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Animal Diseases > GI disease > Flashcards

GI disease Flashcards

1
Q

How are GI disease classified

A

Anatomical location

Functional vs mechanical

Congenital vs acquired

Inflammatory vs non-inflammatory

Infectious vs non-infectious

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2
Q

Describe functional vs mechanical classifications of GI disease

A

Functional: increased or decreased motility, altered digestion, altered absorption

Mechanical: intestinal accidents, foreign bodies, choke, fistulas

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3
Q

What is halitosis

A

Bad breath

May be due to underlying causes including periodontal disease, infections, neoplasia, uremic or ketotic breath, megaesophagus, tissue necrosis, tumours, ulcerations etc

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4
Q

What is dysphagia

A

Difficulty eating or swallowing

Food drops from the mouth before reaching the esophagus.

Oral pain, masses, neurological issues (rabies), can’t open mouth, etc

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5
Q

Signs of oral disease

A 
Drooling excessively
Pawing at face
Can’t close or open mouth 
Malocclusion 
Bleeding from oral cavity
Bad breath
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6
Q

What are some examples of oral trauma

A 
Wounds
Fractures
Punctures
Dislocations
Burns 
Malalignment 
Burns (electrical cords) 
Trauma from chewing on hard objects
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7
Q

What are the signs of oral trauma

A 
Hungry but reluctant to eat
Pawing at mouth
Decreased grooming
Drooling
Halitosis
Swelling
Bleeding 
Can’t close mouth
Malocclusion
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8
Q

What is malocclusion

A

Abnormal alignment of teeth when the upper and lower teeth fit together, normally they are offset slightly (small over bite is normal)

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9
Q

True or false

Oral masses are relatively common in dogs and cats

A

True

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10
Q

Most oral masses especially in cats are

A

Aggressive tumours

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11
Q

Common masses include

A 
Squamous cell carcinoma
oral melanomas
fibrosarcomas
Oral papilloma 
Oral epulis 
Dentigerous cyst
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12
Q

What are oral papillomas

A

Most common in young dogs
Caused by canine papilloma virus
Highly contagious

Frondular masses that appear on the lips, tongue and oral mucus membranes

Normally heal on their own unless interference is necessary

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13
Q

What is an oral epulis

A

Pink fleshy mass usually located near a tooth, emerging from a periodontal ligament

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14
Q

What are dentigerous cysts

A

Firm masses as a result of impacted teeth

When an adult tooth does not erupt through oral gingiva, it may develop into this cyst

Destructive to surrounding bone

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15
Q

What is stomatitis

A

Inflammation of the oral cavity

Extremely painful

Causes: trauma, uremia, periodontal disease, autoimmune disease, infection (FeLV, FIV, calicivirus)

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16
Q

What is an oronasal fistula and what are some causes

A

When there is communication between the oral and nasal cavities

Can be congenital (cleft palates) Or
Acquired due to trauma, base narrow lower canine teeth (malocclusions), periodontal disease or iatrogenic from extractions,

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17
Q

Describe when a mandibular canine tooth is base narrow

A

They are occluding into the hard palate of the mouth instead of sitting in between the maxillary canine and incisors

Over time, the repeated impaction creates a fistula right through the hard palate into the nasal cavity

Can be from baby tooth still being present

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18
Q

What are some clinical signs and complications of oronasal fistulas

A

Can be asymptomatic

A tooth root abscess causing a oronasal fistula could lead to rhinitis

Pain

Very prone to aspiration pneumonia

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19
Q

How are oronasal fistulas treated

A

Surgical repair

Acrylic molds made to move teeth

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20
Q

What are cleft palates

A

Congenital condition either due to secondary teratogenic process or inherited condition.

The lip and soft and hard palates may all be affected

Affects all species

Cleft palate creates an opening between the oral and nasal cavities (no separation between the two

