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SAM II > Gastrointestinal > Flashcards

Gastrointestinal Flashcards

1
Q

Functions of the pharynx

A

respiratory and digestive functions
circular mm. - constrictions that help push food down the esophagus, prevent air from being swallowed

longitudinal mm. - lift walls during swallowing

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2
Q

Nerves associated with swallowing

A

Oral - CN V, VII, XII - pre-hend food and form bolus which moves to end of tongue
pharyngeal - CN IX, XII - propel bolus along pharynx, closure of larynx by epiglottis + inhibition of breathing
Esophageal - CN IX, X, SNS - bolus moves esophagus into stomach

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3
Q 
Which is not a nerve associated with the oral aspect of swallowing?
A) CN V
B) CN VII
C) CN X
D) CN XII
A

C - CN X

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4
Q

T/F: CN X is associated with all aspects of swallowing (oral, pharyngeal, esophageal)

A

False, it is only esophageal

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5
Q

Causes of dysphagia

A

congenital - cricopharyngealachalasia, esophageal dysmotility

neuromuscular dz - myasthenia gravis, brainstem lesions
myopathy, myositis, neoplastic or paraneoplastic
infectious uncommon

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6
Q

Diagnostic approach to pharyngeal disease

A

PE - watch the animal eat and drink
sedated oropharyngeal exam
look at pulmonary status, muscling, nutrition status
do bloods, rads of head + neck, fluoroscopy, acetylcholinesterase receptor antibody tiger, 2M antibody assay, upper GI endoscopy, MRI for brain stem lesion

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7
Q

Which is true about the esophagus?
A) The dog and cat esophagus has striated muscle the entire length
B) the dog and cat esophagus have smooth muscle the entire length
C) The dog esophagus has smooth muscle in the distal aspect while the cat esophagus is entirely striated muscle
D) The cat esophagus has smooth muscle in the distal aspect while the dog esophagus is entirely striated muscle

A

D is correct

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8
Q

What parasite can cause a mass lesion in the esophagus?

A

Spirocerca lupi

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9
Q

Diagnostic modalities of esophageal disease (in general)

A

sedated oropharyngeal exam + rads w/ contrast (Barium w/ food or water but careful of aspiration or Iohexol)
systemic evaluation, thyroid levels, eval for pneumonia, eval for compressive lesions, fluoroscopy to eval peristalsis + swallowing phases, endoscopy - balloon if stricture seen, Bx if mass, remove FB

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10
Q

Esophagitis

A

inflammation of mucosa
secondary to meds (Doxy), FB, toxins, reflux, etc
Dx: rads = unremarkable endoscopy - see erythema +/- edematous mucosa, ulcers, erosions
Tx: pain management, topical anesthetic (magical mouthwash - buprenorphine, codeine), mucosal protection (sucralfate/carafate), antacid (PPI omeprazole)
monitor for strictures, ID underlying dz

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11
Q 
Which is not a risk factor (discussed in class) for esophageal strictures?
A) Anesthesia
B) trauma
C) neoplasia
D) LARPAR
A

D - I made this up

post anesthesia is a big one, dont forget

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12
Q

Esophageal diverticulae

A

secondary to trauma or congenital abnormality (PRAA)
if small no CS
if large - impactions, esophagitis, can rupture + pyothorax
Dx: rads or fluoroscopy, both w/ contrast
Tx: clear impactions, Sx when necessary

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13
Q

Megaesophagus

A

congenital - <6m, shar pei, fox terrier, GSD, lab, siamese cat, abnormal NM innervation, may improve w/ time

acquired - idiopathic, primary CNS (brainstem lesion), primary neuromuscular dz (MG), neoplastic syndrome, endocrine, lead toxicity, strictures
Tx: underlying dz, nutritional support, decrease risk of aspiration pneumonia, small frequent meals, elevate food
Px: good if patient tolerates interventions, guarded/poor if fulminant MG crisis, severe aspiration pneumonia or intractable regurgitation

