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Medications used in the treatment of feline hepatic lipidosis

Medication Dose Comments
0.9% NaCl Depends on de­gree of dehydra­tion, concurrent cardiac disease, etc Lactate-containing fluids (e.g.
Hartmann's) should be avoided, as lactate requires hep­atic metabolism
Potassium chloride Depends on de­gree of hypo- kalaemia. Hypokalaemia may develop with re-feed­ing. Monitor daily for first 72 hr. Do not exceed 0.5 mmol/kg/hr
Potassium phos­phate 0.01-0.06 mmol/ kg/hr

Give as constant rate infusion in NaCl

Hypophosphataemia may develop with re­feeding. Supplementation indicated if but peripheral prokinetic effects
Ranitidine 2 mg/kg q

8-12 hr

Not licensed for use in cats, but preferred over cimetidine due to prokinetic effect
Vitamin E 10 IU/kg/day Antioxidant often depleted with anorexia or malabsorption
L-carnitine 250-500 mg/ cat/day Promotes utilization of fatty acids by mito­chondria
Taurine 250-500 mg/ cat/day High dietary requirement, as used for bile acid conjugation
s-adenosyl me­thionine 20-40 mg/kg/ day

90 mg/cat/day

Higher dose required if enteric coated tab­lets are crushed for administration via feeding tube. Precursor for L-carnitine and glutathione; antioxidant and hepatopro- tective properties
N-acetyl cysteine 140 mg/kg; di­lute 1:4 with NaCl and give over 20 min Subsequent doses may be given after 8-12 hr at 70 mg/kg.
Precursor for gluta­thione

Abbreviations: AchR, anticholinesterase receptor; Ca, calcium; cf, compared to; CI, con­traindicated; CRI, constant rate infusion; CRTZ, chemoreceptor trigger zone; g, gram; ga, gauge; GI, gastrointestinal; hr, hour; iv, intravenous; KCS, keratoconjunctivitis sicca; kg, kilogram; mg, milligram; min, minute; NaCl, sodium chloride; NSAIDs, non-steroidal anti­inflammatory drugs; po, per os; sc, subcutaneously; μg, microgram.

Recommended reading

Swallowing and regurgitation

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Vatrous BJ. The esophagus. In: Thrall DE, editor. Textbook of Veterinary Diagnostic Radiology. 4th edn. Philadelphia, PA: WB Saunders; 2002:329-348.

Idiopathic megaoesophagus in a dog

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Iuilford WG, Stombeck DR. Diseases of swallowing. In: Guilford WG, Center SA, Strombeck DR, Williams DA, Meyers DJ, editors. Stombeck’s Small Animal Gastroenterology. 3rd edn. Philadelphia, PA: WB Saunders; 1996:211-238.

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Myasthenia gravis in a dog

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Oesophageal stricture in a cat

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Oesophageal foreign body in a dog

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Persistent right aortic arch in a dog

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Feline dysautonomia

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Gastrointestinal physiology - the normal stomach and small intest­ines

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Vomiting

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A foreign body in the small intestine of a dog

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Chronic partial gastric dilatation in a dog

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Pancreatitis and alimentary lymphoma in a dog

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Hypoadrenocorticism in a dog

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Lymphocytic inflammatory bowel disease/alimentary lymphoma in a cat

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Ingestion of glue by a dog

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Lead ingestion in a puppy

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Gastric adenocarcinoma in a dog

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Pancreatitis in a cat

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Linear foreign body in a cat

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Porto-systemic shunt in a dog

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Hepatic lipidosis in a cat

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Intestinal disorders: diarrhoea

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Small intestinal diarrhoea

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Protein losing enteropathy in a dog

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Inflammatory bowel disease and adverse reaction to food in a dog

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Guilford WG. Adverse reactions to food. In: Guilford WG, Center SA, Strombeck DR, Wil­liams DA, Meyer DJ, editors. Strombeck’s Small Animal Gastroenterology. Philadelphia, PA: WB Saunders; 1996:436-450.

