Gastrointestinal Flashcards
What are the 5 cranial nerved involved in oesophageal motility?
Trigeminal (V)
Facial (VII)
Glossopharyngeal (IX)
Vagus (X)
Hypoglossal (XII) - motor only, the rest are sensory and motor
Distribution of striated vs. skeletal muscle in oesophagus of cats vs. dogs
Dogs have striated muscle all the way down, cats only in the proximal 2/3
Which muscle makes up the upper oesophageal sphincter?
Cricopharyngeus muscle
Breed predisposition to the following that may result in dysphagia:
a) Pharyngeal weakness
b) Cricopharyngeal achalasia
c) Muscular dystrophy
d) Inflammatory myopathies
e) Masticarotry muscle disorders
a) Golden retrievers
b) Cocker and springer spaniels
c) Bouvier des Flandres, CKCS
d) Boxers, Newfoundlands
e) Large breed dogs
Breeds predisposed to congenital MegaO
Megaoesophagus Should Not Get Food Stuck In their Lower oesophagus
Miniature shnuazers, SharPei, Newfoundland, GSD, Great Dane, Fox Terriers, Siamese, Irist setters, Labradors
What percentage of dogs with MG may have pharyngael weakness as their only clinical sign?
0.01
What is the anatomical cause of cricopharyngeal achalasia
Thickening of the cricopharyngeus muscle
What is the most common vascular ring anomaly in dogs? Which breed(s) are predisposed?
Persistent right aortic arch - GSD and Irish Setters
Most common oesophageal neoplasias in dogs vs. cats
Fibrosarcoma and osteosarcoma (can results from Spirocerca granuloma transformation).
Cats = SCC
Which breed is predisposed to congenital oesophageal fistulas?
Cairn terriers
Why are prokinetics unlikely to be useful in the management of oesophageal dysmotility/megaoesophagus disorders?
None of the prokinetics affect striated muscle. Can actually make the signs worse.
What percentage of MG patients with megaO will respond to therapy?
Approximately 50%
What is the proposed mechanism of action of sildenafil in the treatment of congenital idiopathic megaoesophagus?
It decreased LES tone
What are the types of hiatal hernia in dogs and the most common
I = sliding of the abdominal oesophagus and stomach throguh the oesophageal hiatus, this is most common
II = paraoesophageal = stomach only moving into the oesophagus
IV = liver, stomach and SI displaced into the thorax.
Breeds predisposed to hiatal hernia
Brachys: Pug, EBD, FBD, Boston
NonBrachy: Shar-Pei, Chow Chow
Treatment of hiatal hernia?
Treat medically for oesophagitis initially
BOAS surgery
Pexy
What are the main family of bacteria present within the gastric flora?
Proteobacteria (99.6%) - this includes helicobacter spp.
Firmicutes (0.3%)
Breeds predisposed to hypertrophic gastropathy
Drentse Patrijshond
Basenji
Shih Tzu (pyloric)
Breeds predisposed to atrophic gastritis
Lundehunde
Breeds predisposed to gastric neoplasia
Belgian Shepherd
Rough collie
SBT
Lundehunde
What acid-base abnormality can develop with a pyloric outflow obstruction?
DDx for this metabolic abnormality
Hypochloraeimc metabolic alkalosis with paradoxical renal aciduria- this occurs when Cl loss exceeds HCO3 loss.
Paradoxical aciduria occurs because the kidney will attempt to re-absorb Na in a attempt to concserve water. HCO3 is also reabsorped. Na/H+ exchagne leads to loss of H+ in the urine.
DDx. is parvoviral enteritis and increased gastric acid secretion (e.g. with gastrinoma).
Gastric Secretory Testing:
- Methods
- Interpretation
IV secretin, calcium should increase serum gastrin
pentagastrin or bombesin can also stimualte gastric acid secretion
Interpretation:
- pH <3 with increase gastrin is inappropropriate and may indicate gastrinoma
- pH > 3 and increased gastrin could indicate achlorhydria
n.b. basenji can have increased gastrin in the abscence of a gastrinoma
Parasitic causes of (acute) gastritis
Ollanus spp. physaloptera spp.
DDx for GI ulceration