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!Small Animal Medicine > Diseases Of The Stomach > Flashcards

Diseases Of The Stomach Flashcards

1
Q

What are the potential causes of gastritis?

A

Drugs, hyperacidity, infectious, primary gastritis, stress/ exercise induced, systemic

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2
Q

Acute gastritis

A

CS <2 weeks
Dogs > cats
Vomiting food +/- bile, inappetence

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3
Q

What are the possible causes of acute gastritis?
(Normal PE)

A

Dietary indiscretion
Food intolerance
Gastric FB
Stomach worm

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4
Q

Tx of acute gastritis with normal PE

A

Small amounts of liquid
Deworm
Easily digestible diet then gradual transition to normal diet
Protectants/ absorbants

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5
Q

Prognosis for for acute gastritis if PE normal

A

Good and self- limiting
Complete recovery
more dx if progression

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6
Q

Diagnostics for acute gastritis if PE abnormal

A

Coagulogram with hematemesis
Abnormal US or rads
Cortisol or ACTH, total T4 (cats)
Gastric mucosal bx and histopathology

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7
Q

Tx for for acute gastritis if PE abnormal

A

IV fluids for dehydration and abnormal electrolytes
Antiemetics (if no obstruction)- maropitant
Antacids and gastroprotectants
Deworm
Diet therapy

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8
Q

Chronic gastritis

A

CS > 2 weeks
Idiopathic and adverse food reaction
Inflammatory
Bx required

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9
Q

MOA of chronic gastritis

A

↑ pro inflammatory mediators
↓ immunomodulatory mediators
Inflammation

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10
Q

Common causes of chronic gastritis

A

Metabolic disorder, parasitic, neoplasia, infectious agent

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11
Q

CS of chronic gastritis

A

Intermittent persistent vomiting
Hematoemesis
WL
Anorexia/ hyporexia
Dermatological signs: hypersensitivity and nutritional

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12
Q

Chronic gastritis differentials

A

Acute gastritis
Idiopathic gastritis/ dietary intolerance
Inflammatory gastritis
Pyloric stenosis
Gastric mass (neoplasia or granuloma)
Gastric mucosal hyperplasia

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13
Q

Ruling out the metabolic causes of vomiting (chronic gastritis)

A

CBC, serum chemistry, urinalysis
Dog: cortisol/ ACTH, TLI, CPLI
Cat: total T4
Pre and post bile acids
Bile culture

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14
Q

Endoparasite dx (chronic gastritis)

A

Fecal cytology
Sheathers
Zinc sulfate
Baerman technique
Deworm
Fenbendazole trial

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15
Q

Tests for infectious causes of vomiting (chronic gastritis)

A

Dog: Pythian serology
Cat: Dirofilaria Ag and Ab tests, FeLV/ FIV
Histoplasma urinary Ag test

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16
Q

Tests for chronic gastritis

A

Bx: endoscopy, laparoscopy, exploratory laparotomy
Histopathology +/- immuniphenotyping

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17
Q

Inflammatory features of chronic gastritis

A

Lymphocytic/ Plasmacytic*
Eosinophilic
Pyogranulomatous
Suppurative
Lymphoid folliculat hyperplasia
Neoplasia

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18
Q

What is lymphocytic/ plasmacytic (chronic gastritis) seen with

A

Seen with IBD (chr. inflamm enteritis/ CIE)
Food responsive GI dz
High exercise-induced gastroenteritis (alaskan shed dogs)

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19
Q

Dx lymphocytic/ plasmacytic

A

Histopathology
Distinguish from lymphoma with immunophenotyping

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20
Q

Eosinophilic gastritis

A

Infiltration of eosinophils into mucosa, lamina propria and muscularis
Definitive dx with histopathology

21
Q

Dogs with eosinophilic gastritis

A

Young (<5y)
Rotties and shepherds predisposed
Peripheral eosinophilia seen
Leads to pyloric perforation

22
Q

Cats with eosinophilic gastritis

A

Ragdolls and male cats predisposed
Feline eosinophilic sclerosing fibroplasia
Proliferative masses formed at pyloric sphincter
Peripheral eosinophilia common

23
Q

Chronic gastritis tx

A

Elimination diet (limited Ag or hydrolyzed diet)
Deworm
Anti-inflammatories to immunosuppressive glucos
Cyclosporine, H2 antagonists and metoclopramide

24
Q

Helicobacter tx for chronic gastritis

A

Amoxicillin, clarithromycin, metronidazole
Amoxicillin, bismuth sub salicylate and metro

25
Q

Which helminths cause parasitic gastritis?

