Canis ISSN: 2398-2942

Malabsorption

Contributor(s): Ken Harkin, James Simpson, Aarti Kathrani

Introduction

  • Poor absorption of nutrients from small intestine.
  • Cause: altered intestinal mucosal or lymphatic function.
  • Signs: chronic diarrhea, weight loss, vomiting, polyphagia or anorexia.
  • Diagnosis: history, physical examination, laboratory tests, abdominal ultrasound, intestinal histopathology.
  • Treatment: dependent on underlying cause.
  • Prognosis: can be guarded.

Pathogenesis

Etiology

  • Mucosal damage often due to inflammatory or neoplastic response.
  • Multiple causes of inflammation including:
    • Parasitic.
    • Bacterial.
    • Dietary.
    • Hypersensitivity
    • Infectious agents.
    • Most cases idiopathic.
  • Intestinal lymphangiectasia (IL), resulting in dilated and ruptured lacteals and loss of protein rich lymph into the intestinal lumen.
  • Multiple cases of IL including:

Specific

Pathophysiology

  • Reduced nutrient absorption due to:
    • Villous atrophy Intestine: villus atrophy → decreased surface area → decreased absorptive capacity.
    • Mucosal damage → loss of mucosal integrity → increased intestinal permeability.
    • Mucosal damage → loss of brush border enzymes → decreased digestion and absorption. 
    • Infiltration of lamina propria with inflammatory or neoplastic cells → reduced absorption and altered motility.
    • Lymphangiectasia → malabsorption of lipoproteins and fats due to defective lacteal function.

Timecourse

  • Weeks to months.

Diagnosis

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Treatment

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Outcomes

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Toresson L, Steiner J M, Suchodolski J S, Spillmann T (2016) Oral cobalamin supplementation in dogs with chronic enteropathies and hypocobalaminemia. JVIM 30 (1), 101-107 PubMed.
  • Allenspach K (2013) Diagnosis of small intestinal disorders in dogs and cats. Vet Clin North Am Small Anim Pract 43 (6), 1227-1240 PubMed.
  • Dossin O, Lavou√© R (2011) Protein-losing enteropathies in dogs. Vet Clin North Am Small Anim Pract 41 (2), 399-418 PubMed.
  • Hall E J (2011) Antibiotic-responsive diarrhea in small animals. Vet Clin North Am Small Anim Pract 41 (2), 273-286 PubMed.
  • Simpson K W, Jergens A E (2011) Pitfalls and progress in the diagnosis and management of canine inflammatory bowel disease. Vet Clin North Am Small Anim Pract 41 (2), 381-398 PubMed.


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