GI/hepatobiliary articles Flashcards
A novel balloon technique to induce intra-abdominal hypertension and its effects on cardiovascular parameters in a conscious dog model
Min Jang et al jvecc 2018
Peritoneal catheter to increase IAP: Foley urethral catheter + latex balloon placed in abdominal cavity
IAP measured via foley u-cath (intravesicular pressure)
Acute increase in IAP caused discomfort, V and incr RE.
Medical management of esophageal perforation secondary to esophageal foreign bodies in 5 dogs
Helsa Teh et al jvecc 2018
Full thickness defect in 4/5 dogs
Tx: IVF, IV ABX, pain meds, PPI
2 dogs had percutaneous G tube
complication after EFB removal: pneumothorax, pneumomediastinum
Computed tomographic features of intra-abdominal hypertension in three dogs.
Min Jang et al jvecc 2019
Compression of CdVc, direct renal compression, and the extension of peritoneal fluid into the vaginal canal and vaginal cavity are consistent with a diagnosis of IAH
Multicenter investigation of hemostatic dysfunction in 15 dogs with acute pancreatitis.
Lindsey Nielsen et al jvecc 2019
All dogs hypercoagulable (higher MA, shorter R + K, greater alpha angle, higher G)
Higher D-dimer, fibrinogen, and vWF Ag activity; lower AT and PT
Retrospective evaluation of factors associated with degree of esophagitis, treatment, and outcomes in dogs presenting with esophageal foreign bodies (2004-2014): 114 cases.
Abigail B Bongard et al jvecc 2019
Success rate 95% complication rate 22%
Dogs w/ EFB >24h more likely to have severe esophagitis and major complications
Fishhooks more likely to require surgical intervention
Successful management of acute bilirubin encephalopathy in a dog with immune-mediated hemolytic anemia using therapeutic plasma exchange.
Geoff G Heffner et al jvecc 2019
Tbil 4.6 –> 91.4 mg/L –> developed kernicterus (lateral, vertical nystagmus, extensor rigidity, stuporous)
TPE SID q24h x 3 days
-Decreased tbil, IgG and IgM
Gradual neuro improvements and decreased pRBC requirement
Survived
Prevalence and impact of cholecystitis on outcome in dogs with gallbladder mucocele
Erin Rogers et al jvecc 2020
30% had cholecystitis –> acute on chronic and with necrosis
14% had bacteria but 89% had ABX pre-op
No association b/w cholecystitis or subtypes OR bacterial culture w/ survival
17% mortality
cholecystitis is commonly found in GBM dogs but not associated w/ survival
The pattern of mortality in dogs with gastric dilatation and volvulus
Sharp et al jvecc 2020
- 1% survived to discharge, 35.9% nonsurvivors
- 31% of non survivors euthanized (most before tx) and 6% died
83.5% survival if excluded euthanized dogs
Median group age higher in euthanized group
Successful management of clinical signs associated with hepatic encephalopathy with manual therapeutic plasma exchange in a dog
Culler jvecc 2020
TPE performed for hyperammonemia (235) prior to sx ligation –> TPE, 1 plasma volume –> 50% reduction in NH3 –> sig. improved Cx and remained stable –> 5d later had shunt ligation and did well –> 10d post-d/c 63
The benefit of manual plasmapheresis: avoid unnecessary pRBC transfusion (just do autotransfusion), performed via central line, no special equipment aside from centrifuge and access to donor FFP, less risk of anticoagulant causing bleeding
Colonic torsion in 4 Great Danes
Peter S. Czajkowski DVM,Katy J. Fryer DVM, DACVS jvecc 2020
Colonic torsion confirmed by pneumocolon or barium enema
All had previous gastropexy
2/4 recurre
Likely association b/w colonic torsion and altered GI motility
Risk factors and prognostic indicators for surgical outcome of dogs with esophageal foreign body obstructions
Brigitte A. Brisson javma 2018
Terrier breeds most common
Older age, longer duration of entrapement, perforation associated w/ poor px
Duration of entrapment, BW, anorexia, rectal temp, perforation associated w/ sx
84% success rate
Overall mortality 5%
Outcome of elective cholecystectomy for the treatment of gallbladder disease in dogs
Gabina Youn javma 2018
Elective sx has lower mortality (2% vs 20%)
Nonsurvivors had lower albumin and higher ALT and Tbil.
