SA GI disease Flashcards
Types of GI disease
Functional disorders
Increased motility
Decreased motility
Altered digestion
Altered absorption
Congenital or acquired
Noninflammatory
Enzymatic, intestinal accidents
Inflammatory
Infectious and non infectious
History needed for GI disease
Identify the complaint
Pain, vomiting, diarrhea, no BM…
Has there been a change in appetite
Change in bowel movement
Colour, frequency, volume, change over time
Vomiting or regurgitation
What do you need to identify for vomit
When did it start
Frequency
Amount (volume)
Contents
Consistency
Patterns (triggers, times)
Any known disease, toxicity, dietary indiscretion
Regurgitation characterisitcs
Passive
Esophageal
No prodromal signs
NEVER includes bile
Characteristics of vomit
Active (peristalsis)
Stomach, proximal intestine
Prodromal signs
MAY include bile
Canine papillomas are
Common
Caused by K9 papilloma virus
Benign ‘wart-like” growths
Easily transmissible
What are canine papillomas and where are they often
Epithelial and mucosal epithelial cells
Cells replicate uncontrollably
Mouth >eyelids> prepuce and vulva
C/S and treatment of canine papillomas
Healthy host is usually asymptomatic
Clinical cases are due to immune suppression
Treat underlying condition (if applicable)
Usually self-limiting- 1-5 months
Surgical removal
Autologous vaccine
Azithromycin
Esophagitis is and what causes it
Inflammation of the esophagus
Many causes including foreign body, trauma, heat, chemical, chronic vomiting, gastroesophageal reflux, tetracycline antibiotics
Gastroesophageal reflux
Iatrogenic- most common
CS of esophagitis
Inappatence to anorexia- because it hurts
Weight loss
Regurgitation
Treatment of esophagitis
Supportive care
Maintenance nutrition and hydration
Decrease inflammation
Remove cause of irritation (ex. Foreign body)
Assisted (forced) feeding
Nasogastric tube
Esophageal tube
Gastric tube
E tube feeding is
Esophageal feeding tube
Soft feeding tube is surgically placed in the cervical esophagus. Food and water can be injected into the stomach via the e tube
G tube feeding is
Gastric tube
Surgically placed through the abdominal wall, directly into the stomach
G-tubes can stay in indefinitely
esophageal structures is
Narrowing of the esophagus
Often scar tissue due to prior trauma (from choke or esophagitis)
Clinical signs of esophageal stricture
Anorexia
Weight loss
Depression
Multiple attempts to swallow
Regurgitation
Respiratory signs - due to aspiration
Diagnosis of esophageal stricture
is with barium
Complications
Aspiration pneumonia
Megaesophagus
Megaesophagus is
Esophagus is permanently stretched
Whole or part
Megaesophagus is caused by
Idiopathic
Congenital anomalies (PRAA)
Primary condition: hypothyroidism, myasthenia gravis
Primary stricture
CS of magaesophagus
Malnutrition- regurgitation, inappetence
Respiratory signs due to aspiration pneumonia
Due to regurgitation
Very high barium risk
Very high GA risk
Will usually cause death at a young age
How to manage magaesophagus
Need to sit up will eaten in what is called a bailey chair
This will allow the food to go through the esophagus without getting stuck
Have them sit 15 minutes after eating
Small frequent meals
Signalment of GDV
Great dane; other large to giant, deep chested breeds
Large meals followed by intense exercise
Sudden ADR with bloat
Results of GDV
Loss of blood flow to stomach→ rapid tissue necrosis→ toxemia/perforation
Dilated stomach pushes against vena cava→ decrease blood flow to heart via vena cava→ shock
Pushes against lungs so they can’t expand
EMERGENCY
Presenting complaint of GDV
Bloated, enlarged
Regurgitation
ADR, recumbent, collapsed
(Evenings)
Treatment of GDV
Asses
Start shock treatment if required
Deflate stomach with gastric tube if possible
Can also do a trochanter like in cattle, use a 16G needle
Blood collection for CBC, serum chemistry, blood gas
Surgical untwist and replacement
Can get PCV post op
Prognosis is guarded
Risk of recurrence without a gastropexy is 90%
Gastropexy is
