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Treatment > Block 4 > Flashcards

Block 4 Flashcards

1
Q

How many teeth do dogs have?

A

42

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2
Q

How many teeth do cats have?

A

30

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3
Q

What is the canine tooth?

A

04

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4
Q

What is the carnesial on the maxillary?

A

08

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5
Q

What is the carnesial on the mandible?

A

09

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6
Q

What is normal probe depth in dog?

A

1-3mm

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7
Q

What is normal probe depth in cats?

A

0.5-1mm

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8
Q

How many molars does a cat have?

A

1 in each arcade

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9
Q

What teeth are cats missing on the mandible?

A

05 and 06 of the premolar

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10
Q

What does PD stand for?

A

Periodontal disease

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11
Q

What is PD stage 0

A

No disease

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12
Q

What is PD stage 1

A

Gingivitis (reversible)

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13
Q

What is PD stage 2

A

Periodontitis present, attachment <25% loss (unlikely reversible without dedicated owner)

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14
Q

What is PD stage 3

A

25-50% loss

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15
Q

What is PD stage 5

A

> 50% loss

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16
Q

What is open vs closed root planing?

A

Scraping away the bacteria underneath the gingiva

Open: Making a flap to get lower
Closed: Smaller pockets that can be done without a flap

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17
Q

What antibiotic can be added to slow progression of PD 2 and PD 3?

A

Doxirobe

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18
Q

What is M1-3?

A

Mobility

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19
Q

What is M1

A

0.2mm-0.5mm

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20
Q

What is M2

A

0.5-1mm

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21
Q

What is M3

A

> 1mm

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22
Q

What is F1-3?

A

Furcation

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23
Q

What is F1

A

<50% under crown

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24
Q

What is F2

A

> 50%

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25
Q

What is F3

A

Can push a probe all the way through the furcation

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26
Q

What are the 7 scenarios that you remove a tooth?

A

PD4, M3, F3, abscess, fracture, resorptive lesion, crowding, trauma

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27
Q

What is type 1 resorptive lesion?

A

Roots still present
Whole tooth extraction

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28
Q

What is type 2 resorptive lesion

A

No root left
Crown amputation

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29
Q

What is type 3 resorptive lesion?

A

Mix of both types of lesions

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30
Q

What is an uncomplicated fracture?

A

No pulp exposure

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31
Q

What is a complicated crown fracture?

A

Pulp fracture

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32
Q

What is a risk for fractures?

A

Infection of the pulp

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33
Q

What normally causes oral nasal fistulas after canine extraction?

A

Too much tension on suture

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33
Q

What does calicivirus cause?

A

Tongue ulceration

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34
Q

Where is the #1 place for a oral nasal fistula to occur on a dog?

A

Underneath canine tooth after extraction

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35
Q

What opioids can you use for standing equine dentals?

A

Butorphanol or morphine

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35
Q

What number is the wolf tooth?

A

05 or first premolar

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35
Q

Do you need to trim back gingival hyperplasia to reduce bacterial pockets?

A

Yes!

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36
Q

Does a blind woof tooth need to be extracted?

A

Absolutely!

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36
Q

What is the first tooth that you can see in a horse’s mouth in the back area?

A

06

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37
Q

Should you extract a lower wolf tooth?

A

Yes

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37
Q

Does a normally formed wolf tooth need to be extracted?

A

Not necessarily

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37
Q

What does a diastama cause?

A

Fermentation leading to an acidic environment causing an anaerobic bacterial infection

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38
Q

When do you extract the wolf tooth?

A

After it is erupted, not necessarily at castration

SAFER BEFORE 18 MONTHS

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39
Q

What is the most common cause of equine periodontal disease?

A

Diastema

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39
Q

What is a transverse ridge?

A

Like a small mountain in the tooth

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39
Q

Is the wolf tooth the same as the canine?

A

NO!!

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39
Q

What is a ramp?

A

Up slope on the bottom 11s

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39
Q

ALWAYS EXTRACT BLIND WOLF TEETH

A
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40
Q

What is a hook?

A

Top tooth down, usually 06

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40
Q

What do you do about a hook?

A

Grind down 2-3mm at a time, dont want to expose pulp

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41
Q

What must you do to a step?

A

Take it down

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42
Q

What does the secondary bacterial infection caused by the diastema cause?

A

Sinusitis

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42
Q

How to treat EOTRH?

A

Removal of teeth

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43
Q

Can you create a deworming protocol without seeing the farm first?

A

Nope

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43
Q

What does EOTRH?

A

Equine odontoclastic tooth resorption and hypercementosis

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44
Q

***** ON EXAM: What is the GI parasite control plan for a dog or cat during first year of life?

A

2, 4, 6, and 8 weeks, then monthly and fecal recheck (2x or more)

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45
Q

Do you deworm at fixed intervals?

A

No!

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45
Q

Should you tailor strongyle control to the active transmission season?

A

YES!

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45
Q

Where is anthelmintic resistance worst in?

A

Southern US

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45
Q

What is refugia?

A

Parasites that have not been exposed to dewormers

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45
Q

Should you use fecal egg counts to diagnose clinical disease in horses?

A

NO!

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45
Q

Does refugia work for all parasites?

A

NO!

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45
Q

What parasites do we consider refugia a part of our management plan?

A

Food animals or horses only

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45
Q

Which hosts should we do efficacy tests on?

A

Ones that actually are treated on? (dogs for a dog disease)

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45
Q

What is the most common reason for oral maxillofacial surgery?

A

Trauma

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45
Q

How do you tell if a drug is effective against parasitic infection?

A

Fecal egg count reduction test

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45
Q

What would the removal of one half of the rostral mandible be called?

A

Rostral mandibulectomy

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45
Q

Where can you go to find reliable recommendations in companion animals?

A

CapCVet

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45
Q

Where does fenbendazole work?

A

In the intestine

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45
Q

During mandibular surgery, they use different terminology than dentistry

A

They consider each side of the mandible as an individual bone

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46
Q

What would the removal of one hand of both sides of the mandible be called?

A

Bilateral mandibulectomy

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46
Q

Where is the caudal inferior alveolar block located?

A

Near the caudal part of the ramus. inside of the jaw

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47
Q

What are the margins for removal of neoplasia on mandibulectomy?

A

1cm

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48
Q

What is the most common complication with mandibulectomy?

A

Mandibular drift

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49
Q

What is tight lip syndrome?

A

Rostral edge of lip tissue pulled over mandibular dental arcade

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50
Q

What does tight lip syndrome inhibit?

A

Mandibular growth

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51
Q

What is tight lip syndrome described most in/

A

Shar-peis

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52
Q

What are important complications of maxillectomy?

A

Oronasal fistula

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53
Q

How long does it take dogs to start eating after surgery?

A

48hrs

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54
Q

How long will it take the majority of dogs to adapt?

A

2 weeks

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55
Q

If a cat is having a hard time eating, what can be done?

A

Feeding tube

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56
Q

Can you remove the whole tongue in dogs? Cats?

A

Dog: yes
Cat: No

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57
Q

What types of cleft palate are there?

A

Hard palate only
Combo
Soft palate only

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58
Q

Is treatment of cleft palate always necessary?

A

Not if not clinical!

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59
Q

How do you diagnose a cleft palate?

A

Sedated oral exam
Remove any debris trapped in the cleft

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60
Q

What can be a sequela of cleft palate?

A

Aspiration pneumonia

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61
Q

Cleft palate can be a multi staged surgery

A
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62
Q

When is the best time to treat cleft palates?

