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522 (dog & cat class) > GI med 2 > Flashcards

GI med 2 Flashcards

1
Q

what is “acute gastroenteritis” or acute gastritis? what are the typical clinical findings? what are important ddx?

A

sudden gastric insult causing vomiting

V+, ± hematemesis, anorexia, nausea, d+

primary GI!!: dietary indiscretion, ± infectious, ± intoxications

(secondary GI less common)

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2
Q

how do you dx acute gastritis

A

C/S, hx, PE ± MEDB

usually no GI urgency markers

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3
Q

how do you tx acute gastritis

A

therapeutic trial (NPO!)

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4
Q

what is “chronic gastroenteritis” or chronic gastritis? what are important ddx?

also called what?

A

chronic, intermittent or daily vomiting

dietary intolerance (hypersensitivity; allergy) - cause rarely ID’d

food responsive enteropathy

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5
Q

what is the tx for chronic gastritis

A

therapeutic trial

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6
Q

tell me about the two different types of hypoallergenic diets

A

hydrolyzed: enzymatic hydrolysis –> produce low molecular weight protein hydrolysates

novel protein: protein source that animal should not have had contact with

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7
Q

failed trial? GI urgency markers? what do??

A

GI diagnostics!

abd rads, abd US, endoscopy, surgical biopsies, GI blood panel, fecal float, Giardia or deworm (if baby)

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8
Q

do fecal cultures work for when you have an animal with GI urgency markers or an animal that fails a therapeutic trial?

A

nope! dont do.

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9
Q

true or false: like humans, H. pylori causes gastric ulcers in small animals

A

false!! it does NOT

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10
Q

true or false: Helicobacter pylori causes chronic vomiting that responds to therapeutic trials

A

false. it causes chronic vomiting that does NOT respond to trials

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11
Q

how do you diagnose H. pylori in SA?

A

endoscopic or surgical gastric biopsy (histopath)

urease test (bac t produce urease) - not specific

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12
Q

what is the tx for H. pylori in SA

A

Metronidazole, amoxicillin, famotidine ± pesto-bismol, ± omeprazole

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13
Q

why might a Basenji be chronically vomiting?

A

hypertrophy of funds mucosa

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14
Q

why might a brachycephalic be chronically vomiting?

A

hypertrophy of pyloric mucosa –> gastric outflow obstruction

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15
Q

why might a Lundehund be chronically vomiting?

A

protein-losing gastroenteropathy; atrophy of gastric mucosa; adenocarcinoma

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16
Q

what fungal agent in south of US and South America causes chronic vomiting in animals?

A

pythiosis

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17
Q

what are delayed emptying/motility disorders?

A

normal gastric emptying: organized interaction of smooth muscle with neural and hormonal stimuli

delayed emptying: outflow obstruction or defective propulsion
- typical presentation: vomiting food 8-16 hr after meal

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18
Q

what is the typical C/S and hx of delayed gastric emptying/motility disorder?

A

C/S: vomiting food many hours after a meal (looks barely digested)

hx:
- brachycephalic (pyloric hypertrophy)
- older, weight loss, hematemesis –> neoplasia
- cats + hairballs

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19
Q

what are some common causes of delayed gastric emptying/motility disorders?

A
  • pyloric hypertrophy**
  • neoplasia*
  • pancreatitis*
  • recent sx
  • certain drugs
  • idiopathic**
  • IBD
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20
Q

how do you dx delayed emptying/motility disorders?

A
  • breeds at risk
  • endoscopy, biopsy
  • U/S
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21
Q

how do you tx delayed emptying/motility disorders?

A

directed at underlying cause if present
- pyloric hypertrophy –> sx
- dietary mods –> GI diet, wet food

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22
Q

true or false: it is normal for cats to cough up hairballs frequently

A

false. if increased frequency or weight loss, could be a sign of something more serious

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23
Q

what is the tx for frequent hairballs in cats?

A

(little evidence based)

  1. special hair ball diet (insoluble fibre or larger kibble)
  2. diet mod
  3. grooming
  4. smaller meals
  5. gastric lubricants (paraffin)
  6. pro kinetics

basically trial and error. if they’re getting worse or continuing, need other diagnostics

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24
Q

true or false: gastric ulcers are not common in cats and dogs unless there is a predisposing factor.

A

true!!!!

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25
Q

what are the causes of gastric ulcers in animals?

A
  • decreased blood flow (shock, anesthesia)
  • hyper secretion of acid (MCT, gastrinomas)
  • NSAIDs and glucocorticoids***
  • exercise-induced, stress
  • Addison’s**
  • aspirin, ibuprofen***
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26
Q

true or false: COX-2 selective agents are less ulcerogenic

A

true

27
Q

what are the clinical findings of a SA with Gi ulceration

A

vomiting, hematemesis, melena
pale gums, abd pain, shock

28
Q

how do you dx GI ulceration in SA?

A

CBC: regen anemia, (lack of stress leukogram in Addisons)
Chem: elevated BUN

rads, US, endoscopy (can see gastric ulcer), surgical biopsies

29
Q

why is there an elevated BUN with GI ulceration in SA?

A

breaking down blood (protein), sending to liver, makes BUN

30
Q

how do you tx gastric ulcers in SA?

A
  • IV fluids, resuscitation (shock)
  • GI protectants
  • anti-emetics (metoclopramide, maropitant)
  • Abx
  • opioids for pain (bupe, methadone, hydromorphone)
31
Q

what GI protectants are there for Gastric ulcers?

