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VTEC.2600 > Exam 3 > Flashcards

Exam 3 Flashcards

1
Q

Regurgitation

A

Reflux of undigested food from mouth or esophagus before it has reached the stomach

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2
Q

Congenital megaesophagus (chronic regurgitation in immature animal) - what causes it?

A

Great Danes, Irish Setters, German Shepherds, etc. – due to impaired motor neuron function

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3
Q

Cricopharyngeal achalasia (chronic regurgitation in immature animal) - What causes it?

A

muscle doesn’t relax – prevents food from entering esophagus

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4
Q

Chronic regurgitation in adult animals (list of conditions)

A

megaesophagus
Neurologic diseases
Chaga’s disease

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5
Q

Megaesophagus

A

In a dog with megaesophagus, the esophagus muscles do not force food into the stomach. When gravity alone does not allow the food to enter the stomach, the food will simple regurgitate, or fall back out of the mouth

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6
Q

Management of Achalasia (A rare disorder making it difficult for food and liquid to pass into the stomach.), other Anomalies

A

Usually surgical correction, or
Bougienage (. A bougie is a thin cylinder of rubber, plastic, metal or another material that a physician inserts into or though a body passageway, such as the esophagus, to widen the passageway, guide another instrument into a passageway, or dislodge an object.) and treatment of esophagitis
Remove foreign bodies, and treat for esophagitis

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7
Q

Management of Megaesophagus

A

Feed the animal on stairs or from an elevated platform
Gravity helps move ingesta to stomach
Feed different forms of food/different feeding regimens to find what is best tolerated
Observe closely for aspiration pneumonia

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8
Q

Management of Reflux Esophagitis

A

Medical therapy for esophagitis
Withhold food for 3-4 days; then offer small amounts of a food slurry 3-6 times daily for several days. If this is well tolerated, feed a canned food for several more days; thereafter, gradually return to a normal diet.

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9
Q

Vomiting

A

Forceful ejection of the contents of the stomach and sometimes proximal small intestine – some delay after eating;
partially digested;
pH may be <4

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10
Q

common causes of vomiting`

A

obstruction of the bowels or stenosis. Various GI diseases.

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11
Q

Results of vomiting on the body

A

Electrolyte and acid-base imbalances

Dehydration

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12
Q

Management of Vomiting

A

Fluid therapy if dehydration present
Withhold all food 12-48 hours; withhold water 12-24 hours
Specific therapy for cause, if it can be identified
After vomiting has stopped, gradually return patient to full feed and water over a 3-5 day period
Highly digestible food is recommended

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13
Q

Gastric Dilatation with Volvulus (GDV) (Bloat)

A

Laxity of the gastrohepatic ligament
Gastric dilatation with gas
Obstruction to eructation and passage of gas from the stomach

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14
Q

Possible Causes of bloat Bloat

A

Consumption of large amounts of food in one feeding
Physical activity shortly after eating a large meal
Excessive dietary calcium
Rapid food consumption
Giant and large breeds of dogs predisposed

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15
Q

Clinical signs of Bloat

A 
Sudden abdominal bloating
Retching with inability to vomit
Moaning in pain
Dyspnea
Collapse
Death may occur within a few hours
Due to absorption of endotoxins, acidosis, tissue hypoxia, spleen strangulation, shock
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16
Q

Management of Bloat (after it has occurred)

A

A true emergency
Decompress stomach
Treat for shock
Administer oxygen
If volvulus has occurred, correct surgically and perform gastropexy; feeding tube may be inserted at time of surgery
Withhold food and water 24 hours post-op. Start back on small amounts water and highly digestible food; gradually increase to normal requirement over several days

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17
Q

Prevention of Bloat

A

Feed smaller meals more often
Use mechanisms which prevent gulping food (and air)
No strenuous exercise for 2 hours after feeding
No excess calcium in diet
Some recommend elective gastropexy

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18
Q

Diarrhea

A

Passage of loose or liquid stools at increased frequency

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19
Q

clinical signs of small bowel diarrhea

A

Less frequent
Large volumes
If hemorrhagic, blood is dark red to black,tarry (melena)

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20
Q

clinical signs of small bowel diarrhea

A

Frequent
Small amounts
Often contains mucus and/or fresh blood

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21
Q

Effects of diarrhea

A

Fluid/electrolyte losses

Dehydration

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22
Q

Management of diarrhea

A

Fluid therapy if dehydrated
Withhold food, but not water for 1-4 days for more severe cases
Treat initiating cause if can be identified
Return slowly to food with highly digestible diet normal diet over several days

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23
Q

Colitis Causes

A 
Parasitic
Bacterial
Stress
Neoplasia
Etc.
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24
Q

Clinical signs of colitis

A

Large bowel diarrhea

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25
Q

Constipation or Tenesmus causes

A 
Obstructive neoplasms
Megacolon
Pelvic abnormalities
Fungal
Dietary – eating bones
Etc.
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26
Q

management of constipation

A

Enemas, manual evacuation of stool, surgery as appropriate
High fiber diets generally best for recurrent problems
Exercise frequently, manage medically as warranted

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27
Q

sources of intestinal gas

A

Swallowed air
Gas diffusion from blood to gut lumen
Acid-base neutralization reaction produces CO2
Bacterial fermentation of nutrients – methane, CO2, etc.