A

Early (3-4 months age)

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63
Q

What is the artery that needs to be protected in cleft palate surgery?

A

Palatine artery

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64
Q

What is important post-op in cleft palate surgery?

A

Nothing hard PO for 4 weeks, including toys

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65
Q

What is the most common salivary gland for disease?

A

Sublingual

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66
Q

What is magic mouth wash made up of?

A

Lidocaine, Maalox (aluminum), benadryl

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67
Q

What is the most common disease of the salivary gland?

A

Sialadenitis (inflammation of gland)

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68
Q

In a parotid sialocele surgery, what must be avoided

A

Facial nerve

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68
Q

What is the most common type of sialocele?

A

Cervical sialocele

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69
Q

What is the second most common type of sialocele?

A

Sublingual/RanulaI

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70
Q

How to you cure a cervical sialocele?

A

Removal of BOTH mandibular and sublingual salivary gland
Something about lingual nerve

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71
Q

Why must mandibular and sublingual glands be removed?

A

They share the same duct

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71
Q

Does how much protein matter?

A

Less of how much, more of the type of protein

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71
Q

What is like the #1 takeaway from a lot of Rudinsky’s lectures?

A

Dont jump to a liver diet

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72
Q

What should you keep in mind about protein content in growing animals?

A

Higher protein in kidney diet, worry more about where the protein is coming from

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72
Q

What are 7 things that make up a “typical” liver diet?

A

Reduced/modified protein
Reduced copper content
Increased zinc
Decreased sodium
Increased soluble fiber protein
L-carnitine fortified
Anti-oxidant enriched

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73
Q

What liver diseases are copper and zinc content specific for?

A

Copper hepatopathies

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74
Q

What does increased copper cause/

A

Oxidative stress

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75
Q

What does increased zinc do?

A

Zinc reduces the intestinal absorption of copper

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76
Q

What is the metabolism of copper?

A

Absorbed in intestine
Stored in liver
Secreted in bile

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77
Q

What should zinc supplementation not be combined with?

A

d-penicillamine
Decreases effect of both

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78
Q

What is the reason for decreased sodium content?

A

Avoids contributing to formation of portal hypertension and ascites

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78
Q

Reasons to modify protein?

A

Hepatic encephalopathy

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79
Q

Reason to decrease sodium?

A

Ascites/portal hypertension

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79
Q

Reason to reduce copper and increase zinc?

A

Copper hepatopathy

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79
Q
A
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79
Q

Why enrich with anti-oxidants?

A

Allergies

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80
Q

Reason to increase soluble fiber?

A

Hepatic encephalopathy

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80
Q

Why fortify with L-carnitine?

A

Increased L-carnitine to potentially aid in fatty acid oxidation

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80
Q

What is the threshold for copper hepatopathy?

A

400 (800 is bad)

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80
Q

What is a useful copper chelator?

A

Penicillamine

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81
Q

What supplement can give to a copper hepatopathy dog?

A

Zinc

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82
Q

What are the top 4 things to do for a copper hepatopathy dog?

A

Low copper diet
Copper chelator (penicillamine)
Zinc supplement
Anti-oxidant diet

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82
Q

What are 2 low copper proteins?

A

Eggs
White meat

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83
Q

What is a low copper diary product?

A

Cottage cheese

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83
Q

Where can you go to find copper concentration?

A

USDA website

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83
Q

What does a portosystemic shunt cause?

A

Heptaoencephalopathy (HE)

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83
Q

What is high in HE?

A

ammonia

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83
Q

What is medical therapy for portosystemic shunt?

A

Lactulose
Antibiotics
Anti-epileptic

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84
Q

Do you reduce protein in a PSS animal?

A

Not unless symptomatic

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84
Q

How do you treat lymphocytic disease?

A

Immunosupression

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84
Q

**Are elevate liver enzymes an indication for the use of a liver diet?

A

NO!!

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84
Q

What is copper needed for?

A

Normal METABOLISM

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85
Q

What does high amounts of copper cause?

A

Oxidative stress

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85
Q

What 2 molecules carry copper?

A

Albumin
Transcuprein

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85
Q

How is copper excreted?

A

through bile

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85
Q

What are the 5 treatments to copper hepatopathy?

A

Low copper diet
Copper chelation
Decrease inflammation
Zinc supplement
Anti-oxidant

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85
Q

*Typical Liver Diet

A

*Modified protein content
*Reduced copper content
*Increased zinc
*Decreased sodium
*Increased fiber
*L-carnitine
*Anti-oxidant

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86
Q

What is copper chelation?

A

Medications utilized to increase mobilization of copper out of body

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86
Q

Beside penecillamine, what is the other copper chelator that can be used?

A

Tridentine hydrochloride

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86
Q

Can zinc supplement and copper chelator be combined?

A

NO!!

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86
Q

What is a copper specific anti-oxidant?

A

Vitamin E

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87
Q

What is a classic anti-oxidant to be used with Cu hepatopathies?

A

Denamarin

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87
Q

Should you use colchicine?

A

No!!

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87
Q

What are the 2 reasons not to use it?

A
  1. Documented to cause decreased copper excretion
  2. High side effect profile
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87
Q

What is a nutraceutical?

A

food that has pharmaceutical benefit

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88
Q

What is s-adensyl-methionine (SAMe)

A

glutathione donor (aka an anti-oxidant donor)

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88
Q

Where is glutathione found (GSH)

A

Synthesized and found in almost every cell type
(Hepatocytes have higher levels)

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88
Q

What is something that you can prescribe to every liver patient?

A

Glutathione (GSH)

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88
Q

What is glutathione?

A

I think it is an antioxidant

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88
Q

What is another heptatoprotectant that can be prescribed?

A

N-acetylcysteine

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88
Q

What does cysteine do?

A

Increases glutathione levels

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89
Q

Where is cysteine best characterized?

A

Acetaminophen toxicity

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89
Q

What is a better home treatment for a hepatoprotectant than the IV acetylcystein?

A

S-adenosylmethionine (SAMe)

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89
Q

What are 2 brands of SAMe?

A

Denamarin
Denosyl

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89
Q

What is silymarin?

A

Milk Thistle

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90
Q

What is silymarin (milk thistle) specifically known to inhibit the uptake of?

A

Amanita mushrooms

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91
Q

What does silymarin specifically affect?

A

P450 metabolism

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91
Q

What is ursodiol?

A

Bile acid of chinese black bear

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91
Q

What does ursodiol cause?

A

Stimulates bile flow

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91
Q

What type of disease is ursodiol (bear bile) most useful in?

A

Liver cirrhosis (inability for bile to leave)

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92
Q

What are the 2 reasons to not use hepatoprotectants?

A

Tolerance
Finances

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92
Q

With necroinflammatory disease, what should you use?

A

SAMe +/- ursodiol

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92
Q

Which cholestatic disease, what should you use?

A

Ursodiol +/- SAMe

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92
Q

What is the first line of defense against immunomodulatory chronic hepatitis?

A

Corticosteroids there are others if the side effects are too high

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92
Q

What are the top 4 drugs for immunomodulatory chronic hepatitis?

A

Corticosteroids
Azathioprine
Mycophenalate
Cyclosporine

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93
Q

What are the top 2 drugs in cats for immunomodulatory chronic hepatitis?

A

corticosteroids
Cyclosporine

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94
Q

What is an iatrogenic side effect of prednisone (corticosteroid)?

A

Iatrogenic hyperadrenocorticism

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94
Q

What are the 3 types of hepatic encephalopathy?