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14
Q

Describe the layers of the stomach

A

submucosa - dense connective tissues, structural support, blood vessels + lymphatics
- Meissner’s plexus
muscularis - layers of smooth muscle perpendicular to each other
- Auerbach’s (myenteric) plexus
serosa - connective tissue layer

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15
Q

Enteric nervous system (ENS)

A

= brain of the gut
functions autonomously but communicates w/ CNS
cross connections so gut can provide info to CNS and CNS can affect GI function

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16
Q

Stomach secretions and functions

A

gastric juice - muscular walls churn food into chyme, stored food for 2-6h, absorbs glucose + alcohol
HCl - acidic medium (pH 1) for enzyme action, kills bacteria
Water - solvent and for hydrolysis
mucus - protects stomach wall from acidic gastric juice, lubricant for movement of food in stomach
pepsin - proteins to polypeptides
rennin - converts protein into insoluble curds (coagulate milk) for hydrolysis of pepsin

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17
Q

Gastrin localization and main physiologic actions

A

gastric antrum, duodenum (G cells), pancreas

stimulate secretion of gastric acid + IF from parietal cells
stimulate secretion of pepsinogen from chief cells

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18
Q

Physiological action of Cholecystikinin (CCK)

A

stimulate gallbladder contraction, stimulate release of pancreatic enzymes, relaxes sphincter of Oddi for release of bile and enzymes

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19
Q

physiological action of secretin

A

stimulate secretion of HCO3 from pancreas

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20
Q

Physiological action of vasoactive intestinal peptide (VIP)

A

increases water + electrolyte secretion from pancreas + gut

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21
Q

Physiologic action of Motilin

A

increases small bowel motility and gastric emptying

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22
Q

Somatostatin localization + physiological action

A

stomach, SI, pancreas (D cells)

inhibits secretion and action of many hormones

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23
Q

Mucosa of the stomach

A

superficial epithelium
lamina propria (below epithelium) - loose connective tissue, immune system cells, nutritional support
gastric glands - mucus neck cells, parietal cells (H/K ATPase pump - HCl), chief cells (digestion)
Neuroendocrine cells - enterocromafin - serotonin _ histamine, somatostatin, gastrin
muscularis mucosa - thin muscle layer

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24
Q 
Most intrinsic factor in the dog comes from:
A) liver
B) kidney
C) pancreas
D) heart
A

C - pancreas

IF is vital for B12 (cobalamin) absorption

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25
Q

Stomach physiology

A

reservoir for food + starts digestion

  • protein (pepsin) + fat digestion (gastric lipase)
  • vitamin + mineral absorption - some IF in dogs

motility
- migrating motility complex, neural and hormonal stimulus, pressure/distension - mechanoreceptors, nutritional content of food (fat slows movement)

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26
Q

Clinical signs associated with the stomach

A

vomiting, hematemesis, melena, retching, burping, ptyalism, weight loss, abdominal distension + pain

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27
Q

Acute Gastritis

A

inflammation of stomach, sudden onset of CS, symptomatic + supportive care
Bx diagnosis but we often presume
Dx: based on Hx + CS, trial response to symptomatic care if not systemically ill, if persistent CS or patient systemically ill, systematic dx + supportive care
- fluids, antacids, anti-emetics (once FB r/o, vomiting protracted or severe enough to cause dehydration + electrolyte imbalances), pain meds, water + bland diet reintroduced

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28
Q

Gastric Foreign body

A 
Dx + Tx
based on Hx + CS - obstructive lesion has intermittent or persistent CS
MC in young
r/o other causes and systemic illness
Sx or endoscope
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29
Q

Stomach food bloat

A

acute vomiting or retching w/ abdominal distension + discomfort
at least 24-36h, fluids but withhold food, walk frequently, pain management +/- lavage +/- Sx

