FASAVA 筆記分享 part2

講師是UC Davis的教授，是我這次整個congress聽到覺得最棒的講者。當初給這位教授的教室很小，很多醫生最後都站著聽講

主題： the latest on infectious GI disease

🔺Giardia
1. most common sign is “asymptomatic”
2. associated with small intestinal diarrhea
3. most strains are non-zoonotic
4. diarrhea is often self-limiting

If test positive -> ignore or treat with single dose only, if recur don’t treat again

ELISA (snap) test for giardia: only to be used for initial dx, NEVER use it to check efficacy of tx (coz it can remain positive for up to 4 wks after elimination)

Tx:
metronidazole, Fenbendazole(highest efficacy), Ronidazole, Frontal plus, Secnidazole

🔺Campylobacter can be non-pathogenic commensial
🔺Raw diet animal : 60-70% +ve on Salmonella, healthy animal but zoonotic risk

‼️Take home message:
-Isolation of bacterial ,viral or parasitic enteropathogen doesn’t denote a cause-and effect phenomenon
-bacterial, viral and parasitic enteropathogens are commonly isolated from healthy asymptomatic dogs and cats

🔺Granulomatous colitis (boxer and French Bulldog)
Cause: Adherent and invasive E. coli
Tx: fluoroquinolones 6-8 wks, up to 17% resistance
DO NOT use steroid, as will make worse

🔺AHDS Acute Hemorrhagic Diarrhea Syndrome (to replace previously known HGE)
-acute onset of vomiting and hemorrhagic diarrhea
-frequently associated with hemoconcetration
-can be associated with infectious and non-infectious causes

🔺If see hemoconcentration with normal protein-> think about Clostridium perfringens

🔺Antimicrobial therapy is controversial for management of C. Perfringens
Study shows same outcome between AB and placebo groups

🔺Need to assess the patient 2-4 times/day, if see increased temp, WBC (toxic left shift), and systemic signs: then give ABs

‼️‼️非常重要‼️‼️
Rational use of ABs in diarrhea patient
1. Hemorrhagic diarrhea with signs of sepsis
2. Prevention of bacterial translocation
3. Severely immunocompromised patient
4. Management of AB responsive diarrhea
5. Management of a specific bacterial enteropathogen eg E. Coli in Boxers with granulomatous colitis

#看了就餓了
#有緣待續