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Systemic Pathology II > Part 2-Esophagus-forestomachs-stomach > Flashcards

Part 2-Esophagus-forestomachs-stomach Flashcards

1
Q
  1. What condition is pictured below?
  2. In what species does this occur most often?
  3. Explain the pathogenesis.
  4. What happens as a result?
A
  1. PRAA
  2. Cattle and dogs occurs more often
  3. Left aortic arch is normally developed and the right one regresses. In some cases, right develops along with the left –> vascular ring between aorta and PA called ligamentum arteriosum –> megaesophagus.
    Puppies will start to regurg and lose weight.
    Die of aspiration pneumonia.
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2
Q
A

Congenital megaesophagus –persistent right aortic arch (vascular ring) -
puppy
Dilatation of esophagus will be cranial to the aorta. ?
PRAA
Esophagus is the large brown thing
Looking at left side

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3
Q
  1. What is a common sequelae of PRAA?
  2. What species is this most common in?
  3. What can this consequence also be a result of?
A
  1. Megaesophagus can also be acquired in cases of PRAA.
  2. This consequence is most common in dogs.
  3. It can be idiopathic or a manifestation of myasthenia gravis
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4
Q

A dog named Lucky was enjoying Thanksgiving dinner with his family. To make him feel like he was included, his mom gave me a potato wedge as a treat. Unfortunately, Lucky choked on this potato wedge and died. His owner permitted you to perform a necropsy and you see this. What is your diagnosis?

A

When an animal chokes
If animal swallows a potato whole or a pieve of corn –> condition called choke. Esophagus can not expand too much –> object gets stuck –> focal areas of necrosis –> poor vascular supply, ischemic injury. Linear area of necrosis in esophageal mucosa. Animals can not feed or drink properly.

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5
Q
  1. What condition can cause erosion and ulceration of the esophageal mucosa?
  2. What other species can this occur in?
A
  1. Reflux-esophagitis, horse aka heartburn
    leakage of gastric contents in esophagus –> erosion and ulceration of esophageal mucosa.
  2. can also occur in pigs and people.
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6
Q

What condition is pictured below?

A

Erosive-ulcerative esophagitis, BVD

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7
Q
  1. What condition is pictured below?
  2. What is the most common etiologic agent?
  3. What species is this commonly seen in?
  4. What does this condition result in?
  5. In what part of the body does this occur?
A
  1. Parasitic esophagitis:
  2. Spirocerca lupi in dogs
  3. Results in chronic (granulomatous) esophagitis (A) which occasionally lead to neoplastic transformation: formation of sarcomatous lesions (mainly osteosarcomas and fibrosarcomas).
  4. Occurs in distal esophagus
    Common in south, and saint kitts?
    A = benign
    B = ulcerative and proliferative - malignant? relist4en
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8
Q
  1. What condition is pictured below?
  2. What is the etiologic agent?
A

RUSVM, 2014 – dog
1. Esophageal Osteosarcoma
2. S. lupi
Osteosarcoma and fibrosarcoma have been described in cases of s. lupi

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9
Q
  1. What condition is this cow suffering from?
  2. What does this condition result in?
  3. Explain the pathogenesis.
A
  1. Bloat, tympany in a heifer, web.
  2. Distended left paralumbar fossa
  3. Ruminal tympany or bloat: “Over-
    distention of the rumen and reticulum
    by gases produced during
    fermentation”.
    A. Primary: Often associated with new diets (young alfalfa, clover, too much carbs)
    that promote the formation of stable foam (frothy bloat).
    B. Secondary: Caused by physical or
    functional obstruction of the esophagus
    resulting in failure to eructate (e.g.: vagus
    indigestion, esophageal papillomas,
    lymphosarcoma etc..)

Animals can die of cardiac failure.

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10
Q
A

Bloat, cow-AVC
Need to make sure this animal died recently because if animal has been siting for awhile they will become bloated.

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11
Q
A

Bloat, cow, AVC

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12
Q

You perform a necropsy on a cow that died from bloat. During the necropsy, you see this.
1. What is pictured below? How does this form?
2. What function does it serve?
3. How do you determine if the cause is ruminal bloat?