A

Type A - Acute liver failure associated
Type B - PSS associated
Type C - Chronic liver disease associated

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95
Q

What are the 4 components to treatment of hepatic encephalopathy?

A

Correct precipitating event
Modify dietary protein
Decrease ammonia absorption
Modify microbiome

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96
Q

Does ammonia or ammonium cross diffuse better?

A

Ammonia

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97
Q

What is the most common precipatiting factor HE?

A

Infection

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98
Q

What can oner restriction of protein have on HE?

A

Can make it worse!

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98
Q

Is organ meet a good protein?

A

No, very encephalopathic

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99
Q

What are 2 ways to reduce circulating ammonia?

A

Nonabsorbable disaccharides (alter colonic pH)
Oral antibiotics (to reduce ammonia-producing bacteria)

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100
Q

What is a non absorbable disaccharide that can be given?

A

Lactulose

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101
Q

What does lactulose do?

A

In the colon, lactulose is metabolized by gut bacteria into organic acids (like lactic acid and acetic acid), which acidify the intestinal environment.
The acidic pH helps convert ammonia (NH₃) into ammonium (NH₄⁺), a form less readily absorbed into the bloodstream, thus reducing ammonia levels.

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101
Q

What are 3 ways that the microbiome can be influenced of HE patient?

A

Antibiotic
Probiotic
Prebiotic

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102
Q

What does the C stand for?

A

Coagulopathy

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102
Q

What is lactulose categorized into?

A

Prebiotic

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102
Q

What is the acronym for liver disease complications?

A

CANINE

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102
Q

What are 3 antibiotics used with HE?

A

(MAN)
Metronidazole
Amoxicillin
Neomycin

Rifaximin but really expensive

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103
Q

What does the N stand for

A

Ncephalopathy

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103
Q

What does the A stand for

A

anemia

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103
Q

What does the I stand for?

A

Intestinal and gastric ulcers

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103
Q

What does the N stand for?

A

Ndotoxemia and infection

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103
Q

What does the E stand for?

A

effusion

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103
Q

What is the downside to omeprazole?

A

Liver metabolism

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103
Q

What is a good H2 blocker?

A

Famotidine

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104
Q

What are 3 acid suppressors for GI ulcers?

A

H2 blockers
Proton pump inhibitors
Omeprazole

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104
Q

What mechanism causes endotoxemia and infection?

A

Impaired kupffer cell function

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104
Q

What causes intra hepatic portal hypertension?

A

Cirrhosis

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104
Q

What type of H2 blocker should be avoided?

A

P450 inhibitors

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104
Q

Why does portal hypertension occur?

A

Increased pressure due to cirrhosis

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104
Q

What are 2 causes of post-hepatic portal hypertension?

A

Right heart failure
Pericardial effusion

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104
Q

What are 4 consequences of portal hypertension?

A

Ascites
Acquired PSS
Hepatomegaly
Gastric ulcers

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104
Q

What are 4 management strategies for ascites and edema?

A

Sodium restriction
Diuretics
Colloids
Abdominocentesis

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105
Q

Why does portal hypertension cause gastric ulcers?

A

Decreased blood flow makes the stomach more friable

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105
Q

What is an acquired shunt secondary to?

A

Pulmonary hypertension

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105
Q

What dog breeds get extra hepatic shunting vessels?

A

Cats, small dogs

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105
Q

What dog breeds get intrahepatic shunting vessels?

A

Large breed

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105
Q

What is a clinical sign of PSS especially in cats?

A

Hypersalivation

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105
Q

What is a clinical sign of PSS?

A

Urate stones

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105
Q

What are the 2 locations that the liver gets blood?

A

80% portal blood
20% Arterial blood

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105
Q

What is seen in RBCs of PSS cases?

A

Microcytic (small) RBCs

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105
Q

What may be seen in urinalysis of PSS cases?

A

Ammonium crystals

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106
Q

What are 2 primary liver function tests?

A

Serum bile acids
Blood ammonia levels

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106
Q

Given a PSS, what type of clearance increases?

A

Renal clearance over intestinal clearance

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106
Q

Serum bile acids increase with _______ types of liver disease

A

ALL
Hepatocellular dysfunction
Cholestasis
PSS

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107
Q

What is a more specific test for PSS?

A

Blood ammonia

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108
Q

What are the 3 medical managements for congenital PSS?

A

Protein-restricted diet
Lactulose, antibiotics
Correct precipitating events

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109
Q

What is the stainless steel ring that is used for constricting PSS?

A

Ameroid constrictor

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110
Q

What is the schedule of ameroid constricting?

A

Rapid phase - 14d
Gradual - Up to 60d

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110
Q

How is hepatic microvascular dysplasia differentiated from PSS?

A

Protein C

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110
Q

What type of PSS can a aneroid constrictor be used on?

A

Extrahepatic PSS

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110
Q

What is an asymptomatic reason for increased SBA?

A

Hepatic microvascular dysplasia

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111
Q

Can you treat hepatic microvascular dysplasia?

A

No

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111
Q

What do all surgical shunt corrections need to be pre-treated with?

A

Anti-epileptic

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111
Q

If dogs have a high protein C activity, >70% what does that likely mean?

A

MVD (but DOES NOT differentiate)

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111
Q

What is the best technique for determining fecal load?

A

Fecal flotation

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112
Q

If protein C is <70%, what does that mean?

A

It is PSS

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113
Q

What are the 3 consequences of PSS?

A

Hepatic encephalopathy
Urate urolithiasis
Hepatic atrophy

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114
Q

What is the least toxic anthelmintic?

A

Benzimidazoles

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114
Q

What do you need to change between large and small animals with fecal floats?

A

There is a different media

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115
Q

What is MOA of benzimidazoles?

A

Binds to beta-tubulin, disrupts microtubules to kill parasites

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115
Q

Why does the MOA work in parasites?

A

Their higher concentration of beta tubulins

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115
Q

What has the fasted rate of absorption of the benzimidazoles?

A

Liquid

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115
Q

What has the best concentration of the benzimidazoles?

A

Pellets

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115
Q

Where do benzimidazoles primarily work?

A

Within the gut

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115
Q

What is an issue with imidazothiazoles?

A

Narrow margin of safety

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115
Q

What does levamisole not work on?

A

Cestodes or trematodes

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115
Q

What is the mechanism of action of imidazothiazoles?

A

Cholinergic agonist at synaptic acetylcholine receptors on nematode muscle cells

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116
Q

What is the main difference between levamisole and pyrantel?

A

Levamisole has a narrow margin of safety

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116
Q

What is a cestodicide?

A

Praziquantel

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116
Q

What are cestodicides effective against?

A

Cestodes

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116
Q

What is the outcome of chronic fascioliasis?

A

Biliary hyperplasia and fibrosis

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116
Q

What is fascioliasis?

A

A zoonotic fluke

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117
Q

What is the life cycle of fascioliasis?

A

Immature fluke penetrates bowel wall and migrates to liver in 4 days

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117
Q

How long does it take for fascioliasis to mature?

A

8-12 weeks

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117
Q

What does acute fascioliasis cause?

A

Liver failure with jaundice
Clostridial disease

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117
Q

Once the fascioliasis is mature, what happens?

A

Penetrates bile duct leading to chronic fascioliasis

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117
Q

What is a bad, common sequela post-choke?

A

Aspiration pneumonia

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117
Q

What are macrocyclic lactones effective against?

A

BOTH endo and ectoparasites

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117
Q

How can you treat adult flukes?

A

Albendazole and benzensulfonamides

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117
Q

What macrocytic lactones are used most commonly world wide?

