Gastrointestinal Flashcards

Question

List mechanical causes of oral preparatory dysphagia.

Answer 1

* Periodontal disease * Oral mass or swelling * Foreign body * Oral trauma * Cleft palate

Answer 2

* Cranial nerve IX, X, XI dysfunction * Myasthenia gravis * Polymyositis

Answer 3

* Esophageal foreign body * Vascular ring anomalies * Esophageal stricture * Hiatal hernia

Answer 4

It helps identify laryngeal paralysis, which poses a significant aspiration risk.

Answer 5

* Swallowing fluoroscopy * Endoscopy * Esophageal manometry

Answer 6

German Shorthaired Pointer.

Answer 7

Videofluoroscopic swallow studies.

Answer 8

Free-standing, free-feeding swallow protocols.

Answer 9

* Nasal/Nasopharyngeal: Mass, foreign body * Upper Airway: Laryngeal paralysis, epiglottic retroversion, pharyngeal collapse * Lower Airway: Productive/severe cough

Answer 10

* Foreign body * TMJ disease * Retrobulbar abscess * Stomatitis

Answer 11

* History * Physical & Neurologic Exam * Minimum Database * Imaging

Answer 12

Videofluoroscopy ## Footnote It's used to assess swallowing dynamics.

Answer 13

Mechanical issues such as strictures and foreign bodies ## Footnote It allows for direct intervention and biopsy collection.

Answer 14

* Dystrophin Deficiency: Golden Retriever, Brittany Spaniel, Mini Schnauzer, GSD * Cricopharyngeal Achalasia: Cocker Spaniel, Golden Retriever * Idiopathic Esophageal Dysmotility: Terrier breeds, Shar-Pei * Vascular Ring Anomaly (PRAA): GSD, Irish Setter * Gastroesophageal Intussusception: GSD * Hiatal Hernia: Bulldogs, Pugs, Shar-Pei * Hereditary/Familial Megaesophagus: Schnauzer, GSD, Great Dane, Setter, Siamese cat

Answer 15

Elevated bowl ## Footnote This helps facilitate swallowing.

Answer 16

Upright feeding (Bailey chair) ## Footnote This position minimizes the risk of aspiration.

Answer 17

* Underlying cause * Aspiration risk * Caloric intake capability

Answer 18

False ## Footnote Swallow studies have reduced sensitivity for microscopic reflux or aspiration events.

Answer 19

Nuclear scintigraphy ## Footnote This test is non-invasive and does not require anesthesia.

Answer 20

* Digested food * Bile-stained material * Acidic contents.

Answer 21

Undigested food, tubular-shaped, neutral or alkaline pH.

Answer 22

Often shortly after eating, but not diagnostic.

Answer 23

Typically acidic.

Answer 24

Dogs have an entire esophagus of striated muscle; cats have smooth muscle in the distal 1/3 to 1/2.

Answer 25

* Inflammation (e.g., esophagitis) * Obstruction (e.g., foreign body) * Hypomotility (e.g., megaesophagus).

Answer 26

Cervical and thoracic radiographs, contrast esophagram, video fluoroscopy.

Answer 27

Small, frequent meals and elevated feeding.

Answer 28

* Volume depletion * Electrolyte/acid-base disturbances * Esophagitis * Aspiration pneumonia.

Answer 29

The emetic center in the medulla oblongata contains various receptors including 5-HT1 and alpha-adrenergic receptors.

Answer 30

* Vagal and sympathetic nerves * Vestibular system * Cerebral cortex.

Answer 31

Withhold food for 12–24 hours and gradually introduce a bland diet.

Answer 32

Cisapride.

Answer 33

NTS (nucleus tractus solitarius) ## Footnote This center integrates signals that trigger the vomiting reflex.

Answer 34

CRTZ, vestibular system, vagal and sympathetic afferents, cerebral cortex ## Footnote These inputs are critical for the regulation of vomiting.

Answer 35

5-HT1, alpha-adrenergic ## Footnote These receptors play a role in the modulation of vomiting responses.

Answer 36

D2, H1, alpha-2, 5-HT3, M1, ENK (mu/delta), NK1 ## Footnote These receptors are involved in detecting signals that can induce vomiting.

Answer 37

Responsive via D2 receptors ## Footnote Apomorphine is used as an emetic in dogs due to its action on these receptors.

Answer 38

Less responsive to dopamine agonists; responsive to xylazine (alpha-2) ## Footnote This difference is important for selecting appropriate treatments for vomiting.

Answer 39

Outflow obstruction ## Footnote This can be a critical finding in cases of vomiting.

Answer 40

CRTZ, vestibular system, vagal and sympathetic afferents, cerebral cortex ## Footnote These inputs are crucial for the vomiting reflex.

Answer 41

Infectious diseases ## Footnote Examples include canine parvovirus in dogs and feline panleukopenia in cats.

Answer 42

Typically present in early adulthood ## Footnote This can occur even in young animals.

Answer 43

* German Shepherds * Rough-Coated Collies * Cavalier King Charles Spaniels ## Footnote Breed-specific predispositions assist in diagnostics.

Answer 44

Fecal antigen ELISA ## Footnote Parvovirus is associated with leukopenia, fever, vomiting, and diarrhea.

Answer 45

* Fever * Conjunctivitis * Neurologic signs * Nasal and footpad hyperkeratosis ## Footnote Diagnostic tests include conjunctival swab PCR or direct fluorescent antibody testing.

Answer 46

Fecal ELISA, fecal flotation with centrifugation, or direct fluorescent antibody ## Footnote Giardiasis presents with diarrhea, weight loss, and seborrhea.

Answer 47

False ## Footnote Many patients will have a largely unremarkable physical exam.

Answer 48

* Hematochezia * Flatulence * Fecal incontinence ## Footnote The diagnostic test is PCR of diarrheic feces.

Answer 49

Colonic biopsy with histopathology, PAS staining, E. coli FISH ## Footnote This condition presents with hematochezia, tenesmus, weight loss, and anemia.

Answer 50

* Fever * Vomiting * Lymphadenomegaly ## Footnote Diagnostic tests include fecal sedimentation with zinc sulfate centrifugation and blood PCR.

Answer 51

Fecal ELISA or direct fluorescent antibody ## Footnote Clinical signs often include diarrhea without systemic signs.

Answer 52

* Upper respiratory tract (epistaxis or hemoptysis) * GI tract (oral cavity, esophagus, stomach, small intestine) * Colon/cecum (rare unless delayed transit) * Dietary sources (raw diets, ingestion of blood)

Answer 53

* Activated charcoal * Iron supplements * Bismuth-containing antidiarrheals * Large amounts of blueberries

Answer 54

50–100 mL of blood must be ingested before melena is appreciable.

Answer 55

* Complete Blood Count (CBC) * Serum biochemistry panel * Urinalysis * Prothrombin time (PT) * Activated partial thromboplastin time (aPTT) * Fecal flotation

Answer 56

Anemia ## Footnote It can be mild to severe and may be regenerative or non-regenerative.

Answer 57

Upper GI hemorrhage ## Footnote Influenced by blood loss volume, hemorrhage timing, GI transit, and hydration status.

Answer 58

* Ingestion of blood * Inflammatory causes (e.g., IBD, gastritis) * Infectious causes (bacterial, fungal, parasitic, viral) * Ischemic or traumatic causes * Post-surgical causes * Drug-induced causes * Neoplastic causes * Vascular anomalies * Metabolic/systemic diseases * Coagulopathies and bleeding disorders

Answer 59

To reduce gastric acidity and promote mucosal defense and healing ## Footnote Medications include proton pump inhibitors, synthetic prostaglandin analogs, and sucralfate.

Answer 60

* Broad-spectrum anthelmintic * Probiotic supplementation * Bland diet with soluble fiber

Answer 61

* Melena: black, tarry stool from upper GI * Hematochezia: bright red blood from lower GI

Answer 62

Petechiae suggest coagulopathy, while icterus suggests hepatobiliary disease.

Answer 63

* Campylobacter spp. * Clostridium spp. * Mycobacterium spp. * Salmonella spp.

Answer 64

False ## Footnote Blood can also originate from extra-GI sources.

Answer 65

Salmonella, Campylobacter ## Footnote These are common bacterial pathogens associated with gastrointestinal diseases.

Answer 66

Pythium, Histoplasma ## Footnote These fungi are known to impact gastrointestinal health.

Answer 67

Ancylostoma, Physaloptera ## Footnote These parasites can lead to significant gastrointestinal symptoms.

Answer 68

Parvovirus ## Footnote This virus is particularly harmful in young animals.

Answer 69

GDV, intussusception ## Footnote GDV stands for gastric dilatation-volvulus.

Answer 70

NSAIDs, corticosteroids, anticoagulants ## Footnote These drugs can lead to gastrointestinal complications.

Answer 71

GIST, lymphoma, gastrinoma ## Footnote These tumors can cause various gastrointestinal symptoms.

Answer 72

AV fistula ## Footnote Arteriovenous fistulas can disrupt normal blood flow.

Answer 73

Liver disease, PSS, hypoadrenocorticism ## Footnote These conditions can affect gastrointestinal function.

Answer 74

DIC, rodenticides ## Footnote Disseminated intravascular coagulation (DIC) and rodenticide poisoning can cause bleeding.

Answer 75

Anemia (regenerative or iron-deficiency), Thrombocytopenia/-cytosis, Leukogram variability, Eosinophilia ## Footnote These findings help determine the underlying cause of gastrointestinal symptoms.

Answer 76

PPIs: Omeprazole, pantoprazole, Misoprostol, Sucralfate ## Footnote These medications help manage gastric ulcers.

Answer 77

Cecum, colon, rectum, anal canal hemorrhage; small intestine if transit is rapid ## Footnote Understanding these causes is key to diagnosing hematochezia.

Answer 78

Red dye, beets, perineal wounds, anal sac abscess ## Footnote These can confuse the diagnosis of true hematochezia.

Answer 79

Fecal float, direct smear ## Footnote These tests help identify potential parasites or other issues.

Answer 80

Broad-spectrum dewormer (fenbendazole, pyrantel), Probiotic, Bland diet + soluble fiber ## Footnote These treatments can help resolve mild cases of hematochezia.

Answer 81

Painful or difficult defecation typically associated with anorectal abnormalities ## Footnote Often occurs concurrently with tenesmus

Answer 82

Involuntary and unconscious leakage of fecal material due to failure to retain feces ## Footnote Can result from neurologic or non-neurologic causes

Answer 83

Functional and mechanical ## Footnote Functional causes include dietary, metabolic, neurologic, and endocrine factors

Answer 84

Diets low in insoluble fiber and pica ## Footnote Pica involves consumption of indigestible materials

Answer 85

Hypokalemia, hypercalcemia, hypomagnesemia, dehydration ## Footnote Chronic diseases causing polyuria and polydipsia can predispose animals to dehydration

Answer 86

Congenital spinal cord malformations, trauma to lumbar or sacral spinal cord, dysautonomia ## Footnote Congenital abnormalities noted in certain breeds

Answer 87

Intraluminal obstructions, extraluminal obstructions, pseudocoprostasis ## Footnote Can include foreign bodies, neoplasia, strictures, and pelvic fractures

Answer 88

Anal sacculitis, perianal fistulas, perianal hernias, congenital anomalies ## Footnote Particularly noted in certain dog breeds

Answer 89

It can produce symptoms similar to tenesmus or dyschezia ## Footnote Important to rule out urinary disorders before gastrointestinal workup

Answer 90

Chronic enteropathies or parasitic infections ## Footnote Conditions like stress colitis can also trigger tenesmus

Answer 91

Disruption of neural pathways controlling anal sphincter or colonic motility ## Footnote Includes upper and lower motor neuron sphincter incontinence

Answer 92

Occurs with lesions cranial to sacral spinal cord segments ## Footnote Causes include intervertebral disc disease and spinal neoplasia

Answer 93

Caused by injury to sacral spinal cord or associated peripheral nerves ## Footnote Examples include sacrocaudal luxation and cauda equina syndrome

Answer 94

Structural, functional, or behavioral issues affecting rectum or anal sphincter ## Footnote Includes reservoir incontinence and external anal sphincter dysfunction

Answer 95

Inability to store feces due to decreased rectal compliance or capacity ## Footnote Often seen with severe colitis or proctitis

Answer 96

Tenesmus preceding defecation ## Footnote Painful defecation without tenesmus indicates anorectal disease

Answer 97

Chronic enteropathy, parasitic infections, and dietary indiscretion ## Footnote Can also be associated with stress colitis

Answer 98

Fungal and algal infections such as pithiosis and histoplasmosis ## Footnote These infections may primarily affect the small intestine

Answer 99

Neurogenic and non-neurogenic causes.

