SAM 3 Flashcards
Periodontitis; clinical signs
halitosis, discomfort when eating
blood tinged slaiva, blood on toothbrush, chew toy, food
oronasal fistula –> nasal discharge
Chronic ulcerative periodontiti syndrome
Peridontitis ; treatment
Aim: to remove supra/sub gingival plaque, polishing the teeth, teeth extraction
if pocket deeper > 4-5 mm: Ab locally, gingival flap
before-after dental treatment ab: clindamycin, metronidazol, spiramycin, amoxicillin
Peridontitis prevention
Prevent plaque formation. Regular oral hygiene n Toothbrush, dental diet, che toy, rinse chlorhexidine, gel
Feline Odontoclastic Resorptive Lesions (FORL); types and reasons
- Type tooth resorption: inflammatory form
Due to periodontal diseases. painful - Type tooth resorption: not inflammatory form
Replaced the resorbed tissue by bone tissue
Idiopathic reason. Not so painful - Type tooth resorption: surface
Mild, reversible
Acidic pH of the oral cavity? (hairball?)
Feline Odontoclastic Resorptive Lesions (FORL); clinical signs
common in older, persian cats
relucatance to eat dry food
pain when eating
hyperplastic gingival tissue covers on resprptive lesions on crowns
Feline Odontoclastic Resorptive Lesions (FORL); Diagnosis
Anaesthesia w/ sound/probe
X-ray
Feline Odontoclastic Resorptive Lesions (FORL); Treatment
according to stages
tooth extraction
crown amputation
laser therapy
stomatitis: clinical signs
anorexia/dysphagia
salivation, drooling, ptyalism
halitosis
local lesions (red, erosion, ulcer, necrosis, vesiculum, granuloma proliferation, hyperplasia plaque)
Stomatitis; aetiology
Systemic diseases:
- Uremia, DM
Immune mediated diseases :
- SLE, pemphigus folicaeus, vulgaris, idiopathic vasculitis, bollosus pemphigoid
Traumatic, physical/chemical agents:
- foreign bodies, injury, tartar, acids, heavy metals, pesticides, diffenbachia
Infective diseases:
- FCV, FeLV, FIV
Stomatitis: specific types
- Feline chronic gingivostomatitis
- Feline eosinophilic granuloma complex
- Ulcerative stomatitis
- Canine eosinophilic granuloma
ulcerative stomatitis - types
- maltese terrier (immune mediated, ulcerative)
- cavalier king charles spaniel ( ulcerative/eosinophil)
- chronic ulcerative stomatitis (kissing ulcer)
maltese, cocker, poodle, dachshund, terrier
Feline chronic gingivostomatitis; aetiology
Idiopathic multifactorial
hypersensitive
FeCV
Feline chronic gingivostomatitis; Diagnosis
Faucitis caudal part (inflam of throat)
Hyperglobulinaemia
Histopathology (Ly-pl infiltration)
Feline chronic gingivostomatitis; Clinical signs
- Halitosis, dysphagia, pain when eating
- difficult to open mouth
- enlarged mandibular lymph nodes
- Symmetrical ulcerative stomatitis
Feline chronic gingivostomatitis; Treatment
- extraction of all teeth
- AB (clindamycin, amoxycillin clav acid, metronidazole, azitromycine, spiramycine)
- analgesic (opioids, NSAIDS, gabapentin)
- Glucocorticoids (metylprednizolone, prednisolone)
- cyclosporin
- local rinse/gel (chlorhexidine)
- feline interferon
Feline eosinophil granuloma complex (FEGC); types
- Oral eosinophilic ulcer –> upper lip
- eosinophilic granuloma (linear), plaque in the mouth (rare) –> tounge, lips, gum, pharynx
- cutaneous lesions –> skin of abdomen, hindlimbs
Feline eosinophil granuloma complex (FEGC); aetiology
- unknown
- allergy
- immune mediated
- hypersensitivy diseases
- infective agents
- genetics
Feline eosinophil granuloma complex (FEGC);
clinical signs
dysphagia
salivation
pain
Feline eosinophil granuloma complex (FEGC);
Diagnosis
clinical signs CBC: eosinophilia histology allergic test DD: neoplasia, foreign body rx, mycotic infections
Feline eosinophil granuloma complex (FEGC);
Treatment
- Underlying cause!