Stomach is fixed in place to abdominal wall
Reduced risk of volvulus
Preventative
At time of spay/neuter
Gastrointestinal foreign bodies (GI FB) is common in
Common in dogs and cats
History of getting into “stuff”
Younger animals
4 factors are important with GI FB
Shape of the object
What it is made of
Where it is stuck
time/duration it has been stuck
FB In the stomach
Best surgical prognosis
Gastrotomy
May digest with time, endoscopic retrieval, vomit on own
Common see intermittent vomiting
When are FB a concern in the stomach
Sharp
Toxic
Blocks pyloric sphincter or moves out of the stomach and causes an obstruction in the SI
SI foreign body is and concerning when
Intraluminal = something stuck inside
Concerns
Intraluminal FB can push against the intestinal wall and block off blood flow
Trauma injury/perforation if sharp
Surgical outcome is good if there is no perforation or necrosis
Treatment for SI FB
If healthy…enterotomy
If damaged….. Intestinal resection and anastomosis
reduction= cut out
anastomosis= reconnect
Linear FB is and common in
Common in cats with string
Pulled the SI taunt
Large intestinal FB
If it has made it this far, the animal will likely be able to pass it on its own
If obstructed, guarded to poor prognosis
Because poor blood supply to colon
Poor healing
Rapid necrosis
Why is time important for FB
Prognosis declines significantly once clinical signs appear
Usually a sign that gut is compromised
Necrotic tissue release toxins
Bacteremia
Septic shock
For better prognosis
Treat cats within 36 hours of cs
Treat dogs within 72 hours of cs
Diagnosis of FB
History and PE
Imaging
Radiographs +/- contrast medium
Ultrasound
Signs of an emergency with a FB
Severe dehydration
Acute abdomen (Fast and really painful abdomen)
Fever
Lethargy
Severe frequent vomit
Blood in vomit or blood in diarrhea
Pale or injected MM
Low temp
To vomit or not for FB? why?
NEVER induce vomiting with a foreign body
Complications?
Trauma due to increased peristalsis
Perforated with liner FB
Esophagitis
Intestinal anastomosis is
Attaching two sections of intestine
History for diarrhea
Colour and consistency
Volume
When did it start
Frequency
Straining
Can they hold it or is it explosive
Other GI signs, energy level
Dietary indiscretion, food change
Hx of vaccines and deworming
Causes of diarrhoea
Acute diarrhea
Dietary indiscretion
Drug reactions
Parasitic infection
Viral infection
Inflammatory bowel disease, food intolerance, exocrine pancreatic insufficiency, neoplasia, Addisions disease
Adverse drug reaction
Antibiotics
NSAIDs
Steroids
Chemical irritation
Bacterial diarrhea
Clostridium perfringens spores in a fecal smear
E.coli
Salmonella
Common viral causes of diarrhoea in dogs
Parvovirus
Coronavirus
Distemper
Common viral causes of diarrhea in cats
Panleukopenia virus
Coronavirus
Treating acute diarrhea in adult dogs
Supportive care
Fluids- maintain/correct hydration
Bland diet
Some vets fast 24 hours in CERTAIN CASES
Slow re-introduction of bland diet
Increasing amounts over 4-7 days
Gradual reintroduction of regular diet
Probiotics
GI protectants and absorbents
Treat primary condition
Anti Parasiticides, stop drug, antibiotics (maybe)
Parvo is
Canine parvovirus infection
All canids
Summer
Endemic in SK
Transmission of parvo
Fecal-oral transmission
Can have vertica route
Stays in the environment; very hard to kill
Non-enveloped virus
heat/cold/dying resistant
Resistant to many disinfectants
Requires black or hydrogen peroxide based
Pathophysiology of parvo
Damages intestinal epithelial cells
Malabsorptive diarrhea (nutrient and water loss)
Hemorrhage
Breakdown of intestinal barrier
Bacteria enter blood stream
Infects immune cells
Immunosuppression
Cant fight off bacteremia
Alerts for parvo
signalment/history
8w-6mo
Unvaccinated, vaccinated owner, has not completed puppy series
Rescue, stray
Black and tan breeds; german shepherd, rottweiler
Complaint
Diarrhea
With or without blood
Vomit
With or without blood
Maybe lethargy
KEEP IN CAR UNTIL VET SAYS OTHERWISE!
