Clinical Approach To GI Disease in SA Flashcards
Define diarrhoea (3)
- Faecal volume
- Water content
- Frequency of defaecation
Where does water absorption occur? (2)
LI
SI
Name 3 signs of SI disease in dogs (4)
- large volume
- watery
- melaena
- weight loss
What are the LI disease clinical signs (7)
- Urgency
- Straining/tenesmus
- Haematochezia
- Small volume passed more often
- Mucus
- Fresh blood
- “Incontinence”
If there is oral dysphagia, what is there an abnormality in?
prehending and transporting bolus to base of tongue
If there is pharyngeal dysphagia, what is there an abnormality in?
Transporting bolus from oropharynx
If there is circopharyngeal dysphagia, what is there an abnormality in?
Transporting bolus through upper oesophageal sphincter
If there is oesophageal dysphagia, what is there an abnormality in?
transporting bolus through the oesophagus
If there is gastro-oesophageal dysphagia, what is there an abnormality in?
transporting bolus across the lower oesophageal sphincter
What are the clinical signs of dysphagia?
gagging, dropping food, retching, difficulty eating, exaggerated swallowing, ptyalism, fear of eating/ravenous appetite
What is this issue here?
These radiographs were taken because the cat was “bringing up frothy phlegm and occasionally yellow fluid and food”. The owners thought he had a fur ball.
The radiographs suggest collapse of the right middle lung lobe and a bronchial pattern which we see with airway disease in cats. Perhaps the history was misleading or we didn’t ask the right questions….
Abdomen looks normal
No lateral as was for vomit
Look at thorax – bronchial
problems and has airway disease!!
Owners can be misleading
What do we need to ensure is included on the phhysical exam for a GI issue?(8)
- temperature
- MM & hydration
- heart rate & rhythm, pulse rate & quality
- abdominal palpation
- perineal assessment
- thoracic auscultation, breathing rate & pattern
- peripheral lymph nodes
- weight & BCS
Name 4 things we can find out through a rectal exam (5)
Do we need a specific diagnosis?
A lot of cases we don’t actually need to diagnose and can just be ££££. Although it is the ultimate goal we often fall short of this
What action to we take for a patient presenting with GI signs?
Not worried?
Not sure?
Worried?
- Not worried?
- can you just manage the clinical signs?
- “supportive care”
- self limiting might mean no action at all….
- Not sure?
- screen to rule disease in or out
- Worried…. Step in
- treat/stabilise the patient
- address the 2ry problems if necessary
- further investigations
This dog has a suspect gastric torsion, what are your concerns here?
Lots missing:
Suspect gastric torsion
Most important thing is that dog MUST be on fluids
May need to be on Oxygen too!!
Distension = diaphragm issues and pressure
BP and ECG monitor in the ideal world
Give 4 reasons we wouldn’t invesigate GI disease (5)
- Primary disease could be self limiting?
- Cost implications
- Unnecessary stress to the patient?
- The dog or cat is too old?
- The worry about what you can find
Discuss how to approach treatment of a sick patient
When should you collect blood and urine?
- Treatment of secondary problems can be a higher priority than reaching a diagnosis
- If possible collect bloods and urine before fluid therapy
What screening tests can we do for GI disease? (5)
Blood tests
- PCV/TS
- to help assess hydration status
- haematology
- cell numbers
- cell morphology (smear)
- biochemistry
- total T4 (thyroxine)
- CATS only
Urinalysis
- SG, stix +/- sediment
Faecal tests
Imaging
Further blood tests
What may abnormal blood findings mean in GI disease (2)
- relate to the primary cause of disease
- be a consequence of the disease
What blood parameter is often raised in disease? What does this mean?
Liver enzymes - often nothing to worry about
What test gives us information about liver function?
Pre and post prandial bile acids
What test giives us information about pancreatic disease?
- fPLI or cPLI
- TLI
What test gives us information about intestinal absorption?
- cobalamin (B12)
- folate
When would we use a GI endoscope?
FB
Chronic disease
When might wwe use ultrasound guided aspirate/biopsy? (3)
- mass lesions
- abnormal organs
- abdominal fluid
With GI disease, what should we kknow regarding the signalment? (3)
- Breed
- Breed related disease
- Age
- Sex
Name 4 things on the differentials for GI disease in young (5)
Infectious?
parasitic?
congenital?
nutritional/stress?
motion sickness
What 2 things are on the differentials for GI disease in an older animal?
- neoplastic
- degenerative
GI disease - what do we need to take from general history taking? (9)
- Vaccination status
- Worming
- Environment/husbandry
- farm dog
- “puppy farm” dog
- rescue cat
- indoor/outdoor cat
- In contact animals?
- Travel history
- Diet - change? Behaviour? Scavenge?
- Appetite - including any change
- Other illness whether previous or concurrent?
- Owners okay?
What questions should we ask about an animals vomiting?
- Is this a rare event?
- How often?
- Timing
- What are the owners seeing?
What may be seen by an owner if there is GI bleeding? (4)
- Haematemesis
- Melaena
- Lethargy
- Pica
What questions should we ask about the diarrhoea? (7)
- What (exactly) is being passed?
- colour
- consistency
- undigested food
- blood
- fresh blood?
- melaena?
- steatorrhoea
- fatty
- pale
- “offensive smell”
- How often?
- What volume?
- Any mucus?
- Any pain and/or straining?
- Borborygmi?
- Flatulence?