Vomiting, lethargy/anorexia, icterus or azotemia = less likely to survive than those w/o these signs
Investigation of potential risk factors for mesenteric volvulus in military working dogs
Shane J. Andrews javma 2018
German Shepherd Dog breed and history of gastrointestinal disease were risk factors
MWDs with a history of prophylactic gastropexy or other abdominal surgery were more likely to acquire MV than were those without
Incidence of chyloabdomen diagnosis in dogs and cats and corresponding clinical signs, clinicopathologic test results, and outcomes: 53 cases (1984–2014)
Alex Hatch DVM, javma 2018
Cause: Malignant neoplasia most common
MST 31 days w/ neoplasia, 73 days w/o neoplasia
Confirmed ratio of abdominal fluid triglyceride concentration to serum or plasma triglyceride concentration > 1:1 = better diagnostic criteria
Likelihood and outcome of esophageal perforation secondary to esophageal foreign body in dogs
Allyson A. Sterman, javma 2018
Esophageal perf is UNCOMMON (12%) – 10 fishhooks and 5 bone
Fishhooks and delay between EFB ingestion and initial evaluation were risk factors for perforation
87% survival with esophageal perf
Comparison of body condition score and other minimally invasive biomarkers between dogs with gastric carcinoma and dogs with chronic gastritis
Tonje Seim-Wikse JAVMA 2019
Older dogs (>8y), thin (BCS<4), high CRP and MCP-1 and abnormally low folate = useful in identifying dogs w/ carcinoma vs gastritis
Gastric carcinoma= most common type of gastric cancer in dogs, 70-90% met @ time of dx, no effective tx, short MST, Cx the same as gastritis
Retrospective evaluation of anemia and erythrocyte morphological anomalies in dogs with lymphoma or inflammatory bowel disease
Cyril Parachini-Winter, JAVMA 2019
Anemia and >3 RBC morphological changes (esp. eccentrocytes) should increase suspicion of LSA compared to IBD
Intestinal incisional dehiscence rate following enterotomy for foreign body removal in 247 dogs
Alena Strelchik JAMVA 2019
Dehiscence occurred in 2% of enterotomy
Longer LOH if dehisced
8 dogs (3%) were septic and none dehisced
Factors associated with dehiscence and mortality rates following gastrointestinal surgery in dogs
Sukhjit S. Gill JAVMA 2019
ASA >3 grade were more likely to develop GI dehiscence
ASA >3 and high lactate were less likely to survive
Evaluation of the effectiveness of preoperative administration of maropitant citrate and metoclopramide hydrochloride in preventing postoperative clinical gastroesophageal reflux in dogs
Ciaran T. Jones JAVMA 2019
3% had intra-op and 14% had post-op GER = not sig. b/w cerenia + reglan vs not
Increased odds for post-op GER if male, overweight BCS, GI surgery, and required dexmed CRI post-op
Evaluation of short-term outcomes and potential risk factors for death and intestinal dehiscence following full-thickness large intestinal incisions in dogs
Christian R. Latimer javma 2019
7 day dehiscence rate 10% and mortality rate 17%
Increased odds of death suggestive of sepsis (pre-op anorexia, hypoglycemia, neutrophils w/ toxic changes, received pre-op ABX)
Increased dehiscence risk: colon trauma/dehiscence, pre-existing peritonitis, blood products, >2 classes of ABX, +ve microbial culture, open abd management
Characteristics and long-term outcomes of dogs with gastroesophageal intussusception
Janet A. Grimes JAVMA 2020
Males and GSD, 13.2 months old
Cx: V, R most common
88% survived to discharge, MST 995 days
L- or bilateral gastropexy – sx or endoscopic (PEG tube)
Dogs w/ acute (≤ 7 days) Xz or a previous diagnosis of megaesophagus were more likely to have persistent regurgitation than were dogs without these factors
–> Rec tx for all GEI dogs
Cholangitis and Cholangiohepatitis in Dogs: A Descriptive Study of 54 Cases Based on Histopathologic Diagnosis (2004–2014)
J.L. Harrison, jvim 2018
Chronic neutrophilic cholangitis or cholangiohepatits = most common
May have cholecytsitis and biliary tract obstruction
50% had bacterial infection: E. coli + enterococcus most commonly cultured
Cholecystectomizd dogs had decreased risk of death
Gallbladder Mucocele: Variables Associated with Outcome and the Utility of Ultrasonography to Identify Gallbladder Rupture in 219 Dogs (2007–2016)
J.A. Jaffey, jvim 2018
GBM w/ GB rupture and bile peritonitis 2.7x more likely to die
- occurred in 21% of dogs
- no association b/w culture or ABX admin
US was 56% sensitive and 92% specific in identifying GBM
14% had +ve bacterial culture
Evaluation of SNAP cPL, Spec cPL, VetScan cPL Rapid Test, and Precision PSL Assays for the Diagnosis of Clinical Pancreatitis in Dogs
H. Cridge, jvim 2018
Assay alone is not enough to diagnose panc
- SpecCPL (>400 ug/L) had highest sp and sn of all
- DGGR-based assay not specific for pancreatic lipase (precision PSL)
A retrospective study of 157 hospitalized cats with pancreatitis in a tertiary care center: Clinical, imaging and laboratory findings, potential prognostic markers and outcome
Ran Nivy, jvim 2018
78% survival
Nonsurvivors more likely to have lethargy, pleural effusion, *hypoglycemia, *azotemia, *TPN, ionized hypocalcemia, and persistent anorexia in hospital
*= newly identified factors
Acute pancreatitis and acute kidney injury in dogs
E Gori Vet J 2019
AKI diagnosed in 26.2%, oliguria/anuria associated w/ poor outcome
Increased clinical severity index and azotemia in dogs with acute pancreatitis were associated with an increased risk of mortality.