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28
Q

Management of flatulence

A

Feed free choice or several times daily in quiet location alone; adding water to food may help
Feed highly digestible, low fiber, moderately low protein, soy free, wheat free diet
Do not feed any vegetables, milk, table scraps, or vitamin mineral supplements

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29
Q

Coprophagy

A

Eating feces, not generally harmful, boredom or habit

30
Q

Coprophagy management

A

Difficult to eradicate behavior
For-Bid® - food additive if eating own feces
Treat feces with hot pepper sauce, etc. to cause animal to have unpleasant experience
If dog is eating cat feces, barring access to litter boxes prevents
Habit usually returns

31
Q

clinical signs of hepatic disease

A

Lethargy, anorexia, depression, weight loss, vomiting, diarrhea, ascites, icterus, CNS signs, bleeding tendencies

32
Q

Management of hepatic disease

A

Symptomatic therapy for clinical signs
Feed highly digestible diet moderately restricted in salt, fat, and high-quality protein, high in B vitamins
For encephalopathy where clinical signs not relieved by above diet, use more protein restrictive diet, as for renal disease

33
Q

Anorexia

A

Loss of appetite before caloric needs have been met`

34
Q

Drive to eat is controlled by

A

Hunger – physiologic state resulting from lack of food

Appetite – desire for food

Satiety – lack of desire to eat because caloric needs have been satisfied

35
Q

Adverse effects of inadequate food

A 
Impaired immunity
Decreased resistance to infection, shock
Slower recovery from surgery, cytotoxic drugs
Decreased wound strength
Muscular weakness
Organ failure
Death
Severity of signs increases over time
36
Q

Nutrient Precedence and Needs

A

Water – highest priority
Energy – 2nd priority
Protein
Vitamins/Minerals

37
Q

Causes for nutritional support based on history

A

Recent loss of >10% BW/below optimal BW (BCS 1 or 2)
Restricted food intake/infusion of simple IV fluids for > few days
Increased losses
NVD or malabsorption from any cause
Surgical absence of portion of GI tract
Draining abscesses/wounds/burns

38
Q

Causes for increased need of nutritional support

A

Extensive burns, infection, trauma, or recent surgery
Fever
Chronic disease or organ dysfunction

39
Q

How to identify anorexia from physical examination

A

General Appearance
Cachexia, edema
Skin
Thin, dry, scaly, easily pluckable hair, decubital ulcer, non-healing wounds
Musculoskeletal
Muscle weakness/atrophy, growth retardation, bone or joint pain, epiphyseal swelling
Organ Systems
Hepatomegaly, splenomegaly, ascites, small bowel distention, tumors, pregnancy

40
Q

Fluid/Electrolyte Therapy

A 
Proper fluid balance has primary importance
Goals
Rehydration or treatment of shock
Electrolyte replacement
Normalization of acid-base balance
41
Q

Routes Preferred for fluid therapy

A

Oral preferred - “If the gut works, use it!”, If not oral, SQ/IV/intraosseous/intraperitoneal
If dehydrated >6%, best to give at least ½ IV

42
Q

Contraindications to oral fluid tx:

A

Vomiting
>8% dehydration (mesenteric blood flow inadequate for fluid absorption)
Pre-anesthesia

43
Q

Subcutaneous fluid therapy

A

Warmed to body temperature fluids
Never > 2.5% dextrose/glucose
Give <20-30 mL/kg BW at one time in several sites
Absorbed over 6-8 hours

44
Q

intravenous fluid therapy if:

A

Dehydration > 8%
Fluid losses faster than GI or SQ absorption
Shock or electrolyte imbalances present
GI tract can’t be used

45
Q

Intraosseus fluid therapy

A

Primarily in the neonate, when vein inaccessible

46
Q

Intraperitoneal Fluid therapy

A

Rarely used
Dialysis
Used in Pig, when veins not easily accessible

47
Q

Fluid types

A 
Lactated Ringer’s Solution (LRS)
Normal saline (0.9%)
Isotonic Dextrose (5% or 2.5% Dextrose in water (D5W; D2.5W))
48
Q

Feeding

A

Should begin AFTER fluid volume, electrolyte, and acid-base abnormalities have been corrected
Use GI tract when possible
Growth foods best unless contraindicated by uremia, etc.

