Nonsurgical GI - Oral, Esophageal and Forestomach Disorders

Question 1

Etiology of “wooden tongue”

Answer 1

Actinobacillus ligniersii

Question 2

Actinobacillosis causes a _____ infection of the tongue.

Answer 2

Granulomatous

Question 3

Actinobacillosis is primarily seen in ____ on ____ feedstuffs.

Answer 3

cattle; rough

Question 4

T/F: Actinobacillus ligniersii is a common inhabitant of the oral cavity.

Answer 4

true

Question 5

How does a cow get actinobacillosis?

Answer 5

Via oral wound - infection begins at the base of the tongue, and may infect other soft tissues of the oral cavity

Question 6

C/S of actinobacillosis

Answer 6

Anorexia
Abnormal chewing
Hypersalivation
Enlarged firm tongue
Regional lymphadenitis

Question 7

Is culture usually done if you suspect actinobacillosis in a cow?

Answer 7

No - if the tongue feels like a brick, you can expect that it is “wooden tongue”. Do a culture if the cow does not respond to therapy.

Question 8

Gram stain of actinobacillosis will result in gram ___ rods +/- ___ granules.

Answer 8

negative; sulfur

Question 9

Treatment for Actinobcaillosis

Answer 9

Sodium iodide IV

Oxytetracycline

Question 10

Prognosis of actinobacillosis?

Answer 10

Good- as long as there is no sloughing of the tongue epithelium

Question 11

Etiology of “lumpy jaw”

Answer 11

Actinomyces bovis

Question 12

Actinomycosis is ____ of the jaw, more commonly affecting the ____ than the maxilla.

Answer 12

Osteomyelitis; mandible

Question 13

T/F: Actinomyces bovis is a common inhabitant of the oral cavity.

Answer 13

True

Question 14

How does a cow get actinomycosis?

Answer 14

Via oral wound

Question 15

C/S of Actinomycosis

Answer 15

Bony swelling, periosteal response
Fibrous tissue reaction
Draining tracts
Decreased appetite, difficulty chewing
Hypersalivation
Weight loss

Question 16

Gram stain of pus from a cow infected with actinomycosis will result in gram ___ filamentous branching rods +/- ____ granules.

Answer 16

positive; sulfur

Question 17

A differential diagnosis of actinomycosis is tooth root abscess. WHich one is more common?

Answer 17

Actinomycosis is much more common than a tooth root abscess.

Question 18

Treatment for Actinomycosis

Answer 18

Sodium iodide IV - tx until you see signs of iodine toxicity.

Question 19

What are signs of iodine toxicity?

Answer 19

Dadruff in an adult ruminant, can also see thickening of ocular, nasal, and oral secretions

Question 20

Can you use isoniazid to tx actinomycosis?

Answer 20

No, animals cannot enter food chain!

Question 21

Prognosis of actinomycosis

Answer 21

Guarded - often comes back at a later date

Question 22

Papular stomatitis is caused by a _____.

Answer 22

parapoxvirus

Question 23

T/F: Papular stomatitis is zoonotic.

Answer 23

True

Question 24

C/S of papular stomatitis

Answer 24

Often asymptomatic, papules and plaques on muzzle, lesions develop and regress for several months

Question 25

T/F: papular stomatitis has a high mortality.

Answer 25

False - has a high morbidity, but should NOT die from it ever

Question 26

Tooth root abscesses are more common in what species? On which teeth?

Answer 26

Camelids - mandibular molars, fighting teeth.

Question 27

Lump on a jaw in a camelid is a ______ until proven otherwise. Lump on a jaw in a cow is ______ until proven otherwise.

Answer 27

Tooth root abscess; lumpy jaw

Question 28

Diagnosis of tooth root abscess

Answer 28

Radiography: Bony lysis of lamina dura Periodontal sclerosis Periosteal reaction

Question 29

Medical therapy for tooth root abscess includes chronic antibiotic therapy , especially against facultative _____ bacteria.