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30
Q

Gastric erosions + ulcers

A

mucosal barrier injury (disruption of normal gastroprotection, decreased blood flow, hyper secretion of acid, decreased mucous or bicarb) secondary to neoplasia, trauma, meds, uremic gastritis
CS/Dx: vomiting, hematemesis, melena, retch, inappetence, weak, anything assoc w/ underlying dz, anemia, BUN
endoscopy best for visual confirmation + Bx
Tx: tx primary dz, mucosal protection –> sucralfate, PPI (omeprazole), pain management, blood transfusion, nutrition

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31
Q

Helicobacter Gastritis

A

acute or chronic vomiting
spiral gram neg bacteria, can be present normally, pathogenicity assessed based on correlation to inflammatory infiltrates, based on pathology assessment of infiltrative nature into crypts/pits
Tx: triple therapy - amoxicillin, tetracycline, pepto-bismol, flatly, omeprazole, Pepcid AC, clarithromycin, azithromycin, erythromycin

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32
Q

Gastric roundworms

A

toxocara canis/cati
visual or fecal dx
tx - fenbendazle or pyrantel pamoate

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33
Q

gastric physalloptera

A

canine and feline, 2-6cm worms
may see on endoscope, hard to see in fecal
Tx: pyrantel pamoate

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34
Q

Ollulanus tricuspsi in stomach

A

feline, <1mm, seen on biopsy, gastric juice evaluation, vomitus evaluation
tx fenbendazole

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35
Q

Gastric pythiosis

A

chronic vomiting
oomycete - P. insidiosum, tropical dz, standing water, thickened gastric outflow tract
pyogranulomatous inflammation, high fatality rate, pythiosis vaccine
terbinafine + itraconazole (antifungals) +/- Sx

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36
Q

Gastroesophageal reflux (GERD)

A

chronic vomiting or regurgitation
lip licking, hard swallow, ptyalism, halitosis, esophagitis
secondary to primary gastric or small intestinal dz
Dx: CS + Hx
Tx: PPI (omeprazole) + sucralfate (gastropretactant)
find and Tx primary dz

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37
Q

Inflammatory gastritis

A

chronic vomiting
inciting cause rarely Idd, other causes r/o
endoscopy or Sx Bx
Dx: infiltrate of inflammatory cells in mucosa + lamina propria
#1 lymphoplasmacytic infiltrate, also eosinophilic, mast cells
Prior to Bx: Tx, symptomatic, antacid/gastroprotectants, antiemetics, empiric deworming (fenbendazole, pyrantel), diet trial w/ hypoallergenic or novel protein diet
After Bx: immune modulation, prednisone (dog), prednisolone (cat), mycophenolate, azathioprine, chlorambucil

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38
Q

What happens if you don’t treat inflammatory gastritis?

A

Atrophic gastritis
chronic vomiting, marked mononuclear cell infiltrate, thinning of gastric mucosa, atrophy of gastric glands
Tx inflammation and helicobacter if present

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39
Q

Hypertrophic gastropathy

A

chronic projectile vomit hours after eating, diffuse or focal hypertrophy or mucosa, muscularis or both
inflammatory infiltrates assoc w/ hypergastrinemic conditions
dec clearance from renal or liver dz
gastrin excreting tumor, pronounced in pyloric outflow region
older small breeds
Tx underlying dz +/- surgical resection of thickened tissue

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40
Q

Congenital pyloric stenosis/hypertrophy

A

boxers, Boston terriers, English bulldogs, siamese cats
muscular thickening of pyloric sphincter
delayed gastric emptying - vomiting several hours after meal
CS: poor weight gain, aspiration pneumonia, depression, dehydration
medically tx systemic effects of dehydration + acid/base, Sx

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41
Q

Acquired pyloric stenosis

A

inflammation, neoplasia, Sx correction

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42
Q

Gastrinoma

A

Zollinger Ellison syndrome, gastrin secreting tumor
chronic vomiting, thickened gastric wall, hypertrophy of pylorus, gastric ulceration - effects of high gastrin
reflux esophagitis +/- diarrhea
neuroendocrine, tumor usually in pancreas
Dx: gastrin levels - TAMU, fasted +frozen serum, low pH of gastric juice, US, CT, scintigraphy, Bx
Tx: Sx, PPI, octreotide (inhibits gastrin), guarded to poor Bx

