Investigation of vomiting Flashcards
What lab tests may be useful for investigation of vomiting?
Minimum database
TLI/ folate/ cobalamin
PLI
ACTH stim (any animal where obvious reason can’t be found)
Faecal parasitology/ culture
Infectious diseases (e.g. parvo)
Total T4 (normally reserved for those over 8)
Compare the use of abdominal ultrasound and abdominal CT to investigate vomiting
Animals over 25kg - CT more acurate. Doesn’t really matter below that
To assess intestinal layers (e.g loss or thickening) the ultrasound is needed.
When is endoscopic sampling not useful (compared to full thickness)
If a lesion is in the intestinal muscularis
If the lesion is in the duodenum
If multiple organs need samples
What does hyperechoic fat signify?
Inflammation within the abdomen
When is surgical biopsy not preferred?
Severe hypoalbuminaemia
If the animal is likely to need steroids ASAP and cannot wait the 7-10 days needed post surgery
If the animal has co-mobidities meaning a long GA is not ideal
Which gastric acid suppressants are better at increasing gastric pH? (N.B not necessarily clinically useful still though!) All should be given on an empty stomach
Omeprazole BID is much better than ranitidine, famotidine is better than ranitidine
When can misoprostal be useful?
When there is GI erosion due to an NSAID
When is sucralfate useful?
Binds to areas of incomplete mucosal lining, so good for GI erosion - ** can prevent other drugs/ food being absorbed though so best on an empty stomach**
Why may hydrolysed diets not work when the GI disease is due to food reactions? Why might they still even when this should occur?
Most diets are with protein broken down to 5-15 kDa, which means if the diet is still made from the protein that causes a reaction, the protein may still be big enough to react.
HOWEVER - this size still prevents IgG cross linking, reducing type 1 hypersensitivity reactions
How long should you give a diet trial before you either switch brand/ try a novel protein/ give up?
4 weeks
When may a high fibre diet be useful?
Some cases of large intestinal diarrhoea
When may ultralow fat diets be useful?
Lymphangiectasia - can increase albumin levels and decrease clinical signs
When would immunosuppressives be appropriate?
IBD
Lymphangiectasia
Neoplasia
Which immunosuppressives are commonly used in GI disease?
Preds
Chlorambucil - particularly good for cats with small cell lymphoma
Cyclosporine - mostly used if S/E of preds are unacceptable
Azathioprine - care with S/E
