Exam 1 Flashcards
How do the dog and cat esophaguses (esophagui?? Idk the plural for this) differ?
Dog- all skeletal muscle
Cat- 2/3 striated muscle in the upper part and smooth muscle in the lower 1/3, Also herringbone pattern with barium studies
what does the fundus, body, and antrum do?
Fundus- storage of food
Body- mixing of food
Antrum- propulsion
What do the peptic (chief) cells do?
create pepsinogen
What do the Parietal (oxyntic) cells do?
Create hydrochloric acid and intrinsic factor
How do peptic and parietal cells work together?
Peptic cells create the pepsinogen which becomes pepsin because of HCl from parietal cells
Explain the phases of digestion and what controls the stomach in each one
Cephalic- preparing to eat- the brain is controlling the stomach
Gastric- breaking down food- the stomach is controlling itself
Intestinal- emptying the stomach and further absorbing and digesting- the intestines control the stomach here
what is the difference between an omega-3 and an omega-6 fatty acid
omega-3 is anti-inflammatory and vasodilative and omega-6 is inflammatory and vasoconstrictive
Why can cats not utilize 18-carbon long chain fatty acids?
Do not have the enzyme (delta-6-desaturase) to convert it into a 20 or 22 carbon amino acid
What type of anemia (hematology wise) would you see with a porto-systemic shunt (hint: it would be the same as iron deficiency anemia)
Microcytic, hypochromic anemia
What type of anemia (hematology wise) are you most likely to see with a GI bleed
Macrocytic, hypochromic anemia
What are 5 indirect biochemistry markers that can indicate liver function
Albumin, glucose, cholesterol, BUN, Bilirubin
What does GGT, ALT, and ALP show and how are they different? (broad difference)
GGT and ALP are elevated if there is cholestatic disease and ALT is a liver damage enzyme
Should I be concerned if a cat has a few bilirubin crystals in its urine (aka bilirubinuria)
Yes! it is always abnormal for a cat to have this (dogs can have a few and its normal though)
I have a dog that I am concerned has esophageal dysmotility/ dysphagia. Would a barium contrast study be a good thing to use to conclusively diagnose this
NO! These dogs have an increased risk of aspiration so you should never give them barium
What are the four tests on a GI panel and what do they test for/show (very briefly)
TLI- exocrine pancreatic ability through quantification of trypsinogen and trypsin
PLI- testing for pancreatitis
B12- decreased with ileal disease or pancreatitis in cats
Folate- decreased with intestinal disease and increased with bacterial overgrowth
What are some clinical signs of an animal with dysphagia
May see problems with forming the food bolus and moving it to esophagus, exaggerated swallow, food/water falling out of mouth, gagging
A cay presents to you and the owner is complaining that the cat hasn’t been wanting to eat, it runs away or gets angry any time she goes to pet it near its face, and you see in its chart it is herpes positive.
You sedate the cat and do an oral exam and see redness and ulceration along its gums and near the back of its throat. What are you thinking this may be?
Stomatitis
A cat presents for an ulcer on its lip. You do a cytology and there are eosinophils in it. What disease could this be? How should you treat it
Eosinophilic Granuloma Complex
Treat with glucocorticoids and possibly surgery
A rottie presents with a history of dysphagia and the owner says he doesn’t want to open his mouth and growls when pet on his head. You give him a physical examination and the muscles around his jaw seem hard and enlarged. What could be going on? Describe the disease and its etiology
Masticatory myositis which is caused by an autoantibody reaction to the 2M muscle fiber
A dog refluxing under anesthesia and a cat with chronic URIs can both be at risk for this disease even though these things seem so unrelated. What disease is this?
Nasopharyngeal stenosis
Which is more of an active process regurgitation or vomiting
vomiting
A 4 month old puppy presents for a history of “throwing up” its food immediately after eating. The owner says it always spits up undigested food and some saliva. What may it have?