A

Avermectins and milbemycins

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117
Q

What do macrocytic lactones not work against?

A

Tapes and flukes

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117
Q

What is a drug that kills both endo and ectoparasites?

A

Endectocides

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117
Q

What is a common symptom of choke?

A

BILATERAL nasal discharge

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117
Q

What is the MOA of macrocyclic lactones?

A

Paralytic effects through GABA/glutamate gated Cl- channels

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118
Q

What uncommon clinical sing is seen in a guarded prognosis for choke?

A

Subcutaneous emphysema

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118
Q

What is an uncommon motility disorder in horses but is over represented in Friesian horses?

A

Megaesophagus

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118
Q

**What can you NOT use in food animals in the US?

A

Nitroimidazoles

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118
Q

With an esophageal tube, what should you lavage with?

A

ONLY WATER

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118
Q

What is the most common esophageal disorder in horses?

A

Choke

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118
Q

What should you sedate a choke horse with?

A

Alpha-2 or and opioid

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118
Q

What do you want to make sure happens during treatment of choke?

A

That there is a low head carriage

118
Q

What drug do you use to relax the horse’s esophagus during choke?

A

Buscopan

118
Q

3 ways you can prevent choke?

A

Soft, good-quality feed
Slower feeding
Adequate dental care

118
Q

What is the most common tumor of the esophagus?

A

Squamous cell carcinoma

118
Q

What is the volume of an average adult horse’s stomach?

A

8-12L

118
Q

What is a dietary modification used after a choke case?

A

A mash, soak food in H2O

118
Q

is the squamous or glandular easier to treat?

A

Squamous is easy to treat, glandular is hard to treat

118
Q

What should you avoid as analgesia for choke cases?

A

NSAIDs (ulcer)

119
Q

What are the types of equine gastric ulcer syndrom?

A

Equine squamous gastric disease
Equine glandular gastric disease

119
Q

Why are race horses more at risk of equine squamous gastric disease?

A

Because the horse is continuously sloshing around the stomach

119
Q

What is EGUS?

A

Equine gastric ulcer syndrome

119
Q

What are 3 gastric mucosal protective factors?

A

Mucosal blood flow
Mucus (rich in bicarb to help neutralize acid)
Continuous grazing

120
Q

What are drugs available to reduce pH of stomach

A

Omeprazole

120
Q

Why does high concentrate feed increase risk of EGUS?

A

Products of fermentation are acidic

120
Q

Is glandular or squamous on the top?

A

Squamous

121
Q

Where is the #1 site for ESGD?

A

Margo plicatus

121
Q

What can be a cause/exacerbate equine glandular gastric disease?

A

NSAIDs

121
Q

What is ptyalism

A

Excess salivation

122
Q

What is a diagnosis of EGUS?

A

Gastroscopy

123
Q

How long do you treat a foal with EGUS?

A

28 days

124
Q

Does aloe vera work?

A

YES!

124
Q

What is the limitation to buffers for treatment of gastric ulcers in horses?

A

Need to be administered every 2 hours

125
Q

What is DGE in foals?

A

diffuse gastric erosion

125
Q

What should be available at all times to a horse with known EGUS?

A

Roughage (hay, grass)

125
Q

What “phenomena” is associated with lumpy jaw?

A

Splendore-Hoeppli

125
Q

How can you treat actinomycosis?

A

Penecillin, sodium iodide

125
Q

***How do you treat a gastric impaction in horses?

A

Lavage!!! (Diet coke)

125
Q

What gross looking bug is found in the wall of horse GI?

A

Gasterophilus intestinalis (ivermectin)

126
Q

What is a common foreign body on the west coast of cows’ pharynx?

A

Foxtails

126
Q

What bacteria is lumpy jaw?

A

Actinomycosis

127
Q

What is a parasite that causes choke in bovines?

A

hypoderma esophagitis

127
Q

What is actinomycosis

A

Hard, non-painful swelling of the bone

128
Q

What bacteria is wooden tongue/

A

Actinobacillus

129
Q

What is wooden tongue?

A

Tongue thickened, hard, protrudes from the mouth

129
Q

Where do hypoderma lineatum live?

A

Migrate around esophagus

129
Q

What is necrotic laryngitis?

A

Calf diptheria

130
Q

What age does calf diptheria onset?

A

3-20m

130
Q

What bacteria causes calf ciptheria

A

Fusobacterium necrophorum

130
Q

Where do hypoderma bovis live?

A

Along spine

131
Q

What is necrotic laryngitis?

A

Acute infection of laryngeal mucosa and cartilage of young cattle

132
Q

What is the treatment for necrotic laryngitis?

A

NSAID
Penecillin
Tracheostomy (if needed)

133
Q

What is the treatment for pyrrolizidine alkaloid toxicity?

A

Change in feed (highly palatable feed)
NSAIDs
SAMe
Keep out of sunlight - precent photosensitization
Remove from pasture - prevent continued exposure

133
Q

What is pyrrolizidine alkaloid toxicity?

A

Toxin from plant consumption

134
Q

What is treatment for ascending cholangiohepatitis?

A

Antibiotics

135
Q

What is treatment of hepatic encephalopathy?

A

Dextrose
Fluid therapy
Mineral oil (intestinal lube)
Oral antibiotics (reduce ammonia production)
Lactulose

136
Q

What is Tyzzer’s

A

Clostridium piliforme

137
Q

How do you treat Tyzzer’s?

A

Euthanasia

138
Q

How can you TRY to treat Tyzzer’s?

A

Penecillin and tetracycline
Plasma infusion
Fluids + dextrose

139
Q

What is the overarching goal of treating hepatic encephalopathy in horses?

A

Antibiotics to reduce ammonia production (metro)

Lactulose (decrease intraluminal pH)

Cathartics (mineral oil, lactulose, sodium sulfate, magnesium sulfate)

140
Q

What is bilirubin?

A

Digest heme

141
Q

What is pre hepatic jaundice?

A

Hemolytic

142
Q

What is anisocytosis?

A

RBC are different sizes

143
Q

What do different size RBC mean?

A

It is regenerative

143
Q

Wehre is bilirubin conjugated?

A

Liver

144
Q

Where is the obstruction in intrahepatic jaundice?

A

Within the liver

145
Q

Where does conjugated bilirubin go?

A

Into the intestine

146
Q

Where is urobilirubin excreted?

A

Either in intestine or renal

147
Q

What does extra hepatic jaundice mean?

A

Liver is likely fine but obstruction in bile duct

147
Q

Where does conjugated bilirubin go normally?

A

Out bile duct into urobilirubin

148
Q

What are causes of hepatic jaundice?

A

Inflammation
Lipidosis
FIP
Lymphoma
Hepatotoxicity

149
Q

What causes post-hepatic jaundice?

A

Pancreatitis
Cholecystitis
Cholelithiasis
Biliary mass

149
Q

What does a left shift on blood work mean?

A

Inflammation/infection

150
Q

What is the most liver specific liver enzyme?

A

ALT

150
Q

If no hemolysis is seen on CBC what will there be a lack of?

A

Low RBC

151
Q

What is a cholestatic patter?

A

Increased ALP proportionally to ALT

Normal GGT!

152
Q

What do the RBC look like in hepatic lipidosis?

A

Poikilocytosis

152
Q

How does the liver appear on ultrasound of a lipidotic cat?

A

Hyperechoic

153
Q

What are the 3 types of cholangitis?

A

Neutrophilic
Lymphocytic
Chronic

154
Q

What is neutrophilic chonagitis?

A

Ascending biliary bacterial infection (anaerobes, G(-))

155
Q

What transitions cholangitis to cholangiohepatitis?

