Diseases of the Canine and Feline Stomach

Question 1

what are the causes of acute gastritis?

Answer 1

gastric foreign body (obstruction), acute pancreatitis, infectious disease, systemic disease

Question 2

what is the clinical presentation of acute gastritis?

Answer 2

vomiting, lethargy, depression, polydipsia, hematemesis, cranial abdominal pain

Question 3

what are the diagnostic techniques used to diagnose acute gastritis?

Answer 3

history and PE, abdominal radiographs, biochemical tests in order to exclude other diseases, response to therapy

Question 4

how is acute gastritis managed and treated?

Answer 4

rest the GI tract (12-24 hrs without food, may need to restrict water if vomit right after drinking a lot), supportive care, feed a bland diet (highly digestible, not a lot of fat)

Question 5

what are the causes of chronic gastritis?

Answer 5

• inflammatory (idiopathic)
  
  • lymphoplasmacytic
  • eosinophilic
• food responsive disease
• reflux
• helicobacter (?)

Question 6

chronic lymphoplasmacytic gastritis

Answer 6

• etiology
  
  • mostly idiopathic
  • may be associated with food responsive disease

Question 7

what are the clinical signs of chronic LP gastritis?

Answer 7

vomiting (most consistent), hematemesis, appetite changes, PE usually unremarkable, weight loss may be present

Question 8

what are the diagnostics techniques used to diagnose chronic gastritis?

Answer 8

• exclude other causes: parasites, tumors, FRD
• biopsy (endoscopy, surgery)

Question 9

how is chronic gastritis treated?

Answer 9

diet trials (hypoallergenic)

acid reducers (omeprazole)

cisapride/metoclopramide

immunomodulation in moderate to severe dz

Question 10

eosinophilic gastritis

Answer 10

• uncommon, unknown cause
• eosinophils infiltrate mucosa
• peripheral eosinophilia +/-
• mucosa may be ulcerated
• tx: dietary manipulation and/or corticosteroids
  
  • deworm
• Rottweiler predisposed

Question 11

helicobacter gastritis

Answer 11

• causes lymphoid hyperplasia in some dogs and cats
• may be associated with chronic vomiting
• not associated with ulceration in dogs and cats
• diagnosis of exclusion
  
  • Warthin-Starry stain on biopsy
• tx?: amoxicillin, clarithromycin, metronidazole

Question 12

reflux gastritis

Answer 12

• Bilous Vomiting Syndrome
• defect in pyloric function or a gastric motility defect allows prolonged contact of bile with mucosa
• bile is a detergent-damages cells

Question 13

clinical signs of reflux gastritis

Answer 13

• chronic vomiting of bile-stained material after a prolonged fast
• most often in the early morning
• vomitus contains bile-stained mucus and occasionally fresh blood

Question 14

treatment of reflux gastritis

Answer 14

• increased feeding frequency
• cisapride/metaclopramide
• H2 recepter antagonists
• PPI (omeprazole)

Question 15

what is a gastric ulcer?

Answer 15

circumscribed break in the mucosa with acid-pepsin

mucosal barrier disrupted

Question 16

what are the causes of gastric ulcers?

Answer 16

ulcerogenic drugs (never use NSAIDs and steroids together), liver disease, tumors, protein-calorie malnutrition, uremia, stress (? may be more in humans than animals)

Question 17

what are the clinical signs of gastric ulcers?

Answer 17

vomiting, depression, inappetance or anorexia, melena, anemia

Question 18

what are some differentials for gastric ulcers?

Answer 18

Addison’s disease, parasites, tumors

Question 19

how are gastric ulcers treated?

Answer 19

eliminate the underlying cause, PPI, sucralfate, H2 blockers-MCT, blood transfusion, endoscopy, surgery

Question 20

what is the clinical presentation of gastric outflow disorder?

Answer 20

intermittent vomiting (projectile) for a long duration (months to years) with increasing frequency, contains food hours after eating

hypochloremia, hypokalemia, metabolic alkalosis

may be congenital (Starts at weaning) or acquired stenosis

Question 21

what are the diagnostic techniques used to diagnose gastric outflow disorder?

Answer 21

radiographs (+/- contrast), ultrasound, endoscopy, surgery

Question 22

how is gastric outflow disorder treated?

Answer 22

surgery: Y-U pyloroplasty or pyloromyotomy

Question 23

gastric tumors

Answer 23

• uncommon
• chronic vomiting, inappetance or anorexia, loss of body weight and condition
• anemia, diarrhea and hematemesis
• adenocarcinoma most common in dog, lymphoma in cat
• diagnosis: imaging, endoscopy

Question 24

gastric parasites

Answer 24

• Ollulanus and Physaloptera (more common)
• intermediate host dung beetle
• chronic vomiting
• endoscopic diagnosis
• tx: pyrantal or fenbendazole?