Answer 100

Caused by lesions cranial to the sacral spinal cord, associated with conditions like IVDD and CNS inflammatory diseases.

Answer 101

Damage to sacral spinal cord segments (S1–S3), cauda equina, or pudendal nerve, including cauda equina syndrome and peripheral neuropathies.

Answer 102

Inability of the colon and rectum to retain feces for appropriate periods.

Answer 103

* Aging * Trauma * Neoplasia * Perineal or pelvic surgery

Answer 104

To evaluate anal tone and reflexes, which helps distinguish between neurogenic and non-neurogenic causes.

Answer 105

* Low-fiber diet * Pica * Electrolyte imbalances * Dehydration * Obesity/inactivity

Answer 106

* Abdominal Radiographs * Abdominal Ultrasound * Contrast Studies

Answer 107

* Urinary tract disease * Lower urinary tract infection * Urolithiasis * Prostatic disease

Answer 108

Partial response to metronidazole, with relapse upon discontinuation.

Answer 109

Persistent incontinence with absent sphincter tone suggests permanent neurologic or structural damage.

Answer 110

Affected animals often retain conscious awareness of defecation.

Answer 111

Essential for suspected fiber-responsive or food-responsive enteropathy.

Answer 112

Food/fiber-responsive colitis ## Footnote Chronic enteropathies can lead to diarrhea, specifically food or fiber-responsive colitis.

Answer 113

* Trichuris vulpis * Ancylostoma ## Footnote These parasites are known to affect dogs and can lead to gastrointestinal issues.

Answer 114

Tritrichomonas foetus ## Footnote This protozoan is notably found in cats and can cause significant gastrointestinal symptoms.

Answer 115

* Pythium * Histoplasma * Prototheca ## Footnote These organisms can cause enteric diseases in various animals.

Answer 116

* IVDD * Arachnoid cysts * Neoplasia * Degenerative myelopathy * Dysautonomia ## Footnote Upper motor neuron lesions can result from various conditions affecting the nervous system.

Answer 117

* Cauda equina syndrome * Sacrocaudal luxation * Diffuse LMN disease ## Footnote Lower motor neuron lesions can cause fecal incontinence and are associated with specific diseases.

Answer 118

* Vincristine * Macadamia nut toxicity ## Footnote These conditions can lead to nerve damage and result in fecal incontinence.

Answer 119

* Anxiety * Cognitive dysfunction ## Footnote Behavioral issues can significantly impact bowel control in pets.

Answer 120

Obstruction ## Footnote Tenesmus is the feeling of incomplete defecation and can signal a blockage.

Answer 121

Luminal narrowing ## Footnote This can suggest a physical obstruction in the intestines.

Answer 122

* Boxers * French Bulldogs ## Footnote Certain breeds are predisposed to this condition, which affects the colon.

Answer 123

* Abdominal rads * Ultrasound * Contrast studies * Additional tests (T4 panel, malignancy screen, Histoplasma ELISA) ## Footnote These tests provide more detailed information about the patient's gastrointestinal health.

Answer 124

* Endoscopy * Advanced imaging (CT, MRI) * CSF tap * Specialized testing (anorectal manometry, electromyography) ## Footnote These advanced techniques help in diagnosing complex conditions affecting the gastrointestinal tract.

Answer 125

Offensive odor prompting veterinary evaluation ## Footnote While often benign, it can indicate dietary intolerance, dysbiosis, or other GI disturbances.

Answer 126

* Aerophagia * Bacterial fermentation * Diffusion from the bloodstream * Chemical reactions ## Footnote Aerophagia is particularly common in brachycephalic breeds.

Answer 127

More than 99% odorless gases: * Carbon dioxide (CO₂) * Hydrogen (H₂) * Methane (CH₄) * Nitrogen (N₂) * Oxygen (O₂) Less than 1% includes sulfur-based compounds responsible for malodor ## Footnote Sulfur-based gases are primarily responsible for the offensive odor associated with flatulence.

Answer 128

Approximately 75% ## Footnote These gases are major contributors to flatulence volume.

Answer 129

Affects gas production, intestinal motility, and microbiota through mechanical stimulation and fermentation ## Footnote Fiber can be categorized by solubility, fermentability, viscosity, and chain length.

Answer 130

* Soluble: Dissolves in water (e.g., pectins, gums) * Insoluble: Adds bulk to stool (e.g., cellulose) * Fermentable: Readily fermented (e.g., inulin) * Non-fermentable: Minimal bacterial breakdown (e.g., wheat bran) ## Footnote Viscosity is a sub-classification of soluble fibers.

Answer 131

Fermentable oligosaccharides, disaccharides, monosaccharides, and polyols that are poorly absorbed in the small intestine ## Footnote FODMAPs increase intestinal osmolality, promote water influx, enhance bacterial fermentation, and result in increased gas production.

Answer 132

Brachycephalic breeds ## Footnote Their facial anatomy leads to increased intake of air, resulting in more flatulence.

Answer 133

Dietary modification ## Footnote This includes avoiding ingredients high in fermentable FODMAPs and implementing exclusive diet trials.

Answer 134

Binds sulfur-containing gases to reduce the odor of flatulence ## Footnote It does not decrease gas production or volume.

Answer 135

Reduces surface tension of gas bubbles, facilitating easier expulsion ## Footnote No veterinary studies have validated its effectiveness in dogs or cats.

Answer 136

Vital role in diagnostic workup to rule in or out potential causes ## Footnote Chronic GI disorders are often multifactorial, requiring interpretation within the context of patient history and additional diagnostics.

Answer 137

Direct smears, sedimentation, and centrifugal flotation ## Footnote These methods help identify helminths and protozoa.

Answer 138

Moderate-to-low sensitivity due to: * Low pathogen burden * Intermittent shedding * Variability in operator experience * Negative results do not rule out infectious disease ## Footnote These factors can lead to false negatives.

Answer 139

Proximal small intestine ## Footnote Requires enzymatic deconjugation by folate deconjugase to form folate monoglutamate.

Answer 140

Proximal small intestinal disease or mucosal damage ## Footnote Increased serum folate may indicate intestinal dysbiosis due to bacterial overproduction.

Answer 141

Released from protein by pepsin and HCl in the stomach, binds to R-protein, then absorbed in the ileum via intrinsic factor ## Footnote Exocrine pancreatic insufficiency is a common cause of hypocobalaminemia.

Answer 142

Phosphorus deficiency ## Footnote Levels correlate with prognosis in dogs with chronic enteropathies.

Answer 143

Low sensitivity; best for rapid identification of motile forms ## Footnote Used to identify protozoal trophozoites and oocysts.

Answer 144

Centrifugal flotation due to higher sensitivity ## Footnote Detects nematode ova, protozoal cysts, and larvated ova.

Answer 145

Lethargy, weight loss, diarrhea, vomiting, hematochezia, hypercalcemia ## Footnote Primarily reported in Texas, Louisiana, Florida, and North Carolina.

Answer 146

Direct fecal smear, culture pouches, PCR ## Footnote PCR is the gold standard for diagnosis.

Answer 147

Often subclinical; diarrhea may be seen, especially in young animals ## Footnote Pathogenic potential is unclear as it is also found in asymptomatic animals.

Answer 148

Fecal antigen ELISA, Giardia IFA, modified Ziehl-Neelsen acid-fast stain, PCR ## Footnote Oocysts are rarely detected via standard flotation.

Answer 149

Often subclinical; may present with chronic vomiting ## Footnote Dogs are more frequently affected than cats.

Answer 150

Enrichment culture followed by PCR on feces, direct fecal PCR, antimicrobial susceptibility testing ## Footnote Diagnosis requires clinical signs in conjunction with a positive test.

Answer 151

C. jejuni, C. coli, C. helveticus, C. upsaliensis ## Footnote Most infections are self-limiting.

Answer 152

Toxin testing (ELISA for Toxins A and B), organism detection via fecal culture, antigen ELISA, real-time PCR ## Footnote Pathogenicity in dogs and cats remains unclear.

Answer 153

Large bowel diarrhea ## Footnote Particularly predisposed in Boxers and French Bulldogs.

Answer 154

A syndrome characterized by severe diarrhea with blood in dogs, often associated with infections.

Answer 155

Classified into biotypes A–E, each producing various virulence factors.

Answer 156

Large bowel diarrhea.

Answer 157

Periodic acid–Schiff (PAS)-positive macrophages.

Answer 158

FISH (fluorescence in situ hybridization).

Answer 159

Neorickettsia helminthoeca.

Answer 160

Acute onset fever, vomiting, diarrhea, hematochezia, weight loss, lymphadenopathy.

Answer 161

Pacific Northwest of the United States.

Answer 162

Fecal sedimentation and flotation.

Answer 163

PCR on feces or oropharyngeal swabs.

Answer 164

Fever, malaise, vomiting, diarrhea, ocular and nasal discharge, respiratory signs.

Answer 165

76.5–86.3%.

Answer 166

Sequencing or quantification of RNA.

Answer 167

Weight loss, anorexia, fever, lymphadenopathy, chronic GI signs.

Answer 168

Antibody ELISA on serum.

Answer 169

Diarrhea, hematochezia.

Answer 170

To aid in the diagnosis of protein-losing enteropathy (PLE).

Answer 171

Calprotectin, S100A12, methylhistamine, bromotyrosine.

Answer 172

Detects clonality of B- and T-cell receptors.

Answer 173

Global intestinal dysbiosis.

Answer 174

Sensitivity: 80%, Specificity: 86%.

Answer 175

A single biomarker is unlikely to reliably differentiate GI disease etiologies.

Answer 176

Flotation + ELISA.

Answer 177

Giardia, Tritrichomonas, amoebae, larvae ## Footnote Direct smear is useful for identifying specific protozoa and larvae in fecal samples.

Answer 178

Centrifugal flotation ## Footnote This method is preferred for detecting roundworm, hookworm, whipworm, and protozoal cysts.

Answer 179

Sedimentation ## Footnote Sedimentation is effective for isolating heavier ova in fecal samples.

Answer 180

Nematode and lungworm larvae ## Footnote This technique helps in the recovery of larvae from fecal samples.

Answer 181

Flotation + ELISA ## Footnote This combination offers 83-95% sensitivity and 96-99% specificity.

Answer 182

Sedimentation (NaCl), PCR ## Footnote PCR is considered the gold standard for accurate diagnosis.

Answer 183

Smear, culture pouch, PCR ## Footnote Fresh diarrheic samples are preferred for accurate results.

Answer 184

IFA ## Footnote Immunofluorescent assay (IFA) provides high accuracy for Giardia detection.

Answer 185

IFA, ELISA, Ziehl-Neelsen stain, PCR ## Footnote Cryptosporidium infections can often be subclinical and may indicate immunosuppression.

Answer 186

Clinical significance unclear; some dogs improve with H. pylori-like therapy ## Footnote Further research is needed to clarify the role of Helicobacter in canine health.

Answer 187

Culture + PCR ## Footnote Correlation with clinical signs is essential for accurate diagnosis.

Answer 188

Usually self-limiting ## Footnote Most cases resolve without the need for treatment.

Answer 189

ELISA for Toxins A/B, culture, PCR ## Footnote Often associated with dysbiosis in the gastrointestinal tract.

Answer 190

ELISA, PCR for CPE, NetE/F/G ## Footnote Associated with acute hemorrhagic diarrhea syndrome (AHDS).

Answer 191

PAS+ histology, FISH ## Footnote Culture and sensitivity testing are essential due to breed predispositions.

Answer 192

93% sensitivity ## Footnote PCR has a lower sensitivity of 40% for detecting Neorickettsia.

Answer 193

PCR, ELISA ## Footnote ELISA shows varying sensitivity depending on the freshness of feces.

Answer 194

PCR on swabs, blood, urine, feces, CSF ## Footnote Serology is also used to confirm infection with a significant increase in titers.

Answer 195

90% sensitivity, 100% specificity ## Footnote Antibody testing and histopathology are also utilized for diagnosis.

Answer 196

Antibody ELISA, tissue culture, PCR, Western blot ## Footnote Monitoring response can be done with ELISA.