A

Necrosis of hepatocytes beyond limiting plate (into liver)

156
Q

What is triaditis in cats?

A

Pancreatitis
IBD
Cholangitis

157
Q

How do you treat neutrophilic cholestatic liver disease in cats?

A

Antibiotics (ampicillin and metro)
UDCA
SAMe
Vit K (coagulation)
Food
Fluids

158
Q

What do you treat lymphocytic cholestatic disease?

A

Prednisone (immunosuppression)
UDCA
SAMe

159
Q

How to treat hepatic lipidosis?

A

Feed
UDCA
SAMe

160
Q

What do you need to do prior to placing feeding tube?

A

Give Vit K to help with coagulation

161
Q

What does fluid rehydration look like for hepatic lipidosis cats?

A

No dextrose
No lactate (no LRS)

162
Q

CAN GIVE COBALAMIN TO HEPATIC LIPIDOSIS CATS AS SUPPLEMENT

A
162
Q

What clotting factors does vitamin K activate?

A

2, 7, 9, 10

163
Q

Why is there a vitamin K deficiency in liver disease patients?

A

Intestinal malabsorption
No bile acids for micelle formation and absorption.

164
Q

What route do you need to give vitamin K supplementation?

A

Parenteral (just not PO)

165
Q

What can be a complication of hepatic lipidosis treatment of cats?

A

Refeeding syndrome

166
Q

What is refeeding syndrome?

A

Severe deficiency of electrolytes and fluid shift during refeeding due to insulin release and cell reuptake of glucose, P, K, Mg, and water

167
Q

What to avoid refeeding syndrome?

A

Feed slowly, monitor closely with electrolytes and fluid

168
Q

What is the affect of glutathione

A

Hepatoprotectant
Antioxidant

169
Q

Why do we want antioxidant supplementation?

A

Liver is bombarded with oxidants to filter

170
Q

What is the affect of SAMe

A

Hepatoprotectant
Antioxidant

171
Q

What is the affect of Ursodiol

A

Hepatoprotectant

172
Q

What is an extra hepatic biliary obstruction?

A

Gallbladder mucocele

173
Q

What does a mucocele look like on ultrasound?

A

Kiwi

174
Q

How can you medically manage mucoceles?

A

Hepatoprotectants

175
Q

What are the 3 causes of infectious hepatitis in dogs?

A

Viral
Leptospirosis
Leishmania

176
Q

What 2 drugs can be used to decrease inflammation associated with chronic hepatitis?

A

Corticosteroids
Azathiaprine

177
Q

What 2 drugs can be used to decrease hepatic copper associated with chronic hepatitis?

A

Penicillamine
Zinc

178
Q

What 2 drugs can be used to decrease oxidant injury associated with chronic hepatitis?

A

SAMe
Vit E

179
Q

What drug can be used to promote choleresis associated with chronic hepatitis?

A

Ursodiol

180
Q

What part of the lab work is increased in Cu associated liver disease?

A

ALT (hepatocellular injury)

181
Q

What is the difference between acute liver disease and acute liver failure?

A

Failure includes hepatic encephalopathy and coagulopathy

182
Q

What is the number 1 cause of acute liver injury?

A

Drugs and toxins

183
Q

What is one of the highest risk drugs of acute liver injury?

A

Acetaminophen

184
Q

What is the treatment for acute liver injury?

A

Supportive care

185
Q

What are the 5 lobes of the liver (from left to right)?

A

Left lobe
Quadrate
Right medial
Right lateral
Caudate

186
Q

What 2 lobes of the liver is the gallbladder located between?

A

Quadrate and right medial

187
Q

What are the 2 lobes of the caudate?

A

Papillary process
Caudate process

188
Q

What are the 2 afferent vessels entering the liver?

A

Portal vein
Hepatic artery

189
Q

What is the efferent drainage of the liver?

A

Caudal vena cava

190
Q

What are the 5 ligaments within the liver?

A

Right and left triangular
Coronary
Hepatorenal
Falciform
Lesser omentum

191
Q

What is the sphincter around the major duodenal papilla?

A

Sphincter of Oddi

192
Q

Since dogs have major and minor duodenal papilla, what pancreatic duct combines with the common bile duct?

A

Minor pancreatic duct

193
Q

What are 6 indications for liver surgery?

A

Portosystemic shunt
Liver torsion
Neoplasia (focal lesion)
Elevated bile acids
Trauma
Hepatopathy

194
Q

What are 6 indications for extra hepatic biliary surgery?

A

Pancreatic disease (can block duct)
Neoplasia
Gallbladder mucocele
Cholelithiasis
Bile peritonitis
Biliary obstruction

195
Q

What are 2 examples of topical hemostatics?

A

Gelatin (foam)
Cellulose (mesh)

196
Q

What are ways to take a biopsy of the liver?

A

TruCut
Laparoscopically
Guillotine
Punch
Lobectomy

197
Q

What should you avoid when dealing with liver biopsies or surgeries?

A

NSAIDs

198
Q

What should be done after hepatic surgeries?

A

NG tube places for feed

199
Q

How often do you check weights post liver surgery?

A

Every 8 hours

200
Q

What is the #1 cancer of the pancreas?

A

Insulinoma

201
Q

Why would you perform surgery in a pancreatitis case?

A

To confirm diagnosis
Often to treat local complications, not primary disease

202
Q

When would you consider surgery for pancreatic pseudocysts?

A

If persistent clinical signs and failure of other techniques

203
Q

What is the significance of the blood supply to the pancreas?

A

There is common bloody supply to both the pancreas and duodenum so compromise to it may require resection of duodenum

204
Q

What is the surgery for rerouting the biliary duct?

A

Cholecystoenterostomy

205
Q

What is an important peri-operative concern for insulinoma surgery?

A

Hypoglycemia

206
Q

3 Main pancreatic surgeries?

A

Mass enucleation
Pancreatic biopsy
Partial pancreatectomy

207
Q

***What limb of the pancreas is preferred if needing a biopsy?

A

Distal right limb

208
Q

What is the distal right limb preferred for biopsy?

A

Readily accessbile
Avoids pancreatic duct
Vascular supply to other organs is preserved

209
Q

What 2 techniques are there for pancreatic biopsy?

A

Blunt dissection
Suture fracture

210
Q

REASONS FOR PANCREATECTOMY: NEOPLASIA, ABSCESS, PSEUDOCYST

A

UP TO 90% OF PANCREAS CAN BE REMOVED

211
Q

What is most common complication associated with pancreatic biopsy?

A

Pancreatitis

212
Q

Is surgical intervention of insulinoma usually curative?

A

No (metastasis)

213
Q

What will damage to pancreatic duct cause?

A

Exocrine pancreatic insufficiency

214
Q

What can be a complication associated with glucose regulation of insulinomas?

A

Can quickly switch from hypoglycemia is hyperglycemia (diabetes mellitus!!!!)

215
Q

What is a risk factor for constipation to keep in mind?

A

Electrolyte derangements
(hypokalemia / hypercalemia)

216
Q

What is most important factor of constipation?

A

Water intake

217
Q

What are a couple other contributing factors to constipation?

A

Medications affecting GI motility
Pain
Dont use opioids

217
Q

What is the hardest/driest score on fecal scoring?

A

1

218
Q

What is cisapride?

A

Medication used to increase GI motility

219
Q

What is the initial treatment for megacolon?

A

Manual deobstipation

220
Q

What is an alternative treatment to megacolon?

A

NG tube with CRI of Go-Lytely

221
Q

What needs to be given in addition to Go-Lytely?