- hypoallergenic diet
- endo and ectoparastitic treatment
- antihistamines
- glucocorticoids (prednisolone, triamcinolon)
- Cyclosporin
Glossitis Types
- Superficial
- deep, ulcer (often w stomatitis) –> infective diseases, immune mediated, chemicals, metabolic diseases
- strangulation of tounge –> foreign bodies
- neoplasma
- trauma
- congenital microglossia rare
Oral neoplasia
Types
- malignant melanoma
- squamous cell carcinoma
- fibrosarcoma
- epulides (fibromatous epulis and acanthomatous epulis)
- papillomatosis
Oral neoplasia
most common type in dogs and cats
Dogs: Malignant Melanoma (MM)>SCC>FibroSarcoma
Cats:
SCC»>fibrosarcoma (FSA)
Sialocele
- Clinical signs
- Diagnosis
- Treatment
- Salivary duct rupture/obstruction
Clinical signs: dysphagia, gagging
Diagnosis: FNA, cytology
Treatment: surgical removal of salivary gland/ducts
Sialoadenitis
- Clinical signs
- Diagnosis
- Treatment
Clinical signs:
- bilateral enlarged lymph nodes
- Dysphagia, gagging fever
- if necrosis –> painful
Diagnosis: FNA
Treatment: glucocorticoid + ab
Sialadenosis
- Clinical signs
- Diagnosis
Clinical signs:
- retching, gulping, ptyalism
Diagnosis
- FNA not characteristic
Regurgitation characteristics
spontaneous
passice backflow
undigested food, no bile
eating the regurgitated content
Vomiting characteristics
Nausea
active muscle contractions, retching
undifested or digested food, gastric chyme, bile
List the esophageal diseases
- oesophagitis/stricture
- Gastro-oesophageal reflux (GOR)
- Motility disorders /megaesophagus
- oesophageal foreign body
- spirocecosis
- hiatal hernia
- vascular ring anomalies (PRAA)
- neoplasia
Oesophagitis
- clinical signs
odynophagia regurgiatation salivation food refusal coughing fever dyspnea
Oesophagitis
- diagnosis
Clinical signs
incr WBC
endoscopy!!
Oesophagitis
- treatment
Omeprazole + prokinetics
sucralfate suspension
Total Parenteral Nutrition/Enteral Nutrition
Asp. pneumonia –> AB
Oesophagitis
- prognosis
good
untreated; stricture, megaesophagus
Gastro-oesophageal reflux (GOR)
- clinical signs
oesophagitis reverse sneezind chronic bronchitis laryngitis rhinitis chronic vomiting
Gastro-oesophageal reflux (GOR)
- Diagnosis
symptoms + history
endoscopy
DD: oesophagitis, hiatal hernia, stricture
Gastro-oesophageal reflux (GOR)
- aetiology
delayed gastric emptying upper airway obstruction hiatal hernia anesthesia eructation
Gastro-oesophageal reflux (GOR)
- Definition
poor closure of cardia
Gastro-oesophageal reflux (GOR)
- Treatment
- low fat diet
- proton pump inhibitors
- prokinetics: cisapride, tegaserod
- sucralfate
- enhance cardia closure: metoclopramide, erythromycin, GABA B type agonist baclofen
- brachycephal syndrome –> surgery
Gastro-oesophageal reflux (GOR)
- prognosis
usually good
Oesophageal foreign body
- clinical signs
regurgitation salivation distended abdomen coughing fever dyspnea
Oesophageal foreign body
- diagnosis
clinical signs
incr WBC
Thoracic xray or endoscopy (riskful)
Oesophageal motility disorders
- aetilogy
idiopathic muscle dystrophy myastenia gravis autoimmune d post anesthetic conditions oesophagitis
Oesophageal motility disorders
- types of dysmotility
megaesophagus!!!