Guilford WG. Idiopathic inflammatory bowel disease. In: Guilford WG, Center SA, Strom- beck DR, Williams DA, Meyer DJ, editors. Strombeck’s Small Animal Gastroenterology. Philadelphia, PA: WB Saunders; 1996:451-486.

Guilford WG, Jones BR, Markwell PJ, et al. Food sensitivity in cats with chronic idiopathic gastrointestinal problems. Journal of Veterinary Internal Medicine. 2001;15:7-13.

Moore LE. Protein-losing enteropathy. In: Bonagura JE, Twedt DC, editors. Kirk’s Current Veterinary Therapy XIV. Philadelphia, PA: Saunders Elsevier; 2009:512-514.

Γapp T, Griffin C, Rosenkrantz W, et al. Comparison of a commercial limited-antigen diet versus home-prepared diets in the diagnosis of canine adverse food reaction. Veterin­ary Therapeutics. 2002;3(3):244-251.

Intussusception in a cat

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Bellenger CR, Beck JA. Intussusception in 12 cats. Journal of Small Animal Practice. 1994;35(6):295-298.

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3atsikas MN, Papazoglou LG, Papaioannou NG. Ultrasonographic findings of intestinal in­tussusception in seven cats. Journal of Feline Medicine and Surgery. 2003;5(6):335-343.

Schwandt CS. Low-grade or benign intestinal tumours contribute to intussusception: a report on one feline and two canine cases. Journal of Small Animal Practice. 2008;49(12):651-654.

Feline exocrine pancreatic insufficiency

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Fyfe J. Feline intrinsic factor (IF) is pancreatic in origin and mediates ileal cobalamin (CBL) absorption. Journal of Veterinary Internal Medicine. 1993;7:133.

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Reed N, Gunn-Moore DG, Simpson K. Cobalamin, folate and inorganic phosphate abnor­malities in ill cats. Journal of Feline Medicine and Surgery. 2007;9:278-288.

Simpson KW, Fyfe J, Cornetta A, et al. Subnormal concentrations of serum cobalamin (vit­amin B12) in cats with gastrointestinal disease. Journal of Veterinary Internal Medicine. 2001;15:26-32.

Steiner JM, Williams DA. Feline exocrine pancreatic disorders: insufficiency, neoplasia and uncommon conditions. Compendiumfor ContinuingEducationfor the Practicing Veterin­arian. 1997;19:836-847.

Steiner JM, Williams DA. Feline exocrine pancreatic disorders. Veterinary Clinics of North America Small Animal Practice. 1999;29:551-575.

Steiner JM, Williams DA. Serum feline trypsin-like immunoreactivity in cats with exocrine pancreatic insufficiency. Journal of Veterinary Internal Medicine. 2000;14:627-629.

Westermarck E. Treatment of pancreatic degenerative atrophy with raw pancreas ho­mogenate and various enzyme preparations. Journal of Veterinary Medicine Series A. 1987;34:728-733.

Westermarck E, Wiberg M, Steiner JM, Williams DA. Exocrine pancreatic insufficiency in dogs and cats. In: Ettinger SJ, Feldmann EC, editors. Textbook of Veterinary Internal Medicine. 6th edn. St. Louis, MO: Elsevier Saunders; 2005:1492-1495.

Williams DA. Feline exocrine pancreatic insufficiency. In: Kirk RW, Bonagur JD, editors. Current Veterinary Therapy XII. Philadelphia, PA: WB Saunders; 1995:732-735.

Parvovirus infection in a dog

Davies M. Canine parvovirus strains identified from clinically ill dogs in the United King­dom. Veterinary Record. 2008;163:543-545.

Davis-Wurzler GM. Current vaccination strategies in puppies and kittens. Veterinary Clinics of North America: Small Animal. 2006;36:607-640.

IeMari K, Maynard L, Eun HM, Lebreux B. Treatment of canine parvoviral enteritis with interferon-omega in a placebo-controlled field trial. Veterinary Record. 2003;152:105-108.

Guilford WG, Strombeck DR. Gastrointestinal tract infections, parasites and toxicoses. In: Guilford WG, Center SA, Strombeck DR, Williams DA, Meyer DJ, editors. Strombeck’s Small Animal Gastroenterology. Philadelphia, PA: WB Saunders; 1996:411-432.