A
  1. “Bloat line” at the level of the thoracic inlet. Esophageal mucosa looks like a light blue on the right. Rumen is pushing thoracic viscera, so blood is pushed towards head and neck –> forms line.
  2. This s the most reliable post- mortem indicator of ante-mortem bloat, cow,
  3. Check pH of rumen, especially frothy bloat, is acidic (ruminal acidosis). If under 5.5 then it is most likely ruminal bloat.
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13
Q

What can be seen in the image below?
What species is this commonly found in?
What is this made of? What is another form of this that is composed mainly of plant material?

A

1-2. Trichobezoars (hairballs)– cattle, also found in dogs and cats.
- Are not as heavy as enteroliths (intestinal stones that form within the colon and can obstruct the intestine, resulting in colic) and are located in the forestomach and abomasum.
2. Hair, Phytobezoars or phytotrichobezoars → composed mainly of plant material impregnated with some phosphate salts may also be found in the colon of horses.

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14
Q
  1. What condition is pictured below?
  2. What is a secondary complication of this condition?
A

Foreign bodies
1. Traumatic reticulitis -cattle
2. Puncture diaphragm but can also puncture pericardium and heart –> pericarditis, endocarditis –> cardiac tamponade. Puncture lungs on occasion too.

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15
Q

What condition is pictured below?
What does this condition lead to?
What species is this condition most commonly seen in?

A
  1. Traumatic reticuloperitonitis (“hardware disease”, cow).
  2. Led to vagus indigestion and ruminal atony.
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16
Q
  1. What condition is pictured below?
A

Traumatic reticuloperitonitis

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17
Q

Chronic pericarditis and epicarditis is not an unusual complication. of?

A

Traumatic reticuloperitonitis aka hardware disease in cows

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18
Q
A

Chemical rumenitis (lactic acidosis, grain overload), cattle

Damages ruminal epi
Destroys keratonuocytes
if we open rumen, we see the reticulum is normaly greenish but when damaged you se focal areas of ulceration. On hiso: nutrophilic busculs within the mucosa.

Complications of chemical ruminitis: bacteria can get into portal circulation –>
1. bacteremia (in cattle and sheep) —> liver abscesses (b/c portal vein enters liver) –> vena cava thrombosis (significant cause of death in feedlot cattle and also in dairy cattle occasionally). OR valvulaar endocarditis

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19
Q
  1. What condition is pictured below?
  2. What is this indicative of?
  3. What does this represent?
  4. What types of feed are more likely to cause chemical ruminitis?
A
  1. “stellate ulcers” (ruminal scars)
  2. Usually indicative of old bouts of chemical rumenitis.

If animal has suffered from bouts of chemical rumenitis and survives –> ruminal scars.

  1. Represents healed areas of ulceration. Proliferation of CT and formation of scars.
  2. Grain overload.
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20
Q

What is pictured below?

A

6-month-old heifer, history of grain overload. AVC-1998

Several animals in herd developed bloating, inappetence, ruminal atony, etc.

One of the treatments for chemical rumenitis = rumenectom. Open rumen, take out all of ruminal contents b/c very acidic and then replace ruminal content with fresh ruminal content from slaughter house and close. In some cases this is effective treatment, but in other situations –> peritonitis. This is what they saw in the room. Areas of ulceration in the rumen containing necrotic caseous material. Proliferation of fungi, not just bacteria, from ruminal contents –> mycotic ruminitis. Some animals do not recover from this –> euthanize.

Fungi like blood vessels and produce thrombosis –> ischemic injury.

In this case, Rupture of wall of rumen –> periotonitis.

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21
Q

Stomach/ Abomasum
◼ Gastric dilatation, volvulus & displacement
◼ Gastric impaction/ rupture
◼ Gastro-duodenal ulceration
◼ Inflammation:
 Uremic gastritis
 Bacterial gastritis/ abomasitis
 Mycotic gastritis/ abomasitis
 Parasitic gastritis
◼ Gastric Neoplasia
 Squamous cell carcinoma –horses
 Lymphosarcoma, cattle, horses etc..

A
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22
Q

What condition is pictured below?

A

We see this more commonly in pigs, especially sows.
Have very long gastrosplenic ligament. If eat a lot of food or drink a lot of water. Torsion of stomach along the gastrosplenic ligament. Involvement of stomach but also involvement of the spleen.

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23
Q

What condition is pictured below?

A

Gastric dilatation-volvulus, dog
If not taken immediately to surgery –> death.
Stomach in this case is turned 180 degrees.
Venous infarction of stomach, spleen.
In pigs: Somtimes after feeding or drinking, get excited and fight, develop this.