Answer 197

Cytology, culture, histopathology, PCR ## Footnote Prototheca is opportunistic, particularly in immunocompromised hosts.

Answer 198

Sensitivity: 74%, Specificity: 95% ## Footnote This index is based on seven bacterial taxa.

Answer 199

Anti-OmpC IgA, anti-calprotectin IgA, anti-gliadin IgA ## Footnote These panels have 80% sensitivity and 86% specificity but limited validation.

Answer 200

Clonality; not specific to lymphoma ## Footnote It should be used as an adjunct in diagnostic processes.

Answer 201

Differentiation between IBD and lymphoma ## Footnote This technique is not yet commercially available.

Answer 202

Reduced maxillary artery blood flow, temporary or permanent blindness, neurologic complications ## Footnote This is why preventive measures are important.

Answer 203

Overzealous manipulation such as excessive pharyngeal packing, tongue traction, elevation of lingual mucosa ## Footnote Management includes dexamethasone and gauze wrapping.

Answer 204

Supportive therapy with crystalloids, colloids, blood products, and topical irrigation ## Footnote Specific treatments include phenylephrine and lidocaine.

Answer 205

Oral pain, fever, lethargy, anorexia ## Footnote It can also be associated with ulcerative necrotic mucosa and exposed bone.

Answer 206

A condition seen in young cats, limited to gingiva around maxillary and mandibular cheek teeth ## Footnote It can be managed with gingivectomy and professional dental cleaning.

Answer 207

A benign, ulcerative, proliferative lesion in cats ## Footnote It is often caused by chronic trauma from the maxillary 4th premolar.

Answer 208

Feline calicivirus, herpesvirus, fungal organisms, immune-mediated mechanisms ## Footnote These factors contribute to the multifactorial etiology.

Answer 209

Nodular lesions with yellow/white speckles on the tongue, ulcers on lips ## Footnote It is often immune-mediated and can be triggered by ectoparasites or food hypersensitivity.

Answer 210

Pemphigus vulgaris, bullous pemphigoid, lupus erythematosus ## Footnote These conditions involve autoantibody production against epithelial structures.

Answer 211

Prednisone/prednisolone and methylprednisolone acetate ## Footnote These corticosteroids help manage symptoms and inflammation.

Answer 212

Immune-complex mediated; involves deposition of immune complexes in dermal capillaries ## Footnote It may also affect oral mucosa.

Answer 213

Severe skin and mucosal lesions, systemic signs ## Footnote It is a serious condition that can have significant morbidity.

Answer 214

False ## Footnote Antibiotics should be part of a comprehensive treatment plan, not the sole treatment.

Answer 215

A condition possibly immune-complex mediated, associated with infections and drug reactions ## Footnote Clinical signs may include oral ulcerations, cutaneous lesions, and systemic signs depending on severity.

Answer 216

Deposition of immune complexes in superficial dermal capillaries; occasionally affects oral mucosa.

Answer 217

A severe, often life-threatening drug reaction.

Answer 218

Depression, fever, anorexia, extensive mucocutaneous sloughing.

Answer 219

Immediate cessation of causative drug, supportive care including fluid therapy and wound management.

Answer 220

Occurs secondary to acute or chronic kidney disease; results from retention of uremic toxins.

Answer 221

Ammonia-like halitosis, painful oral ulcerations on labial and buccal mucosa, lateral tongue margins, lip commissures.

Answer 222

* Sublingual area * Palatoglossal folds * Soft palate * Palatine tonsils * Orbit floor * Pharyngeal wall * Across the hard palate between maxillary cheek teeth.

Answer 223

* Halitosis * Drooling * Retching * Gagging * Decreased appetite or drinking * Pawing at the face.

Answer 224

Advanced imaging: Ultrasound, CT, MRI.

Answer 225

Stabilize patient, manage non-cardiogenic pulmonary edema, conservative debridement once necrotic tissue is evident.

Answer 226

An autoimmune myopathy targeting type 2M muscle fibers in masticatory muscles.

Answer 227

Young adult to middle-aged, large-breed dogs.

Answer 228

* Painful swelling of the temporalis and masseter muscles * Exophthalmos * Trismus * Lethargy.

Answer 229

Type 2M Antibody Titer.

Answer 230

Dexamethasone followed by prednisone.

Answer 231

Leakage of saliva into submucosal or subcutaneous tissues due to rupture of a salivary duct or gland.

Answer 232

* Painful orbital swelling * Exophthalmos * Malaise. * Mucopurulent discharge.

Answer 233

Non-neoplastic woven bone proliferation of the mandible and temporomandibular joints.

Answer 234

Primarily young Bullmastiffs.

Answer 235

* Weight loss * Exercise intolerance * Snoring.

Answer 236

Supportive care, analgesia, and potentially phenobarbital.

Answer 237

Irregular cortical bone proliferation and thickening of the calvarium ## Footnote Primarily seen in young Bullmastiffs

Answer 238

* Painful skull swelling * Exophthalmos * Fever * Lymphadenopathy

Answer 239

Typically self-limiting

Answer 240

* Primary hyperparathyroidism * Nutritional or renal secondary hyperparathyroidism

Answer 241

Excess parathyroid hormone (PTH) results in bone resorption and fibrous tissue replacement

Answer 242

* Facial swelling * Loose teeth * Rubbery jaw * Oral mucosal ulceration * Tooth mobility

Answer 243

* Marked osteopenia * Loss of trabecular bone * Loss of lamina dura

Answer 244

May be reversed by dietary correction

Answer 245

Virally induced benign oral tumor in dogs <1 year old ## Footnote Caused by canine oral papillomavirus

Answer 246

* Whitish, cauliflower-like masses on mucous membranes * Typically self-resolving within 1–3 months

Answer 247

Benign tumor common in dogs, rare in cats, located in gingiva near incisors, canines, or premolars

Answer 248

* Ossifying: Contains bone-like material * Fibromatous: Lacks ossified components

Answer 249

* Surgical excision * Extraction of affected teeth * Curettage of the alveolus

Answer 250

Epithelial odontogenic tumor that is locally invasive and causes bony lysis

Answer 251

* Canine acanthomatous ameloblastoma * Conventional ameloblastoma

Answer 252

Not a true neoplasm, but a hamartoma (malformation of normal dental tissue)

Answer 253

* Compound odontoma: Organized, tooth-like structures * Complex odontoma: Disorganized mix of dental tissues

Answer 254

Malignant Melanoma

Answer 255

* Pigmented or non-pigmented * Rapid growth * Early bone invasion * Ulceration * High metastatic rate

Answer 256

Squamous Cell Carcinoma (SCC)

Answer 257

* Gingiva * Lips * Cheeks * Tongue * Sublingual mucosa

Answer 258

Second most common oral tumor in cats, third in dogs, often appears as an ulcerated mass

Answer 259

Less likely to metastasize compared to appendicular osteosarcoma

Answer 260

* T (Tumor) – Size and extent of the primary lesion * N (Node) – Regional lymph node involvement * M (Metastasis) – Presence of distant metastasis

Answer 261

CT scan for detailed assessment of primary tumors and metastasis

Answer 262

10% buffered formalin, 1 part tissue to 10 parts fixative

Answer 263

* Parotid * Mandibular * Medial and lateral retropharyngeal

Answer 264

* Tumor biology and behavior * Surgical risks and complications * Expected quality of life and survival time

Answer 265

* Neurologic issues * Muscular problems * Structural abnormalities * Inflammatory conditions

Answer 266

* Esophagitis * Esophageal strictures * Sliding hiatal hernia

Answer 267

* Regurgitation * Gagging * Dysphagia/swallowing impairment * Aspiration pneumonia (in severe cases)

Answer 268

Control swallowing via 31 pairs of striated muscles and 5 cranial nerves ## Footnote CN V, VII, IX, X, XI, and XII play critical roles.

Answer 269

Dogs have entirely striated musculature; cats have smooth muscle in the distal third of the esophagus.

Answer 270

* Oral-Preparatory Phase (Voluntary) * Oral Phase (Voluntary) * Pharyngeal Phase (Involuntary) * Esophageal Phase (Involuntary)

Answer 271

When the bolus reaches the tonsils ## Footnote This phase involves several key events such as elevation of the soft palate and vocal fold closure.

Answer 272

Regurgitation ## Footnote It must be differentiated from vomiting or oropharyngeal dysfunction.

Answer 273

* Central Nervous System Disease * Infectious/Inflammatory * Metabolic disorders * Myopathic/Neuropathic issues * Structural Abnormalities

Answer 274

* Repetitive swallowing attempts * Gagging, retching, or coughing * Nasal regurgitation * Dropped food from mouth

Answer 275

* Cleft palate * Cricopharyngeal dysfunction * Muscular dystrophy * Pharyngeal weakness

Answer 276

Videofluoroscopic Swallow Study (VFSS) ## Footnote It uses contrast medium to assess swallowing events.

Answer 277

* Laryngoscopy * Pharyngoscopy * Esophagoscopy * Electromyography (EMG) * Esophageal Manometry * EndoFLIP * Esophageal pH and Impedance Testing

Answer 278

A catheter-free method that allows normal activity and diet while monitoring pH levels.

Answer 279

Both acid and non-acid reflux, providing a more comprehensive assessment.

Answer 280

* Foreign bodies * Obstructive masses (e.g., polyps, lymphoma, SCC) * Infections * Extension of rhinitis, stomatitis, or sinusitis * Chemical/caustic injuries

Answer 281

* Dysphonia * Snoring * Gagging * Coughing * Swallowing impairment * Hyperthermia * Hypersalivation

Answer 282

* Analgesics * Topical and systemic antimicrobials * Hydration * Nutritional support

Answer 283

A disruption of coordinated bolus transport from the oropharynx to the esophagus.

Answer 284

* Morphologic: Obstruction, cleft palate, cricopharyngeal achalasia * Inflammatory: Infections, myositis * Neoplastic * Neuromuscular: Myasthenia gravis, muscular dystrophy, polymyositis, hypothyroidism, cranial neuropathies

Answer 285

* Dysphonia * Gagging * Repeated attempts to swallow a single bolus * Swallowing impairment * Coughing

Answer 286

* Thoracic and cervical radiographs * Swallow study (VFSS) * Laboratory workup: CK activity, acetylcholine receptor antibody titer, thyroid testing, electrodiagnostics, biopsy

Answer 287

A congenital or acquired neuromuscular disorder involving the upper esophageal sphincter.

Answer 288

* Cricopharyngeal Achalasia * Cricopharyngeal Asynchrony

Answer 289

* Repeated swallowing attempts * Gagging and retching * Nasal regurgitation * Worsening signs around weaning * Aspiration pneumonia

Answer 290

Videofluoroscopic Swallow Study (VFSS)

Answer 291

* Supportive care with small, frequent, fat-restricted canned meals

Answer 292

Proton pump inhibitors (PPIs) like Omeprazole.

Answer 293

* Anorexia * Odynophagia * Regurgitation * Hypersalivation * Swallowing impairment * Coughing (if aspiration pneumonia is present)

Answer 294

* Gastroesophageal reflux during anesthesia * Chemical injuries * Pill-induced esophagitis * Esophageal foreign bodies * Post-surgical trauma

Answer 295

* Balloon dilation * Bouginage * Intraluminal stenting * Tramcinolone injection * Topical mitomycin C

Answer 296

* Acute regurgitation * Swallowing impairment * Odynophagia * Gagging * Hypersalivation

Answer 297

Confirms diagnosis, assesses mucosal damage, guides retrieval.

Answer 298

Removed via rigid endoscopy using: * Sigmoidoscope * Grasping forceps.

Answer 299

With flexible endoscope using: * Snare * Basket forceps or may be pushed into stomach for surgical removal via gastrotomy.

Answer 300

Fast 24–48 hours for mucosal healing; consider PEG tube placement if severe ulceration/necrosis.

Answer 301

Persistent Right Aortic Arch (PRAA).

Answer 302

Compression occurs due to: * Aorta (right) * Ligamentum arteriosum (left dorsolateral) * Pulmonary trunk (left) * Heart base (ventral).

Answer 303

Signs usually present at 4–6 weeks: * Regurgitation of solid foods * Failure to thrive despite normal appetite * Weight loss * Moist cough, dyspnea.

Answer 304

Surgical ligation and transection of the ligamentum arteriosum.

Answer 305

Esophageal tumors are rare, accounting for <0.5% of all cancers.

