Gastrointestinal emergencies Flashcards
Where can the problem occur?
Anywhere from oral cavity to anus
What are the most common additional diagnostic tests we can perform?
Clinical pathology
Radiograps
ultrasound
endoscope
exploratory laparotomy
What should you never forget to check?
String check
Where can problemsoccur before even getting to the stomach?
Oral cavity and esophagus
What can occur in young animals, that have foreign bodies/dietary indisecretions and infectious?
Predominate
In older animals we see gastroenteral emergencies often secondary to _____ disease and _____
Organ disease and neoplasia
What is the difference between vomitting and regurgitation?
Vomitting: active expulsion of the GI contents
forceful contraction of the abdomen and diaphragm
Regurgitation: No active expulsion of fluid or food
no nausea prior
typically an esophageal disorder
What are the signs before vomiting occurs?
Nausea
True or false: during regurgitation the food is digested
False
the food is undigested
What does yellow mixed with green color mean?
Old and new bile,often seen with pancreatitis
What does brown vomit mean?
Reflux of fecal material further down the gastrointestinal tract, or a dog that ingests feces
What does frank blood in vomit often indicate?
Ulceration in esophagus,stomach or upper duodenum
What does coffee ground type vomit indicate?
Digested hemoglobin
What does white fluids vomit mean?
Gastric or esophageal in origin
What does yellow and white vomit mean?
Gastric fluid mixed with bile from the duodenum
What does green fluid vomit mean?
Presence of bile recently from the duodenum
What do you tell the owner if they refuse to come in when there pet has been vomiting?
Remove the food for 12 hours and water for 3-4 hours
small amounts of water should be reintroduced first
than if improvement seen,offer 1-2 tablespoon of a bland diet
When a patient has diarrhea, what can be the infectious causes?
Viral- Parvo or corona
Bacterial
fungal
parasitic
Rickettsial
If the stool looks like rasberry jam
common in middle age canines
What could this dog have?
Hemorrhagic gastroenteritis
If a dog has parvo what precautions do we need to take?
Isolation precautions
What can gastrointestinal ulcers be secondary to? what meds can we give?
Secondary to neoplasia
NSAIDS and steroids
What is an acute abdomen stabilizing the GI patient defined as?
Sudden onset of pain in the abdomen from a variety of gastrointestinal diseases
What should you check on the patient?
Hydration status and compare weight to previous
What do you watch for?
Perfusion abnormalities
What does fluid therapy include?
(Fluid type)
Balanced electrolyte solution ( LRS, normosol-R, plasma lyte)
What diagnostic tests do you run?
(Acute abdomen)
CBC, chem and consider radiographs/abdominal ultrasound
What is the general treatment?
Treat the pain, but avoid NSAIDS in case of gastric ulceration
Opioids are ideal but can slow down gut motiity
enternal nutritions should be started ASAP, antiemetics may be prescribed
Parenteral nutrition may be required - dextrose mixed with amino acids
What are the common foreign bodies found in dogs?
stones, socks, underwear, toys, plastic wrap and bags, corn cobs, apple cores fruit pits
what are the common foreign bodies found in cats?
jewelery ( shiny), coins needles, thread, toys
Why should you always look under a cats tongue?
Look for thread wrapped around it
What foreign bodies are often very serious and what can they lead to.
Linear foreign bodies
can lacerate the intestine
what can mimic a foreign body?
A tumor
What is the diagnosis for a foreign body?
X-ray, abdominal palpation, history, abdominal ultrasound
What can animals present when having a foreign body?
Shock
What is the treatment for foreign bodies?
Hydration is critical, surgery is often needed
Are young or older animals predisposed to Intussusception and what condition can it be due to?
Young animals
parasitism
How to diagnose Intussusception?
Contrast radiography or abdominal unltrasound
What are the signs of a Gastric dilation volvulus?
-Retching
-Repeated unsuccessful attempts to vomit
-Rapidly progressing depression and weakness
-abdominal distention
-increased resp rate
- pale oral MM
When can GDV often occur?
-Occurs often after eating and drinking and then getting exercise
Which size of dog breed is GDV more common in?
Large breed dogs, deep chested
What is the treatment for GDV?
-Flow by oxygen
-fluids
-decompression of stomach, stomach tube or needle decompression
-antibiotics
- surgery
What is the post op care for GDV?
-EKG, high risk of ventricular arrhythmias within first 12-24 hours
- fluids
-analgesia, opioids not NSAIDS
- nutrition, glutamine needed to keep enterocytes healthy
What are the preventions for GDV?
Feed small meals
Avoid meals right after intense exercise
Avoid raised food bowl
Prophylactic tacking of the stomach during neuter or spay
What is the cause for hemorrhagic gastroenteritis (HGE)?
Parvovirus, or idiopathic
What is the presentation of HGE?
Bloody diarrhea and vomiting
What is the diagnosis for HGE?
Parvo snap test
CBC for anemia
Chem- look at the proteins
What is the treatment for HGE?
Supportive care: iv fluids, synthetic colloids
Watch BP,HR and weigh the patient
What is pancreatitis?
Pancreatitis is the activation of pancreatic enzymes that lead to auto digestion of the pancreas and para-pancreatic tissue
What will pancreatitis trigger?
Trigger the inflammatory process through neutrophils activation and production of cytokines and free radicals
What happens if we leave pancreatitis unchecked?
This will lead to systemic inflammatory response syndrome
What is the history for pancreatitis?
Anorexia, abdominal pain and intermittent vomiting.
Diarrhea may also be present
How do we diagnose pancreatitis?
Abdominal ultrasound,
pancreatic lipase test
What is the treatment for pancreatitis?
Supportive fluids
Pain management
What is the diagnosis for peritonitis?
Finding bacteria in fluid from an abdominocentesis
Infection may be introduced from an ____ penetrating wound or from ______ injury?
External and internal
What is the treatment for peritonitis?
Supportive care and treating underlying condition
Fluids resuscitation, antibiotic, analgesia
Culture the fluid
May require open abdominal drainage