A

Cerenia
Causes nausea!

222
Q

What is Go-Lytely?

A

Osmotic laxative solution (PEG)

223
Q

Does exercise stimulate peristalsis?

A

yes

224
Q

What do laxatives do to electrolytes in bowel?

A

Move fluids into intestine to promote motility

225
Q

How does fiber increase bowel movement?

A

Considered a bulk-forming laxative, stimulates intestinal motility

226
Q

How can lubricant laxatives be given?

A

Per rectum

227
Q

What mechanism of laxative does Go-Lytely and Miralax use

A

Hyperosmotic laxative

228
Q

What is hyper osmotic laxative?

A

Transitions fluid across gradient into intestines to promote motility

229
Q

What drug is most commonly used for colonic motility?

A

Cisapride

230
Q

What is proctitis?

A

Inflammation of rectal mucosa

231
Q

How to treat proctitis?

A

Dietary changes, steroids

232
Q

How do you treat a perineal hernia?

A

Surgical correction

233
Q

What causes rectal prolapse?

A

Chronic tenesmus (straining)

233
Q

What is the treatment for rectal prolapse?

A

Manual reduction + purse string

234
Q

What is treatment for rectoanal stricture?

A

Balloon dilation

235
Q

What is perianal fistula?

A

Gross rectal disease with holes

236
Q

What dog breed gets perianal fistulas the most?

A

German shephards

237
Q

What is the treatment for perianal fistulas?

A

Oral cyclosporine
Antibiotics if secondary infection
Increase fiber diet

238
Q

How to treat anal sac abscess?

A

Clip, clean, flush
Antibiotic therapy

238
Q

What is cyclosporine?

A

an immunosuppressive agent

239
Q

Is constipation and obstipation the same thing?

A

NO!

240
Q

What is a true hernia?

A

Through a natural opening

241
Q

What is a false opening?

A

Traumatic/paramedian
Not a natural opening

242
Q

Where does a hiatal hernia come through?

A

Esophageal hiatus

243
Q

What is type 1 hiatal hernias

A

Intermittent movement of gastroesophageal junction into thoracic cavity

244
Q

Is a hiatal hernia true and congenital?

A

Yes

245
Q

When do you most often see type 1 hernias?

A

BOAS

246
Q

What is type 1 hernia?

A

Sliding hiatal hernia

247
Q

What is the medical management of hiatal hernia?

A

Reduce gastric acid secretion and protect esophageal mucosal protection

248
Q

What can be surgical management of type 1 hiatus with BOAS?

A

Tie back (unilateral arytenoid lateralization)

248
Q

Is surgical or medical management chosen first?

A

Medical management

249
Q

What are the 3 surgeries for hiatal hernias?

A

Diaphragmatic hiatal reduction
Esophagopexy
L sided gastropexy

249
Q

When is surgical management considered?

A

When medical management fails

250
Q

What are the 3 phases of gastric acid secretion?

A

Cephalic
Gastric
Intestinal

251
Q

What is secreted in gastric phase?

A

Histamine (stretch receptors)

251
Q

What is secreted in the cephalic phase and what secretes it?

A

Acetylcholine
Parasympathetic

252
Q

What is secreted in intestinal phase?

A

Gastrin (G cells, peristalsis to intestines)

253
Q

What inhibits gastrin acid secretion (G cells)

A

Somatostatin

254
Q

What cell is involved in gastric phase of gastric acid secretion?

A

ECL cells

255
Q

What are 3 receptors that are targeted by antacids?

A

Histamine - H2 receptor antagonists
Prostaglandin - Misoprostol
ATPase - Proton pump inhibitor

256
Q

What are some examples of antacids?

A

Aluminum hydroxide
Calcium carbonate
Magnesium hydroxide

257
Q

What is the mechanism of action of antacids?

A

Decrease pepsin, stimulates local prostaglandin

258
Q

What is the clinical efficacy and use of antacids

A

Rapid onset but short acting
Insufficient evidence for GUE or GERD

259
Q

What is an adverse effect of antacids?

A

Interferes with PO drug absorption

260
Q

What do the H2 receptors secrete?

A

Gastric acid

261
Q

What is the mechanism of action of H2 blockers

A

Block histamine receptor so no gastric acid can be secreted by the parietal cells

261
Q

What is the onset/resistance of H2 blockers?

A

Works 3-13 days before tolerance is built up

262
Q

What are 3 examples of H2 receptor blockers?

A

Cimetidine
Ranitidine
Famotidine

263
Q

Which of the H2 receptor blockers are resistant in dogs and cats?

A

Ranitidine

263
Q

Are H2 receptor antagonists or PPIs better?

A

PPIs

264
Q

What are 4 PPIs?

A

Omeprazole
Pantoprazole
Esomeprazole
Lansoprazole

265
Q

When are PPIs most effective?

A

When taken shortly before a meal of with a meal

266
Q

What is the MOA of PPIs?

A

Targets final pathway by binding the PPI and inhibiting it from releasing hydrogen, thus increasing pH

267
Q

How often must a PPI be taken?

A

2x/day

267
Q

Does administration of both an H2 receptor antagonist and PPI help?

A

No, may make it WORSE

268
Q

What is an adverse affect of PPIs?

A

Intestinal dysbiosis

269
Q

What is misoprostol?

A

A prostaglandin analog

270
Q

Does prostaglandin increase or decrease gastric acid secretion?

A

Decrease

271
Q

What are 3 adverse affects of misoprostol?

A

Abdominal pain
Diarrhea
Abortion

271
Q

What is misoprostol good for?

A

Effective at decreasing gastric lesions association with high aspirin dosage

272
Q

How do you give sucralfate?

A

Slurry

273
Q

What does sucralfate do?

A

Interferese with pepsin (acidic)

274
Q

When should you not give sucralfate?

A

To a consipated patient (aluminum)

275
Q

WHAT IS SOMETHING TO BE REALLY AWARE OF WITH SUCRALFATE?

A

DECREASED BIOAVAILABILITY WITH MANY DRUGS

276
Q

What does GUE stand for?

A

Gastroduodental ulceration and erosion

277
Q

What is the standard of care for GUE?

A

PPIs

278
Q

Is there evidence for prophylactic use of gastroprotectants in dogs and cats with non erosive gastritis?

A

No

279
Q

Does hepatic disease cause GUE?

A

yeah

280
Q

When should you start gastroprotectants?

A

With it is associated with GI bleeding

281
Q

What is SRMD?

A

Stress-related mucosal damage

282
Q

What is beneficial to working dogs?

A

They have SRMD and use of PPIs may benefit to decrease SRMD

283
Q

Can renal disease cause GUE?

A

Yes, rarely

284
Q

Is there evidence to support prophylactic use of gastroprotectants in kidney disease animals (IRIS 1-3)?

A

No

285
Q

Same thing goes with pancreatitis. Basically dont use gastroprotectants unless there is evidence of GUE

A
286
Q

GI bleeding is common with immune thrombocytopenia

A
287
Q

How do PPIs help with reflux esophagitis?

A

Doesn’t decrease amount of pepsin but just increases the pH

288
Q

Why is IVDD associated with GI issues?

A

Because of the high use of steroids

289
Q

Basically, use PPIs with GUE, SRMD, reflux esophagitis otherwise there is no reason to treat prophylacticly treat (hepatic is a maybe)

A
290
Q

What does GERD stand for?

A

Gastroesophageal reflux disorder

291
Q

What are the 3 options for treatment of GERD?