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Mohour AJ, Leisewitz AL, Jacobson LS, et al. Effect of early enteral nutrition on intestinal permeability, intestinal protein loss, and outcome in dogs with severe parvoviral en­teritis. Journal of Veterinary Internal Medicine. 2003;7(6):791-798.

Prittie J. Canine parvovirus enteritis: a review of diagnosis, management and prevention. Journal of Veterinary Emergency and Critical Care. 2004;14(3):167-176.

Introduction to haematochezia and melaena

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Haemorrhagic gastroenteritis in a dog

Guilford WG, Strombeck DR. Acute hemorrhagic enteropathy (Hemorrhagic gastroenteritis: HGE). In: Guilford WG, Center SA, Strombeck DR, Williams DA, Meyer DJ, editors. Strombeck’s Small Animal Gastroenterology. Philadelphia, PA: WB Saunders; 1996:433-435.

Hall EJ, German AJ. Diseases of the small intestine. In: Ettinger SJ, Feldman EC, editors. Textbook of Veterinary Internal Medicine. 6th edn. Philadelphia, PA: Elsevier Saunders; 2006:1332-1377.

Sasaki J, Gorvo M, Asahina M, et al. Hemorrhagic enteritis associated with Clostridiumper- fringens type A in a dog. Veterinary Medicine and Science. 1999;61(2):175-177.

Spielman BL, Garvey MS. Hemorrhagic gastroenteritis in 15 dogs. Journal of the American Animal Hospital Association.. 1993;29(4):341-344.

Colonic vascular ectasia in a dog

Daugherty MA, Leib MS, Lanz O, Duncan RB. Diagnosis and surgical management of vascular ectasia in a dog. Journal of the American Veterinary Medical Association. 2006;229:975-979.

Goldman CK, Parnell NK, Holland CH. Hormone therapy for treatment of colonic vascular ectasia in 2 dogs. Journal of Veterinary Internal Medicine. 2008;22:1048-1051.

Rogers KS, Butler LM, Edwards JF, et al. Rectal hemorrhage associated with vascular ectasia in a young dog. Journal of the American Veterinary Medical Association. 1992;200:1349-1351.

Van Cutsem E, Rutgeerts P, Vantrappen G. Treatment of bleeding gastrointestinal vascular malformation with oestrogen-progesterone. The Lancet. 1990;335:953-955.

Intestinal leiomyoma in a dog

Forst D, Lasota J, Miettinen M. Gastrointestinal stromal tumors and leiomyomas in the dog: a histopathologic, immunohistochemical, and molecular genetic study of 50 cases. Ve­terinary Pathology. 2003;40(1):42-54.

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Maas CPHJ, 2008. A new look at intestinal smooth muscle tumours: clinical, histologic and immunohistochemical aspects for reclassification. Proceedings of 18th ECVIM-CA Congress. 4-6 September 2008, Ghent, Belgium.

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Myers NC, Penninck DG. Ultrasonographic diagnosis of gastrointestinal smooth muscle tu­mours in the dog. Veterinary Radiology and Ultrasound. 1994;35(5):391-397.

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Powers BE, Hoopes PJ, Ehrhart EJ. Tumor diagnosis, grading and staging. Seminars in Ve- ternary Medicine and Surgery. 1995;10:158-167.

Corticosteroid induced gastrointestinal ulceration in a dog

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Crawford LM, Wilson RD. Melena associated with dexamethasone therapy in the dog. Journal of Small Animal Practice. 1982;23:91-97.

Guilford WG, Strombeck DR. Chronic gastric disease. In: Guilford WG, Center SA, Strom- beck DR, Williams DA, Meyers DJ, editors. Strombeck’s Small Animal Gastroenterology. 3rd edn. Philadelphia, PA: WB Saunders; 1996:275-302.

Moreland KJ. Ulcer disease of the upper gastrointestinal tract in small animals: Patho­physiology, diagnosis, and management. CompendiumforContinuingEducationforthe Practicing Veterinarian. 1988;10(11):1265-1279.