Disease course for parvo
Day 0- fecal oral transmission
Day 0-7 -incubation period (no clinical signs; can shed)
Day 4-10 - prodromal period (lethargy, fever, anorexia)
Day 7-14- clinical signs
Vomit diarrhea
+/- presence of blood
Lethargic, fever, dehydration
Outcome depends on if treated or not
If animal recovers- will shed virus for about 14 days after all clinical signs resolve
Prognosis with parvo
Puppies
Highly fatal
Adults and fully vaccinated puppies
Mild diarrhoea
Depends on
Age
Vaccine status
Degree of dehydration
Clinical severity
And if treated or not
How to diagnose parvo
Idexx Parvo SNAP test
Test is on feces
Test in car
Will have two blue dots when positive
A positive control blue dot in the top middle
A darker blue dot in the middle left
Can get a faint positive if recently vaccinated
Why do parvo puppies need to be isolated
Highly transmissible
Can be deadly to any other puppies in the clinic
Very hard to get rid of
Can’t fight anything else off
Treating parvo
Isolation
IV fluids
Antibiotics
Antiemetics
Introduce a bland, easily digestible diet as soon as possible
Additional supportive care as required
Prevention of parvo
Vaccinate!
Colostrum
Deworming
Decrease transmission
Isolate recovered dogs for 2 weeks
Restrict movement of unvaccinated puppies
Causes of constipation
Dehydration (chronic renal disease)
Genetic defect in intestinal smooth muscle
Diet- sand, lack or fibre, bone, hair
Nerve damage
Megacolon is
Secondary to chronic constipation
Due to a genetic smooth muscle defect
Medical management of constipation and megacolon
Optimal hydration
Enemas
Increase dietary fiber
Laxatives
Prescription medications to increase motility
Cisapride
Peritonitis is
Inflammation of the peritoneum and the abdominal cavity
Indicates an abdominal problem- many disease processes can cause peritonitis
Need to monitor for peritonitis in patients that are recovering from abdominal surgery
Prognosis is always poor
Recognizing peritonitis
Lack of (or decreased) GI sounds
Inflammatory fluid in abdomen
Swollen abdomen
Leaking/wet incision
Fever or signs of shock
There are two forms of feline coronavirus
Wild type
Mutated virus (feline infectious peritonitis virus)
Feline corona enteritis
Wild type virus
High prevalence
Subclinical to diarrhea
Can recover with supportive care
Easily spread by saliva, urine, feces, blood
Feline infectious peritonitis
Rare
Mutated virus
Spontaneous mutation AFTER infection
Not transmissible
Fatal without treatment
Feline infectious peritonitis (FIP) has what two forms
Wet
Dry
Wet form FIP
Fluid in thorax and/or abdomen
Peritonitis
Dry form FIP
Neurological signs
Disseminated abscesses
Prognosis of FIP
Historically- no treatment options, euthanasia recommended
Things are changing
February 2024 –GS-441524 becomes legally available in Canada with an Emergency Drug Release
Efficacy of treatment is >80%
7-10 days to apply for EDR and acquire medication
Treatment period of about 12 weeks
Injectable and oral formulations available
Umbilical hernia
Muscle wall defect
Genetics
Infection
Tearing of umbilicus too close to the body wall
Non reducible hernia (falciform fat hernia)
Degenerative liver disease is and caused by
Age-related
Natural wear and tear causes damage
Related to detoxification function
Always be aware of potential liver disease in seniors
Decreased drug metabolism
Higher anaesthetic risk
Hepatic lipidosis (fatty liver disease in cats)
Obese cats
Decreased ability to break down fat
Hepatic lipidosis pathophysiology
The cat stops eating
Fat metabolism begins
Fat is brought to liver faster then liver can break it down
Fat accumulates in hepatocytes
Decreased hepatocyte function
Clinical signs of fatty liver
Early stages may go unnoticed by owner, especially in a multi cat household
Anorexia
Vomiting
Lethargy
Weight loss
Dehydration
Jaundice
Seizures
Treatment of fatty liver
E-tube, G-tube
Slow reintroduction of food
Enough to prevent more fat metabolism
Not enough that he fat in the liver us used up
Watch out for REFEEDING SYNDROME
Too much or too fast
Hypophosphatemia
Generalized muscle weakness (including heart)
Often fatal
Acute abdomen is
SEVERE! ACUTE! PAIN! Abdomen
Pancreatitis is caused by what in dogs
Dogs: leakage of digestive enzymes→ pancreas begins to digest itself
Pancreatitis is caused by what in cats
Cats: there is often an infectious component
Signs of pancreatitis
Vomiting and acute abdomen
Keep cats eating, dogs can fast
Diagnosis and treatment of pancreatitis
History
PE findings- painful abdomen
Treatment
Aggressive fluid therapy
Analgesia
Antiemetics
Low fat diet (dogs)
