Small Animal Vomiting and Diarrhoea

The third #vetfinals session was appropriately placed just prior to the #y4rev GI exam so we were hoping it might prove useful to all! Zoe was our guest expert again and fuelled on tea and hummus tweeted from @vetfinalsguest (I will break her eventually and she will become a tweep herself!)

Zoe kicked off with the case presentation – a staffie with v+and d+ which is gonna be pretty regular for those of you going into SA practice in a few months time!

A0030P0001

Questions for the owner were pretty straight forward and there were lots of good ideas.

http://twitter.com/annabriggs/status/197023961849135104

And Nay also noticed that the dog had pretty horrid skin too so probably worth asking about dietary trials too!

We quickly moved onto differentials

http://twitter.com/annabriggs/status/197025584260452352

Bit of an outside spot from Jenn

and Zoe replied that this was a good question, but apparently there is no conclusive evidence that helicobacter causes D+ 

….and then Zoe added the clinical exam findings

The pyrexia was immediately spotted 

Everyone was sure that this was not one that would leave the hospital for the time being, and rightly so because of the level of dehydration and the HGE

Zoe wanted to know a bit more about the potential for parvovirus, and although you all knew there was a snap test she warned:

There were many suggestions for haematology and biochemistry, and Zoe agreed that trying to rule out other issues was important. She pushed you for the mechanism of action of parvovirus and Louise & Jen knew about this

We then moved onto other potentials….

…and Ali and Nay knew all about this

Jenn wanted to know about giving this dog antibiotics – she’d seen fluoroquinolones given in practice but wasn’t sure why

Louise stepped in

And eventually the conclusion was reached that potentiated amoxycillin was good for the G+ve spectrum, with metronidazole to be avoided because of the fact it kill anaerobes which we think are good gut commensals to have around. Moving on from the antibiotic question (it was stressing a few of you out!)

The topic of antacids merited further discussion

So although the licensed option, cimetidine is not useful in these cases….a prokinetic may be useful if severe ileus is present

We also decided against interferon owing to the lack of efficacy

Derrick was (nearly) top of the class for this

And most of you got the idea that a bland diet is what was needed

Apart from Anna with this off the wall fish curry themed suggestion – probably not the best way to go!

http://twitter.com/annabriggs/status/197039255715971072

Prognosis next?

And Emma made a good additional point

Anna also pointed out the importance of potential in contacts

http://twitter.com/annabriggs/status/197040961333895168

And that was where we ended it (barring the dinner tweets of course!) As Zoe pointed out:

Here is a link to a good summary paper for further reading:

Next sessions in mind are equine (hopefully next week) and I’m working on a cow one!