| Diarrhea part 3 |
| The Physical Examination A complete physical examination my reveal important clues about the cause of diarrhea. The nutritional status of the patient and any evidence of dehydration should be carefully noted. Overt physical abnormalities are uncommon in most dogs with chronic diarrhea. The most common findings are a loss of body weight and condition in dogs with nutrient mal-absorption or protein-losing enteropathy. A thickened intestine and enlarged mesenteric lymph nodes may occasionally be palpated in a few dogs with chronic diarrhea associated with either inflammatory bowel disease or lymphosarcoma. Physical findings in dogs with colities are usually normal. Diffuse intestinal tumors, Bacterial overgrowth (antibiotic responsive diarrhea) Bacterial or viral infection, Intestinal Parasites. Clinical Significance of Physical Findings in Intestinal Disease Physical Finding Clinical Association Dehydration Diarrheal fluid loss (Diarrhea, vomit) Depression, Electrolye imbalances, weakness debilitation Emaciation, Protein calorie malnutrition malnutrition Pallor (anemia) Gastrointestinal blood loss Anemia of chronic disease Edema/effusion Protein losing enteropathy Clinical Significance of Abdominal Palpation Physical Findings Clinical Association Masses Foreign body, neoplasia, granuloma Thickened intestinal loops Tumor, inflammation Sausage loops Intussusception Aggregated loops Linear foreing body, Adhesions Pain Inflammation, obstruction, ischemia Gas, fluid Distention Obstruction, ileus Mesenteric Inflammation, infection Lymphadenopathy neoplasia Specific Diagnosis of Chronic Diarrheal Disease Once the problem has been identified as small or large bowel in origin from the results of the history and physical examination, a specific diagnosis can be made by means of appropriate diagnostic studies. It is routine in both chronic small and large bowel diarrhea to obtain a hemogram, blood chemistries, urinalysis and a complete fecal examination. The Sequential Diagnosis of Chronic Diarrhea Small and Large Bowel Diarrhea: Hemogram, Blood Chemistries, Urinalysis, Fecal Examination. Small Bowel Diarrhea: Absorption Studies, Digestion Studies, Radiographs, Biopsy, Response to rational therapy..refer Large Bowel Diarrhea: Diet Change, Colonloscopy, Biopsy, Response to rational therapy...refer. Part 4 |