Causes: brachycephalic breeds, folate deficiency, teratogens

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21
Q

What are the clinical signs of cleft palates

A

Milk dripping from the nose when suckling

Won’t gain weight as their litter mates are

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22
Q

Treatment of cleft palates

A

Stomach tubing to prevent aspiration pneumonia and ensure caloric intake

Surgical correction

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23
Q

True or false

Animals with cleft palates can be bred and probably won’t pass on condition

A

FALSE

They should not be bred

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24
Q

Regurgitation is a ____ process

Vomiting is a ___ process

A

Regurgitation is a passive process

Vomiting is an active process

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25
Q

Are there prodromal signs to vomiting or regurgitation

A

Vomiting

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26
Q

Are there abdominal contractions with vomiting or regurgitation

A

Vomiting

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27
Q

Is there bile present with vomiting or regurgitation

A

Never with regurgitation but may be present with vomiting

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28
Q

Is there closure of the epiglottis with vomiting or regurgitation

A

There is with vomiting, not with regurgitation

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29
Q

Why is it significant that there is not closure of the glottis with regurgitation

A

Higher risk of aspiration with an open glottis

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30
Q

What are prodromal signs

What are the prodromal signs of vomiting

A

Signs that occur prior to something happening

Drooling, licking lips, yawning, restlessness, vocalization, abdominal contractions

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31
Q

Why might regurgitation be happening

A

Obstruction in the esophagus preventing flow

Decreased esophageal motility (can cause Diaphragmatic hernia of the stomach)

Megaesophagus (congenital or acquired)

Foreign bodies (choke in horses)

Gastric dilatation and volvulus)

Esophageal structures, abnormalities, twisting of the stomach can all prevent material from moving into the stomach

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32
Q

What is the treatment of regurgitation

A

Depends on underlying cause

Surgical correction

feeding in upright position with megaesophagus and maintain for 10-15 minutes (Bailey chairs)

Canned food meatballs

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33
Q

What are some of the many underlying causes of vomiting

A

Primary GI problems (infections, obstructions, dietary intolerances) or problems occurring elsewhere such as renal or liver disease, pancreatitis, foreign bodies, inflammation, neoplasia, parasites, toxicities, medications

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34
Q

What are some animals that do not vomit

A

Horses, ruminants some exotics

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35
Q

True or false

Cats don’t easily vomit

A

False

There are very very prone to vomiting

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36
Q

What are some tests useful for determining cause of vomiting

A

Radiographs
Ultrasound
Bloodwork
Diet trials

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37
Q

What is hematemesis

A

Vomiting up blood

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38
Q

What is the treatment of vomiting

A

Depends on cause

Fluid therapy
Anti-emetics 
Pain control
Probiotics or special diets 
Surgery
Medication
Treat underlying problem
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39
Q

What does it mean if the animal is vomiting black blood vs frank red blood

A

Black: bleeding in the stomach or intestines

Frank: bleeding in the esophagus

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40
Q

What is acute abdomen

A

Severe abdominal pain (like colic in horses)

Fast onset

Vomiting may be present

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41
Q

What is more likely with really severe abdominal pain

A

The more severe the pain the worse the prognosis and more likely surgery is needed

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42
Q

What are some causes of acute abdomen

A 
Enteritis 
Foreign body/impaction 
GI torsion 
Perforating ulcers 
Peritonitis 
Urolithiasis 
Pyometria
Liver disease 
Pancreatitis
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43
Q

Pain perception in the abdomen is different than on the surface of the body. Pain is perceived with

A 
Distension or spasm of the GI tract 
Traction 
Torsion 
Inflammation of the GIT or peritoneum 
Vascular compromise
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44
Q

Diagnostics for acute abdomen

A

Full history and physical exam
Radiographs or ultrasound
Bloodwork

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45
Q

Treatment of acute abdomen

A

Medical vs surgical management

Pain control
Circulatory control
Medications
Dietary changes
Stool softening agents
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46
Q

What are some stool softening agents used

A

Magnesium sulphate orally
Mineral oil orally
Oral or IV fluids

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47
Q

What is peritonitis

What can it be caused by

A

Inflammation of the lining/peritoneum of the abdominal cavity

May be due to an infectious or non infectious cause

Virus or bacteria localized in the peritoneum and other membranes causing inflammation

Perforating ulcer, deviated gut, organ rupture, egg yolk peritonitis in birds, pancreatitis or iatrogenic

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48
Q

What are some clinical signs of peritonitis

A 
Abdominal pain
Reluctance to move
Abdominal distension 
Fever
Anorexia
Depression
Increased HR 
Decreased motility
Fluid accumulation
49
Q

Why is peritonitis/abdominal pain hard to differentiate from back pain

A

Because of the method/technique of palpating to abdomen, also puts stress/pressure on the back

50
Q

What is ileus (paralytic ileus)