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43
Q

70% of all malignant canine stomach tumors

A

adenocarcinoma

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44
Q

MC malignant feline stomach tumor

A

lymphosarcoma

45
Q

Bilious vomiting syndrome (BVS)

A

Dx: early morning vomiting of bile, usually young dogs
reflux of duodenal fluid into stomach + irritation of gastric mucosa
Tx: frequent small feedings, pro kinetics, gastroprotectants, novel protein diet

46
Q

Histology of small intestine

A

single columnar epithelium + lamina propria form villi w/ crypts of Lieberkuhn between
central lymph vessel in each villus
absorptive enterocytes w/ microvilli + goblet cells dispersed
jejunum villi = tall, ileum = short, histo identical except presence of paneth cells
paneth cells = eosinophilic cytoplasmic granules in clusters at base of crypts

47
Q

Physiology of SI

A

digestive enzymes

  • peptidases
  • nucleases
  • disaccharidases
  • utilizes bile acids + pancreatic enzymes
  • absorption of nutrients
  • barrier to infection
  • complex immunologic organ
48
Q

Brush border enzymes + absorption

A

active transport: glucose, galactose
facilitated diffusion: fructose
diffusion: SCFA

long chain FA + f soluble vitamins - diffusion (+ micelles) _ exocytosis to chylomicrons formed in ER, moved to lacteals

49
Q

Energy requirement for enterocytes

A

glutamine

50
Q

Hemorrhagic gastroenteritis (HGE)/ acute hemorrhagic diarrhea syndrome

A

acute onset of profuse hemorrhagic diarrhea (raspberry jam)
small/toy breeds
general GI CS
Dx: hypovolemic shock, PCV >60%
Tx: fluids, antibiotics (Unasyn +/- metronidazole), gastroprotectants, antiemetics, nutrition
Px: good w/ aggressive support

51
Q

A client comes in because her toy yorkie has been feeling unwell. She explains he has been lethargic, vomiting, not eating, and cries when she touches his belly. This morning she noticed his poop looked like raspberry jam. what do you suspect?

A

HGE - hemorrhagic gastroenteritis aka acute hemorrhagic diarrhea syndrome

52
Q

Diplydium canis

A

SI
ingestion of fleas, shed proglottids
Tx: praziquantel + fenbendazole

53
Q

Toxocara canis/cati

A

whipworms, SI

ingestion of eggs or maternal transmission

54
Q

Giardia duodenalis

A

SI
Dx: trophozoites on direct smear, cysts on fecal float, ELISA (1st time only)
Tx: fenbendazole + metronidazole + bathing

dont confuse w/ tritrichomonas fetus (cat), large bowel, also trophozoites

55
Q

Coccidia

A

SI, fecal oral or predation, sporozoites infect enterocytes
worse in immunocompromised/young
Dx: direct smear or fecal float
Tx: sulfadimethoxine, support

56
Q

Cryptosporidium parvum

A

SI
species specific but not zoonotic, fecal oral, contaminated food/water
self limiting SI diarrhea, life threatening if immunocompromised
Tx: paromomycin, Tylosin

57
Q

Toxoplasma gondii

A

SI
zoonotic, oocysts require 1-5d to be infectious after passed - clean litter daily
predation - bradyzoites in muscle, fecal contamination
CS: Gi signs uncommon, pneumonitis
Dx: antibody tigers - IgG + IgM useful when assoc w/ sick pet, positive titer doesnt mean shedding or clinical dz
Tx: TMS every 12h for 4 weeks, clindamycin