Rohrer CR, Hill RC, Fischer A, et al. Gastric hemorrhage in dogs given high doses of methylprednisolone sodium succinate. American Journal of Veterinary Research. 1999;60(8):977-981.

Introduction to the colon and colonic disorders

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Leib MS, Monroe WE, Codner EC. Performing rigid or flexible colonoscopy in dogs with chronic large bowel diarrhea. Veterinary Medicine. 1991;86:900-912.

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Washabau RJ, Holt DE. Feline constipation and idiopathic megacolon. In: Bonagura J, editor. Kirk’s Current Veterinary Therapy XIII. Philadelphia, PA: WB Saunders; 2000:648-652.

Washabau RJ, Holt DE. Diseases of the Large Intestine. In: Ettinger SJ, Feldmann EC, edit­ors. Textbook OfVeterinaryInternalMedicine. 6th edn. St. Louis, MO: Elsevier Saunders; 2005:1401-1406.

Webb CB. Anal-rectal disease. In: Bonagura JD, Twedt DC, editors. Kirk’s Current Veterinary Therapy XIV. St. Louis, MO: Saunders Elsevier; 2009:531-533.

Feline constipation and megacolon

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Tritrichomonas in two kittens

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Gookin JL, Copple CN, Papich MG, et al. Efficacy of ronidazole for treatment of feline Tritrichomonas foetus infection. Journal of Veterinary Internal Medicine. 2006;20(3):536-543.

Gookin JL, Staufer SH, Coccaro MR, et al. Efficacy of tinidazole for treatment of cats exper­imentally infected with Tritrichomonas foetus. American Journal of Veterinary Research. 2007;68(10):1085-1088.

Gookin JL, Stebbins ME, Hunt E, et al. Prevalence and risk factors for feline Tritrichomonas foetus and Giardia infection. Journal of Clinical Microbiology. 2004;42(6):2207-2710.

Gunn-Moore DA, McCann TM, Reed N, et al. Prevalence of Tritrichomonasfoetus infection in cats with diarrhoea in the UK. Journal of Feline Medicine and Surgery. 2007;9:214-218.

Mardell EJ, Sparkes AH. Chronic diarrhoea associated with Tritrichomonas foetus in a Brit­ish cat. The Veterinary Record. 2006;158:765-766.

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Colorectal neoplasia in a dog

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Lowe AD. Alimentary lymphosarcoma in a 4-year-old Labrador retriever Canadian. Veter­inary Journal. 2004;45(7):610-612.

Mealey KL, Bentjen SA, Gay JM, Hosick HL. Dexamethasone treatment of a canine, but not human, tumour cell line increases chemoresistance independent of P-glycoprotein and multidrug resistance-related protein expression. Veterinary and Comparative Oncology. 2003;1(2):67-75.

Colonic inflammatory bowel disease in a cat

Guilford WG. Idiopathic inflammatory bowel disease. In: Guilford WG, Center SA, Strom- beck DR, Williams DA, Meyer DJ, editors. Strombeck’s Small Animal Gastroenterology. Philadelphia, PA: WB Saunders; 1996:451-486.

Guilford WG, Jones BR, Markwell PJ, et al. Food sensitivity in cats with chronic idiopathic gastrointestinal problems. Journal of Veterinary Internal Medicine. 2001;15:7-13.

Moore LE. Protein-losing enteropathy. In: Bonagura JE, Twedt DC, editors. Kirk’s Current Veterinary Therapy XIV. Philadelphia, PA: Saunders Elsevier; 2009:512-514.

Parnell NK. Chronic colitis. In: Bonagura JE, Twedt DC, editors. Kirk’s Current Veterinary Therapy XIV. Philadelphia, PA: Saunders Elsevier; 2009:515-520.

Reference ranges for haematology and serum chemistry values for adult cats and dogs

Chandler ML. Pediatric normal blood values. In: Kirk R, Bonagura JD, editors. Current Ve­terinary Therapy. Philadelphia, PA: WB Saunders; 1992:981-984.

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Source: Chandler M.. Small animal gastroenterology. Saunders,2011. — 588 p.. 2011
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