Answer 306

Common tumor types include: * Fibrosarcoma * Osteosarcoma * Leiomyoma * Leiomyosarcoma * Adenocarcinoma.

Answer 307

Signs include: * Regurgitation * Swallowing impairment * Odynophagia * Ptyalism (hypersalivation) * Weight loss.

Answer 308

Treatment options include: * Chemotherapy * Surgery * Radiation therapy.

Answer 309

Circumscribed outpouchings of the esophageal wall that interfere with normal motility.

Answer 310

Acquired diverticula are subdivided into: * Pulsion diverticula * Traction diverticula.

Answer 311

Common signs include: * Regurgitation * Odynophagia * Retching.

Answer 312

Diverticulectomy (Diverticulotomy).

Answer 313

An abnormal communication between the esophagus and adjacent structures.

Answer 314

Retained esophageal foreign bodies.

Answer 315

Primarily respiratory signs: * Coughing * Dyspnea.

Answer 316

Esophagram is the definitive diagnostic test.

Answer 317

Characterized by focal or diffuse dilation of the esophagus and concurrent esophageal dysmotility.

Answer 318

Predisposed breeds include: * Irish Setters * Great Danes * German Shepherds.

Answer 319

Upright feedings, small frequent meals.

Answer 320

Sildenafil.

Answer 321

Survey thoracic and cervical radiographs.

Answer 322

Acetylcholine receptor antibody titer; Tensilon response; ± EMG ## Footnote Tensilon (edrophonium) response is less commonly used.

Answer 323

Mydriasis, bradycardia, fecal/urinary retention ## Footnote These signs are indicative of an autonomic nervous system disorder.

Answer 324

Chelation therapy with Calcium EDTA ## Footnote Chelation therapy helps remove lead from the body.

Answer 325

Protrusion of abdominal contents through the esophageal hiatus of the diaphragm ## Footnote Usually involves part of the stomach entering the thoracic cavity.

Answer 326

* Type I (Sliding) * Type II (Paraesophageal) * Type III (Combination) * Type IV (Rare) ## Footnote Type I is the most common in both dogs and cats.

Answer 327

* Regurgitation * Hypersalivation * Odynophagia * Anorexia * Lip-smacking * Panting * Hard swallowing * Nocturnal episodes ## Footnote These signs arise from the retrograde movement of gastric contents into the esophagus.

Answer 328

* Omeprazole * Sucralfate * Prokinetics (Cisapride or Metoclopramide) * Diet modifications ## Footnote Omeprazole is a proton pump inhibitor that suppresses acid production.

Answer 329

Videofluoroscopic swallow study ## Footnote It assesses esophageal motility and can identify intermittent herniation.

Answer 330

Pyridostigmine 1–3 mg/kg PO q12h ## Footnote This medication enhances neuromuscular transmission.

Answer 331

Some puppies improve over time with diligent supportive care ## Footnote Prognosis can vary based on individual cases.

Answer 332

* Hiatal hernia * General anesthesia * Chronic vomiting * Gastric atony * Pyloric outflow obstruction ## Footnote These factors can contribute to the loss of integrity of the gastroesophageal barrier.

Answer 333

To prevent the retrograde movement of gastric contents into the esophagus ## Footnote Proper LES function is crucial for preventing gastroesophageal reflux.

Answer 334

* Sucralfate * Omeprazole * ± Cisapride in cats ## Footnote These medications help protect the esophageal mucosa and reduce acid production.

Answer 335

Surgery, chemotherapy, or radiation based on type ## Footnote The treatment approach varies depending on the specific type of neoplasia.

Answer 336

To assess the degree of esophageal dilation and signs of aspiration pneumonia ## Footnote Regular monitoring is essential for managing the condition.

Answer 337

* Regurgitation (delayed) * Odynophagia * Salivation ## Footnote Odynophagia refers to pain during swallowing, which can indicate esophageal inflammation or other disorders.

Answer 338

* Cleft palate * Cricopharyngeal dysfunction * Muscular dystrophy ## Footnote These conditions can lead to significant swallowing difficulties in pediatric patients.

Answer 339

* Cervical/thoracic rads * VFSS (Video Fluoroscopic Swallowing Study) * Endoscopy ## Footnote VFSS is particularly useful for evaluating the swallowing process.

Answer 340

* Laryngoscopy * Pharyngoscopy * Esophagoscopy * EMG/NCV * Muscle/nerve biopsy * Esophageal manometry * EndoFLIP * pH/impedance testing ## Footnote These tests provide detailed information about the structure and function of the esophagus and related structures.

Answer 341

* Achalasia: Failure of the lower esophageal sphincter to relax * Asynchrony: Discoordination of swallowing ## Footnote Both conditions can lead to swallowing difficulties but have different underlying mechanisms.

Answer 342

* Endoscopic removal * Surgical removal * Treat mucosa as for esophagitis ## Footnote Prompt removal is crucial to prevent further complications such as perforation.

Answer 343

* Regurgitation * Vomiting * Salivation * Aspiration ## Footnote Hiatal hernias are more prevalent in brachycephalic breeds.

Answer 344

* Hiatal hernia * Anesthesia * Vomiting * Gastric atony * Pyloric obstruction ## Footnote GER can result from a combination of anatomical and physiological factors.

Answer 345

* PPI * Sucralfate * Cisapride * Dietary change * Fundoplication in refractory cases ## Footnote Treatment aims to reduce acid exposure and improve esophageal motility.

Answer 346

A diverse community of bacteria, archaea, viruses, fungi, and protozoa, along with their collective genomes.

Answer 347

* Host metabolism * Energy balance * Immune system development * Gut epithelial health * Immune homeostasis

Answer 348

The symbiotic microbial community residing in the intestines.

Answer 349

By producing short-chain fatty acids (SCFAs) and regulating host immunity.

Answer 350

* Energy sources for the host * Modulation of immune responses

Answer 351

* Disruption of microbial balance * Pathogenic infections * Chronic GI conditions

Answer 352

* Vascular endothelium * Epithelial cells * Mucus layer * Digestive secretions * Immune molecules * Cytokines * Antimicrobial peptides

Answer 353

* Enterocytes * Goblet cells * Enteroendocrine cells * Intraepithelial lymphocytes * Dendritic cells

Answer 354

Secrete mucin 2, contributing to the mucus barrier.

Answer 355

* α-defensins * β-defensins * Reg3 proteins * Lysozymes

Answer 356

Facilitates immune exclusion by binding to bacteria and preventing mucosal adherence.

Answer 357

* Firmicutes * Fusobacteria * Bacteroidetes * Proteobacteria * Actinobacteria

Answer 358

Identifies bacteria phylogenetically and reveals bacterial diversity.

Answer 359

* Broad shifts in microbial composition * Reduced species diversity * Altered relative abundances of specific bacterial taxa

Answer 360

* Gastrointestinal disease * Anatomic and functional abnormalities * Environmental and pharmacologic influences * Host factors

Answer 361

To normalize microbiota composition and function, ideally targeting underlying etiology.

Answer 362

* Psyllium * Fructo-oligosaccharides (FOS) * Mannan-oligosaccharides * Pectin

Answer 363

* Carbohydrate metabolism: 13% * Protein metabolism: 9% * Amino acid metabolism: 7% * Cell wall synthesis: 8% * Vitamin and cofactor synthesis: 6% * Nucleic acid synthesis: 7%

Answer 364

* Impaired neurotransmission * Altered secretion, motility, and pain modulation * Disruption of mucosal homeostasis

Answer 365

Essential for lipid digestion, mucosal immunity, and barrier maintenance.

Answer 366

* Short-chain fatty acids (SCFAs) * Ammonia * Lactate

Answer 367

Alterations in the gut microbiota associated with acute and chronic GI disease.

Answer 368

Glycerophospholipids, sphingolipids ## Footnote These lipids play crucial roles in cellular structure and signaling.

Answer 369

Small sample size, no statistical link to clinical/histologic improvement ## Footnote This suggests the findings may not be generalizable.

Answer 370

True ## Footnote This indicates that ARE may not be a common cause of chronic diarrhea.

Answer 371

* Empiric use often lacks diagnostic confirmation * Relapses common after discontinuation * Can cause dysbiosis and antimicrobial resistance ## Footnote These concerns highlight the need for careful antibiotic stewardship.

Answer 372

* Oral capsules * Rectal catheter * Endoscopy ## Footnote These methods vary in their invasiveness and practicality.

Answer 373

FMT + standard care → faster resolution, shorter hospitalization ## Footnote This suggests FMT may enhance recovery in specific cases.

Answer 374

Confer health benefits ## Footnote Probiotics can improve gut health and immune function.

Answer 375

* Lactobacillus spp. * Bifidobacterium spp. * Enterococcus faecium SF68 * Saccharomyces boulardii ## Footnote Each strain has unique effects and benefits.

Answer 376

* Enhance tight junction protein expression * Increase mucin and defensin secretion * Produce SCFAs * Stimulate secretory IgA (sIgA) * Modulate immune response ## Footnote These mechanisms contribute to gut health and immune function.

Answer 377

* Higher fecal IgA * Enhanced vaccine-induced IgA and IgG responses ## Footnote This indicates a potential role for probiotics in enhancing vaccine efficacy.

Answer 378

Reduced time to resolution from 2.2 to 1.3 days ## Footnote This suggests probiotics can accelerate recovery from diarrhea.

Answer 379

* Flatulence * Borborygmi ## Footnote These side effects are generally rare and transient.

Answer 380

Selectively fermented ingredients that promote growth of beneficial bacteria ## Footnote Prebiotics support gut health by enhancing microbial diversity.

Answer 381

Restore functional microbiome in patients with chronic dysbiosis ## Footnote FMT is considered in cases where conventional treatments have failed.

Answer 382

* Hydrolyzed protein diets * Novel/select protein diets ## Footnote These diets minimize antigen exposure and support intestinal healing.

Answer 383

The stomach functions as a food reservoir, facilitates mechanical breakdown of ingested food, and initiates enzymatic digestion through gastric secretions.

Answer 384

The gastro-mucosal barrier protects the underlying mucosa from gastric acid and proteolytic enzymes, which are non-discriminatory between ingesta and host tissues.

Answer 385

* Bicarbonate-rich, double-thickness mucus layer * Single epithelial cell layer with high resistance to acid * Locally produced prostaglandins that regulate mucosal blood flow, stimulate mucus and bicarbonate secretion, and promote epithelial repair * Robust mucosal blood supply and local immune defenses

Answer 386

The gastric muscularis has an inner circular and outer longitudinal smooth muscle layer that supports receptive relaxation, allowing for accommodation of large food volumes.

Answer 387

* Fundus and Body (acid-secreting regions) * Pyloric region (non-acid-secreting)

Answer 388

* Parietal cells (secrete HCl and intrinsic factor) * Chief cells (secrete pepsinogen A) * Enterochromaffin-like (ECL) cells (release histamine) * Mucous neck cells (produce mucus) * Ghrelin-secreting cells

Answer 389

* Acetylcholine * Gastrin * Histamine

Answer 390

* Somatostatin * Prostaglandins * Vasoactive intestinal peptide (VIP)

Answer 391

* Protein digestion * Absorption of micronutrients (iron, calcium, vitamin B12) * Inactivation of ingested pathogens * Reducing antigenic load delivered to intestines

Answer 392

The WSAVA classification system incorporates macroscopic and microscopic assessments and classifies gastritis based on duration: acute (<2 weeks) or chronic (>2 weeks).

Answer 393

* Short fasting period (<12 hrs) * Gradual reintroduction of water and low-fat, low-fiber, high-moisture diets

Answer 394

* Maropitant * Ondansetron * Dolasetron * Metoclopramide * Chlorpromazine

Answer 395

* Diet * pH * Mucus layer * Host health * Drug administration

Answer 396

Prostaglandins regulate mucosal blood flow, stimulate mucus and bicarbonate secretion, and promote epithelial repair.

Answer 397

For: * Hematemesis * Melena * Gastric erosion or ulceration suspicion ## Footnote These conditions warrant the use of gastric acid suppressants like H2-receptor antagonists and proton pump inhibitors.

Answer 398

Pyrantel pamoate: 15 mg/kg PO, repeat in 2–3 weeks ## Footnote This treatment is used for suspected Physaloptera spp. infections.

Answer 399

Fenbendazole: 50 mg/kg PO q24h × 3 days ## Footnote This treatment is specifically for Ollulanus tricuspis.

