Gastrointestinal

Question 1

Cholecystitis
(how to diagnose & treatment)

Answer 1

• Inflammation of the gallbladder
• Ultrasound will show an enlarged/irritated gallbladder
• Tx: chronic antibiotic therapy (amoxicillin and enrofloxacin) or cholecystectomy

Question 2

Spontaneous rupture of the gall bladder (secondary to? presenting complaint? Treatment?)

Answer 2

• Usually secondary to cholecystitis or biliary mucocele that ruptured
• Will present with abdominal pain and icterus (bile spilled into peritoneum)
• Tx: cholecystectomy and aggressive antimicrobial therapy

Question 3

What is a biliary mucocele?

Answer 3

Excessive mucus is secreted in the gall bladder and becomes solid and occludes common bile duct (causing post-hepatic hyperbilirubinemia)

Question 3

Biliary mucocele treatment

Answer 3

Cholecystectomy (ideally before rupture!!)

Question 4

Canine parvovirus (pathophysiology, prevention and transmission)

Answer 4

• Virus destroys rapidly diving cells (intestinal crypt cells)
• Prevention via DAPP vaccine
• Spread fecal oral

Question 5

Canine parvovirus clinical signs and diagnosis

Answer 5

• leukopenia, fever, severe diarrhea (often bloody), anorexia
• fecal ELISA

Question 6

Canine parvovirus treatment

Answer 6

IV fluids, antibiotics (IV broad spectrum), gastroprotectants (PPI, H2, sucralfate), anti-emetics

PREVENTION KEY

Question 7

Constipation treatment

Answer 7

• DSS (docusate sodium/ senna)
• Soap/water enema
• KY jelly enema
• Stool softeners like laxatone, lactulose, polyethylene glycol 3350
• Increase fiber intake

Question 8

Persistent deciduous teeth is common in ___ breeds

Answer 8

toy/small

Question 9

How to differentiate uncomplicated vs complicated dental fractures?

Answer 9

Uncomplicated- damage is limited to enamel and dentin
Complicated- damage exposes endodontic system and root

Question 10

Most common location of esophageal foreign bodies

Answer 10

thoracic inlet, base of heart, diaphragm (places of esophageal narrowing)

Question 11

Most common esophageal foreign bodies in dogs vs cats

Answer 11

Dogs- bones
Cats- toys, sewing needles

Question 12

Esophagitis (how to diagnose and treat)

Answer 12

Diagnose via endoscopy + biopsy
Treat with sucralfate, H2 antagonist, PPI, Prokinetics (like metoclopramide and cisapride to encourage gastric emptying)

Question 13

Exocrine pancreatic insufficiency pathophysiology (main cause for dogs vs cats)

Answer 13

Inadequate synthesis and secretion of digestive enzymes the pancreas. Results in lack of nutrient absorption.
Dogs- pancreatic acinar atrophy
Cats- chronic pancreatitis

Question 14

EPI clinical signs

Answer 14

Polyphagia, diarrhea, weight loss, yellow/gray feces

Question 15

EPI diagnosis

Answer 15

TLI will be low (less than 5 ug/l)

Question 16

EPI treatment

Answer 16

Exogenous pancreatic enzyme supplementation
Low-fiber diet (fiber can interfere with enzymes)

Question 17

Gastric dilation/volvulus signalment (who is most at risk?)

Answer 17

Large, deep-chested breeds (german shepherds, great danes, rottweilers)
Fast-eaters

Question 18

GDV pathophysiology

Answer 18

Rotation of stomach counter-clockwise resulting in venous compression/congestion and compromise of blood perfusion to the stomach (resulting in necrosis)

Question 19

GDV clinical signs

Answer 19

restlessness, pacing, painful, non-productive vomiting, abdominal distention, shock or CV compromise (weak pulses, pale MM, tachycardia)

Question 20

GDV diagnosis

Answer 20

Radiographs: look for “popeye arm”
Blood gas: metabolic acidosis (d/t increase lactate)
VPCs on EKG analysis

Question 21

When suspecting a GDV, which position for radiographs should you order?

Answer 21

Right lateral abdominal (patient laying on their right, leaving the stomach closest to the beam)

Question 22

When determining GDV prognosis, what should you look at?

Answer 22

Lactate >6 = gastric necrosis
Lactate <6 = good prognosis

If patient is in lateral upon presentation that is also a poor prognosis indicator

Question 23

GDV Treatment (stabilization vs surgery)

Answer 23

• TWO large CEPHALIC IV catheters (avoid saphenous)
• Decompress stomach (OG tube or trocarization)
• Shock dose of crystalloid fluids 80-90 mg/kg in fractions
• Monitor BP and EKG

Surgery: decompress and reposition the stomach, perform gastropexy to prevent reoccurence