GI Disease Flashcards
What are the considerations for GI disease in a patient?
Reperfusion of compromised tissues causing a release of inflammatory mediators
Manipulation of the GI tract can cause vagal stimulation
Megaesophagus
Dilation of esophagus with poor motility
What are the mechanical causes of Megaesophagus?
Vascular ring anomaly Esophageal stricture Tumor granuloma foreign body
What are the neurological causes of Megaesophagus?
Myasthenia gravis
Peripheral neuropathy
What are the concerns associated with Megaesophagus?
Regurgitation and aspiration
Gastroesophageal reflux
What are the characteristics of GI disease?
Hypoproteinemia
Thin BCS
When performing a GI study what should you be prepared with?
Anticholinergics
What are the clinical signs of Hemoabdomen?
Severe weakness Collapse Hypovolemic shock Hypotension tachycardia pale or white mucous membranes
What is Hemoabdomen secondary to?
Hemangiosarcoma or Hemangioma
What fluids are needed for GI disease?
Balanced replacement crystalloids
Colloid
Blood
What is the drug of choice for ventricular arrhythmias?
Lidocaine
What ECG pattern is associated with Splenic disease?
Ventricular arrhythmias
What kind of resuscitation do you use on patients with GI disease?
Goal-directed resuscitation
What drugs should you avoid with Hemoabdomen?
Drugs with significant CV effects (Ace, Dexmed, and propofol)
Avoid large doses of induction agents (use balanced anesthesia)
What drugs should you use with Hemoabdomen?
Opioids and Benzos for premed
Why do you use balanced anesthesia for Hemoabdomen patients?
to decrease the dose of inhalant required
What should you add in monitoring Hemoabdomen patients?
Invasive blood pressure
What should the MAP be kept above for patients with Hemoabdomen?
60mmHg
How do you treat hypotension in patients with hemoabdomen?
If hypovolemia: need fluids
If vasodilation or decreased ionotropy - DECREASE inhalant +/- CV drugs
What are hemoabdomen patients susceptible to Post-op?
ventricular arrhythmias
What are the clinical signs of GI foreign body?
Vomiting
Abdominal pain
What are the chemistry abnormalities seen with GI foreign body?
Hypochloremic metabolic alkalosis
What should you avoid in patients with GI foreign body?
Acepromazine
Dexmedetomidine
If the patient is very sick or septic what drugs should you avoid?
Acepromazine
Dexmedetomidine
Propofol
Etomidate
What drugs should you use in a patient who is very sick or septic from GI foreign body?
Opioid and Benzos +/- ketamine or alfaxalone
What techniques should you used with Patients having a Cholecystectomy?
Use MAC sparing techniques and vasopressors/inotropes
What does GDV cause?
Decreased venous return
Pressure on diaphragm causing hypoventilation
What do you do for GDV before induction?
Gastric trocharization
What drugs should you avoid in GDV?
Etomidate
Propofol
What is recommended for GDV monitoring?
Direct invasive BP monitoring
How do you treat hypotension in GDV?
Turn down vaporizer
add injectables for MAC-sparing effects
FLuid bolus
Vasopressors/inotropes
What are the factors that decide whether an equine colic is medical or surgical?
Ability to control pain pharmacologically
Amount of ongoing gastric reflux obtained through NGT
Abdominocentesis
Serum chemistry and CBC
What is hyperlactatemia a sign of?
poor perfusion +/- GIT ischemia
What is the volume of crystalloids needed before induction of an equine for Colic surgery?
10-20L
All equine patients receiving inhalant anesthesia should have what as monitoring?
Direct Blood pressure
What are the complications of Equine colic surgery?
Hypotension/ poor perfusion
Hypoxemia
Hypercapnia
