| Diarrhea |
| Diarrhea, defined as an increase in fecal water content with an associated increase in the frequency, fluidity and volume of bowel movements is one of the most common complaints in veterinary medicine. If diarrhea has not responded to conventional therapeutic approaches within 10-14 days it is then appropriate to re-evaluate the problem and invest time, money and effort in an attempt to make a specific diagnosis. There are many causes of chronic diarrhea in the dog: Inflammatory bowel disease Plasmacytic Lymphocytic Eosinophilic Lymphangiectasia Intestinal Parasites Intestinal Tumors Bacterial overgrowth (antibiotic responsive diarrhea) Bacterial or fungal infection Exocrine Pancreatic insufficiency A specific diagnosis is based on an understanding of the pathophysiology of diarrhea, on a carefully taken histtory, and the logical application of appropriate specific diagnostic or gut function tests. The History: In chronic diarrhea a complete history is critical, in that it indicates the location, nature, severity and probable cause of the disease process. The history can be divided into 11 categories: Duration; weight loss; appetite; progression or worsening; diet; appearance of the feces; frequency of defecation; presence of vomiting; tenesmus; the environment in which the animal is kept; and the animal's breed and character. It is essential to take the history in a logical and orderly fashion and to avoid snap judgments. It also helps to explain the importance of the questions to the client in advance. A checklist can help to ensure that nothing is forgotten. Checklist of Questions: 1 Duration of Diarrhea: Weeks, months or years; intermittent or continuous 2 Diet: Dietary sensitivities or idiosyncracies; recent dietary change; access to garbage. Diarrhea persists with fasting; the effect of dietary change on fecal consistency. 3 Progression or worsening: If gradually worsening with more diarrhea, decreased appetite and onset of vomiting, suggests severe underlying disease such as lymphoma or severe inflammatory bowel disease. 4 Appetite: Normal, increased, decreased or ravenous. Pica; coprophagia 5 Appearance of the Feces: Volume, color, blood, mucus, flatus. 6 Frequency of Defecation: Amount increased above normal. Accidents in the house at night; urgency. 7 Vomiting: Presence or absence, frequency, nature of vomitus, relationship to eating. 8 Tenesmus: Presence or absence; before, during or after defecation. Description of act of defecation. 9 Body weight and Condition: Overall appearance of animal; documented weight loss. 10Environment: Outdoors or indoors, working dog or pet. Access to parasite infected environment. Obedience trained, change of environment, boarding, new pet, travel. 11Breed and character: Breed related diseases, stress realted (irritable bowel syndrome). Part 2 |