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24
Q

What condition is pictured below?

A

Dog, gastric dilatation, volvulus –Intraluminal hemorrhage, Rhodesian ridgeback dog, AVC-97
Animal was in sepsis
Venous infarction of stomach and spleen.
See this in pigs, more often in sows, and dogs.
B/c of torsion of stomach and spleen –> venous infarction in wall of stomach –> full of blood –> wall is friable due to venous infarction.

25
Q
  1. Abomasal displacement occurs most often in what species?
  2. Where is the abomasum normally located? -
  3. What is the most common form of abomasal displacement? Is this form fatal? What does it result in?
  4. What is the other form of abomasal displacement? Is this fatal? What does it result in?
  5. In general, regardless of the form, what do abomasal displacements lead to?
A
  1. post-parturient dairy cows and calves
  2. normally located ventral and to the right of abdominal cavity
  3. Left-sided is most common: generally non-fatal → partial obstruction of abomasal flow.
  4. Right-sided: Represent ~15% of the abomasal displacement. 20% of these result in abomasal volvulus. Venous infarction end result. Worse prognosis compared to left side.
  5. Abomasal displacements (left-sided or right-sided) lead to abdominal pain, elevated heart rate, anorexia, dehydration, depressed peristalsis with lack of feces and abomasal tympany (high-pitch ping elicited by percussion).
26
Q
  1. What condition is pictured below?
  2. What species does this condition most commonly effect? Why?
  3. What is the most common cause of a gastric impaction/rupture?
  4. Is this an image of an animal pre or post-mortem?
  5. What anatomical characteristic of this species makes this condition even more emergent?
A
  1. Gastric Impaction/ Rupture; Gastric rupture, horse – Cornell files
  2. Most cases of gastric rupture in horses are due to intestinal obstructions (ileus) → a-dynamic (paralytic) or mechanical ileus. A-dynamic ileus results from inhibition of bowel motility most commonly caused by peritonitis. Clinical signs of colic and then stomach can rupture –> fatal peritonitis
  3. Fermentable carbohydrates in large amounts, too much grain and then excessive water intake –> gastric dilatation and eventually impaction.
  4. Is this pre or post mortem? dead animal does not bleed.
  5. Horses are unable to vomit because the cardiac sphincter is very strong. Very rarely are going to vomit. Get NG tube to relieve gastric contents.
27
Q
  1. What condition is pictured below?
  2. What does this condition ultimately lead to?
A
  1. Chronic diaphragmatic hernia (horse)
  2. Leading to gastric rupture and Death. Part of diaphragm ruptured.
    Stomach enter tear of diaphragm –> bacteria proliferation, fluid accumulation, acute cardio-respiratory failure as a result.
28
Q

You are working a shift in a large animal hospital when a horse named Chocolate is presented to you for lethargy, inappetance, dehydration, discomfort, etc. The owner tells you that Chocolate ate about 50 persimmons the other day when he wasn’t around to monitor him. Ever since this incident, Chocolate has been “acting funny.” What is your top differential?

A

Gastric impaction/ rupture (right).
Horse had engorged with persimmons, Cornell files.

Horse can not regurgitate –> severe colic –> if you leave stomach rupture –> death.

29
Q
  1. What is the condition pictured below?
  2. What species is this condition commonly seen in? Why?
  3. In what part of the body is this most commonly found?
  4. What is the pathogenesis of this condition?
  5. What are the clinical signs?
A
  1. Gastric ulceration, Gastric ulcer,
  2. Seen in pigs fed finely ground rations. High wheat component in the feed also plays a role. Common in other domestic animals as well.
  3. Area of ulceration is usually located in the esophageal portion of the stomach covered by stratified squamous epi.
  4. Pathogenesis: usually present in animals given very fine, ground feed. Do it to increase feed efficiency in pigs.
  5. Clinical signs: poor growth b/c bleeding due to exposure of underlying connective tissue. Present with melena. can become anorexic, pale with white MM (in some cases see acute bleeding into the stomach and on pathology will find a stomach full of blood).
30
Q
A

Multifocal areas of ulceration.
Cardiac portion of stomach?
Line between white and darker brown = margo plicatus
Stress related ulcers can also result in presence of gastric ulcers and occasionally can be associated with colic.