This puppy is actually regurging and likely has a congenital vascular ring anomaly which is encircling the esophagus and constricting it causing an obstruction
A dog and a cat have the same problem and present to your clinic! Woah weird! The dog had a bone FB removed from his esophagus a few weeks ago and the cat has recently finished a course of doxycycline. What could be the presenting problem if both of these histories are relevant to the problem
They both have esophageal strictures! It must be esophageal stricture Wednesday
What 3 agents stimulate the production of HCl
gastrin, acetylcholine, and histamine
A Chihuahua presents because its owner gave him the carprofen (NSAID) that was meant for the Great Dane. What medicine that we talked about might be a good idea to give
Misoprostol, it can help with ulcers from NSAID overdoses by increasing bicarbonate and mucous production and increasing mucosal blood flow
What drug is good for treating ulcers because it forms a gel on the mucosal surface of exposed submucosa
sucralfate
Which drug works better as an acid suppressant, famotidine or omeprazole
omeprazole works better because it is a proton pump inhibitor, famotidine is a histamine blocker
What drugs are used to treat gastric ulcers
Cytoprotective agents- sucralfate
Acid suppressants- proton pump inhibitor
Prostaglandin analogs- misoprostol
How do you manage GERD
BOAS surgery if brachycephalic dog
Small frequent meals
Pro-kinetics- cisapride, metoclopramide, etc.
Acid inhibitor- PPI (omeprazole, pantoprazole)
What are three possible causes of chronic gastritis (other than unknown cause even through that is the first one he has listed
Helicobacter, parasites, pythiosis
A dog is having large, very watery bowel movements (think muddy water coming out of a hose, yikes..) but there is no mucous or blood in the stool. is this likely small or large intestinal diarrhea
likely small intestine
Cisapride, erythromycin, metoclopramide, phenothiazine, domperidone, and bethanacol are all used as what
prokinetics
At what locations does maropitant (NK1 antagonist) work
At the pharynx/stomach/intestines (GI organs), at the chemoreceptor trigger zone, at the labyrinths
Famotidine, Ranitidine, and Cimetidine are all what type of drug and what is their MOA
antacids and they are histamine 2 receptor blockers
Omeprazole and Esomeprazole are what type of drug and what is their MOA
antacids and they are protein pump inhibitors
What is a good drug used for its anti-inflammatory effects to treat colitis
azulfidine
Diphenhydramine, dexamethasone, Maropitant, metoclopramide, and ondansatron are all used as what
anti-emetics
What are the four main categories of disruptions of the protective mechanisms of the stomach to result in ulceration
Disruption of epithelial barrier
excess acid production
decrease in mucosal blood flow
decreased prostaglandins
A dog presents for lethargy, anorexia, and hematemesis. You run blood work and there is an anemia, the BUN is higher than the creatinine, and there is a panhypoproteinemia. What might this dog have and what medications might you give to help
a gastric ulcer, give sucralfate to coat the ulcer and give omeprazole (proton pump inhibitor)
misoprostol isn’t necessarily wrong either, especially if there is a possible NSAID overdose
A bulldog presents for reverse sneezing, what a joke right?? However before you chastise the owner for wasting your time you do a physical exam like the good vet you are. You notice this dog could benefit from a BOAS surgery (no surprise), but also during the exam you notice the dog is smacking his lips. Do you think there is something underlying causing the reverse sneezing?
Yes! this dog likely has GERD (gastroesophageal reflux disease) time to get the BOAS surgery, give it small frequent meals, pro-kinetics, and an acid inhibitor
Sydney’s dog Thor likes to puke if he doesn’t get food soon enough, especially in the mornings! Often the vomit is very bile tinged. What is going on with him?
He has bilious vomiting syndrome
T/F I don’t understand why Dr. Barges gets so excited about the microbiome its just a bunch of useless bacteria
False, it is part of the largest immune organ (the gut) and it has many systemic effects
What is a good way to symptomatically treat acute gastroenteritis
fluids, NPO and then bland diet, Probiotics, motility modifying agents (ex. loperamide)
A 7 year-old lab mix presents with acute bloody diarrhea and its lab work shows an elevated PCV. What disease does this dog have and how should you treat it
Acute hemorrhagic diarrhea syndrome
probiotics are the main treatment but also fluids and anti-emetics if needed (anti-emetics probably not in this case)