Answer 400

* Persistent or intermittent vomiting lasting >2 weeks * Delayed gastric emptying * Retention of food in the stomach ## Footnote These signs can indicate chronic gastritis, but diagnosis requires further evaluation.

Answer 401

Lymphoplasmacytic gastritis ## Footnote This type can be present in healthy animals without clinical disease.

Answer 402

* Rottweilers * German Shepherd Dogs ## Footnote These breeds are predisposed to this condition, which often affects young dogs.

Answer 403

* Rugal fold thickening * Ulceration * Peripheral eosinophilia ## Footnote Eosinophilic gastritis can be associated with dietary triggers and dermatologic changes.

Answer 404

Often guarded due to late-stage diagnosis ## Footnote FGESF is more common than eosinophilic gastritis in cats, particularly in Ragdolls.

Answer 405

Characterized by thinning of the gastric mucosa with minimal inflammation ## Footnote This condition leads to decreased acid secretion and is rarely reported in dogs.

Answer 406

* Vomiting * Weight loss * Abdominal pain * Hematemesis ## Footnote Gastric carcinoma is most common in middle-aged to older male dogs.

Answer 407

* Serology (ELISA, Western blot) * Fecal PCR * Rapid urease test * Histopathology * Culture ## Footnote These tools help diagnose Helicobacter spp. infections in dogs and cats.

Answer 408

Triple Therapy: * Amoxicillin: 20 mg/kg PO q8–12h * Metronidazole: 20 mg/kg PO q8–12h * Omeprazole: 1 mg/kg PO q12–24h ## Footnote Treatment typically lasts for 2–3 weeks.

Answer 409

* Vomiting * Diarrhea * Weight loss * Abdominal mass ## Footnote This oomycete infection is more common in young, large-breed dogs.

Answer 410

Surgical resection of hypertrophied mucosa ## Footnote This is the treatment of choice for this condition.

Answer 411

Many infected animals are asymptomatic; some show gastritis or gastric lymphoma ## Footnote The exact pathogenic role of Helicobacter spp. remains uncertain.

Answer 412

May mimic gastric lymphoma ## Footnote Severe infiltrates can complicate the diagnosis, necessitating immunophenotyping.

Answer 413

Gastric neoplasia ## Footnote This refers to the anatomical aspect of the pyloric antrum in the stomach where neoplastic changes may occur.

Answer 414

* Vomiting * Dysrexia * Weight loss * Abdominal pain * Ptyalism * Diarrhea * Hematemesis * Melena ## Footnote These signs indicate potential gastric issues requiring further investigation.

Answer 415

Generally poor, with <3 months survival post-diagnosis ## Footnote The prognosis is quite dire, reflecting the advanced nature of the disease at diagnosis.

Answer 416

50–90% ## Footnote This indicates a high likelihood of metastasis upon initial diagnosis.

Answer 417

* Gastric lymph nodes * Esophagus * Duodenum * Liver * Spleen * Omentum * Adrenal glands * Lungs ## Footnote These sites are often involved when gastric neoplasia spreads.

Answer 418

~6 months ## Footnote This reflects the potential benefit of combined treatment modalities.

Answer 419

Feline gastric lymphoma ## Footnote This type of neoplasm is particularly prevalent among feline patients.

Answer 420

Often mild and nonspecific; anemia and neutrophilia present in ~50% of cases ## Footnote These findings can be indicative of underlying lymphoma but are not definitive.

Answer 421

108 days ## Footnote This duration reflects the effectiveness of treatment in achieving remission.

Answer 422

171 days ## Footnote This metric indicates the expected survival outcome following diagnosis and treatment.

Answer 423

CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone) ## Footnote This regimen is a standard treatment protocol for managing lymphoma in cats.

Answer 424

Ruling out systemic diseases ## Footnote This step is crucial due to the nonspecific nature of vomiting as a clinical sign.

Answer 425

* Older age * Poor body condition * Elevated C-reactive protein (CRP) * Low serum folate ## Footnote These indicators warrant further investigation for potential neoplastic processes.

Answer 426

* Fecal flotation (centrifugal) * Fecal antigen testing * Empirical anthelmintic therapy ## Footnote These tests are less invasive and can help rule out parasitic causes.

Answer 427

GI biopsies ## Footnote Biopsies are essential for definitive diagnosis if initial treatments do not resolve symptoms.

Answer 428

Dietary management ## Footnote This step aims to minimize antigenic stimulation and promote gastric motility.

Answer 429

* High-moisture, low-residue, low-fat diets * Limited-ingredient diets (single novel protein and carbohydrate) * Hydrolyzed protein diets ## Footnote These diets can help reduce irritation to the gastric lining.

Answer 430

* GI neoplasia * Ulcerogenic drugs (NSAIDs) * Hepatic failure ## Footnote These factors are significant contributors to gastric ulceration.

Answer 431

Inhibition of prostaglandin synthesis ## Footnote This leads to reduced mucosal blood flow and impaired epithelial repair.

Answer 432

* Normocytic, normochromic anemia * Microcytic, hypochromic anemia with chronic GI blood loss * Elevated BUN:Creatinine ratio (>27:1) ## Footnote These findings help assess the extent of bleeding and underlying issues.

Answer 433

Upper GI endoscopy ## Footnote This procedure allows for direct visualization and biopsy of lesions.

Answer 434

* Prolonged hospitalization * High-intensity exercise * Post-surgical stress ## Footnote Stress can significantly impact the gastrointestinal tract and lead to ulceration.

Answer 435

* Hepatic failure * Hypoadrenocorticism * GDV * Sepsis * Shock ## Footnote These conditions can compromise the gastric mucosa and lead to ulceration.

Answer 436

Can identify mural lesions or defects, peritoneal fluid, or free gas. ## Footnote Free gas is suggestive of perforation.

Answer 437

Poor visibility due to gas or stomach position, may miss lesions.

Answer 438

CT: 67%, Ultrasound: 65%.

Answer 439

Fecal flotation, ACTH stimulation test, serum gastrin concentration, bile acid tolerance testing, infectious disease panels, abdominal CT angiogram.

Answer 440

GI neoplasia, ulcerogenic drugs (NSAIDs, toceranib, chemotherapeutics), hepatic failure.

Answer 441

Portal hypertension, gastric antral vascular ectasia, hypergastrinemia, altered mucosal barrier, coagulopathy.

Answer 442

NSAIDs, high-dose corticosteroids, toceranib, heavy metal toxicosis.

Answer 443

Can detect subclinical bleeding, but low sensitivity/specificity.

Answer 444

Proton Pump Inhibitors (PPIs).

Answer 445

Binds to ulcerated mucosa to form a protective barrier.

Answer 446

Low-fat, high-moisture diet, multiple small meals per day.

Answer 447

Nuclear scintigraphy, BIPS, wireless motility capsules, abdominal ultrasound.

Answer 448

Nuclear scintigraphy.

Answer 449

Age, body size, meal composition, stress, restraint, sedation.

Answer 450

Rule out mechanical obstruction.

Answer 451

* Neurogenic/Neuropathic: Trauma, post-op stress, spinal surgery, dysautonomia * Inflammatory/Infiltrative: GI ulcers, IBD, parasites, food allergies, neoplasia * Metabolic/Endocrine: Hypokalemia, hypocalcemia, acidosis, DM, HAC, liver disease, hypothyroidism, hypergastrinemia * Systemic Illness: Immune-mediated diseases, peritonitis, abdominal neoplasia * Medications: Opioids, anticholinergics, vincristine

Answer 452

* Distension * Eructation/regurgitation * Palpable pain * Mass effect if obstruction is present

Answer 453

Non-selective 5-HT4 receptor agonist that stimulates cholinergic neurons in the myenteric plexus.

Answer 454

* QT prolongation * Diarrhea

Answer 455

Dopamine D2 receptor antagonist and 5-HT3 antagonist at high doses.

Answer 456

Motilin receptor agonist that enhances gastric emptying.

Answer 457

α2-adrenergic receptor antagonist and 5-HT1/5-HT2 antagonist.

Answer 458

They enhance gastric emptying and intestinal transit.

Answer 459

To activate type-2 chloride channels, increasing luminal fluid secretion.

Answer 460

* Improved GI mucosal blood flow * Decreased bacterial translocation * Stimulation of motility * Promotion of mucosal healing

Answer 461

* Breeds: Great Dane, Standard Poodle, Irish Setter, Weimaraner, Rottweiler, German Shepherd, Retrievers * Feeding habits: Rapid eating, dry kibble only, elevated feeding, large volume meals * Other: Thin BCS, older age, nervous temperament, family history, prior splenectomy

Answer 462

* IV fluid resuscitation * Gastric decompression * Timely surgical intervention

Answer 463

Hypokalemia ## Footnote Hypokalemia refers to low potassium levels in the blood, which can affect muscle function and heart rhythm.

Answer 464

↑ PT/aPTT, Thrombocytopenia, ↑ D-dimers, fibrin degradation products ## Footnote These findings indicate a coagulopathy or disseminated intravascular coagulation (DIC) often present in critical conditions.

Answer 465

* IV fluid resuscitation * Gastric decompression * Surgical repositioning of the stomach * Resection of non-viable tissue * Gastropexy to prevent recurrence ## Footnote Prompt intervention is critical to improve outcomes in GDV cases.

Answer 466

Percutaneous trocharization using a 16–18 gauge IV catheter ## Footnote This method is preferred due to its effectiveness and lower risk of complications compared to oro-gastric intubation.

Answer 467

* Methadone: 0.2–0.5 mg/kg IV * Hydromorphone: 0.05–0.2 mg/kg IV * Fentanyl: 3–5 µg/kg IV * Midazolam: 0.1–0.5 mg/kg IV (as adjunct) ## Footnote Pure µ-opioids are preferred for analgesia during these procedures.

Answer 468

* Vital signs * Blood pressure * Electrolytes * Acid-base status * Lactate levels ## Footnote Frequent monitoring is essential to assess the patient's stability and response to treatment.

Answer 469

* Reposition the stomach * Assess and resect devitalized tissue * Permanent gastropexy ## Footnote Surgical goals focus on restoring normal anatomy and preventing future episodes.

Answer 470

* Pain and ensure adequate analgesia * Electrolyte imbalances * Arrhythmias * GI ulceration * Systemic inflammatory response syndrome (SIRS) * Acute kidney injury (AKI) * Disseminated intravascular coagulation (DIC) * Septic peritonitis ## Footnote Careful monitoring can help identify and manage complications effectively.

Answer 471

To assess prognosis and treatment response, especially in dogs with initially elevated lactate ## Footnote Elevated lactate levels can indicate tissue hypoxia and help guide further management.

Answer 472

* Incisional * Belt-loop * Circumcostal * Laparoscopic-assisted gastropexy ## Footnote The choice of technique may depend on surgeon preference and available resources.

Answer 473

* Smaller, more frequent meals * Avoid elevated feeding * Use slow-feeder bowls * Feed moist or wet food if possible ## Footnote These recommendations help prevent complications related to feeding behavior after surgery.

Answer 474

Gastropexy does not eliminate all risk; ~5–11% may have recurrent gastric dilation ## Footnote Nutritional management remains crucial for long-term prevention of GDV recurrence.

Answer 475

Nutrient absorption and host defense/immune function

Answer 476

* Mucosa * Submucosa * Muscularis * Serosa

Answer 477

* Rugae (3×) * Villi (10×) * Microvilli (20×)

Answer 478

Villus >> Crypt depth

Answer 479

L2 (opposite the aorta and diaphragmatic crura)

Answer 480

Single layer of mesothelial cells

Answer 481

* Secretion * Absorption * Barrier function

Answer 482

* Peyer's patches * Diffuse lymphoid tissue * Mesenteric lymph nodes * Epithelium-associated immune cells

Answer 483

* Tight junctions * Mucus layer * Secretory IgA

Answer 484

* Cholecystokinin (CCK) * Secretin * GIP * Motilin * GLP-1

Answer 485

Enteric Nervous System (ENS)

Answer 486

Migrating motor complex (MMC) cycles

Answer 487

Acid denaturation and pepsin activation in the stomach

Answer 488

Pancreatic alpha-amylase

Answer 489

Sodium-dependent active transport

Answer 490

Emulsifies dietary fats into micelles

Answer 491

* Passive diffusion * Facilitated diffusion * Sodium-dependent active transport * Carrier-mediated transport * Receptor-mediated endocytosis

Answer 492

It must be released from dietary protein by gastric acid and pepsin

Answer 493

* Peristalsis * Gastric and pancreatic secretions * Proteolysis * Innate immunity

Answer 494

* Neutrophils * Macrophages

Answer 495

Exclude toxins and pathogens, maintain immune tolerance to commensals and harmless antigens ## Footnote This includes the ability to differentiate between harmful and harmless substances.