A

Temporary cessation of peristalsis of the intestines

May be from abdominal surgery (iatrogenic), handling of the GIT, peritonitis, electrolyte imbalances (low K or Ca) or from opioids

51
Q

What are clinical signs of paralytic ileus

A 
Anorexia 
Vomiting 
No intestinal sounds on auscultation 
Nausea 
Abdominal distension/discomfort 
Little/no feces produced 
Swollen incision sites
52
Q

What is the most common signalment observed by RVTs associated with paralytic ileus

A

Post operative patients

53
Q

describe intestinal stasis in rabbits

A

Happens in monogastrics and hind gut fermenters

Fibrous diets needed to promote gut motility

Obstructions can occur if motility is disrupted (inappropriate diet ( high carbs low fiber), dehydration, stress, pain)

54
Q

What is the treatment of paralytic ileus

A

Nasogastric tube +/- suction to relieve fluid build up

IV fluids

K+ supplements

pain control

55
Q

What is acute gastritis or gastroenteritis

A

Inflammation of the stomach and/or the small intestine

56
Q

What are some causes of gastritis/gastroenteritis

A 
Dietary indiscretion 
Sudden diet changes
Infections (bacterial/viral/fungal)
Toxins
Ingestion of foreign material
Parasites 
Medications
57
Q

Signs of gastroenteritis

A

Anorexia
Nausea
Vomiting
Decreased appetite

+/- diarrhea, abdominal pain, dehydration

58
Q

What is the treatment of gastroenteritis

A 
Bland diets 
Small frequent meals
Antiemetics/Antacids/gastroprotectants 
Fluid support
Meds to target parasites or antibiotics
59
Q

What is a gastric ulcer

A

Can be superficial or deep

Occurs when the submucosa is exposed to stomach acid

Risk factors: NSAIDs, finely ground feed pellet sizes (pigs), stressed, intense exercise

Common in pigs and horses

60
Q

Clinical signs of gastric ulcers

A

Can be subclinical or can lead to death

Bruxism (grinding teeth)
Ptyalism (drooling) 
Decreased appetite
Melena (digested blood in stool)
Hematemesis 
Abdominal discomfort
Septicemia
61
Q

Treatment of gastric ulcers

A

Antacids
Gastroprotectants
Discontinue meds contributing to ulcers (NSAIDs, steroids)
Aggressive therapy for perforation of ulcers

62
Q

What can intestinal obstructions be from

A

Foreign material

Masses (neoplasia, abscess, granuloma)

Accidents (sudden change in structure of intestine) (intussusception, mesenteric torsion, incarcerations, GDV) when the SI twists upon itself

All prevent forward movement of ingesta and compromises blood flow

Often need surgical repair FAST or it can become necrotic

63
Q

What are the clinical signs of intestinal accidents

A

Very painful
Vascular compromise and damage
Shock
Death

Treatment is often euthanasia or surgery (with foreign bodies treatment is medical management or surgery)

64
Q

What is mesenteric torsion

A

When a section of the small intestine twists around itself. Inflow and outflow of ingesta and blood flow to the area are cut off.

Prognosis is very poor, often ends in euthanasia or surgery

Very painful

Will see a swollen, distended SI

65
Q

What are incarcerations

A

Occurs when a section of the GIT gets trapped within a structure in the abdomen. Intestine May protrude through a hernia in the abdominal wall or diaphragm, fill with ingesta and then not be able to move back out to its normal position.

Can lead to necrosis

66
Q

What is intussusception

A

When a portion of the intestine folds into the adjacent lumen telescoping upon itself (folds inward like rolling a sock)

Often secondary to hypermotility, infections or neoplasia

67
Q

What is gastric dilatation and volvulus (GDV)

A

When the stomach becomes enlarged due to presence of gas, fluid or ingesta and twists upon itself

Most common in deep cheated dogs

Surgical emergency

Blood flow to the stomach is compromised and can cause necrosis

Decreased blood flow from the caudal body back to the heart leading hypovolemic shock

Compression in the chest will decrease breathing

68
Q

Digestion and absorption of nutrients primarily occur in the

A

Small intestine

69
Q

Bile and pancreatic enzymes enter the gut at the proximal

A

Duodenum

70
Q

The small intestine is lined with ___ to increase surface area and increase absorption

A

Villi that are covered in microvilli

71
Q

The absorption of fluids occurs in the ___ and to a lesser extent the ___

A

Mainly in the large intestine

To a lesser extent in the small intestine

72
Q

True or false

Diarrhea is a clinical sign, not a diagnosis

A

True

73
Q

What is diarrhea

A

Can be peracute to chronic

Many different causes and types of diarrhea

74
Q

Describe secretory diarrhea

A

usually from bacteria or viral infections, pathogens secrete a toxin that stimulates epithelial cells to secrete excessive fluids and electrolytes into the lumen

75
Q

Describe malabsorptive diarrhea

A

The gut is not able to absorb nutrients or fluids as normal. This is often due to villous atrophy and fusion of the villi which decreases surface area and absorption.

