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Canine/Feline Internal Medicine > GIT > Flashcards

GIT Flashcards

1
Q

Explain how you can differentiate between the following:

a. Dysphagia, regurgitation
b. Regurgitation, vomiting
c. Small int, lrg int diarrhoea
d. Bleeding lesion & coagulopathy

A

Dysphagia - pain/difficulty eating. Will visualise this during mastication. Food undigested from mouth.
Regurgitation - from the oesophagus. No heaving, no nausea, pH >7, may eat it again.
Vomiting - from stomach/intestine. Heaving, nausea, pH >5 or

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2
Q

Describe history that suggests oropharyngeal disease. Outline diagnostic approach.

A

Dysphagia, excess salivation, reluctance to eat, anorexia, halitosis, weight loss.
History like chasing sticks, caustic agents etc.
Diagnose via thorough oral exam, maybe radiographs and biopsy under anaesthetic.

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3
Q

Outline approach to regurgitation. Justify any tests you’d do.

A

Mainly caused by oesophageal obstruction or oesophageal insufficiency/weakness.
Would maybe do radiographs plain & contrast, fluoroscopy, oesophagoscopy, biopsy. Would do these to check for issues.

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4
Q

Outline a diagnostic approach to vomiting. Justify tests.

A 
Good thorough history (food, changes, foreign bodies etc.) 
Other systemic signs look at these like PU/PD, weakness etc. 
Faecal analysis (parvo etc.) 
Imaging (obstructions, foreign bodies) 
CBC, biochem etc seeing dehydration any changes
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5
Q

How would you diagnose sml int diarrhoea, lrge int diarrhoea & constipation?

A

Based on the clinical signs presented investigation of diet, parasite control, diet modification etc.
Examine the faeces
Rectal examination and palpation
Maybe do radiographs if worried about obstruction or faecal build up

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6
Q

Which is more useful endoscopy or exploratory laprotomy for obtaining biopsy specimens?

A

Endoscopy - too small samples, multiple samples required, not good disease process indicator, technically challenging, only stomach duodenum colon & oesophagus
Ex Lap* - large full thickness biopsies, entire abdomen, need GA. BETTER
*Always take biopsies with Ex Lap even if appears normal.

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7
Q

What is the diagnostic application of folate and cobalamin levels?

A

For chronic sml int diarrhoea & weight loss.
Cobalamin is absorbed in small intestine - bacteria stops this absorption decreasing cobalamin levels.
Folate is also absorbed in sml int.
So check these because it indicates that the sml intestine is compromised.

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8
Q

Outline rational for dog with GDV. What should we discuss with the owner in terms of operative and perioperative periods?

A

First stabilise patient with aggressive fluid therapy (crystalloids), analgesia and maybe decompress stomach.
Need to do PCV, blood smear, glucose, electrolytes, lactate (fluid therapy) before surgery.
Going to de-rotate the stomach, evaluate other organ viability, may need spleen removal, gastropexy to prevent torsion reoccurrence.

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9
Q

A large breed dog has gone surgery for GDV. Spleen was also removed and gastropexy performed. What will your management and treatment involve?

A 
Fluid therapy to maintain perfusion 
Ongoing monitoring of PCV etc. 
Antibiotics 
Analgesia (opioid + ketamine) 
In future - two small meals, no exercise after eating, mixing textures of feed
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10
Q

Describe and justify appropriate management for 12 week old puppy with parvovirus.

A

Supportive therapy
Quarantine
IV fluids, electrolytes, antibiotics, glucose, control vomiting (anti-emetic like metoclopramide), antacids, small regular bland feeds

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11
Q

Why can a strong parvo suspicious case test negative on the cage side parvoviral test.

A

Tested too early - repeat or haemorrhagic faeces Ab coating intereferes or too long post infection

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12
Q

What is protein losing enteropathy and how is it recognised?

