Pathology of The Alimentary System - Part 1, Oral cavity Flashcards
The Alimentary system varies in ?
its morphology and function in
different species.
E.g. neoplasia if alimentary system occurs more often in dogs and cats (small animal species). In farm animals, (pigs, ruminants, horses) especially food animals, infectious conditions are very common.
Dogs and cats develop ___________ _________ more often than farm animals
alimentary neoplasia
__________ and _____ develop a wide range of infectious diseases often poorly controlled by vaccination.
Ruminants, pigs
Horses are prone to intestinal ____________ → colic
displacements
Musculoskeletal conditions also occur often in horses.
Normal oral or gastro-intestinal mucosa should be ?
smooth and shiny.
If that is not the case, this may indicate that there is a problem.
What does feces serve as?
The quality and quantity of the
feces is often an early indicator of alimentary dysfunction, as is regurgitation and vomiting.
List the portals of entry of pathogenic agents.
Ingestion (most common)
- Sometimes pathogenic agent is coughed up from lungs, swallowed, and produces lesions in agent.
Coughed up by the lungs and swallowed
Systemic hematogenous route
Migration through the body (parasites)
What are the body’s defense mechanisms against pathogenic agents?
Saliva
- lubricates mouth and prevents bacterial from adhering to teeth and oral mucosa.
Resident flora and fauna
- compete with pathogenic agents
Gastric pH
- acidic –> harsh environment for most microbial survival
Secreted immunoglobulins
Vomiting
Intestinal proteolytic enzymes
Phagocytes and other effector cells within the mucosa/ submucosa
High rate of epithelial turnover
Increased peristalsis resulting in diarrhea
Define cleft palate and cleft lip.
1. What is an alternative name for this condition?
2. Are these conditions common? In what species?
3. Can both conditions be present in the same individual?
4. What causes this condition?
- Cleft palate (palatoschisis) and cleft lip (“harelip”- cheiloschisis).
2-3. Both are common, specially in calves as well as lambs, horses, dogs. - Both can be present in the same individual.
- Often a genetic disorder but toxins (e.g. ingestion of Veratrum californicum (found in california) and other teratogenic plants like lupines, poison hemlock in cattle & sheep) or maternal exposure to drugs during pregnancy (griseofulvin [antifungal] in queens and mares; steroids in primates).
What condition is pictured below?
What is a common complication of this
Cleft palate/cleft lip
Veratrum californicum
In palatoschisis there is a central defect in the midline fusion of the palatine
shelves resulting in communication
between the oral and nasal cavity.
Animal usually dies of aspiration pneumonia. Can not produce proper negative pressure when sucking in during nursing. Milk starts to spill out, especially through the nostrils.
What is the name of this plant? Where can it be found?
Veratrum californicum (found in california)
What condition is pictured below?
Cheiloschisis (“harelip”) - calf
Sometimes, this can be in combination with cleft palate.
What condition is pictured below?
Cheiloschisis, dog
What condition is pictured below?
Cheiloschisis, calf
Malocclusions are defined as?
What may they result in?
Failure to the upper and lower
incisors to interdigitate properly.
May result in difficulties in the
prehension and mastication of
food. Will not gain enough weight.
What condition is pictured below?
Short lower jaw (brachygnathia) = shortening of the mandible.
Also called brachygnathia inferior because it is shortening of the lower jaw. If shortening of the upper jaw it would be called brachygnathia superior. Brachygnathia superior is difficult to differentiate from prognathia.
What condition is pictured below?
Foal, prognathia → protrusion of the lower jaw. In this case, jaw appears to be longer than the maxillary area (upper jaw).
Define dental attrition.
Dental attrition (loss of tooth
structure caused by
mastication).
Carnivores: teeth similar to ours; enamel is confined to the crown of the teeth (outside the gums). Underneath lies the dentin. Enamel is produced by enamlobloasts, dentin produed by odontoblasts. Dentin is darker yellow in color. Cement.
Label accordingly.
The degree of tooth wear depends on what factors?
Abnormal wearing is common in species of THIS dietary restriction?
The degree of tooth wear depends on the tooth, the animal species and the types of food. Loss of dental function due to normal age- associated wear and tear is common in domestic animals. Abnormal wearing is most common in herbivores → results in “step mouth”.
- What condition is pictured below?
- This condition is common in older or younger individuals? Explain why.
- Abnormal wear and tear is common in animals with THIS dietary restriction.
- What happens if there is a problem on one side of an animal’s mouth?
Dental attrition
Normal in older individuals b/c you are using the teeth over time –> wear and tear.
Abnormal wear and tear of teeth = horses –> step mouth
If there is a problem on one side of the mouth –> dental attrition/step mouth.
