03 - stomach disorders Flashcards
(vomiting)
- vomitus consists of contents from where?
- projectile vomiting usually indicates what?
- vomiting of undigested food more than 12 hours after eating suggests what?
- stomach and duodenum
- gastric outlet or upper small bowel obstruction
- delayed gastric emptying
(vomiting)
- use what contrast for contrast studies if perforation is suspected?
- aqeous iodide
(vomiting)
1-3. 3 principles of symptomatic and supportive treatment?
- fluid therapy (IV best)
- withhold food for 12-24 hours -> highly digestible -> back to normal
- anti-emetics (phenothiazines, metoclopramide, butorphanol)
(acute gastritis)
common, usually mild and self-limiting
1-4. 4 causes?
- foreign body -> mechanical irritation
- dietary indescretion
- irritants
- drugs
(acute gastritis)
- Cx include acute onset of nausea and vomiting
- dx supported by response by therapy in how many days?
- tx?
- 1-2
- underlying cause, withhold food then bland, consider anti-emetic
(gastric foreign bodies)
- gastric FB more common in dogs, linear more common in cats
- most common Cx?
- what should be considered in all animals with acute vomiting?
- acute onset vomiting
(some may present with chronic vomiting, also signs relating to FB zinc or lead)
- gastric FB!
(gastroduodenal ulceration and bleeding)
- what 2 drugs cause?
- what 4 conditions?
- what 1 endocrine dz?
- what 3 cancers?
- what behavior?
- NSAIDS, glucocorticoids
- chronic gastritis, hepatic disease (mucosal blood flow), renal failure, neurologic disease
- hypoadrenocorticism
- gastric neoplasia, mast cell tumors, gastrinoma
- stress
(gastroduodenal ulceration and bleeding)
- Cx?
- anorexia, vomiting, hematemesis, abdominal pain, weight loss
(gastroduodenal ulceration and bleeding)
(dx)
- look at drug hx
- lab eval may show what that would suggest chronic blood loss?
- what is indicated if perforation is suspected?
- endoscopy or laparotomy may be useful
- regenerative anemia or microcytic hypochromic anemia
- abdominocentesis
(gastroduodenal ulceration and bleeding)
- tx?
- H2 blockers and sucralfate
(Chronic Gastritis)
(lymphocytic-plasmacytic gastritis)
- a common histologic diagnosis
(Chronic Gastritis)
(lymphocytic-plasmacytic gastritis)
- idopathic chronic gastritis usually attributed to what 3 things?
- dietary allergy, occult parasitism, reation to bacterial antigens
(Chronic Gastritis)
(lymphocytic-plasmacytic gastritis)
1-4. 4 infectious causes?
- physaloptera, ollulanus tricuspis (cats), pythium insidiosum (dogs), helicobacter
(also enterogastric reflux or chronic mucosal irritation…)
(Chronic Gastritis)
(lymphocytic-plasmacytic gastritis)
- Cx include intermittent vomiting
- vomiting associated with eating?
- not consistently
(Chronic Gastritis)
(lymphocytic-plasmacytic gastritis)
- dx method of choice?
- endoscopy
(chronic gastritis)
(eosinophilic gastritis and granuloma)
- this is usually diffuse
- same clinical signs and stuff as the lymphocytic one
(chronic gastritis)
(therapy)
- treat underlying
- dietary trial with what kind of food?
- H2 blockers/promotiliy drugs may be indicated
- what may be used if there is no response to dietary trial or H2 blockers?
- what if helicobacter?
- easily digestible, fat restricted, carb based diet with a novel protein source (feed frequent small meals)
- prednisolone or azathioprine
- abx
(gastric outflow obstruction)
- causes include FB, chronic hypertrophic pyloric gastropathy, congenital pyloric stenosis, pyloric mass, gastric dilatation-volvulus, or extrinsic compression
(gastric outflow obstruction)
- Cx?
- projectile vomiting of undigested food, abdominal distension, belching, weight loss
(gastric outflow obstruction)
(diagnosis)
- labs unremarkable unless really bad -> then see what?
- hypokalemia, hyponatremia, hypochloremia, metabolic alkalosis
(gastric outflow obstruction)
- what is the definitive tx?
- sx
(gastric motility disorders)
(gastric motility disorders)
- Cx simliar to what other disorder?
- gastric outflow obstruction
(gastric motility disorders)
- treat underlying cause.
- feed what kind of diet?
- low in fat and high in digestible carbohydrate, small amounts frequently
(use promotility drugs as needed)
(hypertrophic gastropathy)
- cause unknown in most cases. Possible causes include stress in small breed dogs, chronic irritation from aspirin therapy, or hypergastrinemia
- surgical excision may be necessary to relieve outflow obstruction.
(gastric neoplasia)
- most common in dogs? in cats?
- 2 that are less common
- what are the second most common gastric tumors in dogs?
- adenocarcinoma, lymphoma
- leiomyosarcoma and fibrosarcoma
- leiomyomas
(benign adenomatous polyps occur infrequently in dogs and cats)
(gastric neoplasia)
- Cx?
- vomiting, hematemesis, anorexia, wt loss
if benign maybe nothing unless obstruction occurs
(gastric neoplasia)
- most useful diagnostics?
- radiography and endoscopy
(gastric neoplasia)
- treatment of choice?
- removal by partial gastrectomy (with chemo if indicated)
(gastric dilatation-volvulus)
- GDV causes complete obstruction of gastric outflow, which impairs venous return thorugh what?
causing what?
- vena cava
hypovolemic and endotoxic shock
(gastric dilatation-volvulus)
cause unknown
- what dogs are predisposed?
- older, large breed, deep chested dogs
risk factors: genetics, lean body conformation, rapid eating, eating from raised bowl, eating one meal daily, exercise or stress after a meal, fearful temperment
(GDV)
- Cx?
- acute abdominal distension, nonproductive retching, salivating, resp distress
(GDV)
- common lab abnormals?
- hypokalemia and metabolic acidosis
(GDV)
- see enlargement of what organ (other than stomach)
- spleen
(GDV)
(GDV)
- prevention involves feeding frequent, small portions of food, and restricting exercise and access to water for 1 hour after eating