BUN and Cr lower in survivors
Effect of clinical signs, endocrinopathies, timing of surgery, hyperlipidemia, and hyperbilirubinemia on outcome in dogs with gallbladder mucocele
J A Jaffey et al Vet J 2019
Increased odds of death: owner recognized jaundice, concurrent HAC, pomeranian, elevated tbil, increased age
Tbil was 61%Sn and 63%Sp useful as biomarker to predict death
NEJM 2018
SUP-ICU: Pantoprazole in patients at risk of GIB in ICU
Mortality rate at 90d and # of clinically important events were similar in those receiving PPI or placebo
Endoscopic and surgical removal of oesophageal and gastric fishhook foreign bodies in 33 animals
M. Binvel JSAP 2018
The endoscopic removal of ingested fishhooks is highly successful (82%)
Survival to discharge was 100%, even in cases of oesophageal perforation or in cases requiring surgery.
Computed tomographic angiography and ultrasonography in the diagnosis and evaluation of acute pancreatitis in dogs.
John M French JVIM 2019
CTA better identified portal vein thrombosis
Heterogenou enhancement = longer LOH, more relapse, more likely to have PVT, increased CPL
Prevalence of Clostridium perfringens netE and netF toxin genes in the feces of dogs with acute hemorrhagic diarrhea syndrome.
Natalie Sindern jvim 2019
Prevalence of C. perfringens encoding for netE and netF is significantly higher in dogs with AHDS compared to control dogs
likely play a role
none found in CPV dogs but found in 12% healthy dog
Hepatic leptospiral infections in dogs without obvious renal involvement.
Katie E McCallum, jvim 2019
L. interrogans/kirschneri and ELE
associated with chronic granulomatous hepatitis without clinical evidence of renal involvement
Development and validation of a novel clinical scoring system for short-term prediction of death in dogs with acute pancreatitis.
Virginie Fabrès jvim 2019
Canine acute panc severity (CAPS) 4 factors: presence of SIRS, coaagulopathy, incr Cr, and ionized hypocalcemia
sCAPs included RR instead of SIRS criteria
CAPS cutoff 11 or sCAPS cutoff 6 had good Sn and Sp for predicting short-term death
Short-term death rate 33-35%
Ultrasonographic features of presumed gastric wall edema in 14 dogs with pancreatitis.
Masahiro Murakami, jvim 2019
preserved wall layering showed submucosal layer thickening
Lymphedema, gastritis, or hypoAlb proposed causes
Usually resolves after AP resolves
Efficacy of an orally administered anti-diarrheal probiotic paste (Pro-Kolin Advanced) in dogs with acute diarrhea: A randomized, placebo-controlled, double-blinded clinical study.
Sophie L Nixon, jvim 2019
Anti-diarrheal probiotic paste (ADPP) containing E. faecium 4b1707 had a shorter duration of D+ (32vs47h) and rate of resolution was 1.6x faster than w/o
Retrospective analysis of esophageal imaging features in brachycephalic versus non-brachycephalic dogs based on videofluoroscopic swallowing studies.
Caroline Eivers jvim 2019
Idiopathic esophageal dysmotility was more common in BAS - prolonged esophageal transit time, decr propagation of 2ry peristaltic waves and GER
BAS dogs associated w/ ED, prolonged transit time, and hiatal hernia
ED more common in young brachycephalic dogs and less common in mesaticephalic breeds
Clinical findings, diagnostic test results, and treatment outcome in cats with hiatal hernia: 31 cases (1995-2018).
Heidi Phillips jvim 2019
> 3yo, 2/3 had sx (phrenoplasty, esophagopexy, and left-sided incisional gastropexy) and 1/3 medically managed
All survived to discharge
Usually have co-morbidity: upper airway obstruction
Cats who were tx’d medically lived longer than sx
**Type 1 HH most common = sliding hernia
Clinical, clinicopathologic, and gastrointestinal changes from aspirin, prednisone, or combination treatment in healthy research dogs: A double-blind randomized trial.
Jacqueline C Whittemore, jvim 2019
GIB occurred commonly in dogs receiving aspirin, pred, or aspirin/pred combo
worst for combo
Higher lesion scores for dogs receiving combination treatment.
