Clinical pathology of the Pancreas and GI tract

Question 1

What is the laboratory testing for the endocrine functions of the pancreas also an assesment for?

Answer 1

An assesment for diabetes mellitus

Question 2

What are some potential risk factors for pancreatitis in dogs?

Answer 2

• High fat diet
• Dietary indescretion
• Drugs
• Endocrinopathies
• Breed predisposition

Question 3

What is the clinical presentation of acute pancreatitis?

Answer 3

• Vomiting
• abdominal pain
• Weakness
• staying in the ‘prayer position’

Question 4

What are some laboratory findings that may indicate Pancreatitis?

Answer 4

• Increased Packed Cell Volume (thrombocytopenia, maybe DIC)
• Increased proteins (dehydration or may decrease if its a negative APP response)
• Azotaemia (too much nitrogen)
• Increase in liver enzymes

Question 5

What three assays are commonly used to test for pancreatitis?

Answer 5

• Spec CPL- immunologic assay
• DGGR Lipase- catalytic assay
• v-LIP- P Triolein based assay

Question 6

Name two pancreatic disorders that aren’t diabetes mellitus

Answer 6

• Exocrine pancreatic insufficiency
• Pancreatitis

Question 7

When do we have pathological problems in the pancreas?

Answer 7

When zymogens are not released at the brush border and are instead released into the interstitial space, mixing with lysosomes

Question 8

What occurs with calcium signalling when pancreatitis is present?

Answer 8

Persistent calcium signalling

Question 9

What two diseases can cause an exocrine pancreatic insufficiency?

Answer 9

• pancreatic acinar atrophy
• chronic pancreatitis

Question 10

How much of the pancreas can be lost before exocrine pancreatic insufficiency occurs?

Answer 10

over 90%, pancreas has large functional reserves

Question 11

What is the treatment for exocrine pancreatic insufficiency?

Answer 11

Dietary supplementation with pancreatic enzymes added to food

Question 12

What are the two ways you can diagnose exocrine pancreatic insufficency?

Answer 12

• Using trypsin-like immunoreactivity
  *increases with pancreatitis (not commonly used anymore)
  decreases with EPI

Question 13

What are two clinical signs of EPI?

Answer 13

• loose stools
• weight loss

Question 14

What is cobalamin?

Answer 14

Cobalamin is a required cofactor in the metabolic pathways involving folate
If there is an absence of it methylmalonic acid accumulates which can cause significat issues for the patient

Question 15

What does a decrease in illeal absorption lead to?

Answer 15

decreased serum cobalamin

Question 16

Name two things that can cause decreased illeal absorption

Answer 16

• Bacterial growth
• decrease in illeal mucosa

Question 17

What is the preferred folate sample and what can an increase in folate indicate

Answer 17

• Serum- haemolysed samples are unsuitable
• may mean there is bacterial overgrowth in the intestine
• or a cobalamin deficiency

Question 18

What does a decrease in folate indicate?

Answer 18

• a small intestinal mucousal disease
• or a dietary deficiency

Question 19

What is a xylose absorption test?

Answer 19

• This evaluates the function of the small intestine
• decreased absorption means small intestine mucousal disease

Question 20

What is a glucose absorption test?

Answer 20

Same but glucose is less expensive and more readily available

Question 21

When is a glucose absorption test most commonly used?

Answer 21

to evaluate patients presenting with chronic weight loss

Question 22

What does a decreased value during the glucose absorption test mean?

Answer 22

• malabsorption (so small intestine mucousal disease)
  incomplete delivery of glucose to the intestine
  increased utilisation of glucose via the hepatocytes

Question 23

What does an unexpectedly high peak glucose mean?

Answer 23

Diabetes mellitus

Question 24

How can you test rumen fluid?

must ensure it is only 10 ml

Answer 24

• Gross evaluation
  » * pH
  » * Microscopic examination
  » * Methylene blue test

Question 25

What are the physical characteristics of rumen fluid in a healthy animal?

Answer 25

• brown/ green in colour
• aromatic smell
• forms sediment in under 8 minutes

Question 26

What does a rumen fluid pH of under 5.5 mean?

Answer 26

» * Acute, severe carbohydrate overload
» * pH is very low if abomasal fluid is collected instead of ruminal fluid, as may occur in left-sided abomasal
displacement*

Question 27

What does a rumenal fluid pH of above 7 mean?

Answer 27

• decreased fermentation
  » * protein overload
  » * urea toxicosis
  » * ruminal alkalosis
  » * dilution with saliva

Question 28

What should healthy rumen fluid contain?

Answer 28

numerous actively-motile small, medium and large protozoa
If the rumen fluid is acidotic or atonic it will have few or no active protozoa

Question 29

How does the methylene blue test work?

Answer 29

In healthy rumen fluid- the protozoa will decolouise the methylene blue