Acute and progressive haematoemesis and/or haematochezia, with vomiting preceding diarrhoea |
− | *Depression | + | *Critically ill or moribund patient in severe cases |
+ | *Depression and anorexia | ||
*Abdominal pain | *Abdominal pain | ||
+ | *Dehydration and hypovolaemic shock occurs over a period of 8 - 12 hours. | ||
*Pyrexia (rare) | *Pyrexia (rare) | ||
− | * | + | *Thrombocytopaenia (severe cases) |
+ | *Prerenal or renal azotaemia (severe cases) | ||
Line 33: | Line 37: | ||
====Other Tests==== | ====Other Tests==== | ||
− | *Faecal | + | *Faecal cytology may reveal red blood cells, occasional white blood cells, ''C. perfringes'' spores or enterotoxin. ''C. perfringes'' spores or enterotoxin can be found in a normal dog, therefore care has to be taken not to overinterprete this. |
===Diagnostic Imaging=== | ===Diagnostic Imaging=== | ||
− | * | + | *Abdominal radiograph may reveal fluid and gas filled small and large intestines. |
− | |||
==Treatment== | ==Treatment== | ||
*Start treatment prior to a full diagnostic investigations. | *Start treatment prior to a full diagnostic investigations. | ||
− | *Aggressive intravenous fluid therapy is | + | *Aggressive intravenous fluid therapy is important for the treatment and prevention of shock. |
**Colloidal or plasma are recommended to replace the intravascular deficit due to loss of protein, followed by crystalloids to complete rehydration. | **Colloidal or plasma are recommended to replace the intravascular deficit due to loss of protein, followed by crystalloids to complete rehydration. | ||
**Clinical improvements should be noted within a few hours but resolution of clinical signs may take a few days. | **Clinical improvements should be noted within a few hours but resolution of clinical signs may take a few days. | ||
− | * | + | *A broad spectrum antimicrobials such as ampicillin combined with fluoroquinole are appropriate against C. perfringes. This is recommended to be given empirically. |
*Initially, nil per os should be implemented. Once vomiting has stopped, a bland and highly digestible diet such as chicken and rice can be introduced. | *Initially, nil per os should be implemented. Once vomiting has stopped, a bland and highly digestible diet such as chicken and rice can be introduced. | ||
==Prognosis== | ==Prognosis== | ||
− | Good. Complete recovery in most cases provided there is no compication such as hypoproteinaemia or sepsis. | + | Good if presented in a timely fashion. The duration of the disease is normally between 24-72 hours. Complete recovery in most cases provided there is no compication such as hypoproteinaemia or sepsis. Howevern, recurrence is possible. |
==References== | ==References== | ||
*Ettinger, S.J. and Feldman, E. C. (2000) '''Textbook of Veterinary Internal Medicine Diseases of the Dog and Cat Volume 2''' (Fifth Edition) ''W.B. Saunders Company''. | *Ettinger, S.J. and Feldman, E. C. (2000) '''Textbook of Veterinary Internal Medicine Diseases of the Dog and Cat Volume 2''' (Fifth Edition) ''W.B. Saunders Company''. | ||
− | *Hall, E.J, Simpson, J.W. and Williams, D.A. (2005) '''BSAVA Manual of Canine and Feline Gastroenterology (2nd Edition)''' ''BSAVA'' | + | *Hall, E.J, Simpson, J.W. and Williams, D.A. (2005) '''BSAVA Manual of Canine and Feline Gastroenterology (2nd Edition)''' ''BSAVA''. |
*Nelson, R.W. and Couto, C.G. (2009) '''Small Animal Internal Medicine (Fourth Edition)''' ''Mosby Elsevier''. | *Nelson, R.W. and Couto, C.G. (2009) '''Small Animal Internal Medicine (Fourth Edition)''' ''Mosby Elsevier''. |
Revision as of 16:53, 11 August 2009
This article is still under construction. |
Signalment
Middle-aged, small-breed dogs such as:
- Toy and Miniature Poodles
- Miniature Schnauzers
- Yorkshire Terrier
- Dachshunds
Description
Haemorrhagic gastroenteritis is characterised by acute vomiting and diarrhoea. Gastrointestinal integrity is loss, resulting in a rapid movement of blood, fluid and electriolytes into the intestinal lumen. The aetiology is unknown but it may relate to Clostridium perfringes enterotoxicosis or an immune-mediated reaction. There is usually no history of garbage, chemical or foreign body ingestion.
Diagnosis
Clinical Signs
- Acute and progressive haematoemesis and/or haematochezia, with vomiting preceding diarrhoea
- Critically ill or moribund patient in severe cases
- Depression and anorexia
- Abdominal pain
- Dehydration and hypovolaemic shock occurs over a period of 8 - 12 hours.
- Pyrexia (rare)
- Thrombocytopaenia (severe cases)
- Prerenal or renal azotaemia (severe cases)
Laboratory Tests
Haematology
- Haemoconcentration with PCV > 60%
- Normal or increased total protein concentrations, but proportionately lower than would be expected from the corresponding increase in PCV due to loss of protein through the intestines.
Biochemistry
Other Tests
- Faecal cytology may reveal red blood cells, occasional white blood cells, C. perfringes spores or enterotoxin. C. perfringes spores or enterotoxin can be found in a normal dog, therefore care has to be taken not to overinterprete this.
Diagnostic Imaging
- Abdominal radiograph may reveal fluid and gas filled small and large intestines.
Treatment
- Start treatment prior to a full diagnostic investigations.
- Aggressive intravenous fluid therapy is important for the treatment and prevention of shock.
- Colloidal or plasma are recommended to replace the intravascular deficit due to loss of protein, followed by crystalloids to complete rehydration.
- Clinical improvements should be noted within a few hours but resolution of clinical signs may take a few days.
- A broad spectrum antimicrobials such as ampicillin combined with fluoroquinole are appropriate against C. perfringes. This is recommended to be given empirically.
- Initially, nil per os should be implemented. Once vomiting has stopped, a bland and highly digestible diet such as chicken and rice can be introduced.
Prognosis
Good if presented in a timely fashion. The duration of the disease is normally between 24-72 hours. Complete recovery in most cases provided there is no compication such as hypoproteinaemia or sepsis. Howevern, recurrence is possible.
References
- Ettinger, S.J. and Feldman, E. C. (2000) Textbook of Veterinary Internal Medicine Diseases of the Dog and Cat Volume 2 (Fifth Edition) W.B. Saunders Company.
- Hall, E.J, Simpson, J.W. and Williams, D.A. (2005) BSAVA Manual of Canine and Feline Gastroenterology (2nd Edition) BSAVA.
- Nelson, R.W. and Couto, C.G. (2009) Small Animal Internal Medicine (Fourth Edition) Mosby Elsevier.