Corticosteroid induced gastrointestinal ulceration in a dog

34 Corticosteroid induced gastrointestinal ulceration in a dog

Problem list and discussion of problems

The dog’s problems included:

The slightly tacky membranes were likely indicative of mild dehydration due to the polyuria.

The pale mucous membranes may have been due to poor perfusion or anaemia. The heart sounds were regular and on palpation her pulses felt normal, making anaemia the more likely diagnosis. Anaemia may be divided into non-regenerative or regenerative, which is determined by performing a reticulocyte count. Non-regenerative anaemias are due to systemic diseases suppressing bone marrow function or primary bone marrow disorders. Regenerative anaemias are due to blood loss or haemolysis. Gastrointestinal blood loss is always a potential problem in animals on corticosteroid treatment.

The muscle wasting was typical of that induced by corticosteroids, but can also be caused by myopathies or weight loss due to illness, where muscle loss can be more prominent than fat loss.

The pendulous abdomen on this dog may have been due to the administration of corticosteroids, which cause muscle weakness and abdominal deposition of fat. Other causes for the abdominal enlargement included ascites or organomegaly.

The polyuria and polydipsia are common side effects of corticosteroids, but other common or concurrent disorders like renal disease, urinary tract infection, endocrine disorders or electrolyte disturbances were also included in the differential diagnoses list.

The elevation in liver enzymes may be due to corticosteroids or primary or secondary liver disorders.

Dark faeces can indicate melaena (the presence of digested blood in the faeces). Usually the stools are described as being dark and tarry. The black colour is a result of the oxidation of haemoglobin and the tarry appearance is from the bacterial breakdown of haemoglobin. Generally melaena is thought to be from bleeding from the upper intestinal tract or from the ingestion of blood (e.g. from epistaxis or oral lesions). Blood must be present in the gastrointestinal tract for several hours (8 hours in humans) before the colour turns black, so a rapid transit time of blood may not show melaena and a very slow transit time may show as melaenic faeces from a bleed in the lower gastrointestinal tract.

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Sep 22, 2016 | Posted by in SMALL ANIMAL | Comments Off on Corticosteroid induced gastrointestinal ulceration in a dog

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