58
Q

Histoplasmosis

A

SI
Mississippi + Ohio river
aerosols into lungs + thoracic LN, disseminated by blood
CS: cats show no GI signs, dogs do
Dx: Bx abnormal tissue, ELISA antigen (may cross react w/ blastomycosis)
Tx: prolonged medical tx - itraconozole or amphotericin B

59
Q

Phythiosis

A

SI
aquatic oomycete, gulf states, exposure to free standing water, penetration of skin/mucosa by motile zoospores
CS: GI, derm (non healing skin lesions) - do not occur together, ulcerative nodules, draining tracts +/- LN enlargement
Dx: eosinophilia, severe transmural thickening, pyogranulomatous + eosinophilic inflammation, GMS to stain
Tx: removal Sx, meds - 2-3m of itraconaole or terbinafine, , immunotherapy if non resectable

60
Q

Candidiasis

A

opportunistic, associated w/ disruption of mucosal integrity

dogs - perforating intestinal lesions after Sx

61
Q

top 3 bacterial causes of intestinal dz

A

Salmonella (SI)
E. Coli (SI)
Campylobacter (LI)

62
Q

Salmonella

A 
gram -, facultative anaerobe
S. typhimurium
zoonotic!
destroys villi
Tx: supportive, fluids, fluoroquinolone, chloramphenicol, TMS, amoxicillin
63
Q

Salmon poisoning dz (SI)

A

dog, salmon, fluke (nanophyteus salmincola), bacteria (neorickettsia helminthoeca)
Pacific Northwest, acute dz
Dx: fluke eggs in feces, inclusions in macrophages (bacteria)
hospitalize, oxytetracycline, doxy, praziquantel (flukes)
Px: good, death in 90% if untreated

64
Q

Canine parvovirus (SI)

A

type 2, fecal oral, shed while sick >10d after, in environment for months, very contagious, ill w/in 4-7d infection
young <6m
likes rapidly dividing cells
Dx: electrolyte shift, SNAP test, PCR to confirm
Tx; supportive care

65
Q

Feline panleukopenia (SI)

A

closely related to Parvo, 50-90% fatal w/o aggressive support
cerebellar hypoplasia w/ perinatal infection

66
Q

Small intestinal neoplasia

A

lymphoma
cats > dogs
infiltrative diffuse dz, thickening of SI on US
Tx: chlorambucil + prednisolone

67
Q

Antibiotic responsive diarrhea (ARD) (SI)

A

SI bacterial overgrowth, no reliable test to prove
abnormal host bacterial interactions, competition for nutrients, malabsorption, diarrhea
assess pancreatic function
CS: diarrhea, GI signs
Dx: response to Tx
Tx: 4-5w of metronidazole or Tyllosin
SIBO - small intestinal bacterial overgrowth – can be clinical sign or secondary pathogenetic mechanism

68
Q

Describe cobalamin + folate absorption

A

Cobalamin (vit B12) -absorbed in distal SI
- values below normal range seen with EPI, bacterial overgrowth in upper SI or dz affecting lower SI

Folate - absorbed in proximal SI
values above normal range seen with bacterial overgrowth in upper SI
below normal - disease of upper SI

69
Q

High folate and low cobalamin levels are suggestive of

A

bacterial overgrowth in upper SI

70
Q

Food allergy hypersensitivity

A

resolves w/ diet change
HS type 1, 2, or 4
hydrolyzed diets with novel proteins, proteins ideally 1KD but bitter so settle for 7-10kD

71
Q

Inflammatory Bowel disease

A

idiopathic, chronic inflammation specific dx criteria
multifactorial causes
Tx: regardless of cause, diet modification (based on nutrient content + digestibility) +/- immunosuppressive tx (most important) - prednisone or prednisolone, can use azathioprine (dog) and chlorambucil (cat) to spare steroids