A

Acid suppression
Close LES
Promote gastric emptying

292
Q

What is the best treatment of GERD?

A

Acid suppression

293
Q

What are the 2 options for increasing LES tone and promote gastric emptying?

A

metoclopramide
cisapride

294
Q

What part of the GI tract does cisapride act on?

A

The whole thing

295
Q

What part of the GI tract does metoclopramide act on?

A

Just the pylorus and proximal duodenum

296
Q

what are the 2 affects of misoprostol?

A

Acid suppression and cytoprotective effects

296
Q

If PPIs are administered for more than 4 weeks, what needs to be done?

A

Need to taper to prevent a rebound gastric acid hyper secretion

297
Q

What is sucralfate affective at doing?

A

Adhering to ulcerated/damaged mucosa

298
Q

What is the myenteric reflex?

A

Intestinal contraction behind bolus and relaxation in front

298
Q

What (again) are the top 2 promotability drug in dogs?

A

Metoclopramide and cisapride

299
Q

What is the MOA of metacopramide?

A

Increase release of acetylcholine which increases contraction of circular muscles

299
Q

What is an additional benefit of metoclopramide?

A

Anti-emetic

300
Q

Can you use metoclopramide in obstructions?

A

NO!

301
Q

Can you use metoclopramide in vomiting disorders?

A

Yeah but make sure it isnt an obstruction

302
Q

Is cisapride or metoclopramide more potent?

A

Cisapride

303
Q

Is cisapride an antiemetic

A

No

304
Q

Which pro kinetic acts upon the whole GI tract?

A

cisapride

305
Q

What is a last resort pro motility that can be used?

A

Erythromycin

306
Q

Does the erythromycin have an antimicrobial effect?

A

no its at a lower dose than antimicrobial

307
Q

Does erythromycin have an affect on the colon?

A

YES!!

307
Q

Can you use erythromycin on a cat?

A

NO!!!

308
Q

What is the MOA of erythromycin?

A

Binds the motilin receptor

309
Q

What does MrMRE stand for?

A

Microbiota related modulation responsive enteropathy

309
Q

What was commonly prescribed for decades for acute and chronic diarrhea?

A

Antibiotics

310
Q

What is the treatment of MrMRE?

A

Biotic drugs (pre, sym, pro)

311
Q

Do you withhold food doe acute diarrhea?

A

No!!!

312
Q

What should you be aware of when searching for psyllium supplementation?

A

No xyllazine in formulation

312
Q

What is her best way to treat diarrhea?

A

Fiber

313
Q

What modifications can you potentially give for acute diarrhea?

A

Highly digestable
Low-fat
Fiber-enriched

314
Q

What is the best source of fiber?

A

Psyllium husk

314
Q

What is a synbiotic?

A

Synbiotics are mixtures of probiotics (helpful gut bacteria) and prebiotics (non-digestible fibers that help these bacteria grow).

315
Q

What group had the best time to remission of clinical signs after acute diarrhea?

A

Psyllium group

316
Q

What is pectin?

A

A prebiotic fiber

317
Q

What does an adsorbent do?

A

Molecules adhere to surface and eliminate

317
Q

What is koalin?

A

Aluminum silicate

318
Q

What are kaolin-pectin products used for?

A

Acute diarrhea

318
Q

What is kaolin considered?

A

An adsorbent

319
Q

What species should you be cautious using Pepto Bismol in?

A

Cats (can use in dogs but not best first line)

320
Q

Can you use motility modifiers to decrease diarrhea?

A

Yes but not first line

320
Q

When a motility modifier is used, what should it be?

A

Loperamid
Atropine causes ileus!

321
Q

What are the 5 types of infectious diarrhea?

A

Bacterial
Viral
Protozoal
Fungal
Parasitic

322
Q

What are a couple antibiotic options for parvo?

A

Metro
Ampicillin

322
Q

***What are the 5 treatment options for parvovirus

A

IV fluids
Anti-emetics
Antibiotic
Fecal transplant
Nutritional support

323
Q

What do you need to address in IV fluids?

A

Potassium chloride and hypoglycemia

324
Q

What is a new treatment for parvo?

A

Canine parvovirus monoclonal antibody (CPMA)

325
Q

What is an antibiotic option for outpatient parvo?

A

Cefovecin

326
Q

How does CPMA work?

A

binds virus and doesn’t allow entry into cell

327
Q

How long does a parvo pup need to be isolated?

A

1 week

328
Q

What is FIP mutated from?

A

Feline coronavirus

329
Q

What rate does coronavirus mutate into FIP?

A

10%

330
Q

New product may make FIP treatable

A
331
Q

What is the product that makes FIP treatable?

A

GS-441524 (GS-44)

331
Q

How is GS-44 given?

A

Oral preferred but also injectable

332
Q

How effective is GS-44

A

Nearly 100%

333
Q

What is a side effect of GS-44?

A

Urolithiasis of stone made from the drug

334
Q

What are the 3 protozoal enteritis?

A

Giardia
Tritrichomonas
Coccidiosis

335
Q

Does all giardia need treated?

A

Nope

336
Q

What is treatment for giardia (3 things)

A

Fenbendazole
Metro
High fiber diet

337
Q

Does the giardia vaccine work?

A

Unlikely

338
Q

How does tritrichomonas present?

A

Chronic waxing-waning large bowel diarrhea

339
Q

What off label treatment has been reportable working for tritrichomonas?

A

Ronidazole

340
Q

What is #1 bacterial cause of diarrhea in cats and dogs?

A

Histo

341
Q

What are the 2 options to treat histo?

A

Itraconazole
Fluconazole (both azoles)

341
Q

What are 2 side effects of treating histo?

A

GI upset
Hepatotoxicity

342
Q

What does itraconazole require?

A

Needs to be given with food

343
Q

***WHAT IS SUPER IMPORTANT ABOUT WHERE YOU GET ITRACONAZOLE?

A

MUST BE NAME BRAND OR GENERIC
(not compounded)

344
Q

What is a different treatment if you can’t give an azole for histo?

A

Amphotericin B

344
Q

What are most bacterial etiologies for acute diarrhea?

A

Self-limiting

345
Q

What is the only acceptable bacterial enteritis to use antibiotics with?

A

E. coli

345
Q

What is best treatment of E coli?

A

Enroflaxacin (Baytril)

346
Q

What diet do you provide if it is just mild esophagitis?

A

Smaller, fat restricted meals

347
Q

How do you treat a moderate to severe esophagitis on top of PPIs?

A

Prokinetics too

348
Q

After esophageal foreign body, what do you need to treat for?

A

Stricture

349
Q

How can you treat an esophageal stricture?

A

Balloon dilation (needed multiple times about every 5 days and average is 3 times)

350
Q

What is a B tube?

A

Its an indwelling balloon dilation that allows owners to dilate the balloon at home to help fix a stricture

351
Q

What is an option for refractory cases of esophagus stricture?

A

A stent

351
Q

What is a vascular ring anomaly that causes esophageal obstruction?

A

Persistent right aortic arch (PRAA)

351
Q

How do you treat persistent right aortic arch?

A

Surgically

352
Q

Wha tis the second most common cause of megaesophagus (behind myasthenia graves)

A

Addison’s (hypoadrenocorticism)

352
Q

What is the treatment for megaesophagus?

A

Treat underlying cuase

353
Q

What is treatment of chronic gastritis?

A

Hypoallergenic diets or hydrolyzed diets

354
Q

What is a bacterial cause of chronic gastritis?

A

Helicobacter

354
Q

Does helicobacter always cause gastritis?

A

No! Sometime normal microflora

355
Q

How to treat helicobacter?