31
Q
  1. What condition is pictured below?
  2. What is the etiologic agent?
  3. Pathogenesis?
  4. Animals with this condition can develop another condition called?
A
  1. Gastric ulceration
  2. NSAIDs- horse
  3. Pathogenesis: ↓ prostaglandin production (PGE2, PGI1 → have a protective role)
  4. Animals with ulcers can develop reflux esophagitis (or heartburn). Gastric fluids damage strati squammy epi.
32
Q
  1. Most gastric ulcers in cats and dogs are ?
  2. What is pictured in the image below? What condition can this lead to? Describe the pathogenesis.
A
  1. Most gastric ulcers in cats and dogs are idiopathic.
  2. Cutaneous mast-cell tumors in dogs may lead to gastric ulceration. when mast cells degranulate, produce histamine –> local inflammatory response in areas. Fluctuating in size may be associated with release of histamines. Release histamine into the blood → binds to receptors on parietal cells of the stomach, increasing HCL secretion.
33
Q
  1. What condition is pictured below?
  2. What species can this condition occur in?
A
  1. Perforated gastro-duodenal ulcer in a dog with a mast cell tumor.
  2. May occur in dogs with solitary cutaneous mast cell tumors.
34
Q
  1. What condition is pictured below?
  2. What are the results of this condition?
  3. What is the etiologic agent?
  4. What species is this condition commonly seen in?
A
  1. Gastric venous infarction in the Stomach, pig
  2. thrombosis & hemorrhage (gastric venous infarction) secondary to endotoxemia or bacterial sepsis.
  3. Salmonellosis is more likely to produce this and also E. coli septicemia. but can happen in any case of bacteremia
  4. Occasionally seen in ruminants and horses. Pigs.
35
Q
  1. What condition is pictured below?
  2. What animals are commonly affected by this?
  3. What do these patients typically develop?
A

Uremic gastropathy (uremic gastritis, cat).
Animals with renal failure.
Like people with renal failure, they may develop renal lesions of uremia that sometimes play a role in clinical deterioration of patient.
Uremic gastropathy, uremic enteritis (remember pathogenesis) –> produce vasculitis and thrombosis
Mineralization of mucosa can occur (see below)

36
Q
  1. What condition is pictured below?
  2. What other underlying condition does this patient most likely have?
A

Uremic gastritis, 2 year-old
Shi-Tzu dog with familial renal
disease, AVC.
Some can be dystrophic or metastatic

37
Q
  1. The histological image below is indicative of ?
  2. What special stain was used on this sample?
A
  1. Uremic gastritis, demonstrating widespread gastric mineralization.
  2. Von- Kossa stain
38
Q
  1. What is the condition pictured below?
  2. What is the etiologic agent?
  3. The species most commonly effected?
  4. What part of the body is most commonly affected?
  5. When does this condition typically occur?
  6. What is the pathogenesis?
A
  1. Abomasitis, lamb – Braxy (bradsot)
  2. Clostridium septicum.
  3. Lambs, occasionally in calves too.
  4. Absomasal mucosa,
  5. Happens usually in winter months when the weather is very cold.
  6. Pathogenesis: unknown. Proposed: associated with consumption of frozen feed that can be fibrous and with ice may result in damage to abomasa mucosa –> environmental conditions for anaerobic bacteria to proliferate. Clostridium produces different exotoxins —> animals develop endotoxemia and die.

Red, hemorrhagic, edematous, fibrin and increased mucous in lumen.

39
Q
A

Abomasitis, lamb – Braxy (bradsot) is caused by Clostridium septicum.
In absomasal mucosa, occasionally in calves too.
Happens usually in winter months when the weather is very cold.
Pathogenesis: unknown. Proposed: associated with consumption of frozen feed that can be fibrous and with ice may result in damage to abomasa mucosa –> environmental conditions for anaerobic bacteria to proliferate. Clostridium produces different exotoxins —> animals develop endotoxemia and die.

Red, hemorrhagic, edematous, fibrin and increased mucous in lumen.

40
Q
  1. What is the condition pictured below?
  2. What species is this commonly seen in? Why?
  3. Describe the pathogenesis of this condition.
    4.
A
  1. Mycotic gastritis/ abomasitis
  2. Seen primarily in calfs with long term antibiotic therapy –> proliferation of fungal organisms within stomach. Mycotic abomasitis is often a sequel of long-term antibiotic therapy which destroys resident
    bacterial flora and promotes the growth of angio-invasive fungi such as Aspergillus, Absidia, Rhizopus, Mucor spp. etc.;
  3. These angioinvasive fungi love BV so whenever there is a mycotic infection, the fungi invades wall –> thrombosis –> focal ischemia. Sepsis and other debilitating conditions are also predisposing factors.
41
Q

What condition is pictured below?