A

Ollulanus tricupis (cat)
Physaloptera spp (dog)

26
Q

CS of parasitic gastritis

A

Asymptomatic or sporadic vomiting

27
Q

Dx parasitic gastritis

A

Xylazine induced vomiting + eval of vomitis
Fecal flotation (physaloptera only)
Endoscopy +/- bx

28
Q

Histopathology of parasitic gastritis

A

Lymphoplasmacytic gastritis with hyperplasia or nodular rugal folds

29
Q

Tx of parasitic gastritis

A

Fenbendazole (panacur) once daily for 2 days

30
Q

Helicobacter pylori

A

Spiral bacterium in stomach of human, dog, cat
Peptic ulcer formation and chronic gastritis

31
Q

Gastric hypertrophy

A

Pyloric hypertrophy
Predisposition in brachys
CS of gastric outlet obstruction

32
Q

DX gastric hypertrophy

A

Rads: pyloric outflow obstruction
Endoscopy: ↑ folds of mucosa or none at all

33
Q

Tx of gastric hypertrophy

A

Sx removal of excess mucosa and pyloroplasty

34
Q

Gastric ulcers etiology

A

Neoplasia, drug induced (NSAIDs) and hepatic failure

35
Q

Gastric erosion- ulceration

A

Damage to gastric mucosal barrier (GMB)
Hypersecretion of H+ ions, ↓ blood flow of GMB
Direct injury
Interference with gastroprotective PG synthesis

36
Q

What conditions have high risk of gastric ulceration

A

Addisons, renal and liver failure, DIC
Neoplasia (MCT), gastric adenocarcinoma, gastrinoma

37
Q

Non-selective PG inhibitors causing gastric ulceration

A

Aspirin, Flunixin meglumine, ibuprofen → associated with erosions

38
Q

Glucocorticoids causing gastric ulceration

A

Pred, dexamethasone, prednisolone

39
Q

Cyclooxygenase (COX2 selective inhibitors) causing gastric ulceration

A

Meloxicam, Carprofen*, deracoxib, etodolac
Combined with glucos = ulcers

40
Q

Idiopathic causes of gastric ulcers

A

Stress
Spinal injury
Exercise induced

41
Q

Clinical findings of gastric ulcers

A

Hematemesis, melena, pale mm, cr. abdminal pain, weakness, inappetence, hypersalivation
+/- circulatory collapse

42
Q

What’s seen on a CBC with perforating uclers?

A

Leukocytosis with left shift

43
Q

Serum chemistry panel with gastric ulcer

A

↓ TP, albumin and globulin
↑BUN
Normal creatinine and USG

44
Q

Serum chemistry panel with GI obstruction

A

↑ HCO3
↓ Na, Cl, K

45
Q

With gastric ulcers, what seen on an US

A

Gastric wall thickening, peritoneal fluid or air

46
Q

What is the gold standard for gastric ulcers?

A

Endoscopy (ulcer is visulaized)

47
Q

Tx for gastric ulcers

A

Stabilize with IV fluids
Severe cases get blood transfusions
Sx removal best to tx to prevent perforations
Abx, analgesia

48
Q

Medical tx for gastric ulcers (reducing gastric acid secretion)

A

H2 antagonist
Famotidine or ranitidine
PPI (stops H+ secretions)
Omeprazole, lanzoprazole or pantoprazole

49
Q

Medical tx for gastric ulcers (mucosal protectants)

A

Sucralfate (provide barrier to acid and pepsin, stimulates PG)
Misoprostol (stimulates mucus secretion, ↑ bicarb, promotoe blood flow and ↓ acid)

!Small Animal Medicine (14 decks)

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