Answer 496

* Tight junctions (epithelial barrier integrity) * Commensal microbiota * Defensins and antimicrobial peptides * Pattern recognition receptors (PRRs) * Immune cell populations involved: Neutrophils, Macrophages, Dendritic cells, Natural killer cells, Mast cells, Intraepithelial lymphocytes (IELs), Lymphoepithelial cells ## Footnote These components work together to provide immediate defense against infections.

Answer 497

Pathogen-associated molecular patterns (PAMPs) and microbe-associated molecular patterns (MAMPs) ## Footnote PRRs are crucial for initiating immune responses.

Answer 498

Toll-like receptors (TLRs), NOD1/NOD2 (nucleotide-binding oligomerization domain-containing proteins) ## Footnote These receptors play a key role in immune recognition.

Answer 499

Recognizes lipopeptides from Gram-positive bacteria ## Footnote TLRs are essential for detecting specific bacterial components.

Answer 500

Promote B-cell activation, enhance response via cytokines and co-stimulatory molecules ## Footnote This activation is crucial for adaptive immunity.

Answer 501

Suppress overactivation and maintain tolerance ## Footnote Treg cells are essential for preventing autoimmune responses.

Answer 502

Danger signals such as cytokines, chemokines, cellular damage ## Footnote These signals indicate a potential threat and activate the immune response.

Answer 503

* Host Defense * Immune System Development * Metabolic Functions * Epithelial Integrity ## Footnote The microbiome plays a critical role in maintaining gastrointestinal health.

Answer 504

Excessive loss of serum proteins (e.g., albumin, globulin) into the intestinal lumen ## Footnote PLE is a syndrome rather than a specific diagnosis.

Answer 505

* Impaired fermentation of SCFAs * Barrier dysfunction * Loss of colonization resistance * Immune modulation failure ## Footnote Dysbiosis can lead to significant gastrointestinal and immune issues.

Answer 506

↓ Secondary bile acids → ↑ inflammation, impaired mucosal defense, ↑ susceptibility to barrier injury and microbial invasion ## Footnote Bile acids play a critical role in maintaining gut health.

Answer 507

* Increased enterocyte loss * Decreased enterocyte production ## Footnote This can lead to malabsorption and is associated with various conditions.

Answer 508

Commensals may be misidentified as pathogens ## Footnote This misidentification can exacerbate inflammatory responses.

Answer 509

May indicate GI blood loss ## Footnote It is important to assess platelet levels in cases of suspected internal bleeding.

Answer 510

* Fecal flotation * Sedimentation * Direct smears * Wet mounts * Targeted PCR * ELISA/IFA testing ## Footnote Targeted tests are critical to rule out parasites and infectious agents.

Answer 511

* Evaluating acute and chronic small intestinal disease * Detecting wall thickness and layering abnormalities * Identifying ulceration, mucosal lesions, neoplasia, ileus, foreign bodies, effusion, and intussusception ## Footnote Ultrasound is a non-invasive imaging technique that provides valuable information about internal structures.

Answer 512

* More accurate than ultrasound in diagnosing mechanical obstructions * Can differentiate surgical vs. non-surgical acute abdomen conditions ## Footnote CT scans provide detailed images that can guide treatment decisions.

Answer 513

Often decreased in ileal damage, mucosal inflammation, or bacterial competition (dysbiosis) ## Footnote Cobalamin is essential for various metabolic processes, and its deficiency is clinically significant.

Answer 514

Chronic enteropathies ## Footnote These markers help in assessing inflammatory conditions in the gastrointestinal tract.

Answer 515

* German Shepherd, Beagle: Antibiotic-responsive diarrhea * Rottweiler: Eosinophilic enteropathy * Soft-Coated Wheaten Terrier: Familial PLE/PLN * Domestic Shorthair (DSH), Siamese: Chronic enteropathy * Ragdoll: Feline GI eosinophilic sclerosing fibroplasia ## Footnote Recognizing breed predispositions aids in diagnosis and management.

Answer 516

Score > 2 indicates dysbiosis; score < 0 indicates normal microbiota ## Footnote This index helps assess the balance of intestinal microbiota and its clinical implications.

Answer 517

Failure to thrive, anemia, neutropenia ## Footnote Genetic mutations can lead to significant health issues in specific breeds.

Answer 518

True ## Footnote This dietary restriction is necessary to ensure accurate test results.

Answer 519

Suspected gastrinoma and immunoproliferative enteropathy in Basenjis. ## Footnote Hypergastrinemia can also occur due to non-intestinal disorders and concurrent antacid therapy.

Answer 520

7 days. ## Footnote This is to normalize gastrin levels.

Answer 521

To assess mucosal integrity via non-carrier-mediated absorption of test markers. ## Footnote Common tests include lactulose-to-mannitol ratio and cellobiose-to-mannitol ratio.

Answer 522

Iohexol. ## Footnote Further validation is required before clinical adoption.

Answer 523

To differentiate inflammatory vs. neoplastic lymphoid infiltrates. ## Footnote Most often used in a stepwise approach in feline chronic enteropathy.

Answer 524

Increased villus granularity, hyperemia, erosions, ulcers, bleeding, masses. ## Footnote Milky-white villus tips suggest lymphangiectasia.

Answer 525

Mast cells, Helicobacter spp., Clostridial spores, yeast, Cryptosporidium spp., Campylobacter spp.

Answer 526

Signs persist for 14–21 days and may be associated with chronic intestinal disorders, secretory diarrhea, motility disorders, or extraintestinal disease.

Answer 527

Endoscopic, surgical, or laparoscopic biopsies if signs are severe or progressive.

Answer 528

5–10% of cases have no GI history or clinical signs. More commonly presents as chronic relapsing or progressive GI signs and clinical signs associated with hypoalbuminemia (e.g., edema, effusion).

Answer 529

Fecal testing ± anti-parasitic trial, imaging (thoracic radiographs, abdominal ultrasound ± FNA and cytologic analysis), and infectious disease panels.

Answer 530

Requires intestinal biopsy with histopathology.

Answer 531

* Lymphangiectasia (villi, propria, submucosa) * Mucosal edema * Inflammatory infiltrates * Dilated cystic crypts.

Answer 532

* Anatomic: Intussusception * Dietary: Sudden change, intolerance, hypersensitivity * Infectious: Bacteria (Salmonella, Campylobacter, Clostridium, E. coli), parasites (Ancylostoma, Trichuris, Giardia, Coccidia), protozoa (Tritrichomonas fetus), viruses (parvovirus, distemper).

Answer 533

* Preserves villous structure * Maintains gut barrier function * Decreases risk of bacterial translocation * Supports enzyme activity * Prevents pro-inflammatory cytokine upregulation * Reduces glutamine and arginine depletion.

Answer 534

Highly digestible, low-fat, with fermentable fiber.

Answer 535

* Histamine-2 receptor antagonists (H2RAs) * Proton pump inhibitors (PPIs) * Prostaglandin analogs * Coating agents.

Answer 536

* May alter intestinal microbiota * Increase risks of bacterial pneumonia and NSAID-induced epithelial injury.

Answer 537

Not routinely recommended for uncomplicated cases; use only when confirmed bacterial/protozoal infection or evidence of sepsis.

Answer 538

* Supportive care * IV fluid therapy * Antibiotics reserved for sepsis/systemic inflammatory response * Adjunctive therapies (antiemetics, probiotics, analgesia) * Early enteral nutrition.

Answer 539

Clostridium perfringens type A.

Answer 540

* Canine parvovirus * Feline panleukopenia virus * Canine coronavirus * Canine distemper virus.

Answer 541

Heterobilharzia americana, a trematode parasite.

Answer 542

Dogs are infected when swimming or wading in freshwater; cercariae released from infected snails penetrate the skin.

Answer 543

* Diarrhea * Weight loss * Ill-thrift * Intestinal obstruction (rare, severe infestations).

Answer 544

Several effective anthelmintics; repeat treatment every 2–3 weeks.

Answer 545

Diarrhea, weight loss, obstruction ## Footnote Toxocara canis is a common roundworm affecting dogs.

Answer 546

Ingestion of embryonated eggs, paratenic hosts, transmammary ## Footnote Toxocara cati is the roundworm affecting cats.

Answer 547

Diarrhea, weight loss, ill-thrift ## Footnote More common in young animals.

Answer 548

Direct lifecycle, transmammary, skin penetration, ingestion of larvae or paratenic hosts ## Footnote Ancylostoma caninum is a hookworm affecting dogs.

Answer 549

Anemia, diarrhea, vomiting, dehydration, ill-thrift, peracute dermatitis ## Footnote Peracute dermatitis occurs due to larval migration.

Answer 550

Praziquantel ## Footnote Dipylidium caninum is a tapeworm primarily affecting dogs.

Answer 551

Diarrhea, malabsorption ## Footnote Heterobilharzia americana causes canine schistosomiasis.

Answer 552

Exclusion of infectious, neoplastic, extraintestinal diseases ## Footnote Chronic enteropathies are defined by GI signs lasting over 3 weeks.

Answer 553

* Isospora spp. * Cryptosporidium spp. * Giardia spp. ## Footnote These pathogens are typically discussed in Chapters 119 & 263.

Answer 554

Surgical resection, Itraconazole + terbinafine + mefenoxam ## Footnote Pythium insidiosum is not a true fungus but an oomycete.

Answer 555

* Azotemia * Anemia * Hypoalbuminemia * Hyperglobulinemia * Hypercalcemia ## Footnote These abnormalities result from the infection's impact on the body.

Answer 556

Resolution on hypoallergenic diet, recurrence with re-challenge ## Footnote An elimination diet trial is crucial for diagnosis.

Answer 557

Improve epithelial barrier function and reduce inflammation ## Footnote Probiotics show variable efficacy in treatment.

Answer 558

Lymphoplasmacytic infiltrates ## Footnote Neutrophilic or granulomatous inflammation may indicate infectious causes.

Answer 559

~416 days ## Footnote The 3-year survival is 15% for IRE and 71% for IBD.

Answer 560

Tritrichomonas fetus ## Footnote Pancreatitis and cholangitis often co-exist.

Answer 561

~60% ## Footnote Younger age and rapid response to diet are risk factors.

Answer 562

Hypoalbuminemia ## Footnote Severe clinical signs and high BUN levels are also negative indicators.

Answer 563

Ultra-low-fat diet (<20 g fat/1000 kcal) ## Footnote Highly digestible diets are also recommended.

Answer 564

Poor, with a median survival time of 74 days.

Answer 565

Severe lymphoplasmacytic enteritis ## Footnote It can progress to spontaneous intestinal perforation.

Answer 566

Protein-Losing Nephropathy (PLN)

Answer 567

Lifelong gluten-free diet ## Footnote Clinical signs resolve with this dietary management.

Answer 568

Paroxysmal Gluten-Sensitive Dyskinesia ## Footnote Treatment includes a gluten-free diet.

Answer 569

* Fungal: Histoplasmosis, Pythiosis * Parasitic: Heartworm, Schistosomiasis * Viral: Parvovirus * Bacterial: Campylobacter, Salmonella

Answer 570

Use at the lowest effective dose ## Footnote Anti-inflammatory doses are recommended for intestinal lymphangiectasia.