partial esophageal dysmotility
dysautonomia
diverticulum
Dysmotlity
- symptoms
- diagnosis
- treatment
Symptoms:
- regurgitation, salivation, coughing, fever, dyspnea, weight loss
Diagnosis
- fluoroscopy, xray
Treatment
- special feeding or PEG
- oesophagitis and the background if possible
- Asp pneumonia –> AB
Megaesophaus
- acuired reasons and treatment
- idiopathic: special feeding + Ca: bethanechol + sucralfate or sildenafil
- myastenia gravis: pyridostigmine
hypoadrenocorticism: prednisolone - lead poisoning: Ca - EDTA
- oesophagitis: omeprazole + prokinetics + sucralfate
- Hypothyreoidism: levothyroxine
- SLE: prednisolone
- polymyositis/polymyopathy: prednisolone
Spirocercosis
- cause
- clinical signs
- diagnosis
- treatment
- Prevention
Cause
- Spirocerca lupi
Clinical signs:
- regurgitation, vomiting, weight loss, dyspnoe, rarely sudden death
Diagnosis
- fecal examination, endoscopy
treatment:
- doramectin, imidacloprid/moxidectin
- surgery
Prevention
- imidacloprid/moxidectin
- milbemycin
Persisten right aortic arch (PRAA)
- clinical signs
- diagnosis
- treatment
- DD
Clinical signs:
- after solid food feeding
- regurgiatation, coughing, dyspnoe, weight loss
Diagnosis
- contrats x ray
- endoscopy
Treatment
- surgery
DD:
- stricture, intraluminal obstruction
Clinical signs of gastric diseases
vomiting hematemesis melena anorexia abdominal pain distended abdomen diarrhea weight loss
Mention the gastric diseases
acute gastritis
gastric erosive ulcerative disease
chronic gastritis
delayed gastric emptying and gastric motility disorders
gastric dilation - volvolys syndrome (GDV)
gastric neoplasia
Acute gastritis
- aetiology
spoiled/contaminated food foreign bodies toxic plants chemicals irritating drugs viral
Acute gastritis
- Clinical signs
Acute onset of vomiting (food, bile small amount of blood)
loss of appetite
rarely fever or abdominal pain
Acute gastritis
- diagnosis
history
physical examination
worsens within 1-3 days –> abdominal US, CBC, biochem
Acute gastritis
- treatment
withhold food for 24 h
antiemetics (maropitant) in persisting vomiting
fluid theraphy/small amount of cool water
GI prescription diet
Acute gastritis
- prognosis
excellent
Gastric erosive- ulcerative disease
- predisposing factors
NSAIDs
- direct damage, inhibit synthesis of PG
SAIDs
- Mucosal cell growth decr, mucus prod decr, gastric acid seretion incr
- Dexamethasone > prednisolone
Metabolic diseases
- liver failure
- hypoadrenocorticoism
- renal failure
- acute panreatitis, IBD, neurological disease
Altered gastric bloodflow, stress related factors
- hypotension, shock, sepsis, surgery, GDV
incr secretion of gastric acid
- tumor
- pyloric outflow obstruction
- chronic gastric distension
Toxic traumatic agents
- bile salts, pancreatic enzymes, lead, foreign bodies, alkohol
gastric neoplasia
Gastric erosive- ulcerative disease
- diagnosis
History
- intermittent vomiting
- hematemesis or melena
- NSAIDs or SAIDs
physical examination
- anemia
- abdominal pain
- melena
Lab
- anemia
- renal failure
- liver disease
- hypoadrenocrticoism
Xray
- usually normal
Endoscopy
- benign ulcers
- supf erosions
- malignant ulcers –> biopsy
Gastric erosive- ulcerative disease
- Treatment
- predisposing causes
- symptomatic therapy –> diet, fluid, antiemetics (maropitant), proton pump inhib (omeprazole), protectants (sucralfat)
- blood transfusion (severe anemia)
- surgery
Chronic gastritis
- Causes
- Clinical signs
- diagnosis
Causes
- Acute gastritis
- specific causes –> helicobacter, parasites, diet, foreign material, fungi
- idiopathic
Clinical signs
- vomiting
- no respons to symptomatic treatment
- anorexia, weight loss
- abd pain
- hematemesis and melenia
Diagnosis
- endoscopy or full thickness biopsy + histopath
- lab test –> not diagnostic
- x-ray and US
Chronic gastritis
- treatment
Exlusions:
- low fat, low fiber elimination diet
- antiparasittic
- helicobacter therapy
If not effective:
- immunesuppressive therapy –> Ca : prednisolone + azathioprine, Fe: Prednisolone + chlorambucil
- antacids –> omeprazole
- protectants –> sucralfate
- prokinetics –> erythromycin, metoclopramide, cisapride
- surgical resections
Delayed gastric emptying
- diagnosis
- History –> Vomiting
- Examination –> normal or abdominal tympany
- lab test –> normal, hypochloremic met alkalosis
- xray –> fluid distended, use contrast
- Endoscopy –> if no evidence of obstructing lesion –> primary/secondary gastriv motility disorder
Pyloric stensosis
- diagnosis
- treatment
- congenital or aquired
Diagnosis
- projectile vomiting
- xray
- endoscopy
Treatment
- pyloroplasty
Primary (idiopathic) gastric motility disorders
- symptoms
- diagnosis
- treatment
symptoms
- postprandial abnormal discomfort
- bloating- chronic vomiting
Diagnosis
- gastric retentions
eleminate obstructive and metabolic causes
Treatment
- Diet
- prokinetics –> cisapride, prucalopride, metoclopramide, erythromycin, ranitidine
Gastric neoplasia
- Symptoms
- Diagnosis
- Treatment
- prognosis
Symptoms:
- weight loss
- worsening of vomiting, anorexia, melena, hematemesis
- Adenocarcinoma .–> older male dogs
- lymphoma –> cats
Diagnosis
- symptoms
- US
- endoscopy
- biopsy
Treatment
- surgery (adenocarcinoma)
- chemotherapy (lymphosarcoma)
Prognosis
- guarded
Causes of vomiting
Diet A/Chr Emetogenic substances A GI tract obstruction A/Chr GI/abdominal inflammation/irritation A/Chr Extraalimentary tract diseases A/Chr Motion sickness A CNS A/Chr Miscellaneous A/Chr
Definition of regurgitation
Expulsion of materials from the mouth, pharynx or esophagus
Definition of vomiting
expulsion of material from the stomach and/or intestines
Definition of expectoration
expulsion of material from the respiratory tract
Causes of acute vomiting
non life threatening:
- acute gastritis, ascaris infect, giradia, motion sickness
Life threatening:
- Foreign bodt, ulcer, parvo, distemper, infectious canine hepatitis, leptospirosis, acute pancreatitis, acute renal failure DKA, pyometra, sepsis etc.