Periodontal disease is caused by?
Resident bacterial films and the acid and enzymes they produce lead to enamel, gingival and periodontal ligament damage.
Dental plaque = composed of clusters of bacteria adhered to the teeth. Become attached to teeth. Placque = tartar. Can become mineralized and form calculus.
Dental calculus (tartar →mineralized dental plaque)
Bacteria attach to gingival crevices –> chronic periodontal disease.
What condition is pictured below?
Periodontal disease
Supragivngival plaque in crown leads to?
Subgingival dental plaque in crevices at root leads to?
Supragivngival plaque in crown –> cavities
Subgingival dental plaque in crevices at root –> chronic periodontal disease. Loss of alveolar bone.
- Are primary diseases of the oral cavity common? Explain why or why not.
- What is the exception to this rule ^ ?
2A. What species is this condition common in?
2B. What is a common complication of this condition?
- Primary diseases are rare.
- The exception is Actinobacillosis (Actinobacillus lignieresii)
→ chronic stomatitis – the tongue is often involved: “Wooden tongue.”
2A. Occurs primarily in cattle (occasionally in swine & sheep).
2B. Produces inflammation of the tongue called glossitis, stomatitis in general
can also produce inflammation of lymph nodes in region. Very rarely involves the bone.
What condition is pictured below?
Wooden tongue
Very large tongue with nodule lesions
Focal areas of ulceration
Pyogranulomatous type fo glossitis
What do you see microscopically in cases of wooden tongue?
A. lignieresii is a Gram-negative rod
Radiating clubs of amorphous eosinophilic material: Splendore-Hoeppli phenomenon= immune complexes surrounded bacterial clustere.
Large cluster of bacteria = pink thing
- What can be seen in this image?
- What is the causative agent?
- This is often seen in which species? At what age? What part of the body is affected?
- Thrush (Candidiasis)
- Candida spp. (eg. C. albicans) type of fungus
Often is observed in oral cavity (affects mucous membranes) of young animals, especially if they are immunosuppressed (Candida is opportunistic) treated with
antibiotics for long periods of time, or animals with underlying debilitating
diseases.
Involves the stratified squamous epithelium of the oral cavity & upper GI tract (including the forestomach of
ruminants).
Round structure = yeasts
Looking for fungal hyphae.
What can be seen in this image?
What is this caused by?
Ulcerative and necrotizing glossitis, uremia
Lingual lesions are often a manifestation of systemic disease like renal disease (uremic glossitis), BVD or other viral infections like
FMD (discussed later).
Diseases of the oral cavity can be caused by what?
Stomatitis - Etiology
Infectious agents
Trauma
Chemical injury
Auto-immune
Idiopathic
What can be seen in this image?
What species are mainly affected?
Lymphoplasmacytic gingivitis, stomatitis –cat. Can be associated with presenece of dental plaque. Can develop resistance to placque.
Many cats are FeLV or FIV positive. FCV can also be involved. Cats may also develop an immune-mediated response (can be severe) to the bacteria within dental plaques/ tartar.
What condition is pictured below?
What species are mainly affected?
What are the clinical signs associated with this condition?
What is the etiology?
- Feline chronic gingivo-stomatitis (FCGS).
- Kind of like an extension of Lymphoplasmacytic gingivitis, stomatitis - Cats!
- Cinical signs: oral pain, dysphagia, ptyalism and weight loss.
- Etiology: unclear. Dental plaque, FCV, and immune-mediated mechanisms appear to be involved. FCGS is also common in FIV positive cats.
What condition is pictured below?
What species are mainly affected?
What are the clinical signs associated with this condition?
- Chronic ulcerative (lympho-plasmacytic) paradental
stomatitis - Most common in older dogs
- Vesicular stomatitides typically results in what?
1a. Define this term.
Vesicular stomatitides results in vesicles.
Vesicle: a raised lesion (up to 1 cm in the largest dimension) filled with clear
(serous) fluid located within the epithelium or between the epithelium and
lamina propria). A larger lesion is referred as bulla.
If you observe a vesicle in the mouth of a dog or cat, what do you do?
If observed in the oral cavity of dogs & cats:
* Rule out immune-mediated diseases (e.g.: bullous pemphigoid, pemphigus
vulgaris, etc.).
* In cats they are often the result of calicivirus infection
If you observe a vesicle in the mouth of a large animal, what do you do?
- If observed in food/ large animals:
- Rule out major viral diseases which are usually non-fatal but result in huge
economic loss.
What is the pathogenesis of viral vesicular stomatitides?
Pathogenesis: viral-induced epithelial damage → intracellular edema in
keratinocytes (ballooning degeneration) → vesicles→ bulla (large vesicles)
→ rupture leads to erosion and ulceration.
