Today's Veterinary Practice

NOV-DEC 2015

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Today's VeTerinary PracTice | november/december 2015 | tvpjournal.com symPTomaTic managemenT of Primary acuTe gasTroenTeriTis Peer reviewed 46 Table 1. Selected Causes of Secondary Acute Gastroenteritis Algal • Prototheca species Bacterial • Campylobacter species • Clostridia species • Escherichia coli • Neorickettsia helminthoeca • Salmonella species Drugs • Antibiotics • Cyclosporine • Glucocorticoids • Mycophenolate • Nonsteroidal anti-infammatory drugs Parasitic • Ancylostoma caninum • Ollulanus tricuspis • Physaloptera species • Strongyloides species • Toxoascaris leonina • Toxocara canis Protozoal • Cryptosporidium parvum • Giardia species • Isospora canis Systemic disease • Bacterial cholecystitis • Gallbladder mucocele • Gastric dilatation and volvulus • Hepatic disease • Hypoadrenocorticism • Pancreatitis • Pyometra • Renal disease • Sepsis • Septic peritonitis • Splenic torsion Toxins • Chocolate • Lead • Mushrooms • Organophosphates • Xylitol • Zinc Viral • Canine coronavirus • Canine parvovirus • Feline immunodefciency virus • Feline leukemia virus • Feline parvovirus (panleucopenia virus) Acute gastroenteritis is a term used to describe a syndrome characterized by the sudden onset of vomiting and/or diarrhea caused by gastrointestinal mucosal infammation. This diagnosis is seldom confrmed by histopathologic evaluation; instead, it is based on a consistent clinical presentation and exclusion of other potential causes for the patient's clinical signs. Mucosal infammation is assumed, but not proven to be present. Therefore, acute gastroenteropathy is perhaps a more appropriate name. DIAGNOSTIC EVALUATION Acute gastroenteritis is among many potential causes of acute vomiting and diarrhea (Table 1). However, in many cases, the cause of primary acute gastroenteritis is not determined. Rapid resolution of clinical signs often means that extensive diagnostic evaluation is unnecessary. Physical Examination No specifc physical examination fndings are pathognomonic for acute gastroenteritis, and some dogs do not have any signifcant abnormalities. Findings consistent with acute gastroenteritis include lethargy, pytalism, and abdominal discomfort. It is particularly important to assess the patient's hydration status and palpate the abdomen carefully, checking for physical examination fndings that would warrant further diagnostic evaluation (ie, abnormalities that suggest the problem is more signifcant than straightforward acute gastroenteritis) (Table 2). Findings that indicate dehydration include dry oral mucous membranes, prolonged capillary refll time, and prolonged skin tent. Tachycardia, weak pulses, and cool extremities are consistent with hypovolemia. Laboratory Analysis Patients with a normal physical examination and Symptomatic Management of Primary Acute Gastroenteritis Yuri Lawrence, DVM, MA, MS, Diplomate ACVIM (Small Animal Internal Medicine), and Jonathan Lidbury, BVMS, MRCVS, Diplomate ACVIM (Small Animal Internal Medicine) & ECVIM (Companion Animal) Texas A&M; University

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