72
Q

Dx criteria of IBD

A

chronic GI signs
histopath evidence of mucosal inflammation
inability to document other cause
inadequate response to tx trials
clinical response to anti-inflammatories + immunosuppressive agents

histopath changes in absence of criteria doesnt allow Dx to be made

73
Q

Protein losing enteropathy

A

MC cause = lymphoma, IBD, lymphangiectasis
CS: hypocholesterolemia, hypoCa, hypoMg, lymphopenia
Can be d/t erosive or ulcerative lesions, lymphatic dysfunction, mucosal changes
low serum cobalamin common, hypercoagulabiltity

74
Q

Lymphangiectasia

A

dilation + dysfunction intestinal lymphatics, abnormal lacteals rupture, lymph leaks into lumen
PLE –> hypoproteinemia, loss of lymphocytes = immunodeficiency
ascites or SQ edema
Dx: nodular masses around lymphatics (lipogranulomas)
Tx: resolve inflammation, fat restricted, calorie dense, highly digestible diet (weight reduction diet not good), diuretics + taps to manage effusions

75
Q

Histology of the colon

A

lack large villi, invaginations of surface epithelium = intestinal crypts of lieberkuhn, tubular crypts extend entire thickness of mucosa
high mitotic index
many more goblet cells vs SI

76
Q

Colonic microbiome

A

interacts w. mucosal immune system, provide energy for colonocytes, synthesize AA + its
colon has highest [] of bacteria in gut
metabolize carbs, proteins, lipids into SCFAs acetate, propionate, butyrate, by-products = H, methane, sulpha compounds, CO2

77
Q

chronic LI inflammation

A

colitis

78
Q

Clinical signs of colonic disease

A

A#1 diarrhea
#2 constipation
unique to colonic dz: frank blood, mucus, tenesmus, dyschezia, urgency

no weight loss or vomiting

79
Q

Acute colitis

A

sudden onset, self limiting, withheld food, give low fat/highly digestible diet
Kaolin based antidiarrheals may bind toxins + produce firmer stools, diphenoxylate or loperamide can reduce tenesmus

80
Q

Chronic colitis

A

acute that doesnt resolve w/in 3weeks

81
Q

Trichuris vulpis (whipworm)

A

LI
hyper K and hypo N - pseudo-Addison’s dz, ACTH stim will be normal
dog > cat, acute or chronic LI diarrhea, fecal oral

82
Q

Heterobilharzia Americana

A

LI
schistosomiasis, trematodes, gulf states
racoons = reservoir
need praziquantel to fix hyperCa

83
Q

Tritrichomonas fetus

A

LI protozoa
young cats in crowded housing
ID in fresh feces, too motile trophozoites, PCR more sensitive

84
Q

Campylobacter

A

LI

gram -, motile, spiral

85
Q

Clostridium difficile

A

LI
gram +, anaerobic, spore forming bacillus
2 toxins: A (enterotoxin) and B (cyanotoxin)

86
Q

Clostridium perfringens

A

LI
gram +, anaerobe, spore forming bacillus
causes acute colitis + hemorrhagic gastroenteritis (HGE)
type A toxins inc major toxin A (enterotoxin) = clostridium perfringens enterotoxin (CPE)
Tx: metronidazole, amoxicillin, erythromycin, tylosin

resistance to tetracyclines common

87
Q

E.Coli

A

commensal unless carries specific pathogenic plasmid gene
ETEC - SI
EPEC - SI + LI
EHEC - LI, produces shiva like toxins that kill colonocytes by inhibition of protein synthesis, results in hemorrhagic diarrhea
PCR to isolate pathogenic genes

88
Q

Granulomatous colitis

A

intracellular E. coli infection
young boxers + frenchies
macrophages full of PAS staining material underlying an ulcerated colonic mucosa
immunosuppressives dont work, tx w/ enrofloxacin

89
Q

Constipation + obstipation

A

obstipation = permanent loss of function
dilated megacolon = end stage of colonic dysfunction
CS: dyschezia, vomiting, anorexia, dehydration
Tx: mild - warm water enemas, laxatives, prokinetics
Severe - correct dehydration + metabolic abnormalities, remove impacted feces, warm water enema + manual extraction