Answer 571

No added survival benefit over steroids alone in one retrospective study

Answer 572

For refractory cases

Answer 573

4–6 mg/m² PO q24h x 7–14 days, then dose reduction

Answer 574

* Ionized hypocalcemia * Vitamin D * Hypocobalaminemia * Hypofolatemia

Answer 575

IV calcium gluconate (10%)

Answer 576

* Calcitriol: 20–30 ng/kg PO q24h x 3–4 days → 5–15 ng/kg PO q24h * Calcium carbonate: 25–50 mg/kg PO q24h

Answer 577

Ultra-low-fat and/or novel/hydrolyzed protein diet

Answer 578

* Adenocarcinoma * Leiomyoma / Leiomyosarcoma * Intestinal lymphoma

Answer 579

Feline intestinal lymphoma

Answer 580

* Weight loss * Diarrhea * Vomiting * Anorexia or hyperorexia * Lethargy

Answer 581

* Low-grade/small-cell: Lymphocytic * High-grade/large-cell: Lymphoblastic

Answer 582

50% in large cell lymphoma, 49% in small cell lymphoma

Answer 583

428–897 days; response rates: 76–96%

Answer 584

Multi-agent chemotherapy (COP or CHOP protocols)

Answer 585

* Weight loss * Anorexia * Vomiting * Diarrhea * Signs of obstruction or peritonitis

Answer 586

Surgical resection

Answer 587

Jejunum and cecum

Answer 588

* Hypoglycemia * Erythrocytosis

Answer 589

Foreign body obstructions

Answer 590

* Hypochloremia * Metabolic alkalosis * Hyperlactatemia

Answer 591

Hypochloremia (51.2%) ## Footnote Other abnormalities include metabolic alkalosis (45.2%) and hyperlactatemia (40.5%).

Answer 592

Radiographs to look for small intestinal dilation (>1.6× height of L5) ## Footnote Ultrasound is also useful for distinguishing intramural lesions, intussusceptions, and foreign bodies.

Answer 593

Excellent (83–99% survival) ## Footnote Perforations or preoperative peritonitis have a guarded prognosis.

Answer 594

* Ileocolic and jejunal (dogs) * Jejunal (cats)

Answer 595

* Mesenteric tears * Hernias * Adhesions

Answer 596

* Sudden abdominal pain * Distension * Pallor * Shock

Answer 597

* Ingestion of sharp foreign bodies * Delayed foreign body removal * Neoplasia * Granulomas * Ischemia

Answer 598

Occurs when more than two-thirds of the small intestine is absent, usually due to surgical resection.

Answer 599

* Nutritional malabsorption * Protein and calorie malnutrition * Diarrhea and weight loss post-resection

Answer 600

* Parenteral fluids and nutrition * Early, limited oral feeding

Answer 601

Proton pump inhibitors (PPIs)

Answer 602

D2 antagonist, 5-HT4 agonist, 5-HT3 antagonist

Answer 603

* Abdominal surgery * Opioid use * Hypokalemia * Pancreatitis * Parvovirus * Peritonitis * Hypothyroidism

Answer 604

Key-Gaskell Syndrome

Answer 605

* Megaesophagus * Urinary retention * Bradycardia * Mydriasis * Dry eyes * GI dilation

Answer 606

Historically poor; survival rates are 21% for cats and 32% for dogs.

Answer 607

* Myopathies * Neuropathies

Answer 608

Imaging shows marked intestinal dilation without obstruction.

Answer 609

Parenteral cobalamin supplementation is life-saving.

Answer 610

* Failure to thrive * Inappetence * Chronic diarrhea

Answer 611

Guarded to grave; median survival reported as 19 days in dogs.

Answer 612

Clinical significance is low due to compensation by other peptidases.

Answer 613

* Recurrent vomiting * Diarrhea * Constipation * Abdominal pain/bloating

Answer 614

Based on exclusion of recurrent GI signs with normal biopsies.

Answer 615

Prevents retrograde flow of colonic contents

Answer 616

Goblet cells

Answer 617

* Polypeptide P * IGFs * GLP

Answer 618

* Generates circular contractions * Prevents excessive elongation

Answer 619

Mediates immune responses in the GI tract

Answer 620

* Bacteria * Archaea * Fungi * Viruses

Answer 621

Converts primary bile acids into secondary bile acids

Answer 622

Assessing disease severity and prognosis in chronic enteropathy

Answer 623

Act as pacemakers in the muscularis layer

Answer 624

Supplies blood, lymphatics, and nerves to the colon

Answer 625

Activate excitatory motor neurons

Answer 626

* Suppresses pathogens * Modulates immune system sensitization * Produces metabolites

Answer 627

* Low-amplitude, non-propagating contractions * High-amplitude, propagating contractions (HAPCs)

Answer 628

* Microfold (M) cells * Dendritic cells * Epithelial cells

Answer 629

Accumulation of primary bile acids and osmotic diarrhea

Answer 630

Enzyme activity often <3× upper reference limit ## Footnote Enzyme elevations should normalize with treatment of underlying enteropathy

Answer 631

ALT/ALP >3× reference range

Answer 632

High cyst count on flotation and motile trophozoites on direct smear

Answer 633

Enteropathogens may be found in healthy animals; empirical antimicrobial therapy is discouraged based solely on culture

Answer 634

Few nucleated cells aside from epithelial cells

Answer 635

Campylobacter, Enteroinvasive E. coli, Histoplasma capsulatum, Prototheca species

Answer 636

Loss of layering + wall thickening

Answer 637

Fragile, dilated blood vessels with a single layer of endothelium

Answer 638

Parvoviral enteritis, leptospirosis, endoparasites, foreign bodies

Answer 639

Acute vomiting, anorexia, abdominal pain, bloody mucoid diarrhea

Answer 640

Rotation along the colon's longitudinal axis

Answer 641

Protozoal, bacterial, or viral infections, dietary indiscretion, food reaction, endoparasites

Answer 642

Toxic Clostridium perfringens strains

Answer 643

To restore microbiota ## Footnote These therapies aim to replenish healthy gut bacteria.

Answer 644

For non-responsive cases after 7–10 days ## Footnote Antibiotics should not be the first line of treatment.

Answer 645

Long-term corticosteroids or sulfasalazine ## Footnote These treatments have delayed action and potential toxicity.

Answer 646

* Lymphocytes * Plasma cells * Eosinophils * Macrophages * Neutrophils ## Footnote These immune cells contribute to the inflammation seen in CIE.

Answer 647

* Immune response to dietary antigens * Parasites * Enteropathogenic bacteria * Commensal dysbiosis * Idiopathic causes ## Footnote The causes can vary widely and often require thorough investigation.

Answer 648

Shows diffuse mucosal infiltration with minimal mucosal destruction ## Footnote Unlike human IBD, which may show granulomas and ulcerations.

Answer 649

* Eosinophilic colitis * Neutrophilic/granulomatous colitis ## Footnote Each subtype may have different underlying causes and treatment approaches.

Answer 650

* Barrier breakdown * Immune dysregulation * Dysbiosis * Genetic susceptibility ## Footnote These factors can interact to worsen gastrointestinal health.

Answer 651

Closer contact between microbiota and immune system ## Footnote This can lead to chronic inflammation and loss of tolerance.

Answer 652

42% developed chronic diarrhea ## Footnote This indicates a high risk of long-term gastrointestinal issues post-infection.

Answer 653

* Reduced microbial diversity * Loss of bacteria supporting barrier integrity * Loss of bacteria regulating immune function ## Footnote These features can contribute to inflammation and disease.

Answer 654

* First-degree relatives have 8–10× higher risk * 150 gene loci linked to susceptibility ## Footnote Genetic factors can significantly influence the risk of developing IBD.

Answer 655

* German Shepherds * Boxers * Great Danes * Labrador Retrievers * Rottweilers * Rough-Coated Collies ## Footnote Certain breeds show a higher prevalence of this condition.

Answer 656

* High-fiber diets * Highly digestible, low-residue diets * Elimination diets ## Footnote These strategies can help manage symptoms and improve gut health.

Answer 657

10–30 mg/kg PO q8–12h ## Footnote This anti-inflammatory drug should be monitored for side effects.

Answer 658

After failure of dietary trials and microbiota modulation ## Footnote Immunosuppressive therapy should follow other treatment options.

Answer 659

* E. coli * Prototheca * Histoplasma * Pythium ## Footnote Identifying these pathogens is crucial for appropriate treatment.

Answer 660

* Destroy commensal microbiota * Promote resistance * Lead to chronic carrier states ## Footnote Careful antibiotic stewardship is essential to avoid these issues.

Answer 661

* Fever >103.1°F * Tachycardia >140 bpm * Tachypnea >40 bpm * Depression in mental status * Systolic blood pressure <90 mmHg * Neutrophilia >20,000/µL * Neutropenia <3,000/µL * Band neutrophils >1,500/µL * Hypoglycemia <63 mg/dL ## Footnote These parameters help determine the need for antibiotics in acute cases.

Answer 662

Dysbiosis ## Footnote Dysbiosis indicates an imbalance in the normal gut flora rather than an active infection.

Answer 663

* Diet modification * High-dose probiotics * Fecal microbiota transplantation (FMT) ## Footnote These approaches aim to restore a healthy microbial balance.

Answer 664

Foamy, PAS⁺ macrophages ## Footnote This finding is indicative of the disease during pathological examination.

Answer 665

NCF2 gene mutation ## Footnote This mutation impairs the ability of macrophages to clear bacteria.

Answer 666

6–8 weeks minimum ## Footnote Prolonged treatment is necessary to ensure eradication of the infection.

Answer 667

>80% success rate ## Footnote With proper therapy, most dogs can achieve long-term remission.

Answer 668

Systemic/disseminated form ## Footnote This form primarily affects the GI tract and other organs.

Answer 669

* Chronic large bowel diarrhea * Hematochezia * Seizures * Ataxia * Blindness ## Footnote These signs reflect severe systemic involvement.

Answer 670

Poor: median survival 14 months ## Footnote Most affected dogs do not survive long after diagnosis.

Answer 671

* Pythium insidiosum * Lagenidium spp. * Basidiobolus spp. * Conidiobolus spp. ## Footnote These pathogens are found in wet environments and affect primarily young, large-breed dogs.

Answer 672

* Wide-margin surgical excision * Itraconazole * Terbinafine ## Footnote Complete surgical excision significantly improves prognosis.

Answer 673

Freshwater snails ## Footnote These snails release cercariae that penetrate the skin of the dog.

Answer 674

Affects dogs in the southeastern U.S. and Gulf Coast ## Footnote Reservoir: raccoons; Vector: freshwater snails

Answer 675

Cercariae migrate to lungs and liver, mature into adult flukes in mesenteric venules, induce granulomatous inflammation in the GI tract and hepatic fibrosis

Answer 676

* Vomiting * Large bowel diarrhea with blood * Hyperglobulinemia, hypoalbuminemia * Hypercalcemia

Answer 677

* Fecal smear/flotation * Biopsy (GI or liver) * Antigen ELISA (fecal) * Fecal PCR: most sensitive and specific

Answer 678

* Praziquantel: 25 mg/kg PO q8h for 2 days * Fenbendazole: 50 mg/kg PO q24h for 10 days, repeat after 3 weeks

Answer 679

Good to guarded if not in liver failure

Answer 680

Rare parasite in cats in Gulf Coast, tropical, and subtropical areas

Answer 681

Larvae penetrate mucosa, migrate to lungs, are coughed up, swallowed; adults settle in colon, forming nodules

Answer 682

* Often subclinical * Severe large bowel diarrhea in young cats

Answer 683

* Fecal flotation: eggs * Baermann technique: larvae

Answer 684

Fenbendazole: 50 mg/kg PO q24h for 5 days

Answer 685

Caused by Trichuris vulpis, common in dogs; rare in cats

Answer 686

Transmitted by ingestion of ova

Answer 687

Larvae migrate to ileum and colon, mature into adults, embed in colonic mucosa, causing colitis and typhlitis

Answer 688

* Acute, intermittent, or chronic large intestinal diarrhea * Tenesmus, fresh blood, mucus * Possible anemia, hyperproteinemia, eosinophilia

Answer 689

* Fecal flotation (may be negative due to intermittent shedding) * Empirical deworming is often diagnostic

Answer 690

* Fenbendazole * Milbemycin * Moxidectin * Febantel (pro-drug of fenbendazole)

Answer 691

Excellent with effective deworming; environmental control essential due to long ova viability

Answer 692

Flagellated protozoan that infects the GI tract of young cats

Answer 693

* Large bowel diarrhea * Hematochezia * Incomplete weight gain * Fecal incontinence, rectal prolapse

Answer 694

* Saline fecal exam * Culture (InPouch TF) * PCR (Real-time) * Biopsy

Answer 695

Ronidazole: 30 mg/kg PO q24h × 14 days; if unresolved, 30 mg/kg PO q12h

Answer 696

Untreated: self-limiting over 5–24 months; prolonged course in multi-cat households

Answer 697

Infection caused by Giardia spp., primarily affecting the small intestine

Answer 698

Only if clinical signs are present

Answer 699

Fenbendazole over metronidazole to avoid inducing dysbiosis

Answer 700

Zoonotic protozoan primarily affecting pigs

Answer 701

Following exposure to infected pigs

Answer 702

* Tetracyclines * Metronidazole

Answer 703

Infection caused by Entamoeba histolytica, primarily a human pathogen

Answer 704

Occasionally causes severe colitis

Answer 705

Metronidazole: 30 mg/kg PO q12h for 3 weeks

Answer 706

Caused by mutated feline coronavirus, usually multisystemic

Answer 707

Ultrasound: bowel wall thickening; IHC on biopsy samples confirms diagnosis

Answer 708

GS-441524, a nucleoside analog, has shown remission in experimental studies

Answer 709

* Adenocarcinoma * Lymphoma * Others (MCT, GISTs, leiomyosarcomas, plasmacytomas)

Answer 710

* Dogs: 7–11 years * Cats: 12.5 years

Answer 711

~1.6 months unless treated with chemo or subtotal colectomy

Answer 712

End-stage dilation of the colon due to chronic dysfunction; most common in cats

Answer 713

* Intraluminal: bone, hair, foreign body, neoplasia * Intramural: neoplasia, infectious * Extraluminal: pelvic fractures, neoplasia

Answer 714

* Inflammatory: colitis, proctitis * Neuromuscular: lumbosacral disease * Metabolic: hypercalcemia, dehydration * Pharmacologic: opioids * Environmental/Behavioral: inadequate litter box

Answer 715

Domestic Shorthair

Answer 716

* Macro-enemas * Manual removal * Fiber diet * Lactulose * Cisapride

Answer 717

Psyllium (1–4 tsp/meal), glycerol/bisacodyl suppositories, microenemas (Microlax) ## Footnote Mild constipation can often be managed with these options to ease stool passage.