A

Antbx

355
Q

What is physaloptera?

A

Nematode - Stomach worm

356
Q

How to treat physaloptera?

A

Fenbendazole

357
Q

How do you treat chronic gastritis from bilious vomiting syndrome?

A

Late night meal

358
Q

What do you want to avoid to avoid gastric ulcers?

A

Concurrent NSAIDS and Steroids

358
Q

How do you treat hairballs?

A

Key to treatment is prevention… Manage coat with diets, daily grooming, gastric lubricants, promotability

359
Q

Which radiograph should you take to differentiate food bloat from GDV

A

Right lateral

360
Q

What is treatment of food bloat?

A

IV fluids and pain management

360
Q

Is acute gastritis usually self-resolving?

A

Yes

361
Q

Why do NSAIDs cause ulcers?

A

They inhibit the production of prostaglandin which is part of the wall

362
Q

What is functional gastric motility disorder considered?

A

A diagnosis of exclusion

363
Q

What are the 3 key signs of GDV?

A

Non-productive retching, abdominal distention, and tachycardia

364
Q

How long will food bloat take to resolve?

A

24-48hrs

365
Q

What are the 4 vomiting centers?

A

Cerebral cortex
Vestibular
Abdominal Viscera
Chemoreceptor trigger zone

366
Q

What are the receptors of the vomtijgn center?

A

5-HT3
NK1
Alpha

366
Q

What are the receptors of the viscera?

A

5HT3 (serotonin)

367
Q

What are the receptors of the CRTZ?

A

D2 (dopamine) and Norepinpehine (alpha2)

367
Q

What are the receptors of the vestibular apparatus?

A

Cat: Acetylcholine (M1)
Dog Histamine (H1)

368
Q

What fluids do you want to give with metabolic acidosis?

A

LRS

369
Q

What fluids do you want to give with metabolic alkalosis?

A

Sodium chloride

369
Q

What is the drug name of cerenia?

A

Maropitant

370
Q

What blocks the NK1 (substance P)

A

Maropitant

371
Q

What blocks the 5-HT3 (Serotonin)

A

Ondansetron

372
Q

What blocks the D2 (dopamine)

A

Metaclopramide

373
Q

What blocks the alpha 2 (norepinephrine)

A

Chlorpromazine

373
Q

What blocks the H1 (histamine)

A

Diphenhydramine

374
Q

What induces vomiting (agonist) of dopamine in dogs?

A

Apomorphine

374
Q

What induces vomiting (agonist) of alpha2 - norepinephrine in cats?

A

Xylazine or dexmedetomidine

375
Q

What induces vomiting (agonist) of histamine?

A

Hydromorphone (dog)

375
Q

What are 3 common causes of chronic diarrhea?

A

Parasites
Exocrine pancreatic insufficiency
Addison’s

376
Q

How do you treat EPI?

A

Pancreatic enzymes

377
Q

Is a specific diet needed in EPI?

A

No

378
Q

What are the 3 steps for chronic diarrhea?

A

Diet
Microbiota
Immunomodulation

379
Q

Are all food reactions from food allergies?

A

NO!

380
Q

What are most common food allergens?

A

Beef, dairy, chicken, wheat, fish

380
Q

What are hydrolyzed diets?

A

Reduced protein size -> reduced allergenicity

381
Q

What are options for food trial/treatments?

A

Limited antigen
Highly digestable
Low fat
Fiber enriched
Home cooked

382
Q

Which disease are low-fat diets especially effective in?

A

PLE from lymphagectasia

382
Q

What is something that will be noticed when you start feeding a more digestible diet?

A

Less pooping

383
Q

What needs to be supplemented in diets?

A

Cobalamin

384
Q

What is insoluble fiber used for?

A

Bulking agent

384
Q

What will the poop with insoluble fiber look like?

A

More and harder poop

385
Q

What are the 5 immunomodulatory agents that can be used for treatment of intestinal disease?

A

Pred
Budesonide
Cyclosporine
Chlorambucil
Mycophenloate mofetil
Azathioprine

386
Q

What is the gastric slip?

A

Mucosa + submucosa falling away from muscularis and serosa

386
Q

When is tensile strength at its lowest (aka the lag phase)

A

3-5 days after surgery

387
Q

When is the highest risk of dehiscence?

A

3-5 days post op

388
Q

What cells produce collagen?

A

Both fibroblasts and smooth muscles

389
Q

What do gastric surgical patients usually have with their electrolytes?

A

Low Na, Cl, K due to stomach acid loss

389
Q

What 3 things must be done pre op?

A

Correct dehydration
Correct electrolytes
Fasting

390
Q

How thick are bites through the stomach?

A

Full thickness!

391
Q

What type of blade is used for stomach incision?

A

11

392
Q

Should you use your hands within the lumen of the stomach?

A

No, use tools

393
Q

Can you double dip on stomach surgery?

A

No!

394
Q

What are the 2 options for closure?

A

single or two layer closure

394
Q

If using a single layer closure, what are the bites?

A

Full thickness

395
Q

If using a two layer closer, what does it look like

A

Mucosa and submucosa = simple continuous
Muscular and serosa = inverting pattern (cushings)

396
Q

What NEEDS to be done pre-op for GDV?

A

Shock dose of fluids

396
Q

Which side of the dog do you stand on for GDV?

A

Right hand

396
Q

What is the pulling/pushing for GDV?

A

Grab pylorus with right and pull toward ceiling
Push body to the left with left hand

397
Q

What are the 4 things to evaluate color in GDV surgery?

A

Color
Thickness
Pulsation
Peristalsis

398
Q

With an incisional gastropexy, where is the cut made?

A

In the pyloric antrum

398
Q

How deep is the cut?

A

Partial thickness!

399
Q

Where is the body wall made for incisional gastropexy?

A

On the RIGHT body wall caudal to 13th rib

400
Q

What are the 5 types of gastropexys?

A

Incisional
Belt loop
Circum-costal
Incorporating
Laparoscopic

401
Q

Are antibiotics needed post op for GDV?

A

Not normally

402
Q

What is the largest part of the small intestine?

A

Jejunum

403
Q

What artery does most all of the blood supply for intestines come from?

A

Cranial mesenteric artery

403
Q

How do you tell the difference between jejunal and colonic vessels?

A

Jejunal are web-like
Colonic are parallel

404
Q

Is colonic return of strength slower or faster than small intestine?

A

Slower

405
Q

What do you increase pre-op as you move more distally?

A

Use of antibiotics (more bacteria)

406
Q

What antibiotic is good to be used in both stomach and intestinal surgeries?

A

Cephalosporins

407
Q

Which direction of foreign body do you make the incision?

A

Aborally

408
Q

What do you do after an enterotomy to ensure adequate closure?

A

A leak test

408
Q

How do you perform resection and anastomosis?

A

Isolate bowel with crushing forceps (on inside part)
Occlude bowel with non crushing (on outside part)

409
Q

What clamps are used for non-crushing?

A

Doyens (one click)

410
Q

What are 5 tips to resolve luminal disparity?

A

Angling clamps
Suture placement
Spatulate intestine
Luminal reduction
Stapler

410
Q

Where os most common anchor place for a linear foreign body in dog and cat

A

Dog: Pylorus
Cat: Underneath tongue

410
Q

What are 2 causes of intussusception?

A

Neoplasia
Parasites

411
Q

What percent results in short bowel syndrome?

A

50-80%

412
Q

What needs to be done 12-24hrs after surgery?

A

Feeding (NG or enteral)

Treatment (8 decks)

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