GI Flashcards
What is intussusception?
The inversion of one portion of the intestine within another
like a collapsible telescope
What is the daily fluid volume entering the gut of a 20kg dog?
2700ml
Where does the fluid come from that enters the gut on a daily basis?
Diet Saliva Gastric Bile Pancreatic SI
The majority of fluid in a dog’s gut is absorbed where?
Jejunum
What things should you consider when a dog is brought in with D&V?
Is intensive emergency treatment needed (fluids)? Is there an underling non-enteric cause? Is surgical management needed? Is hospitalisation needed? Is an infectious cause likely? Is non-specific treatment sufficient?
What are the categories of acute GI disease?
Gastritis (stomach)
Enteritis (SI)
Colitis (colon)
Give some causes of acute gastritis
Dietary indiscretions eg eating rubbish Foreign material Hairballs (bezoars) in cats Certain drugs Acute systemic disease
Describe acute enteritis
Acute onset of profuse diarrhoea, often associated with acute vomiting
Many causes, eg dietary indiscretions, enteric infection
Usually self-limiting
Describe acute colitis
Acute, frequent, small volume diarrhoea
Excessive straining (tenesmus)
Mucoid faeces
+/- fresh blood=haematochezia (blood not always in faeces but passed with it)
Common in dog, rare in cat
Causes: whipworms, rubbish ingestion, protozoa (Giardia, Cryptosporidia etc)
When should you reassess diarrhoea or vomiting after giving systemic treatment?
If signs persist for over 48 hours
What should you check on a clinical exam of a pet with D&V?
General body condition
Hydration status (PVC/TP, mm, skin tenting)
Oral and rectal examination (could be bones around back end, mouth ulcers)
Abdominal palpation
Which diagnostic tests should you carry out when investigating D&V?
Haematology
Serum biochemistry
Urinalysis
Faecal exam for parasites
SNAP tests can be used to test the faeces for what?
Giardia
Parvovirus
How can you test for Giardia in faeces?
SNAP test
Direct smears
Floatation
How can you measure TP?
Refractometer
What is contra-indicated in cases of gastroenteritis?
Corticosteroids and NSAIDs (damage GI mucosa -> ulceration. Also damage kidneys if hypovolaemic)
High corticosteroid use can lead to what?
Cushings disease (hyperadrenocorticism)
How can you maintain a pet with acute D&V’s hydration status?
Oral rehydration solutions
If vomiting water -> give parenteral fluids
When symptomatically treating D&V, compare restricting food intake with feeding through diarrhoea
Restricting GI intake
-Fast for at least 12 hours then feed frequently with small amounts of bland food eg chicken and rice
Feeding through diarrhoea
- Speeds recovery
- Reduces potential of sepsis
- Not practical if there is concurrent vomiting
Give some examples of anti-emetics
Centrally-acting:
- Metoclopramide
- Chlorpromazine
- Maropitant
Anti-cholinergics:
-Atropine
When should you use a gastric mucosal protectant?
Only if:
Vomiting persists
Ulceration is present
- H2-receptor antagonists eg ranitidine
How do absorbents/protectants work? (used to treat diarrhoea)
Give some examples
'Protect' mucosa Bind toxins Bind excess water -Activated charcoal -Kaolin-pectin
Why are opioids used to treat diarrhoea?
Slow the rate of transit
Anti-secretory
-Morphine/kaolin
-Loperamide
Give some pros and cons for using antibiotics to treat D&V
Cons:
- ‘Upset’ the natural flora
- Cause diarrhoea (eg antibiotic-associated colitis)
- Promote resistance
Pros:
- Flora is already ‘upset’
- Risk of sepsis if mucosal barrier is compromised