L7: Diseases of the Canine and Feline Stomach

Question 1

slide 3**

Answer 1

:)

Question 2

acute gastritis mech.

Answer 2

-mucosal damage –> inc. permeability –> acid diffuses back into mucosa to cause gastritis –> ep. cells may necrose and cause erosions (hematemesis)

Question 3

CS of acute gastritis

Answer 3

vomit
lethargy
depression
polydipsia (usually w/o polyuria)
hematemesis
cranial abd. pain

Question 4

differential diagnosis of acute gastritis

Answer 4

gastric FB - obstruction
acute pancreatitis
infectious dz
systemic dz

Question 5

Dx of acute gastritis

Answer 5

• Hx and PE
• abd rads and biochemical tests excludes other diseases
• response to therapy

Question 6

Tx of acute gastritis

Answer 6

• rest the GIT
• supportive care
• feed a “bland” diet

Question 7

Q: what is the most effective for acute self limiting vomiting?**

Answer 7

brief fasting

Question 8

other acute diseases

Answer 8

FB

Gastric Dilatation-Volvulus (surgical)

Question 9

causes of chronic gastritis

Answer 9

• inflammatory (idiopathic): lymphoplasmacytic or eosinophilic
• food responsive disease
• reflux
• helicobacter?

Question 10

chronic (LP) lymphocytic plasmacytic gastritis

Answer 10

• mainly idiopathic
• may be assoc. with food responsive disease
• CS: vomiting, hematemesis (vomit blood), appetite change (usually dec.), weight loss
• Dx of exclusion or biopsy

Question 11

Tx of chronic (LP) lymphocytic plasmacytic gastritis

Answer 11

diet trial (hypoallergenic, novel protein)
acid reducers (omeprazole)
cisapride/metoclopramide
immunomodulation in moderate to severe disease (pred, azathioprine, chlorambucil

Question 12

eosinophilic gastritis

Answer 12

-cause unknown
-eosinophils infiltrate mucosa
+/- peripheral eosinophilia
+/- ulcerated mucosa
-tx: dietary manipulation and/or corticosteroids, deworm, sucralfate
-Rottweilers predisposed

Question 13

Helicobacter gastritis

Answer 13

-causes lymphoid hyperplasia
+/- chronic vomiting
-dx with Warthin-Starry stain on biopsy
(Helicobacter can be part of normal flora)
-not assoc. with ulceration in dogs/cats
-dx of exclusion
-tx controversial: amoxicillin, clarithromycin, metronidazole??

Question 14

Q: why is helicobacter so significant in people?

Answer 14

A: gastric carcinoma

Question 15

Reflux Gastritis (Bilous vomiting syndrome)

Answer 15

• defect in pyloric function or a gastric motility defect allows prolonged contact of bile w/ the mucosa (bile is a detergent which damages cells)
• CS: chronic vomiting of bile-stained material after prolonged fast, most often in early morning, vomitus contains bile-stained mucus and occasionally fresh blood

Question 16

Tx of Reflux Gastritis

Answer 16

• increased feeding frequency
• cisapride or metoclopramide
• H2 receptor antagonists (cimetidine, ranitidine, famotidine)
• Proton pump inhibitor (omeprazole)

Question 17

gastric ulcers mech. and CS

Answer 17

• circumscribed breaks in mucosa bathed by acid-pepsin –> mucosal barrier disrupted
• causes: ulcerogenic drugs, liver disease, tumors, protein-calorie malnutrition, +/- uremia or stress
• CS: vomiting +/- blood, depression, inappetance or anorexia, melena, anemia (usually Fe def. anemia)

Question 18

Dx and Tx of gastric ulcers

Answer 18

Dx: contrast rads or endoscopy and biopsy
Tx: eliminate underlying cause, PPI’s, sucralate, H2 blockers, blood transfusion, endoscopy, surgery, (mostly supportive therapy to increase pH)

Question 19

gastric outlet obstruction

Answer 19

causes: GDV, FB, congenital stenosis, acquired stenosis
CS: intermittent vomiting (maybe projectile, with increasing frequency), HypoCl, hypoK, metabolic alkalosis
-Dx: contrast rads, U/S, endoscopy, surgery
-Tx: surgery

Question 20

Congenital stenosis: clinical presentation

Answer 20

Boxers, Bulldogs, Boston Terriers, cats

-signs usually start at weaning

Question 21

Acquired stenosis: clinical presentation

Answer 21

• older, mostly male smaller breeds

- Lhaso Apso, Pekingese, Shih Tzu

Question 22

gastric tumors

Answer 22

• uncommon
• char. by chronic vomiting, inappetance or anorexia, loss of body weight and condition, +/- sudden anorexia
• anemia, diarrhea, hematemesis
• most found in distal stomach of older male dogs
• dx: imaging, endoscopy

Question 23

most common gastric tumor of dog

Answer 23

adenocarcinoma

Question 24

most common gastric tumor of cats

Answer 24

lymphoma

Question 25

Q: most common site of leiomyomas in the stomach

Answer 25

A: fundus

Question 26

gastric parasites

Answer 26

-ollulanus and physaloptera (<– most common)
-intermediate host dung beetle
CS: chronic vomiting
Dx: endoscopy
Tx: pyrantel or fendbendazole?