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Emergencies > GI Emergencies > Flashcards

GI Emergencies Flashcards

1
Q

Medullary Vomiting Center

Input from

A
  • Chemoreceport trigger zone
  • Higher CNS centers
  • Vestibular System
  • Peripheral sensory receptors

Knowing which of these caused vomiting allows for appropriate treatment

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2
Q

Regurgitation

A
  • Not the same as vomiting
  • Indicates esophageal disorder
  • No nausea after
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3
Q

Regurgitation

Occurance

A

Occurs right after eating or drinking

Food undigested

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4
Q

Projectile Vomiting

Associations / Obstructions

A
  • Pyloric outflow obstuction
  • Significant proximal intestinal obstruction
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5
Q

Projectile Vomiting

causes

A
  • Pyloric thickening
  • Mass compressing pylorus
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6
Q

Assessment Questions

Vomiting

Color / Blood Present

A

Blood means erosion or ulceration in gut has not healed

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7
Q

Assessment Questions

Vomiting

Consistency

A
  • Fluid/Foamy/Thick
  • Thick implies ongoing dehydration
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8
Q

Hematochezia

A
  • Frank Blood
  • If significant, get characteristics

Watery, clotted, mixed with feces

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9
Q

Melena

A

Blood digested feces

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10
Q

Diarrhea and Puppies

Concern with Food Restrictions

A

Caution to withhold food for those under 6 months or for very small breeds

Can suffer hypoglycemia

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11
Q

Physical Exam

5 Vitals

A
  1. Temperature
  2. Pulse
  3. Respiration
  4. Blood Pressure
  5. Pain Score
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12
Q

5 Vitals

Blood Pressure

Doppler

A
  • Preferred
  • Allows flow / perfusion and BP to be assessed
  • Detects arrhythmias
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13
Q

5 Vitals

Blood Pressure

Oscillometric

A
  • Be sure accurate pulses detected
  • Correct cuff size used
  • Poor indicator of blood volume

only 10% of blood in arteries

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14
Q

Venous Volume

How to assess

A
  • 70% of blood in veins
  • Do if concerned for hypovolemia
  • Hold off jugular vein - if unable to palpate, highly likely they are hypovolemic
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15
Q

Abdomen Assessment

A

Auscultate before palpate
* palpate diminishes gut sounds

Look for distended superficial veins
* Veins indicate increased pressure

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16
Q

GDV

A

Gastric Dilation and Volvulus
* Unknown cause
* Suspect accumulation of gas in stomach causes distention and concurrent twisting
* Associated with many clinical diseases

Also known as bloat

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17
Q

GDV Patients

A
  • Typically seen in large, deep-chested dogs
  • Can occue in any size dog at any age
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18
Q

GDV

Signs

A
  • Retching
  • Vomiting: non-productive or only foam/phlegm
  • Restlessness
  • Abdominal distension
  • Recent feeding with new diet or change in schedule
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19
Q

GDV

Prep Supplies

A
  • IV catheter and fluids
  • Oxygen
  • Radiology
  • Stomach tubes / bucket
  • Surgery
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20
Q

GDV

Monitoring

A
  • Vital signs: especially HR, rhythm and pulse
  • Abdominal distension
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21
Q

GDV

Type of Shock

A

Obstructive Shock
* The stomach takes up room and compresses the vena cava, obstructing blood flow back to heart

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22
Q

GDV

Diagnosis / Presentation

A
  • General GDV signs
  • Often present in shock
  • Standing/spreading limbs
  • Hypersalivation
  • Tachycardia
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23
Q

GDV

Radiograph

A

Presents as an “inverted C” in the stomach region

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24
Q

GDV

Treatment

A
  • Large-bore IV catheter for fluid therapy
  • Analgesia
  • Trocharization of stomach*
  • Surgery

*releasing gas from the stomach

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25
Q

GDV Surgery

Step 2

A

Make sure the stomach wall looks healthy, nice and pink
* not black and bruised
* can become necrotic due to stretched out capillaries as stomach distends

26
Q

GDV Surgery

Step 1

A

Untwist the stomach

27
Q

GDV

Post-op Monitoring

A

Essential to monitor EKG
* VPC may occur up to 24 hours after surgery

28
Q

VPC

A

Ventricular Premature Contraction
* abnormal heart rhythm

29
Q

Parvo

A
  • Acute viral gastroenteritis
  • Life-threatening
  • Require isolation protocol for treatment
30
Q

Parvo

Symptoms

A
  • Vomiting or Diarrhea*
  • Fever
  • Dehydration
  • Abdominal discomfort / pain
  • Shock or Hypovolemia
  • Increased CRT
  • Pale MM
  • Tachycardia
  • Weak Pulse