What is pictured below?
Vesicular stomatitides
Pathogenesis: viral-induced epithelial damage → intracellular edema in
keratinocytes (ballooning degeneration) → vesicles→ bulla (large vesicles)
→ rupture leads to erosion and ulceration.
What condition is pictured below?
What is the etiological agent?
Vesicular glossitis – Cat, calicivirus infection
primarily seen in kittens and aging cats that are immunosuppressed.
Pemphigous vulgarus, pemphigus f, calicivirus infection.
Foot and mouth disease is caused by what viral agent? What species are affected?
Foot & Mouth Disease (FMD, Picornavirus)
Ruminants, pigs (cloven-hoofed animals) – no horses
Vesicular stomatitis is caused by what viral agent? What species are affected?
Vesicular Stomatitis (VS, Rhabdovirus)
Ruminants, pigs and horses
Vesicular Exanthema of swine is caused by what viral agent? What species are affected?
Vesicular Exanthema of swine (VES, Calicivirus)
Only pigs
Swine Vesicular Disease is caused by what viral agent? What species are affected?
Swine Vesicular Disease (SVD, Enterovirus)
Only pigs
In the USA and Canada these diseases are classified as
“reportable diseases” – so any suspicious cases need to be
reported without delay to state (provincial) and federal authorities.
Generalities to keep in mind b/c they all will produce ulcerations in oral cavity and vesicles. But pay attention to the differences listed on the this slide in terms of species affected.
What disease is pictured below?
What is the disease pathogenesis?
What are the clinical signs?
Exotic (Foreign) Animal Disease.
Highly contagious with high
morbidity and low mortality.
Virus ingestion/ inhalation
→pharynx → viremia → Oral
mucosa & epidermal sites → lesions
develop in areas subjected to mechanical
injury
Clinical signs: drooling saliva
(ptyalism), lameness
focal areas of ulcerations in tongue
Vesicle (bright red) is partially ruptured. Later on just become ulcers on the far right.
Coronary bands of the digits in addition to the oral cavity.
Lose weight, lame, inappetance.
What condition is pictured below?
Foot and Mouth Disease
Sloughing of the hoof
Coronary bands in the digits
Lesions when become chronic can be severe –> sloughing of hoof. Animal unable to stand.
Runny nose sometimes
What condition is pictured below?
FMD
“A malignant form of the disease without vesiculation
occurs in young animals and occasionally in adults” →
characterized by myocardial necrosis
Rare, but possible.
What condition is pictured below?
Young animals: “tiger heart” → multiple stripes represent areas of inflammation and necrosis, FMD.
Represent myocardial necrosis. Do not have a particular shape.
What condition is pictured below?
Pig suffering from severe lameness, FMD
Calf, piglets
Rarely affects adults.
What condition is pictured below?
FMD
What condition is pictured below?
What species is most commonly affected?
Vesicular exanthema (calicivirus)
Only in pigs
Swollen area = vesicle
Lesions rupture –> areas of erosion and ulceration on right. Secondary bacteria
What condition is pictured below?
Erosive-Ulcerative stomatitides. Cow, BVD
Severe diarrhea, death, can be subclinical too
this is a palette.
Areas of erosion (loss of epithelium but not complete loss of stratified squamous epith)
Ulceration: complete loss of epi and complete exposure of BM, and underlying lamina propria.
What condition is pictured below?
Erosive-Ulcerative stomatitides
Malignant catarrhal fever (MCF), cow
Lesions are more severe b/c the virus produces severe vasculitis
What condition is pictured below?
What is the etiololgy?
Papular Stomatitides
Bovine papular stomatitis.
Etiology: Parapoxvirus Papules on the nares, muzzle, oral cavity. Usually in immunosuppressed individuals (young)
This virus produces a more proliferative type of lesion. Lesions have a coin shape morphology. Area of necrosis is demarcated by a ring of proliferative mucosa.
What condition is pictured below?
papular stomatitides
on histo: destruction of keratinocytes, ballooning degen of keratinocytes.
Cells are swollen, nuclei malformed
Zoonotic condition
What condition is pictured below?
What is the causative agent?
What does this condition result in?
Contagious Ecthyma, also known as Contagious viral pustular dermatitis, Orf,
or “sore mouth”
Worldwide distribution. The cause is a parapoxvirus.
Results in loss of condition since affected animals
“neither suckle nor graze”. High morbidity and low mortality. Mainly in
lambs and goat kids 3 to 6 months of age.
Filled with neutrophils that can rupture, can give rise ot areas of ulceration, erosion, secondary bacterial infection.
Transient condition in most cases.
What condition is pictured below?
