Gastric Disease in Dogs and Cats Flashcards
Name 5 causes of sudden onset vomiting (6)
- Diet
- Change
- Scavenging
- Foreign body
- Drug side effects
- Toxins
- Systemic disease
- Infection
Why are dogs and cats normally resistant to bacterial gastritis?
- Stomach is a tough holding tank which hold onto everything until it has been ground to allow it to pass on. FB can escape this
- Barrier to infection & colonisation of SI
- Sterile environment
When do problems arise with bacterial gastritis? (2)
- Neonates
- Abnormal gastric environment
- Food related
- Antacids
Discuss what you think might be happening here
Lumpy stomach – Think it is worrying like a lymphoma
Was just IBD which had quite an eosinophilic
Biopsies are the best to enable good treatment
How do we describe the pathology of chronic gastritis? (6)
- Cell infiltrates, What is predominate? Is it a mix? – help tell us the underlying cause
- Eosinophilic – weird hypersensitivity or idiopathic
- Lymphocytic
- Plasmacytic
- Granulomatous
- Mixed
- Atrophic/hypertrophic
- Fibrotic
- Oedematous
- Metaplastic
- Ulcerative
What cause of chronic gastritis are we most worried about in humans? But think it has no relevance in dogs these days
•Helicobacter spp
Benign helicobacter is a common finding in dogs and cats. What may it be associted with (3)
- Gastric gland degeneration
- Mononuclear cell infiltrates
- Lymphoid hyperplasia
What is malignant helicobacter associated with in people? (5)
- Chronic inflammation
- Immune response
- Gastric ulceration
- Malignant transformation
- In people has a link to a gastric ulcer
Where is a common site of a gastric ulcer?
Lesser curvature
What can be seen?
Ulcer on the lesser curvature of stomach
= common site of ulcers in dogs
Can also be associated with gastric disease
Why does stomach acid not normally cause ulceration in the stomach? (4)
- Tight intercellular junctions (barrier function)
- Mucus layer
- Bicarbonate rich in a healthy stomach prevents against ulcers
- Local prostaglandins (PG E2) controlling
- Mucosal blood flow
- Bicarbonate production
- Mucus
- Rapid epithelial repair
- Constant repair – susceptible to damage with chemo. High turnover system
What would your worry be here?
This ulcer is small but has a deep crater.
If you get through this wall – perforation is an accident waiting to happen
What are the 3 general causes in a failure of the mucosal barrier?
- Acid hypersecretion
- Direct physical injury
- Reduction in PG E2
- Cox inhibitors
- NSAIDs
- Cox inhibitors
Define benign
Not malignant/neoplastic. Can still be life threatening
What is the benign cause of iatrogenic gastric ulcers?
- Drugs - NSAIDs
- Drug combos - NSAIDs and steroids
What is the worst case scenario of NSAID ulcers?
- Severe GI haemorrhage from the ulcer itself eroding through
- = Debilitated patient
- Then get gastric or duodenal perforation
- Leading on to Septic peritonitis
- Almost always means Death
- Leading on to Septic peritonitis
- Then get gastric or duodenal perforation
- = Debilitated patient
Name 3 benign metabolic/endocrine causes of gastric ulcers (4)
- Hypoadrenocorticism
- Azotaemia
- CKD
- AKI
- Liver disease +/- portal hypertension
- Perfusion related?
- More likely duodenal ulcerations
- (Mast cell tumours anywhere)
- Aggressive anywhere which degranulates which produce histamine and then can cause ulcer
Other than metablic, name 3 benign causes of gastric ulcers (4)
- Inflammatory bowel disease complication
- Shock, sepsis, hypotension (ie perfusion related)
- Stress
- surgery?
- high performance athletes?
- Idiopathic
What is this?
Cat with GI lymphoma
Name 2 malignant causes of gastric ulcers (3)
- 1ry gastric neoplasia
- Carcinoma/adenocarcinoma
- Lymphoma
- Leiomyoma
- Tends to be a benign tumour
- Gastrinoma
- Gastrin producing tumour in the pancreas
- Mast cell tumours
- Degranulation causes histamine release
- Ulcerogenic
What is this?
Polypoid mass close to pylorus
Name physical causes of gastric ulceration (6)
- Foreign body
- +/- Gastritis
- +/- Ulceration
- Obstruction?
- Perforation?
- Less common than in the intestine as the gastric wall Is pretty tough – so rare to do
- Mass lesions causing outflow obstruction
- Neoplastic
- Inflammatory
- Granuloma
- Polyp
- Gastric dilation +/- volvulus
- Hypertrophic gastritis
- outflow tract obstruction
- breed related
- brachycephalics
- Congenital pyloric stenosis
- Possibly “extra gastric” mass lesions
What is this?
Gastric lymphoma
What is this?
Gastric dilation & volvulus
What is this?
Healing gastric ulcer
On the lesser curvature
Biopsy around the EDGE do not want to poke biopsy forceps through
What can be seen in these images?
Both have evidence of delayed gastric emptying – fluid filled stomach
Right lateral recumbent – pylorus full
In stomach position – so think air and fluid distended
What can be seen?
Pyloric outflow obstruction
Thick hypertrophic gastric wall at the outflow of the stomach
Intricate surgery needed
= a form of gastritis à hypertrophic gastritis
What is this?
Hiatal hernia