This can lead to osmotic diarrhea causing fluids to be drawn into the gut lumen

Can often be from viral infections

76
Q

Describe inflammatory diarrhea

A

Often due to infectious origin

Damage occurs to the villi and crypts. This affects vascular and lymphatic drainage and leads to the loss of water, electrolytes and bicarbonate into the lumen

77
Q

What are some causes of diarrhea

A 
Bacterial/viral/parasitic infections 
Dietary indiscretion 
Immune mediated 
Inflammation 
Neoplasia 
Toxins/irritants 
Medications

Secondary to medical conditions (Addison’s disease, exocrine pancreatic insufficiency (EPI), liver disease, heart failure)

78
Q

Describe the chronicity of diarrhea and give an example of each

A

Peracute: clostridium perfringens in lambs and calves -necrotizing toxins, death occurs in a few hours

Acute: parvoviral infections in puppies

Chronic: EPI, inflammatory bowel disease (IBD)

79
Q

True or false

There may be more than one type of diarrhea occurring at once

A

True

80
Q

Describe small bowel diarrhea

A

Large amounts of diarrhea
Infrequent
Weight loss (since nutrient absorption occurs in small intestine)
Melena (digested blood in stool)

81
Q

Describe large bowel diarrhea

A 
Small amounts of diarrhea
Frequently 
Frank blood (hematochezia) or mucus 
Urgency to defecate often
Straining
82
Q

Diagnostics for diarrhea

A 
Full history and physical exam 
Fecal flotation 
Fecal SNAP tests 
Fecal cultures 
Bloodwork
Necropsy
83
Q

What is the treatment for diarrhea

A 
Treat dehydration and ongoing losses 
Toxin absorbers 
Treat underlying causes 
Parasiticides 
Correct acid-base disorders 
Bland diets 
Antibiotics 
Environmental management 
Treat underlying cause
Vaccination 
Fluid support
84
Q

How do you prevent diarrhea

A

Isolation of sick animals
Environmental decontamination
Vaccination

85
Q

What is constipation

A

When an animal is having difficulty having a bowel movement

86
Q

What is obstipation

A

An animal is not able to pass feces

87
Q

What are some causes of constipation

A

Dehydration (often secondary to chronic renal failure in cats)

Due to reduced peristalsis (decreases feed intake, electrolyte imbalances, drugs like opioids, foreign materials, lack of fiber in diet which stimulates motility when it builds up feces)

Pelvic abnormalities (may be from trauma)

Neoplasia

Megacolon in cats

88
Q

Treatment of constipation

A

Laxatives (stool softeners, bowel irritants, lubricants, osmotic agents, bulking agents)

Fluid therapy

Enemas

Dietary management and increase water intake

Prokinetic agents (motility stimulators)

Surgical management

89
Q

What are some congenital abnormalities that affect neonates that involve the GIT

A

Cleft palates

Vascular ring anomaly -persistent right aortic arch (PRAA)

Umbilical and inguinal hernias

Atresia ani

90
Q

What is persistent right aortic arch (PRAA)

A

During embryonic development, there are blood vessels that encircle the esophagus. Normally these regress prior to birth, but that may not occur.