Answer 29

anaerobic

Question 30

Medical therapy for tooth rooth abscess only has a ___% recovery rate.

Answer 30

60

Question 31

Surgical tx for tooth root abscess?

Answer 31

Tooth extraction

Question 32

Balling gun injury is due to?

Answer 32

Aggressive use of instruments in the mouth

Question 33

Choke is caused by?

Answer 33

Obstruction of the esophagus

Question 34

Common offenders for choke:

Answer 34

Root vegetables - potatoes, apples, turnips

Question 35

Common sites of choke

Answer 35

Cranial portion of cervical esophagus Thoracic inlet Base of the heart

Question 36

C/S of choke

Answer 36

``` Free gas bloat Dysphagia Salivation Can compress the lungs - anxiety, swinging of the head or staggering Saves of motility in the esophagus ```

Question 37

Differential diagnoses of choke

Answer 37

``` RABIES Tetanus Botulism Balling gun injury Necrobacillosis ```

Question 38

Tx of choke

Answer 38

Try to pull obstruction out if in cervical esophagus. Try to push into the rumen in distal sites of the estophagus If severe bloat - release gas with trochar/temporary rumen fistula Correct fluid/acid base abnormalities

Question 39

Chock can lead to secondary _______ dysfunction.

Answer 39

esophageal

Question 40

clinical signs of secondary esophageal dysfunction due to choke

Answer 40

Anorexia Regurgitation Hypersalivation Recurrence of choke

Question 41

Tx options for animals with secondary esophageal dysfunction from choke?

Answer 41

Cull, or try to do a rumenostomy to give the esophagus time to heal

Question 42

Simple indigestion is a ______ inappetance due to changes in rumenal microenvironment.

Answer 42

transient

Question 43

Causes of simple indigestion may include:

Answer 43

Moldy/spoiled feed Indigestible roughage Too much feed New type/batch feed

Question 44

C/S of simple indigestion

Answer 44

``` Decreased appetite Decreased milk production Rumen hypomotility Mild bloat Abnormal feces ```

Question 45

Simple indigestion is typically found in _____ animals on a farm

Answer 45

multiple

Question 46

Diagnosis of simple indigestion is by ____

Answer 46

rule out

Question 47

Other names for rumen acidosis

Answer 47

Lactic acid indigestion Toxic indiestion D-lactic acidosis Grain engorgement

Question 48

Rumen acidosis is caused by an overindulgence on _____.

Answer 48

Carbohydrates

Question 49

Common offenders for rumen acidosis

Answer 49

Cereal rains (corn, wheat, barley) High sugar/starch fruit or root crops Corn or milo stubble fields Byproduct feeds (bakery waste, brewers grain)

Question 50

Good quality forage that gets chopped to very fine pieces, decreasing particle size, can act like a ______, and can lead to rumen acidosis as well.

Answer 50

carbohydrate

Question 51

Carbohydrates are rapidly broken down by what two bacteria?

Answer 51

Strep. bovis | Lactobacillus spp.

Question 52

After breaking down carbohydrates, strep bovis and lactobacillus spp. produce what product?

Answer 52

Lactate

Question 53

High lactate in the rumen decrease the pH of the lumen, resulting in an increase in gram ____ bacteria.

Answer 53

Positive

Question 54

With a decreased pH in the stomach, we see large increases in _____ acid.

Answer 54

Proprionic

Question 55

With such a low pH, and acidic byproducts of gram positive bacteria, eventually the protozoa and bacterial flora will die, and we get an increase in ____ and _____.

Answer 55

Glucose and endotoxins

Question 56

Why are endotoxins increased in rumen acidosis?

Answer 56

Because most gram positive bacteria die off, leaving behind gram negative bacteria.

Question 57

Between D and L-lactate products, which one is metabolized in the rumen and which one builds up?

Answer 57

L-lactate is metabolized. | D-lactate builds up

Question 58

Rumen acidosis causes damage to the rumen epithelium. What are the consequences of this?

Answer 58

