Chronic diarrhoea

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If the signs persist or are intermittently present for more than 14 days, diarrhoea is classified as being chronic. Therefore, the disease is not self-limiting and every patient with chronic diarrhoea needs a thorough diagnostic investigation. This chapter covers relevant history, physical examination, differential diagnoses and diagnostic tests.

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18.3 (a) Abdominal palpation of a cat. (b) Digital rectal examination of a dog. (b, Courtesy of J Williams)
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18.4 Algorithm showing the diagnostic approach to the cause of chronic diarrhoea in dogs and cats. α-PI = alpha-proteinase inhibitor; ARD = antibiotic-responsive diarrhoea; cPL = canine pancreatic lipase; cTLI = canine trypsin-like immunoreactivity; EPI = exocrine pancreatic insufficiency; fPL = feline pancreatic lipase; fTLI = feline trypsin-like immunoreactivity; PCR= polymerase chain reaction; PLE = protein-losing enteropathy; SIBO = small intestinal bacterial overgrowth; TEG = thromboelastography; TLI = trypsin-like immunoreactivity; UPC = urine protein:creatinine ratio.
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