Even severe lesions are not accompanied by clinical signs.
Evaluation of the effect of a famotidine continuous rate infusion on intragastric pH in healthy dogs.
Katherine Hedge
famotidine CRI @ 1mg/kg then 0.8 mg/kg/day for 3 days achieved clinical goal of incr pH that promotes healing of gastric tissue injury on day 1
Long-term survival of dogs treated for gallbladder mucocele by cholecystectomy, medical management, or both.
Max Parkanzky, jvim 2019
Higher GBM type (more kiwi like), incr ALP, incr Cr and hyperphos associated w/ decreased survival.
14-day mortality rate of 19.6%
Cholecystectomy had best survival
Metronidazole treatment of acute diarrhea in dogs: A randomized double blinded placebo‐controlled clinical trial
Daniel K. Langlois jvim 2020
Metro 10-15 mg/kg PO q12h x 7d shortened duration (2.1 vs 3.6d) and decreased fecal detection of C. perfringens
Association between abdominal ultrasound findings, the specific canine pancreatic lipase assay, clinical severity indices, and clinical diagnosis in dogs with pancreatitis
Harry Cridge jvim 2020
AUS didn’t correlate well to clinical signs or speCCPL
AUS more sensitive in more severe panc
AUS should not be used in isolation to diagnose pancreatitis and is a poor indicator of severity.
Serum triglyceride and cholesterol concentrations and lipoprotein profiles in dogs with naturally occurring pancreatitis and healthy control dogs
Panagiotis G. Xenoulis jvim 2020
> 70% panc dogs had normal triglyceride and cholesterol levels
Panc dogs had different lipoprotein profiles than healthy dogs
Comparative analysis of the effect of IV administered acid suppressants on gastric pH in dogs
Amanda Kuhl jvim 2020
Esomeprazole, pantoprazole (1mg/kg IV q12h) vs famotidine CRI (1 mg/kg IV then 8 mg/kg/d CRI)
Famotidine CRI and esomeprazole achieved goals established for gastroduodenal ulceration in people in the first 72h
Histopathological findings and canine pancreatic lipase immunoreactivity in normal dogs and dogs with inflammatory and neoplastic diseases of the pancreas
Heike Aupperle‐Lellbach jvim 2020
Normal pancreas: cPLI results WNL and significantly lower than in dogs with mild acute pancreatitis, moderate or severe acute pancreatitis and pancreatic tumors
Mod-severe AP cPLI was 90% Sn
High cPLI indicates serious acute pancreatitis BUT tumour can also incr CPLI
Effect of amoxicillin‐clavulanic acid on clinical scores, intestinal microbiome, and amoxicillin‐resistant Escherichia coli in dogs with uncomplicated acute diarrhea
Melanie Werner et al jvim 2020
No diff b/w recovery b/w tx group and control
Clavamox predisposes the development of amoxicillin-resistant E. coli that can persist for 3w after tx
Bile duct obstruction associated with pancreatitis in 46 dogs
Ashley R. Wilkinson et al jvim 2020
PABDO had longer LOH
prolonged course of illness and improve clinically despite biochemical evidence of progression of EHBDO.
Protease inhibitors, inflammatory markers, and their association with outcome in dogs with naturally occurring acute pancreatitis
Sharon Kuzi et al jvim 2020
19% mortality
Incr inflammation in AP (max CRP, IL-6 and Tnf-alpha)
Serum IL-6, CRP and cPLI were positively correlated
Nonsurvivors had lower AT activity and higher CAPS score
Effects of metronidazole on the fecal microbiome and metabolome in healthy dogs
Rachel Pilla et al jvim 2020
Metro altered microbiome composition (decr richness and decr key bacteria) that did not resolved >4w after metro admin
Ultrasonographic features and prevalence of presumed gastric wall edema in dogs with hypoalbuminemia
Masahiro Murakami jvim 2020
Gastric wall edema seen in 21% of hypoAlb dogs –> common finding?
Serum conc didn’t correlate w/ thickness
Comparative analysis of the effect of PO administered acid suppressants on gastric pH in healthy cats
Phillip Ryan jvim 2020
Esomeprazole was the only one that reached pH changes
The effect of combined carprofen and omeprazole administration on gastrointestinal permeability and inflammation in dogs
Susan M. Jones et al jvim 2020
No change to permeability
Omeprazole/carprofen induced fecal dysbiosis and increased intestinal inflammatory markers
Hyperlipasemia in critically ill dogs with and without acute pancreatitis: Prevalence, underlying diseases, predictors, and outcome
Julia K. Prümmer jvim 2020
DGGR-hyperlipasemia is common in ci dogs
Causes: renal, endocrine, immune-mediated disorders
Hyperlipasemia @ admission + during hospitalization were associated w/ longer hospitalization + higher mortality