A

Syndrome.
Small intestinal diseases causing protein malabsorption.
Can be with or without diarrhoea.
Cause by haemorrhage, hookworm, lymphoma, IBD…
Run urinalysis?

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13
Q

What’s the difference between expectoration, dysphagia, regurgitation & vomiting?

A

Expectoration - respiratory origin
Dysphagia - mouth origin
Regurgitation - oesophagus origin
Vomiting - Stomach/small intestine origin.

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14
Q

How do you differentiate regurgitation & vomiting?

A

Regurgitation - no heaving, no nausea, maybe food, maybe blood, re-eat food, >7pH
Vomiting - heaving, nausea, yellow, inappetant, 8 pH

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15
Q

What are some causes of regurgitation?

A

Oesophageal obstruction

Oesophageal weakness

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16
Q

What stimulates vomiting?

A

Stomach/duodenal distention or irritation
CRTZ stimulation
Vestibular input

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17
Q

The following conditions cause what clinical feature?

  • GIT obstruction
  • Gastrointestinal inflammation
  • Extra GIT disease
  • Diet
  • Drugs/chemicals
A

Vomiting

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18
Q

Why is large intestine disease usually associated with diarrhoea but small intestine disease is often not?

A

Large intestine is for storage of faeces and absorption of Na & Cl.
Small intestine can get diarrhoea from exceeding colon water holding capacity.

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19
Q

How do you differentiate small intestine & large intestine diarrhoea?

A

Small int - Increase volume, no straining, no mucous, weight loss, melaena
Large int - increase frequency, straining, mucous, fresh blood

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20
Q

Define haematemesis, haematochezia & melena

A

Haematemesis - vomiting blood
Haematochezia - fresh blood in faeces
Meleana - digested blood in faeces

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21
Q

What’s the difference between obstipation and constipation?

A

Constipation - difficult evacuation of faeces

Obstipation - cannot physically pass faeces due to obstruction or functional change

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22
Q

Why do you do CBC, biochem, urinalysis when investigating GI problems?

A

CBC - anaemia, thrombocytopaenia (bleeding) eosinophilia (parasites)
Biochem - protein loss, electrolytes, K, Na
Urinalysis - concentrating ability

23
Q

Why don’t we do a faecal culture?

A

ALWAYS will grow bacteria - there is always bacteria in faeces.

24
Q

When do you use barium and when do you use iodine in contrast radiography?

A

Barium normally.

Iodine if there is perforation suspected/confirmed.

25
Q

A 10 week old puppy presents with acute vomiting, multiple episodes and complete anorexia. There is skin tenting and tacky mucous membranes. What is your diagnostic approach?

A

Possible hookworm or parvovirus.
Put on fluid therapy immediately to combat dehydration.
Worming history, faeces, parvo snaptest.
PCV/TP to check hydration status.

26
Q

12yo cat losing weight but eating well and intermittent small intestinal diarrhoea. Body condition 4/9 and hydration is okay. Would you treat?

A

Yes. Obviously is a chronic condition maybe hyperthyroidism, GI issue, IBD. Do a full work up with diagnostics.

27
Q

How do we anticipate fluid therapy requirements?

A

Measure PCV/TP to assess dehydration.
Consider vomiting - hypochloraemia, hypokalaemia, metabolic alkalosis.
Anaemia

28
Q

When would you use hypotonic fluids?

A

NEVER they leak out of vasculature

29
Q

What special consideration should be made with fluid therapy in vomiting patients?

A

Use isotonic crystalloid fluid and consider adding K to combat hypokalaemia and treat metabolic alkalosis.

30
Q

What is the shock rate boluses?

A 
Initial dose 90mL/kg dogs or 40mL/kg in cats over 10-15 minute intervals 
Use HES (synthetic colloid)
31
Q

A 10kg dog with vomiting and diarrhoea is 5% dehydrated. Estimate how much fluid you will give over 24 hours.

