Lecture 3 1/30/25 Flashcards
What is halitosis?
bad breath
Where does halitosis typically localize to?
mouth/oral cavity
What is dysphagia?
difficulty in eating
Which areas can be affected to cause dysphagia?
-prehension
-chewing
-swallowing
What are the characteristics of gagging?
-pharyngeal sign/localizes to pharynx
-stimulated by mechanical irritation of posterior palate or pharynx
What are the characteristics of ptyalism?
-drooling
-increased saliva production by one or more salivary glands
-normal finding in some breeds
What is retching?
unproductive vomiting
What are the characteristics of regurgitating?
-passive expulsion of food, fluid, and/or material
-localized to esophagus
-absence of nausea and bile
-any volume can be produced
What are the characteristics of vomiting?
-active expulsion of ingesta from the stomach and potentially duodenum
-localized to stomach and small intestine
-nausea common; seen as lip smacking and/or salivation
-bile may or may not be present
-any volume can be produced
Which questions help to identify regurgitation vs. vomiting?
-is there abdominal press?
-is there warning?
-is there bile in the expelled material?
–with vomiting, the answer to each question is “yes”
What is hematemesis?
vomiting blood
Where does hematemesis localize to?
upper GI
What is hematochezia?
frank-red blood in the stool
Which areas of the body can be diseased when hematochezia is present?
-anal sacs
-rectum
-large intestine
How does the presence of stool combined with hematochezia help to further localize the issue?
-blood independent of defecation indicates anal sac disease
-blood combined with otherwise normal stools indicates rectal disease
-blood combined with diarrhea indicates large intestinal disease
What is melena?
black, tarry feces; digested blood
What can cause melena?
-upper GI blood loss
-swallowing of blood
What are the characteristics of hemorrhagic diarrhea?
-large volume of diarrhea and blood
-suggests lost of mucosal barrier
-seen with some small intestinal disease
What are the classifications for diarrhea?
-small bowel
-large bowel
-mixed bowel
What are the clinical signs associated with small bowel diarrhea?
-weight loss
-possible polyphagia
-increased volume
-normal frequency
-melena
-slight mucous
-possible vomiting
-no straining
What are the clinical signs associated with large bowel diarrhea?
-no weight loss
-no polyphagia
-straining
-increased or normal frequency
-decreased or normal volume
-hematochezia
-lots of mucous
-no vomiting
What is eructation?
burping/expulsion of gas from oral cavity
What is flatulence?
expulsion of gas from the anorectal canal
What is borborygmus?
rumbling noise of gas as it is propagated through the GI tract
What condition is associated with detecting borborygmus in the thorax?
diaphragmatic hernia
What are the descriptive terms for changes in appetite?
-dysorexia: changes in appetite
-anorexia: no appetite
-hyporexia: decreased appetite
-polyphagia: increased appetite
What is acute abdomen?
sudden onset of severe abdominal pain that often requires surgical intervention
What are the steps to developing a differential list and prioritizing diagnostic tests?
-decide whether the clinical signs are caused by primary GI disease or are secondary to non-GI illness
-localize the signs
-determine duration of clinical signs
-classify the severity of clinical signs
What are the key components of a targeted GI history?
-diet/changes in diet
-exposure to foreign material
-medications and supplements
-deworming/preventatives
-environment
-stool quality
What are the key features of a physical exam when assessing for GI disease?
-body weight/body condition score
-hydration
-oral exam
-palpation of cervical area
-thoracic auscultation
-abdominal palpation
-assessment for peripheral edema
-rectal palpation
What needs to be included in the summary of each problem on the problem list?
-frequency
-severity
-duration
What are the different descriptors for frequency?
-occasional: 1-2 times per month
-intermittent: 1+ times per week
-persistent: no normal periods
What are the different descriptors for severity?
-mild: systemically well; only showing clinical signs related to the problem
-severe: unwell; showing more systemic signs in addition to the noted problem
What are the descriptors for duration?
-acute: < 7 to 14 days
-chronic: > or = 3 weeks
How is the problem list ordered?
-start with the most serious historical or physical exam finding
-make sure to include owner’s chief complaint
-move problems with finite differentials up the list
What is secondary GI disease?
GI disease that results from disease of other organ systems or from systemic disease
What is primary GI disease?
disease or the oropharynx, esophagus, stomach, small intestine, large intestine, and/or rectum
Which diagnostics are used to rule out significant metabolic disease?
-CBC
-chem
-UA
-PLI
-endocrine testing
–baseline cortisol for dogs, T4 for cats
Which fecal tests are important when working up GI disease?
-fecal flotation
-giardia testing
-fecal cultures
-direct fecal smears
Which patients always have an indication for abdominal radiographs?
acutely vomiting animals
What can be diagnosed using abdominal radiographs?
-intestinal obstruction/foreign body
-GDV
-abdominal mass
-decreased serosal detail
What can be diagnosed using abdominal ultrasound?
-free fluid in abdomen
-obstruction
-focal masses
-pancreatic abnormalities
-non-GI disease in abdomen
-intestinal wall thickening
-lymphadenopathy