Contagious Ecthyma. AVC. Lesions usually develop in sites of trauma (corners of the mouth, mammary gland, coronary bands, etc.). It is a zoonotic disease
What condition is pictured below?
Calf, Pathology Museum, FVSc, University of Liverpool.
Oral Necrobacillosis, Fusobacterium necrophorum
Areas of caseous necrosis
cattle, swine are most commonly affected.
swelling of maxilla.
Clinical signs: swollen cheeks, inappeatance, palitosis (bad breath).
What condition is pictured below?
What part of the body is effected?
Oral necrobacillosis
“Calf Diphtheria”, ulcerative and necrotizing inflammation of the buccal, pharyngeal ad laryngeal mucosa.
- What condition is pictured below?
- What stain was used on this histological sample?
- What can be seen here?
- Oral necrobacillosis –> “Calf Diphtheria”
- PAS
- filamentous bacteria
What condition is pictured below?
Feline eosinophilic granuloma – complex (includes eosinophilic granuloma, labial and rodent ulcer)
What condition is pictured below?
Cat, eosinophilic ulcer, palate.
Feline eosinophilic granulomas
Nodular prolifeative lesions in gums
You collected a sample from a patient that was diagnosed with feline eosinophilic granuloma. What do you see in the histological sample below?
Prominent eosinophillc infiltration
Lymphocytes, MQs.
Producing expansion of underling CT. Lesions characterised by prominent eosinophillic infiltration.
Non-neoplastic proliferative lesions of the Oral cavity
Gingival hyperplasia
More common in brachycephalic breeds, present in ~30% of boxers older than 5 years of age.
What condition is pictured below?
Oral Neoplasia
Fibromatous epulis
Considered to be benign.
An epulis is pictured below.
1. What is an epulis?
2. Are they neoplastic?
3. What are they derived from?
4. Are fibromatous and ossifying epulis benign or malignant?
5. What is Acanthomatous ameloblastoma?
- Epulis: Tumors of the periodontal ligament
– type stroma - Whether or no they are true neoplasms is still controversial).
- Derived from dental mesenchyme.
- Fibromatous and ossifying epulis are benign.
Acanthomatous ameloblastoma (previously known as acanthomatous epulis) are locally aggressive and often recur after excision.
What condition is pictured below?
Canine oral papillomatosis
Papovavirus-induced papilliform or
cauliflower-type lesions (“warts”) in the lips
and oral mucosa.
It is transmissible and usually affects
animals younger than 1 year-old. Lesions
regress spontaneously and immunity
is long-lasting
What condition is pictured below?
Canine oral papillomatosis
Papovavirus-induced papilliform or
cauliflower-type lesions (“warts”) in the lips
and oral mucosa.
It is transmissible and usually affects
animals younger than 1 year-old. Lesions
regress spontaneously and immunity
is long-lasting
- What is this a histological sample of?
- What is this composed of?
- What does this condition cause on a microscopic level? What can be seen up close?
- This condition is primarily seen in what species within what age group?
- Oral papilloma
- Verrucous lesion composed of thick keratinized stratified squamous epithelium covering a pedunculate connective
tissue core. Finger like projections - Ballooning degeneration of keratinocytes, Intracytoplasmic inclusion bodies also present.
- Primarily seen in puppies but can also see it occasionally in other animals. In cattle it is mostly cutaneous? papillomatosis.
- What condition is pictured below?
- Which species is this most common in?
- What % of this condition are malignant?
- What are the predispositions of this condition?
- What is the prognosis of this condition?
- Oral melanomas.
- Most common in dogs.
- Around 90% of oral melanomas in dogs
are malignant. - Smaller breed and oral pigmentation are predisposing factors.
- Bad prognosis. Very nasty.
What condition is pictured?
Neoplastic proliferation of melanocytes contianing brownish intracytopalsmic pigment - melanin.
CAn metastatize very quickly.
What condition is pictured?
Amelanotic melanoma, dog
Some melanomas are non-pigmented and are referred to as amelanotic melanomas.
What condition is pictured?
Oral melanoma, dog –Noah’s Arkives
Melanoma, dog – pulmonary metastases, Noah’s Arkives
Melanomas metastaitze quickly to the lungs.
Metastatic clones can become amelanotic!
Squamous cell carcinoma, tongue, dog
Relative common in dogs, especially cats.
Arise from strati squammy
Highly invasive lesions
Locally aggressive
Slow to metastatize systemically to lungs, etc.
QH gelding –marked emaciation
Devloped Swelling of mandible –> lost weight
Fibrosarcoma – palate and maxilla
QH gelding, AVC
From horse above
Exfoliation of teeth
Cause of weight loss? Cancer sometimes does what? Cachexia associated with cancer