``` Chemical rumenitis Epithelial necrosis Epithelial necrosis Absorption of bacteria Bacterial and fungal rumenitis ```

Question 59

C/S in ACUTE rumen acidosis

Answer 59

Individual animal disease - individual animal looks sick. Anorexia and depression Splashy, distended static rumen (osmotic sink in the rumen) Dehydration, tachycardia, cold extremities Weak or recumbent Diarrhea with or without grain Death

Question 60

C/S of Subacute Rumen Acidosis

Answer 60

Herd disease - disease of production limitation. Decreased or variable feed intake Decreased performance Increased incident of lameness Decreased milk fat % - inversion of fat:protein ratio in milk Loose feces

Question 61

Rumen fluid analysis in rumen acidosis

Answer 61

Foul smell | pH

Question 62

Lab test results for rumen acidosis

Answer 62

``` Metabolic acidosis Increased anion gap Hemoconcentration Prerenal azotemia Mild-moderate hypocalcemia ```

Question 63

Diagnosis of subacute rumen acidosis

Answer 63

``` History and PE are NOT pathognomonic Look at ration analysis Rumenocentesis (rumen pH > 5.8 - normal) Manure scoring Lameness scoring Milk fat inversion ```

Question 64

Principles of rumen acidosis tx

Answer 64

Stop acidification Correct metabolic abnormalities Reestablish flora Prevent sequellae

Question 65

Can we use bicarb to alkalinize the rumen to tx rumen acidosis? Why or why not?

Answer 65

No - bicarb + acetic acid will generate bubbles with high surface tension which will result in frothy bloat

Question 66

Good medical tx for rumen acidosis

Answer 66

Carmolax - powder is better than pill form - it is magnesium hydroxide that will alkalinize the rumen without generating a lot of gas/bubbles

Question 67

Sequellae to rumen acidosis

Answer 67

``` Bacterial rumenitis Bacteremia/septicemia Fungal rumenitis Liver abscess Metastatic pneumonia Polioencephalomalacia Laminits ```

Question 68

Prevention of rumen acidosis

Answer 68

Prevent accidents Transition cattle to high concnetrate diet slowly Inophores and buffers in feed - limit gram positive organisms - need to be present at all times for them to help

Question 69

Two types of primary rumen tympany

Answer 69

Pasture bloat and grain bloat

Question 70

Bloat = ____ distension.

Answer 70

rumen

Question 71

Bloat can be seen as an abdominal distension on the upper ____ side of the cow. As it gets more severe, can progress lower, and occasionally can see distension on the ___ side.

Answer 71

Left; right

Question 72

Pasture bloat causes

Answer 72

Lush, rapidly growing legumes - soluble proteins in these plants act as foaming agents Mucins in saliva can break down foam, without enough saliva, the foam cannot be broken down and the cow cannot eructate gas bubbles

Question 73

Causes of feedlot bloat

Answer 73

High grain diets - slow rumen motility and decrease saliva production Mucopolysaccharides produced by rumenal bacteria are responsible for stable foam generation

Question 74

Clinical presentation of rumen tympany

Answer 74

``` Severe abdominal distention (typically on left side) Gasping for breath Prolapsed rectum Raised tailhead Dead ```

Question 75

Medical tx for pasture bloat vs feedlot bloat

Answer 75

Pasture bloat = poloxalene | Feedlot bloat = mineral oil

Question 76

Other tx for rumen tympany besides medical tx include passing a stomach tube, rumen trocar, and tying a rag in the mouth. Why does tying a rag in the mouth help?

Answer 76

It makes the cows salivate - helping to break down gas bubbles

Question 77

Secondary rumen tympany is caused by?

Answer 77

failure of erucation (esophageal blockage, or during step up to high concentrate diet resulting in a free gas bloat secondary to mild grain overload)