49
Q

Coaxing to eat

A 
Hand feed
Warm food to enhance aroma
Have owner visit and feed, or take home for a few hours to feed
Use highly palatable foods
Try different foods
Drug tx – Diazepam in cats and puppies
50
Q

Force Feeding

A

Place food in pharyngeal area
Use syringe or “meatballs”
Hills’ A/D, etc. or human baby food meats
Can add high calorie supplement such as Nutrical™
If feeding > few days, tube feeding better

51
Q

orogastric of nasogastric tube feeding

A 
Least invasive
Orogastric – replaced for each feeding
Nasogastric – may be left in place
Liquids only
Can swallow with tube in place
52
Q

Pharyngostomy or esophagostomy

A

Requires general anesthesia for placement
Esophagostomy tube generally preferred today
Tube bandaged in place; may leave in for weeks; swallow with tube in place

53
Q

Gastrostomy tube feeding

A

Used less often; Post-operative in GDV cases

54
Q

Diets for tube feeding

A

Commercial foods blended with water

Liquid diet, such as CliniCare™

55
Q

Rate and volume for tube feeding

A

Normal dogs can tolerate about 90 mL/kg BW at one time without regurgitation
Adult cats 45mL/kg; kittens 100 mL/kg
If have been anorectic > 2 days, have decreased stomach capacity
Start with half amount and gradually increase volume over several feedings
Minimum three feedings/day

56
Q

Problems/complications of tube feeding

A

Mechanical
Placement of tube – check prior to each feeding
May get regurgitation/aspiration from improper placement or administering excessive quantities
Tube may become occluded if coarse food materials used or not flushed properly
Tightly cap tube when not in use
GI problems
Too rapid administration
Administration of poorly absorbed solutes
Metabolic problems
Hyperglycemia if give too much glucose

57
Q

Obesity

A

> 10-15% over optimal weight

58
Q

Incidence of obesity in pets increases with:

A 
Age, gender (female), breed
Neutering (2X higher)
Overweight owners, feeding habits
Middle-aged to older owners
Reduced physical activity
59
Q

Effects of obesity

A 
Shortens life span
Joint and locomotion problems
Respiratory, cardiovascular difficulties
Liver disease
Skin disease
Digestive problems, i.e. constipation
Increased risk of diabetes
Increased anesthetic and surgical risks
60
Q

Diagnosis of obesity

A 
Complete physical examination
Rule out medical causes (5%):
Cushing’s disease
Hypothyroidism
Congestive heart failure
Diabetes mellitus
Etc.
61
Q

Assessment of Degree of obesity

A

Compare present weight to non-obese weight from medical history
Assess based on amount of fat over ribs, ventral abdomen, over tailhead, over hips, etc. – give body condition score
Evaluate for waddling, sluggishness, poor mobility, lack of grooming in the cat due to inflexibility

62
Q

Management of obesity

A

Psychological Encouragement
Convince ALL persons associated with pet of the necessity for wt. loss
Detrimental effects of obesity
Benefits of weight reduction/maintenance

63
Q

Exercise for Weight Reduction

A

Loss of 1 pound requires energy deficit of about 3,500 kcal

64
Q

Benefits of exercise for weight reduction

A 
Exercise increases energy expenditure
Prevents decrease in RMR that would occur normally when caloric intake decreases
Prevents losses of lean body mass
Improves cardiovascular function
Helps maintain weight loss
65
Q

Dietary Management – Weight Loss

A

Obtain complete client cooperation
Evaluate patient thoroughly
Weigh animal – set goal
Estimate time to reach goal
Decrease caloric intake to 60-70% of that required for maintaining optimum body weight
Feed 3-4 X daily, or as often as practical – increases energy lost as heat
Instruct owner to keep animal out of room when food being prepared or eaten
Change to a weight reduction diet food
Client must follow instructions, and feed only the specific amount of food prescribed
Recommend beginning exercise program gradually
Examine/weigh animal every 1-2 weeks

66
Q

Starvation for Weight Reduction

A

Weight loss of adipose tissue is only 3-5% greater after 7 weeks of fasting than it is when a low calorie reducing diet is fed
Many consider inhumane
Recurrence of obesity more likely
Starvation of obese cats may result in severe hepatic lipidosis and death—always gradually reduce energy intake

67
Q

Drug Use for Weight Reduction

A

Slentrol™ introduced by Pfizer in January 2007 – FDA approved for dogs
Decreases appetite
Decreases fat absorption
Vomiting, diarrhea, lethargy may be side effects

68
Q

Surgery for Weight Reduction

A

Seldom done in veterinary medicine

69
Q

Bougienage

A

A bougie is a thin cylinder of rubber, plastic, metal or another material that a physician inserts into or though a body passageway, such as the esophagus, to widen the passageway, guide another instrument into a passageway, or dislodge an object.

70
Q

Causes of Diarrhea

A

Results from any intestinal malfunction

71
Q

Types of Diarrhea

A

Motility
Active secretory
Passive secretory or osmotic
Malabsorption/maldigestion

VTEC.2600 (3 decks)

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