12. Diseases of the oesophagus in dogs and cats. Regurgitation and vomitus. Flashcards
causes of oesophagitis
caustic substances
gastro- oesophageal reflux
motility disorders
megaoesophagus
doxycycline
clindamycin
anaesthesia
froeign body
clinical signs of oesophagitis
odynophagia (pain when swallowing)
regurgitation
salivation
food refusal
coughing
fever
dyspnoea
diagnosis of oesophagitis
increased WBC
endoscopy
xray
treatment of oesophagitis
omeprazole + prokinetics
sucralfate suspension
total parenteral nutrition
gastro oesophagwal reflux (GOR)
definition
poor closure of the cardia
inflammation due to HCL, pepsin, trypsin, bile, HCO3
causes of gastro oesophagwal reflux (GOR)
delayed gastric emptying
upper airway obstruction
hiatal hernia
anaesthesia
chronic vomiting
clinical signs of gastro oesophagwal reflux (GOR)
reverse sneezing
chronic bronchitis
laryngitis
rhinitis
erucation
diagnosis of gastro oesophagwal reflux (GOR)
clinical signs - history
endoscopy
treatment of gastro oesophagwal reflux (GOR)
low fat diet
H2 receptor blockers
PPI
prokinetics
sucralfate
what durgs enhance the closure of the cardia
metoclopramide
erythromycin
clinical sings of oesophageal foreign body
regurgitation
salivation
abdominal distension
coughing, fever, dyspnoea
diagnosis of gastro oesophagwal reflux (GOR)
clinical signs
thoracic xray
endoscopy
increased WBC
treatment of oesophageal foreign body
endoscopic removal
surgery
gastric tubing
euthansia
types of dysmotility/ oesophageal weakness
megaoesophagus
partial oesophageal dysmotility
dystonia
diverticulum
causes of dysmotility/ oesophageal weakness
idiopathic
muscle atrophy
myasthenia gravis
Autoimmune
post anaesthesia condition
oesophagitis
clinical signs of dysmotility/ oesophageal weakness
salivation
cough (bronchopneumonia)
fever
dyspnoea
weight loss
diagnosis of dysmotility/ oesophageal weakness
fluroscopy, radiography
treatment of dysmotility/ oesophageal weakness
special feeding
PEG (percutaneous endoscopic gastrotomy)
Megaoeasophagus definition
persisten decrease of motility of the oesophagus
what animal is Megaoeasophagus more common in
dogs > cats
cause of Megaoeasophagus
normally idiopathic
may be caused by laryngeal paralysis
NB to check for aspiration pneumonia
congenital Megaoeasophagus
mini schnauzer, great dane, dalmatian
shar pei, irish setter, lb
clinical signs of congenital Megaoeasophagus
usually develops during the weaning phase
no treatment
poor porgnosis
acquired Megaoeasophagus
Primary form
diagnosis by exclusion
large > toy breeds
treat using Bailey chair; sucralfate + bethanechol
acquired Megaoeasophagus secondary form
causes
myasthenia gravis
Addison’s
lead poisoning
oesophagitis
hypothyroidism
neuropathy
snake bit
what is myasthenia gravis
immune response against Ach receptors
Focal/ generalised
treat with pyridostigmine
Spirocercosis cause
spirocercosis lupi - nematode
causes parasitic nodules in the oesophagus, aortic aneurysms & spondylitis
clinical signs of Spirocercosis
regurgitation
vomiting
weight loss
coughing
dyspnoea
sudden death
diagnosis of Spirocercosis
faecal examination
endoscopy
treatment of Spirocercosis
imidacloprid / moxidectin
surgery
prevention of Spirocercosis
milbemycin
persistent right aortic arch
definition
extraluminal compression of the oesophagus by the lig arteriosum
a vascular ring anomaly
cause of persistent right aortic arch
congenital
g. shepherds
clinical signs of persistent right aortic arch
regurgitation
coughing
dyspnoea
weight loss
diagnosis of persistent right aortic arch
survey & contrast radiography
endoscopy
differential of persistent right aortic arch
stricture
intraluminal obstructiontr
treatment of persistent right aortic arch
surgery
Regurgitation vs Vomiting
comes from
Regurgitation - from mouth / pharynx / oesophagus
Vomiting - from stomach / small intestine
Regurgitation vs Vomiting
activity
Regurgitation - passive, no nausea
Vomiting - active, wretching, heaving
Regurgitation vs Vomiting
content
Regurgitation - undigested food, no bile (eating content)
Vomiting - un / digested food, chyme, bile (no eating of content)
expectoration
expulsion of material from the respiratory tract
how to distinguish Regurgitation and Vomiting
history
clinical exam
palpation of distended oesophagus
th. xray
endoscopy
fluroscopy
causes of vomiting
metabolic diseases
endocrine diseases
toxins / drugs
dietary causes
abdominal diseases
gastric diseases
small intestine diseases
large intestine diseases
metabolic diseases causing vomiting
renal disease
hepatobiliary disease
electrolyte / acid base derangements
endocrine diseases causing vomiting
hypoadrenocorticism
hyperthyroidism
diabetic ketoacidosis
toxins / drugs causing vomiting
heavy metals
ethylene glycol
NSAIDS, AB, chemotherapy
dietary causes causing vomiting
allergy
intolerance
abdominal diseases causing vomiting
pancreatitis
peritonitis
neoplasia
gastric diseases causing vomiting
gastritis
GDV
foreign body
delayed gastric emptying
neoplasia
small intestine diseases causing vomiting
IBD
obstruction
parasites
neoplasia
infection
large intestine diseases causing vomiting
constipation
colitis
history of vomiting patient
duration
food in vomit > 8hrs after ingestion
acute / chronic
physical exam of vomiting patient
oral exam
mucosa
cardiac arrhythmia
abdominal palpation
rectal examination
lab d of patient with vomiting
CBC
neutrophilic leucocytosis
biochemical tests
acid base status
hyperkalaemia
anaemia
neutropenia
eosinophilia
hypoproteinaemia
what to see in xray of vomiting patient
foreign body
distention
displacement
delayed gastric emptying
penetrating ulcers
masses
deep ulceration
pyloric obstruction
symptomatic treatment of vomiting
antiemetics
fluid therapy
dietary
antacids
protectives
antiemetics
maropitant
phenothiazines
metoclopramide
ondansetron
fluid therapy
0.9% saline
K supplementation
dietary treatment for vomiting
NPO for 24hrs
low fat, single protein source, chcicken and rice
antacids
H2 receptor antagonists - ranitidine
PPI - omeprazole
protectives
sucralfate - provide barrier to acid penetration. inactivates pepsin, absorbs bile acids, stimulated PG synthesis
Misoprostol - contraindicated in pregnant animals
