11/13 - Microbiome and Referral Cases

Microbiome

What is the term for the overall system of interactions between the GI and microbial flora located in the GI tract? Multiple theories exist, including that bacterial imbalance causes disease and that disease causes bacterial imbalance, and treatment should be done with probiotics. There is also a theorized gut-brain axis in which bacterial byproducts affect health, wellbeing, and mental health. It also serves for immune system interaction and motility interaction and food responsive enteropathies can also affected it.

Probiotics

What drugs include fortiflora and proviable, and are given for diarrhea after antimicrobial use, dietary indiscretion, and stress colitis? Medical grade ones like Visbiome also exist and can be used in chronic enteropathies.

Prebiotics

What drugs include Hill’s GI biome diet and are given for acute diarrhea, over a short term period? They can also be given long term for chronic enteropathies, especially for diarrhea that is antimicrobial-responsive.

Transplant

A fecal microbiota what procedure can be done in cases of acute parvovirus and in refractory chronic enteropathies or PLE? The donor must be healthy, and administration is based on GI signs.

Surgical

Will a surgical, or endoscopic biopsy be able to access the jejunem and all 4 layers of the GI tract? It is more invasive than the other one.

Ileum

If vitamin B12 is low, this often indicates disease in what SI section? EPI can also cause this.

Duodenum

Low folate may indicate decreased absorption in which SI section?

PLE

What condition (abbreviated) can be caused by primary lymphangiectasia, chronic enteropathy, neoplasia, and infection, and typically leads to hypoalbuminemia and negative sequelae? It can be acute or chronic, with chronic having worse prognosis. Diagnostics include infectious disease screening, abdominal ultrasound/radiographs, and endoscopic biopsies. The albumin level determines how fast it is occurring and which diagnostics are recommended. Addison’s must be ruled out.

Lymphangiectasia

Primary what condition is a cause of PLE and can be hereditary or acquired, such as in Yorkies and other toy breeds? It is diagnosed by excluding other causes of PLE and then doing a biopsy. Treatment is with an ultra low-fat diet.

Hypertrophy

Pyloric what condition is one motility disorder of the GI and is also called chronic hypertrophic gastropathy? It is a rare condition with unknown but possibly genetic cause. It is found in middle-older aged Westies, Shih Tzus, and Maltese, and diagnosis is with chronic vomiting workup, ruling out other diseases, and abdominal ultrasound/endoscopy. Treatment is with a surgical Y-U pyloroplasty, which has a high success rate.

Emptying

Delayed gastric what is one rare cause of chronic GI signs, such as gastric dilation, delayed this, regurgitation, vomiting, weight loss, and increased vitamin D? It is poorly understood, with poor prognosis. Referral is necessary for this condition and treatments include prokinetics and small, frequent, low-fat meals. Biopsy can be done to look for smooth muscle disease. The workup for this and similar diseases involves determining if it is mechanical or functional, and involves radiographs, abdominal ultrasound, endoscopy, and functional studies (barium, scintigraphy, wireless capsule camera). Treatments include low fat diet, small frequent meals, fiber/prebiotics, metoclopramide, cisapride, and low dose erythromycin.

Insufficiency

Exocrine pancreas what condition is when there are no enzymes being made, and undigested food and osmotic diarrhea occur/build up? There will be a large volume of steatorrhea and it is most common in young GSD and collie dogs, as well as older cats with chronic pancreatitis and triaditis. The test of choice is TLI, and B12 will be low. Treatment is with pancreatic enzymes and B12.