A

Mycotic abomasitis, calf- Texas A&M University

42
Q
  1. What condition is pictured below?
  2. What stain is being used in the histological sample on the right?
  3. What are the blue dots on the left indicative of? On the right?
A

Mycotic vasculitis/ perivasculitis, dog – Texas A&M
GMS stain on right
Bluish material on left = inflammatory cells
GMS stain shows fungal organisms

43
Q
  1. Name the condition pictured below.
A
  1. Parasitic gastritis
    Gasterophilus nasalis and intestinalis (entrance at proximal duodenum), horse, Cornell files
    Apparently no clinical problems. Can see 100s of these larvae from these flies in the stomach.
44
Q
A

Gasterophilus intestinalis, horse
Proliferative change
Focal erosions
Does not produce any clinical problems in horses

45
Q
A

Erosive-ulcerative lesions caused by Gasterophilus intestinalis, horse

46
Q
  1. What condition is pictured below? (Etiologic diagnosis)
  2. What is the etiologic agent?
  3. What part of the body is affected?
A
  1. Parasitic gastritis.
  2. Ostertagia spp.
  3. Abomasal folds. Proliferative (hyperplastic) abomasitis.

“Moroccan leather” appearance of the affected abomasal mucosa
Seen in canada and the states.

47
Q
A

Rare to see nowadays
Draschia megastoma (spirurid nematode) -produces nodules (brood pouch) close to the
margo plicatus (mucosal/submucosal nodule). Larvae are in this pouch
Granulomatous gastritis,
horse

apparently does not produce major problems to horses.

Inflammatory response in this case: Granulomatous, eosinophillic gastritis

48
Q
A

Haemonchus contortus is a trichostrongylid nematode parasite that causes
disease primarily in sheep and goats. Parasitic abomasitis leads to blood,
loss, anemia and hypoproteinemia

Bottle jaw= subcutanous edema
Severe parasitic diseases produce edema. In this case, it is usually a case of haemonchosis. Hypoproteinemia

49
Q
A

Haemonchus contortus
Pale mucous membranes-sheep

50
Q
A

Parasitic abomasitis, sheep → Blood-sucking trichostrongylid parasite -> can also affect goats and cattle.

Digested blood on left

51
Q
A

Barber poll appearance
Haemonchus contortus, “barber’s pole worm”→(due to its blood-filled intestine). sheep –UCVM, 2008

52
Q
A

Gastric neoplasia
Gastric squamous cell carcinoma, horse
More commonly seen in horses

53
Q
A

Horse, gastric squamous cell
carcinoma
Noah’s Arkives
More common tumor in horses.

fibrosis due to infiltration of tumor
weight loss, hypoproteinemia, anorexic, melana b/c lesion will be bleeding.

54
Q
A

Peritoneal carcinomatosis. Horse, Gastric Squamous Cell Carcinoma, Noah’sArkives
Tumor can push through wall of stomach and invade peritoneal cavity.
Carcinomas are malignant of epithelial origin. Multifocal spreading –> transelomic spreading.

55
Q

? carcinoma are relatively common in horses.

A

Stratified squamous

56
Q
A

Gastric lymphosarcoma
- lymphosarcomas are an important neoplastic disease in domestic animals in general
- there can be involvemnet of GI tract.
- Example of lymphosarcoma in a horse.
- lesions can be nodular and additionally there can be more diffous invovlement in the stomach folds
- Sometimes nematode parastie can produce nodules but there are usually single or a few of them that are close to the margo plicatus.
- several ndues here and some of the ruggae/folds appear to be thickened.
- This horse also presents with some multifocal areas og fastric ulceration

57
Q
A

Abomasal invovement with lymphosarcom sometimes
Enxootic leukosis;. Abomasal involvement ehre.

vEry common in cattle when you have multicentric lymphosarcoma. You will see the folds of the abomasum are a litle noduler, thickened.

58
Q
A

Abomasl folds are diffusely thickened and nodular. Tumor compresses BV –> limiting blood perfusion in area.

Systemic Pathology II (22 decks)

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