*Often seen with blood

31
Q

Parvo

What does it do to the GI tract

A
  • Rapidly attacks dividing cells*
  • Causes lining of intestines to die and slough off
  • May cause patient to become septic - toxins enter blood stream from damaged GI mucosa

* intestines lining made of very rapidly dividing cells

32
Q

Parvo

Patients

A
  • Typically seen in young unvaccinated puppies
  • Can be seen in unvaccinated adult dogs
33
Q

Parvo

Lifespan in Environment

A

Can last in the environment for 6 months
* disinfectant should stay on surface for 10-15 minutes to kill virus

34
Q

Parvo

Question for Owners

A
  • Ask if animal has gotten into garbage, toxins or foreign bodies
  • Also good to ask about vaccine status
35
Q

Parvo

Expected Lab Results

A
  • CBC: decreased WBC
  • PCV / TP: increased (due to dehydration)
  • BG: hypoglycemia
36
Q

Parvo

Preparations

A
  • IV catheters and fluid*
  • Purple top tubes: CBC, PCV, TP, blood glucose
  • Parvo test
  • Fecal
  • Radiology
  • Antibiotics, Antiemetics, Analgesics

*colloids better

37
Q

Parvo

Feeding

A

Use of a Nasogastric Tube
* trickle feed a liquid diet - small amounts
* can also use to aspirate stomach bile

38
Q

Parvo

Monitors

A
  • Mentation and Vitals
  • PCV, TP, Blood Glucose
  • Urination
  • Vomiting / Diarrhea
39
Q

Pancreas

Exocrine

A

Produces enzymes for digestion
1. amylase
2. lipase
3. trypsin

40
Q

Pancreas Testing

A

Cpli and Fpli
* canine and feline pancreatic lipase

41
Q

Trypsin

A

Breaks down/digests protein

42
Q

Lipase

A

Breaks down/digests fats

43
Q

Amylase

A

Breaks down/digests carbohydrates

44
Q

Pancreas

Endocrine

A

Produces insulin

45
Q

Pancreatitis

A
  • Usually associated with vomiting and acute abdominal pain
  • May lead to shock and death
  • Often occurs is middle-aged overweight dogs
46
Q

Pancreatitis

Serum

A

In regards to dogs showing signs of vomiting and anorexia for 8+ hours
* serum will be lipemic (fatty/pink or white)

47
Q

Pancreatitis Testing

CBC and Chemistry

A
  • May see some elevated WBC due to inflammation
  • But otherwise normal
48
Q

Pancreatitis

Phone Screening

A
  • Vomiting
  • Lethargy
  • Recent meal of fatty or spicy foods
49
Q

Pancreatitis

Signs

A
  • Vomiting / Lethargy
  • Fever
  • Dehydration
  • Severe abdominal pain
  • Variable degrees of depression
  • Variable degrees of shock
50
Q

Pancreatitis

Lab Results

A
  • CBC: elevated, immature neutrophils
  • Elevated pancreatic enzymes: Amylase and Lipase
  • CPL: elevated or abnormal
51
Q

AHDS

A

Acute Hemorrhagic Diarrhea Syndrome
* formally HGE
* Acute onset of vomiting / diarrhea often with blood
* Seen in young adult, smaller breed dogs

*Hemorrhagic Gastroenteritis

52
Q

AHDS

Symptoms / Presentation

A
  • Depression
  • Dehydration
  • Absence of abdominal pain
  • Hypovolemic shock may develop
53
Q

AHDS

Lab Results

A
  • PCV: highly elevated
  • Blood glucose: low
  • Altered coagulation parameters
  • Stress leukogram
54
Q

AHDS

Other Diagnosis

A
  • Parvo
  • Intestinal parasite
  • GI ulceration from meds
  • Lead poisonings
  • Salmonella
55
Q

Diaper Rash Cream

A

Be aware of use if patient is able to ingest it
* contains zinc

56
Q

Monitoring Fluid Therapy

Weight

A

With puppies and kittens, take a weight every 6 hours
* kidneys not fully working, easy to overload

57
Q

Urine Specific Gravity

While on IV fluids

A
  • Want around 1020-1030
  • Dehydration will cause it to be high
  • If below 1020, back off of fluids
58
Q

PCV / TP

With Dehydration

A

Both will become elevated

59
Q

PCV

Normal Ranges

A
  • Puppies = mid thirties
  • Adult Dogs = mid forties
  • Adult Cats = mid forties
60
Q

Panleukopenia

A
  • Caused by parvo virus
  • Similar to K9 parvo, but vomiting is more common than diarrhea
  • Very contagious
  • Treat aggressively
  • Less likely to survive than parvo puppies

For cats

Emergencies (8 decks)

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