A structure is created around the esophagus at the base of the heart

Affected animals will present with regurgitation

Contrast studies show megaesophagus that ends at the base of the heart where the stricture occurs

91
Q

What is the treatment of PRAA

A

Surgical ligation of the tissue to eliminate the structure (may have a good prognosis if caught early enough)

92
Q

What is an umbilical hernia

A

More common in puppies than kittens

When the abdominal wall fails to close completely after birth

Can be congenital problem or due to too much traction being applied to the umbilicus when the placenta is removed

93
Q

When are umbilical hernias classified as reducible

A

If you are able to push the herniated tissue back through the abdominal defect into the cavity

94
Q

When is a umbilical hernia considered not reducible

A

When you cannot push the tissue (normally the greater omentum) back through the defect

95
Q

True or false

Small hernias usually close in there own

A

True

96
Q

When can hernias become a serious problem

A

When it involves intestinal loops which become trapped

The hernia becomes swollen and painful

Tissue can become necrotic when it fills with food and gets occluded

97
Q

What is atresia ani

A

A congenital issue when the colon does not communicate with the anus

Normally present at about 6 weeks old with abdominal distension, absence of defecation, straining and failure to thrive

A dimple or pouch may be present in place of the anus

Surgical repair is needed but complications include fecal incontinence and recurrent urinary tract infections

Animal is usually euthanized

98
Q

What are the functions of the liver

A

Production of proteins (albumin)
Coagulation
Digestion
Metabolism and storage of nutrients
Metabolism of drugs and toxins
Extramedullary hematopoesis (produce blood cells)
Metabolism of hemoglobin (converted to bilirubin)

99
Q

Properties of the liver

A

Has the ability to regenerate
Large reserve capacity (more than 60-80% of function needs to be lost to see clinical signs)
Susceptible to injury
Underlying causes of disease must be treated quickly

100
Q

How do you classify liver pathology

A

Underlying etiology

Severity

Time frame

Type of pathology present

101
Q

What are some underlying causes of liver disease

A 
Infections
Toxins
Iatrogenic 
Nutritional deficiencies 
Neoplasia
Ischemia
Genetics 
Inflammation 
Idiopathic 
Secondary to other issues
102
Q

Give an example of when liver disease is subclinical

A

Minor liver damage, may show liver enzyme abnormalities in blood work

103
Q

Give an example of when liver disease is acute

A

Fast onset, diffuse, severe liver disease

Infections, toxicities, fatty liver syndrome

104
Q

Give an example of when liver disease is chronic

A

Gradual onset
Diffuse damage
Fibrosis

Copper storage disease

105
Q

What is hepatitis

A

Inflammation of the liver secondary to infections (often viral)

106
Q

What is hepatic lipidosis

A

Anorexic cats and pregnant or lactating animals

Excess accumulation of fat in the liver

107
Q

What is hepatic necrosis

A

Secondary to toxins or infection (viruses)

108
Q

What are some nonspecific signs of hepatic disease

A 
Anorexia
Lethargy
Vomiting 
Diarrhea
Weight loss
Fever 
Decreased production
109
Q

What are some more specific signs of hepatic disease

A

Jaundice
Abdominal pain
Hepatic encephalopathy (seizures, head pressing, behavioural change, ataxia, coma)
Photosensitization (sensitive to sunburns)
Petechia or abnormal clotting
Ascites

110
Q

Diagnosing hepatic disease

A

Blood work (liver enzymes)
Ultrasound
Fine needle aspirates (FNAs)
Biopsies

111
Q

What is the goal of treatment for liver disease

A

To minimize fibrosis and maximize regeneration

112
Q

What is the treatment of liver disease

A 
Based on underlying cause 
Medications
Low protein diet
Liver support 
With hepatic encephalopathy: mineral oil, lactulose, neomycin/metronidazole
113
Q

True or false

The pancreas cannot regenerate

A

True

114
Q

What is pancreatitis

A

Inflammation of the pancreas due to early activation of pancreatic enzymes in the pancreas which causes inflammation of the tissue. These enzymes start to digest the pancreatic tissue

Can be from direct trauma or infection

Acute and chronic forms and can have acute flare ups

Common in cats and dogs (Yorkshire terriers, mini schnauzers)

115
Q

What causes pancreatitis

A

Often when the animal ingests a high fat meal (often pork)

Genetics: trysinogen may be more prone to self activation

Part of feline triaditis and inflammatory bowel disease

116
Q

What are the signs of pancreatitis

A 
Lethargy
Cranial abdominal pain
Play/pray stance 
Anorexia
Vomiting/diarrhea
117
Q

What is the treatment of pancreatitis

A 
IV fluids
Anti-emetics 
Diet changes (low fat for dogs, hypoallergenic for cats) 
Pain control 
Supportive therapy
118
Q

What is feline triaditis

A

Inflammation of the liver, pancreas and small intestine

Animal Diseases (15 decks)

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