90
Q

megacolon

A

dilation - secondary to electrolyte abnormalities, neuromuscular disorders or idiopathic
hypertrophy - consequence of obstructive lesions

91
Q

Feline idiopathic megacolon

A

middle aged male DSH
absent or painful defecation
permanent loss of colonic structure + function
medical tx then colectomy

92
Q

Vomit reflex

A

visceral receptors - abdominal viscera, acute distension, erosions, ulceration, inflammation, irritation
vagal + sympathetic afferent neurons - entire GIT + peritoneal cavity
CRTZ - mediates vomiting assoc w/ drugs, toxemias, metabolic dz

emetic center - all emetic stimuli converge in emetic center, vomiting stimuli travel directly or indirectly via CRTZ

93
Q

test of choice to Dx exocrine pancreas insufficiency

A

trypsin like immunoreactivity (TLI)

<2.5ug/L dogs, <8ug/L cats

94
Q

Anatomy of pancreas

A

L + R lobes w/ small central body
cat - pancreatic duct fuses w/ bile duct before opening on major duodenal papilla
each lobule = acinar cells, branching duct system, Langerhans cells

95
Q

Physiology of pancreas

A

acinar cells secrete fluid rich in enzymes, pancreatic juice secreted into duodenum in presence + absence of food, secretion in response to cephalic stim + GI stim (secretin + cholecystokinin)

96
Q

what is a zymogen

A

an inactive form of an enzyme, this is how it is stored so it is safe in pancreas

97
Q

digestive enzymes from pancreas

A

protein - trypsin, chymotrypsin, carboxypeptidase
carbs - amylase
fats - lipase, cholesterol lipase, phospholipase

98
Q

Pancreatitis

A

pancreatic auto digestion (activation of enzymes in the gland)

99
Q

Pathophysiology of pancreatitis

A

unopposed free radicals cause increased capillary permeability d/t endothelial cell damage with resultant edema
plasma protease inhibitors consumed (a-macroglobulin)

100
Q

Acute vs chronic pancreatitis

A

acute - fully reversible inflammation, history presence of edema, neut infiltrates + necrosis

chronic - continuing inflammation (lymphocytic or lymphoplasmacytic) w/ irreversible changes like fibrosis
can be subclinical or recurrent w/ episodes of severe illness (acute on chronic)

101
Q

Clinical signs of pancreatitis

A

dogs - anorexia, vomiting, weakness, abdominal pain, dehydration, diarrhea
cats - anorexia + lethargy mc

102
Q

pancreatic lipase immunoactivity

A

canine - decreased in dogs w/ EPI vs healthy, increases w/ pancreatitis + renal dysfunction
feline - may be more specific to dx EPI vs TLI or US

103
Q

Test of choice for exocrine pancreatic insufficiency

A

TLI - trypsin like immunoreactivity

104
Q

Tests of the pancreas

A

TLI used to Dx EPI
PLI researched - may be good for cats
US - valuable see non-homogenous masses, loss of echo density, cystic masses, biliary obstruction
Bx - most definitive dx but many risks + complications

105
Q

Treating pancreatitis

A

dogs - feed whenever possible, ultra low fat diet, if not hungry use NG tube or esophagostomy, jejunostomy if relentless vomiting, supportive tx, antivomit meds, analgesia, tx underlying dz

cats - DONT restrict fat

106
Q

MC disorder of feline exocrine pancreas

A

pancreatitis

107
Q

Exocrine Pancreatic insufficiency

A

90% secretory ability lost = maldigestion
pancreatic acinar atrophy - genetic or immune mediated
GSD, collie, eurasians
CS: weight loss, steatorrhea, poor hair coat
TLI levels - species specific
B12 - often low and needs supplement
Tx: give animal IF + 12, abs (tylosin or metronidazole)

108
Q

T/F: liver specific signs show rapidly when liver is dz

A

false, only w/ end stage

109
Q

what lobe is gall bladder in?

A

quadrate

SAM II (3 decks)

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