Today's Veterinary Practice

JAN-FEB 2018

Today's Veterinary Practice provides comprehensive information to keep every small animal practitioner up to date on companion animal medicine and surgery as well as practice building and management.

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PEER REVIEWED 34 CE: INFLAMMATORY BOWEL DISEASE In cats with IBD, hyperproteinemia and mild elevation in liver enzymes (alanine aminotransferase and alkaline phosphatase) are often reported. 7,22,40 Dogs with PLE frequently have hypoalbuminemia and hypoglobulinemia, which may be accompanied by hypocholesterolemia and hypocalcemia. The presence of hypoalbuminemia correlates with a negative outcome in dogs. 33,38 Cats with IBD may have increased serum pancreatic lipase concentrations (suggestive of pancreatitis). This association does not appear to influence clinical outcome, based on a recent report. 41 However, increased serum pancreatic lipase concentrations in dogs with IBD have been associated with a poorer clinical outcome. 42 Dogs and cats with chronic small bowel disease may have decreased serum cobalamin concentrations secondary to cobalamin malabsorption. Failure to recognize and correct hypocobalaminemia can delay clinical recovery, even with specific therapy for IBD. 43 Hypocobalaminemia has also been correlated with a poor prognosis in dogs with chronic enteropathies. 33 Diagnostic Imaging Abdominal radiographs can be used to assess the following: ■ Extra-alimentary tract disorders causing gastroenteritis (eg, neoplasia) ■ Caudal displacement of the small intestine and potential abdominal effusion with loss of cranial radiographic abdominal detail associated with pancreatitis ( FIGURE 2 ) ■ Overt renal or hepatic changes ( FIGURE 3 ) associated with dysfunction, damage, or neoplasia Abdominal ultrasonography is superior to abdominal radiography in defining diffuse GI mucosal disease, intestinal wall thickness ( FIGURE 4 ), and mesenteric lymphadenopathy seen with IBD as well as other infiltrative (eg, lymphoma) disorders. 44 FIGURE 2. Lateral abdominal radiograph of a dog with pancreatitis. Note the loss of abdominal detail in the cranioventral abdomen with caudal displacement of the small intestine. Courtesy of Dr. Eric Van Eerde. FIGURE 3. Lateral abdominal radiograph of a dog with hepatocellular carcinoma. Note the increase in soft tissue opacity (mass effect) in the cranioventral abdomen. Courtesy of Dr. Eric Van Eerde. FIGURE 4. Ultrasound images showing jejunal muscularis thickening in a cat with IBD. ( A ) Cross-sectional image showing thickened small intestinal wall (0.44 cm). ( B ) Longitudinal section demonstrating a similar thickened appearance (0.38 cm). Normal small intestinal wall thickness in cats is reported as 0.16 to 0.36 cm. 24 Courtesy of Dr. Jacob Ewing. A B

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