A
  • PPI (omeprazole, pantoprazole)
  • misoprostol (PGE2 analog)
  • sucralfate
32
Q

what is bilious vomiting syndrome? ie. what is the pathogenesis?

A

dogs

chronic intermittent vomiting of bile secondary to reflux into stomach

reasons not understood

33
Q

what are the C/S of bilious vomiting syndrome?

A

vomiting early morning of bile

34
Q

how do you dx bilious vomiting syndrome?

A

C/S, rule out other causes

35
Q

how do you tx bilious vomiting syndrome?

A

meal late at night, antacids

if no response, consider additional workup to rule out other conditions

36
Q

what is hemorrhagic gastroenterocolitis (HGE)? AKA acute hemorrhagic diarrhea syndrome

A

it’s a syndrome, the cause is usually unknown… could be:
- acute hypersensitivity reaction
- C. perfringens

mixture of V+, small and large bowel D+, hematochezia

37
Q

what is the typical clinical presentation of hemorrhagic gastroenterocolitis? C/S, test results, clinical findings, etc

A

V+, SI and LI D+, hematochezia, acute abdomen, shock/hypovolemia

acute dehydration, hemoconcentration, protein loss (PCV and TS similar in value!!!)

38
Q

how do you dx and tx hemorrhagic gastroenterocolitis?

A

dx: C/S, hx
tx: treat shock, NPO is v+, gastro diet, probiotics

px good, improvement within hours

39
Q

true or false: canine parvovirus (CPV-2) is:
a) highly contagious
b) aerosol transmission
c) vaccination prevents
d) more common in summer

A

a) true
b) false. fecal-oral
c) false. vax protects, reduces severity
d) true

40
Q

what cell tropism does canine parvovirus love?

A

rapidly-dividing cells (intestines, BM)

41
Q

what are the C/S of canine parvovirus?

A
  • 4-7 days after infection
  • typical situation: puppy recently adopted!!! weaning-6mo
  • acute v+, d+, hematochezia, hematemesis, depression, febrile or hypothermia, abd pain (intussusception)
42
Q

how do you dx Parvo in dogs?

A

CBC: leukopenia, anemia
chem: panhypoproteinemia
fecal antigen ELISA (can take up to 10-12 days after infection to become positive ….. retest!!)

vaccination can cause false positive on ELISA

43
Q

how do you tx canine Parvo? (also feline Parvo/feline panleukopenia)

A

supportive (nutritional ASAP)

plasma or albumin transfusions (plasma = no proven benefit?)

pain meds (opioids)

monitor

44
Q

feline panleukopenia is caused by…?

A

parvovirus

mortality 50-90%

similar tx as canine Parvo

45
Q

canine and feline coronavirus causes what C/S?

A

usually self-limiting d+, although in cats can mutate to FIP

46
Q

feline panleukopenia (parvovirus) causes ____ before birth

A

cerebella hypoplasia

47
Q

what are the C/S and risk factors for Giardia?

A

C/S: small or large bowel d+ or recurring d+, vomiting

risks: young, immune compromise, shelters, kennels, pet stores

48
Q

how do you diagnose Giardia?

A

3 zinc sulfate floats, or ELISA or PCR

49
Q

how do you tx Giardia?

A

fenbendazole

(metronidazole less effective)

50
Q

true or false: Giardia is zoonotic

A

true

51
Q

food hypersensitivities (allergies) typically cause what type of disease?

A

chronic SI disease with often with derm signs

52
Q

how do you dx and tx food hypersensitivities ?

A

hypoallergenic diet trial 6-8 weeks

53
Q

what breed has gluten-sensitive enteropathy?

A

Irish Setters

54
Q

What is ARD? what is it’s other name? what is the pathogenesis?

A

antibiotic-responsive diarrhea

SIBO: small intestinal bacterial overgrowth

dysbiosis, causing malabsorption syndrome and diarrhea

55
Q

who gets primary ARD?

A

young GSD, local IgA deficiency

56
Q

what causes secondary ARD?

A
  • abnormal GIT, motility disorder
  • chronic enteropathies
  • acute enteropathies
  • meds, diet
57
Q

what are the C/S of ARD/SIBO?

A

small bowel diarrhea ± vomiting, weight loss, borborygmi, flatus, decreased appetite

58
Q

how do you diagnose ARD/SIBO?

A

eliminate other causes, esp EPI

folate (elevated), cobalamin (low)

59
Q

how do you tx ARD/SIBO?

A
  • metronidazole, tylosin 4-6 wks
  • diet change
  • cobalamin SC if needed
60
Q

what is EPI? what are the causes/pathogenesis?

A

exocrine pancreatic insufficiency

insufficient synthesis and secretion of pancreatic enzymes

primary (dogs, autosomal recessive): GSD, Eurasians, rough-coated collies

secondary (cats): old age, chronic pancreatitis, more rare!

61
Q

what are the C/S of EPI?

A

steatorrhea (not always), voluminous loose stools, weight loss, increased appetite

62
Q

how do you diagnose EPI

A

low TLI (sensitive + specific!!)

63
Q

how do you tx EPI

A
  • pancreatic enzyme supplementation with food!
  • cobalamin supplementation as needed
  • high-quality diet

522 (dog & cat class) (31 decks)

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