Answer 718

Macro-enemas (10 mL/kg saline + lactulose + mineral oil), manual removal, fiber diet, lactulose (0.2–2 mL/kg PO q8–12h), cisapride (0.01–0.2 mg/kg PO q12h) ## Footnote These treatments aim to alleviate symptoms and manage the condition effectively.

Answer 719

>2 days, large fecal mass, significant colon distension; failure to respond to medical Rx ## Footnote Severe obstipation often requires urgent intervention due to its complications.

Answer 720

Anesthesia, manual removal, enemas. If chronic and nonresponsive: consider subtotal colectomy (esp. in cats) ## Footnote Surgical options may be necessary for chronic cases that do not respond to other treatments.

Answer 721

Pelvic osteotomy ## Footnote This procedure is indicated to correct anatomical issues affecting stool passage.

Answer 722

Subtotal colectomy ## Footnote This surgery is performed when conservative treatments fail to resolve the condition.

Answer 723

Bulk-forming, Hyperosmotic, Stimulant, Lubricating ## Footnote Each type of laxative has a different mechanism and use in managing constipation.

Answer 724

Draws water into colon; softens stool ## Footnote Lactulose and Mg salts are common examples.

Answer 725

5 mg/cat PO q24; short-term use only ## Footnote This stimulant laxative should be used cautiously due to potential side effects.

Answer 726

Sodium phosphate enemas due to risk of electrolyte disturbances and dehydration ## Footnote Care must be taken to prevent serious complications from inappropriate treatments.

Answer 727

Only in hydrated patients with early-stage disease ## Footnote Fiber can exacerbate issues in dehydrated patients or those with advanced disease.

Answer 728

Mild, recurrent, or moderate cases of constipation ## Footnote These agents help enhance gastrointestinal motility.

Answer 729

Ineffective in cases of established megacolon due to irreversible colonic dilation and loss of smooth muscle function ## Footnote Understanding contraindications helps prevent ineffective treatment.

Answer 730

5-HT4 agonist; serotonergic prokinetic ## Footnote It is the most effective agent for enhancing colonic motility.

Answer 731

Diarrhea ## Footnote While effective as a gastroprotectant, its use can lead to gastrointestinal upset.

Answer 732

Subtotal colectomy ## Footnote This procedure is often necessary when all other treatments have failed.

Answer 733

Good prognosis in most cases ## Footnote Most patients experience significant improvement post-surgery.

Answer 734

Transient diarrhea, usually self-limiting within 1–3 weeks ## Footnote Monitoring and management of this complication is important postoperatively.

Answer 735

* Columnar Zone * Intermediate Zone (Anal-Rectal Line) * Cutaneous Zone ## Footnote The cutaneous zone opens to the external environment.

Answer 736

* Ventral sacrococcygeal muscles * Levator ani muscle * Coccygeal muscles * Rectococcygeus muscle ## Footnote These muscles contribute to the pelvic diaphragm and defecation mechanics.

Answer 737

Serves as an anatomical landmark; minimal role in continence.

Answer 738

External Anal Sphincter (EAS). ## Footnote EAS is a band of striated voluntary muscle.

Answer 739

Stimulates rectal motility.

Answer 740

When the cerebral cortex deems defecation 'appropriate'.

Answer 741

* Local trauma * Rectal foreign bodies * Radiation therapy * Infectious agents (e.g., Prototheca) ## Footnote No clear sex or age predilection for proctitis.

Answer 742

Partial prolapse involves the mucosa only; complete prolapse involves all layers of the rectum.

Answer 743

* Painful defecation * Proctitis * Large intestinal enteropathies * Parasites * Anal sac disorders * Colorectal tumors ## Footnote Conditions causing tenesmus can also lead to prolapse.

Answer 744

Hematochezia.

Answer 745

* Benign polyps and adenomas * Adenocarcinomas * Lymphomas * Leiomyosarcomas * Hemangiosarcomas * Plasma cell tumors ## Footnote Colorectal tumors account for up to 60% of all GI neoplasms in dogs and cats.

Answer 746

* Atresia ani * Rectovaginal fistulas ## Footnote Atresia ani prevalence is 0.007% in dogs.

Answer 747

* German Shepherds: Perianal fistulas * Boxers, French Bulldogs: Granulomatous colitis * Siamese cats: Alimentary lymphoma ## Footnote Certain breeds are predisposed to specific rectoanal conditions.

Answer 748

Result from embryologic development defects, often associated with urogenital malformations.

Answer 749

* Types 1–4 exist * Types 1–3 seen in dogs and cats.

Answer 750

Diagnosis is made via visual inspection for absent or stenotic anus, perineal swelling, abdominal distension, and tenesmus.

Answer 751

* Extra-intestinal defects (e.g., cleft palate, hydrocephalus, skeletal malformations) * Urinary tract infections if fistulas are present * Megacolon seen on abdominal radiographs.

Answer 752

Anoplasty.

Answer 753

Good long-term prognosis with a median survival of ~41 months.

Answer 754

~60% of GI tumors are colorectal tumors, with adenomas being the most common.

Answer 755

* Boston Terriers * Miniature Poodles * Pekingese.

Answer 756

* Levator ani * Coccygeus.

Answer 757

* Tenesmus * Perineal swelling * Constipation * Painful defecation.

Answer 758

18–25% risk.

Answer 759

Herniorrhaphy with internal obturator muscle transposition.

Answer 760

Post-operative complications can include incisional infection and rectal prolapse.

Answer 761

* German Shepherds (~85% of cases) * Australian Shepherd * Beagle * Border Collie.

Answer 762

Medical management with calcineurin inhibitors like cyclosporine or tacrolimus.

Answer 763

* Excessive grooming of the perineum * Tenesmus * Hematochezia * Purulent discharge from beneath the tail.

Answer 764

4–7 years.

Answer 765

* Impaction * Inflammation (sacculitis) * Infection (abscessation).

Answer 766

* Cavalier King Charles Spaniels * Labrador Retrievers * Chihuahuas * Miniature Poodles.

Answer 767

Scooting (up to 80%).

Answer 768

* Food allergies * Flea allergy dermatitis * Parasitic diseases

Answer 769

Apocrine Gland Anal Sac Adenocarcinoma, a type of neoplastic anal sac disease ## Footnote Accounts for <20% of perianal tumors in dogs and cats.

Answer 770

50–90% ## Footnote Indicates high aggressiveness of the tumor.

Answer 771

* Regional lymph nodes * Lungs * Abdominal organs

Answer 772

DLA-DQB1 allele ## Footnote Implicated in the development of the tumor.

Answer 773

* Tenesmus * Painful defecation * Discharge from the anal sac * Flattened/ribbon-like stools

Answer 774

~1,200 days (~40 months) ## Footnote Indicates a favorable outcome with early intervention.

Answer 775

~21–26% ## Footnote Recurrence or metastasis occurs at 350–600 days post-op.

Answer 776

Poorer outcomes reported ## Footnote Median survival is ~89–169 days.

Answer 777

Surgical resection + castration ## Footnote Reported to be curative in ~90% of cases.

Answer 778

Conscious or unconscious leakage of feces from the rectum/anus ## Footnote Can occur due to various underlying mechanisms.

Answer 779

* Intervertebral disc disease (IVDD) * Discospondylitis * Spinal tumors * Arachnoid cysts * Cauda equina syndrome

Answer 780

Reservoir incontinence from colorectal inflammation ## Footnote Aging changes to the anal sphincter can also contribute.

Answer 781

~50% ## Footnote Indicates a significant risk associated with the procedure.

Answer 782

* Cranially: Diaphragm * Dorsally: Lumbar vertebrae and sublumbar muscles * Laterally: Oblique and transverse abdominal muscles, and a small portion of the ilial wing * Ventrally: Rectus abdominis muscles

Answer 783

* Kidneys * Most portions of the ureters * Adrenal glands * Aorta * Caudal vena cava * Lumbar lymph nodes

Answer 784

A single layer of surfactant-producing mesothelial cells attached to a fibroelastic basement membrane

Answer 785

* Glycosylated proteins * Mast cells * Macrophages * Lymphocytes * Adipose cells

Answer 786

Gaps in the basement membrane that allow absorption of fluid and particulate matter into local lymphatics via lacunae

Answer 787

It is a semipermeable membrane, allowing absorption, exudation, and transudation of fluid

Answer 788

A small amount of peritoneal fluid is normally present, with juvenile animals having a slightly higher volume than adults

Answer 789

* Infectious etiologies * Chemical irritants * Foreign material * Neoplasia * Trauma

Answer 790

Infection/inflammation without an identifiable intraperitoneal cause, often hematogenous spread

Answer 791

Infection/inflammation caused by an identifiable intraperitoneal disease, such as GI tract rupture

Answer 792

Persistent or recurrent peritonitis following appropriate treatment

Answer 793

* Gastrointestinal: GI perforation * Hepatobiliary: Liver abscess rupture * Pancreatic: Ruptured infected pancreatic abscess * Lymphoid organs: Splenic abscesses * Genitourinary: Urinary tract rupture * Other sources: Penetrating wounds, iatrogenic contamination

Answer 794

* Bioperitonitis (bile leakage) * Uroperitoneum (urine leakage) * Pancreatitis (enzymatic leakage)

Answer 795

Golden-green granular pigment on cytology

Answer 796

Reported survival rates range from 32% to 54%

Answer 797

* Lymphoma * Carcinomatosis * Sarcomatosis

Answer 798

A neoplasia arising directly from mesothelial cells, affecting pleura, pericardium, and peritoneum (in that order)

Answer 799

Total Nucleated Cell Count (TNCC) < 3,000/µL

Answer 800

Total Nucleated Cell Count (TNCC) > 3,000/µL

Answer 801

* Heart failure * Neoplasia

Answer 802

Presence of intracellular bacteria in cytologic evaluation

Answer 803

Abdominal fluid bilirubin concentration greater than twice the concurrent serum bilirubin concentration

Answer 804

> 20 mg/dL

Answer 805

Milky, white fluid

Answer 806

PCV ≥ 25% of the peripheral blood PCV

Answer 807

72.3% ## Footnote This statistic highlights the effectiveness of ultrasound in guiding sampling procedures.

Answer 808

87.4% ## Footnote This indicates a high level of accuracy for ultrasound in specific conditions.

Answer 809

Engorgement indicates high central venous pressures ## Footnote This can suggest conditions like heart failure or cardiac tamponade.

Answer 810

* Non-perforated Ulcers: 67% * Perforated Ulcers: 93% ## Footnote CT is superior to other modalities in detecting these conditions.

Answer 811

78.5% ## Footnote This statistic helps in understanding the prevalence of lesions in this condition.

Answer 812

False ## Footnote Medical stabilization is prioritized over immediate surgical intervention.