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Stress colitis in dogs

Stress colitis in dogs


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Stress colitis in dogs: an overview.

Stress colitis is a syndrome that occurs most commonly in dogs after acute stress and may occur after chronic stress or any stress (i.e., after surgery). The cause of stress colitis remains unclear but includes a disturbance of the brain-gut axis and neuroendocrine responses to stress, increased intestinal permeability, hypoperfusion and a mucosal lesion caused by inflammatory mediators. The clinical signs of stress colitis may vary depending on the severity of the lesion. Acute stress colitis in dogs presents with acute abdominal pain, vomiting, decreased appetite, diarrhea, fever, weight loss, and hemoccult-positive diarrhea. In dogs with chronic stress colitis, clinical signs include diarrhea, weight loss, abdominal pain, vomiting, increased fecal consistency, increased fecal fat, anorexia, and occasionally rectal bleeding. Although the pathogenesis of stress colitis is not completely understood, intestinal lesions may develop and worsen when associated with a primary disease such as IBD. The primary treatment of dogs with stress colitis is supportive and includes intravenous fluid therapy and antiemetic drugs. In most cases, the prognosis for dogs with stress colitis is good. Complications that may arise from stress colitis include hemorrhagic diarrhea, secondary peritonitis, and abscessation. Although no effective medications have been developed for the treatment of stress colitis in dogs, the medical management of these dogs may be considered to be similar to that of other inflammatory bowel diseases. When treating dogs with stress colitis, the clinician should also be alert to potential complications, such as dehydration and peritonitis, secondary to increased intestinal permeability.

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Carcinoids, lymphomas, and neoplasms such as pheochromocytomas, hemangiomas, and metastatic tumors may occur.

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Many medications may affect the GI tract. Some drugs (e.g., antacids, oral contraceptives) are contraindicated in the cat. The following is a summary of common medications that have side effects in the GI tract ([Box 2.10](#b0055){ref-type="boxed-text"} ). Many drugs have adverse effects on the GI tract (see Chapter 3).BOX 2.10Drugs Associated with GI Tract Side Effects•Antihistamines: Increased risk of GI ulceration•Aspirin: Increased GI ulceration•Antibiotics: Dysbiosis of the GI flora and increased risk of drug-induced colonic obstruction, may also produce enterotoxigenic *E. coli* and cause vomiting and diarrhea. May increase potential for development of hepatic encephalopathy, which may lead to seizures, lethargy, and coma.•Cyclooxygenase inhibitors: Gastric hypoalgesia and inhibition of prostaglandin synthesis, increased risk of GI ulceration, GI bleeding, and perforation•Calcium channel blockers: Increased GI ulceration•Diuretics: Increased GI transit time and risk of GI ulceration, bleeding, perforation•HERBAL: Increased GI motility, antidiarrheal effects, increased GI transit time, increased risk of GI hemorrhage•HERBAL: Increased GI motility, antidiarrheal effects, increased GI transit time, increased risk of GI hemorrhage•Opioids: May cause constipation, paralytic ileus, nausea, and vomiting•Selective serotonin reuptake inhibitors (SSRIs): GI nausea, constipation, increased risk of GI hemorrhage•TRAMADOL (opioid): Increased risk of respiratory depression•NS Ds: Increased risk of gastric bleeding•Phenytoin: Increased risk of GI ulceration, GI bleeding•Prokinetics: Increase GI motility•SSRIs: Increased risk of GI hemorrhage•Valproate: Risk of hepatotoxicity•Cephalosporins: Risk of GI ulceration, GI bleeding, perforation, toxic megacolon•VIPERGEL (PGE~1~ receptor antagonist): Nausea•ZOXIGA (inhaled anticholinergic): Nausea, diarrhea, abdominal cramps, and constipation•


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