Page 2717 - Cote clinical veterinary advisor dogs and cats 4th

Diarrhea, Large Bowel 1411

Diarrhea, Large Bowel
VetBooks.ir Large bowel diarrhea

Abnormalities (other than diarrhea) on history, physical, or rectal exam?
yes
no
Pursue diagnostic clues (e.g., rectal scraping if
rectal mucosa thickened/cobblestone, imaging
if mass or pain on abdominal palpation)
First episode:
• Fecal flotation/direct or fecal
antigen ELISA (more sensitive) No resolution or recurrence:
• Supportive care (e.g., Repeat physical, CBC, biochemical
probiotics, empiric profile, urinalysis
anthelmintics, dietary
modification) Owner preference

Additional fecal exams (as indicated): Therapeutic trials (influenced by
• Direct smear signalment/history)
Address identified abnormalities • Fecal antigen ELISA (very sensitive) • Anthelmintic
• Enteric pathogen PCR • Diet (fiber, novel ingredient, fat content)
• Fecal culture • Antimicrobial (e.g., metronidazole)

Abdominal imaging:
Address identified abnormalities • Radiographs If no response to trials
• Ultrasound

Colonoscopy: If no cause identified, pursue therapeutic
Address identified abnormalities • Cytology trials. After failed anthelmintic, dietary, and
• Histopathology antimicrobial trials, steroid trial reasonable

Clinical Algorithms

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