A 
Estimate a 500mL fluid deficit. 
Maintenance usually 50mL/kg/day 
Ongoing loss of 50mL/kg/day 
??? 
2L in 24 hours.
32
Q

When do you not give K?

A

Hyperkalaemic

Bradycardic

33
Q

What are hypoallergenic or hydrolysed diets used for?

A

More for conditions like IBD and GI issues.

Like Hills canine i/d or hydrolysed (Ag very small) or novel protein

34
Q

How do you calculate RER? (Resting energy requirements)

A

30 x (weight in kg) + 70 = RER kcal/day

35
Q

Give an example of an appetite stimulant.

A

Periactin (Cyroheptadine)

36
Q

Provide an example and MOA of your choice of the following drug categories:

  • Antiemetic
  • Antacid
  • Motility modifier
  • Anti-inflammatory
A

Antiemetic - Metoclopramide inhibits CRTZ. Not w/ obstructions or Maropitant NK1 antagonist lasts 24 hrs
Antacid - Sucralfate protects mucousa or Omeprazole blocks gastric acid secretion.
Motility modifier- Ranitidine acetylcholinesterase inhibitor
Anti-inflammatory - Bismuth subsalicylate anti-PG & bactericidal or Metronidazole antibacterial

37
Q

When you use antibiotics what should you consider?

A

Right antibiotic, right dose for the right length of time.

Use antibiotics if there’s blood in the poo. (indicates mucousal damage)

38
Q

Explain use of emetics and which you would choose.

A

Indicated for toxin ingestion. NOT caustic substances

Use Apomorphine for dogs, Xylazine for cats.

39
Q

What’s an enema?

A

Makes them poo.

Cleanse colon, remove toxins, constipation.

40
Q

Dog has a large non painful swelling under the jaw. Some dysphagia, gagging & dyspnoea. What do you think?

A

Sialocoele. Take an aspiration - will probably see thick mucoid fluid.

41
Q

What indicates oesophageal disease?

A

Regurgitation

42
Q

Describe megaoesophagus.

A

Either congenital or can be due to persistent right aortic arch (vascular ring anomaly).
Diagnose with contrast radiography.
Upright feeding, treat underlying condition.
Okay prognosis worse with aspiration pneumonia.

43
Q

Why do you get oesophagitis?

A

Reflux during surgery
Persistent vomiting
Caustic medication

44
Q

How do you diagnose and treat oesophagitis?

A

Diagnose with radiographs (dilate) or do biopsy.

Treat with sucralfate, upright feeding, omeprazole antacid

45
Q

What are the common sites of oesophageal obstruction?

A

Thoracic inlet, heart base, cranial diaphragm

46
Q

Dog is regurgitating solid material but no liquid. What are you thinking?

A

Oesophageal cicatrix - scarring of the oesophagus so you get liquid passing through but not solids.
Get oesophagitis. Treat this and do bougienage to treat stricture.

47
Q

What causes gastritis?

A

Diet, foreign objects, viral/bacteria, NSAIDS…lots of causes

48
Q

Why is PCV high in cases of haemorrhagic gastroenteritis?

A

Haemoconcentrated because the animal is losing more water than blood.

49
Q

How do you diagnose a more chronic gastritis case?

A

Take multiple biopsies.

50
Q

What is meant by IBD?

A

Idiopathic disease not understood completely.
Lymphocytic plasmacytic is the most common form.
Need to do elimination diets.

51
Q

What are the main causes of protein losing enteropathy in dogs & cats?

A

Dogs - IBD, hookworm, lymphoma, GI ulceration etc.

Cats - lymphoma, lymphoplasmacytic

52
Q

What are some causes of large intestine diarrhoea/

A

FIV
Bacteria
Whipworm

53
Q

How do you get oesophageal strictures?

A

Secondary to deep inflammation from foreign bodies, reflux or dry pilling cats

Canine/Feline Internal Medicine (9 decks)

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