Causes of chronic vomiting
Metabolic diseases:
- renal, pancreatitis, hepatic, biliary, hypoadrenocorticoisn, incr Ca, feline hyperthyroidism, decr K.
Gastric diseases:
- foreign bodt, mucosal hypertrophy, gastritis, neoplasia, polyps, hypomotility, enterogastric reflux, parasites
Small int diseases:
- giardia, nematodes, IBD, subileus, neoplasia, fungi
Large int diseases:
- obstipation, chronic colitis
Neurologic diseases:
- vestibular disease, autonomin epilepsy, neoplaia
Primary GI diseases from metabolic diseases: Anemia Neutropenia Neutrophilic leucocytosis Eosinophilia Hypoproteinemia Hyperkalemia
Anemia
- Acute (regen/non-regenerative)
- chronic gastric bleeding
Neutropenia
- parvo
Neutrophilic leucocytosis
- acute pancreatitis
- IBD
- bacterial enterocolitis
Eosinophilia
- parasites
- eosinophilic gastroenteritis
- hypoadrenocorticoism
Hypoproteinemia
- PLE
- Chronic renal failure
- chronic hepatic disease
Hyperkalemia
- renal failure or hypoadrenocorticoism
Symptomatic - supportive theraphy in vomiting patients
Antiemetics:
- maropitant- citrate
- phenotiazine
- metoclopramide
- ondansetron
Fluid:
- 0,9% saline infusion (%10bwkg + 50ml/kg/day)
- K supplementation (max 0,5 mmol/kg/hour/IV)
Diet:
- NPO 24 h, then low fat if vomiting stops
Antacids:
- H2 receptor antagonists ( famotidine > ranitidine > cimetidine)
- Proton pump inhibitors (omeprazole, pantoprazole, lansoprazole)
Protectives:
- sucralfate
- misoprostol (NSAID induced gastitis, not in pregnant animals)
Diarrhea, mention the 4 major mechanisms/types
Osmotic diarrhea
secretory diarrhea
exudative diarrhea (incr permeability)
Dysmotility (altered peristalsis)
Classification of diarrhea
- acute or chronic
- intestinal or extraintestinal
- Small bowel (SB) or Large bowel (LB) or diffuse
- Acute, self limiting or acute, life threatening
Extraintestinal causes of diarrhea
Disorders of digestive organs other than GI
- pancreas (EPI, chr pancreatitis), liver and bile duct
Toxic
- liver and kidney failure
endotoxaemia
hypoadrenocorticois
Systemic infection
- distemper, leptospira, FIP, FeLV, FIV
circulatory failure
- heart failure, portal hypertension (PSS), IMHA
Disorders affect peristalsis
- hyperthyroid, peritonitis, pancreatitis
Metastatic tumours (hemangiosarcoma)
Parvovirus - treatment
Fluid therapy
- crystalloid, collois, electrolyte
Antimicrobial therapy
- broad spectr (amox-clav + gentamycin/amikamycin iv)
- amox-clav + enrofloxacin
Feeding
- syringe feeding, intestinal diet or nasoesophageal tube
- max 2 days starvation
other:
- antiemetics: maropitant + metoclopromide, ondansetron
- analgesics: opiates
- GI protectants: omeprazole, sucralfat
- Interferon omega
- hyperimmune serum; early stage prevention
- concurrent infections
- supportive treatments : adsorbent, vitamin, mirtazapine
- Dysbiosis: probiotics
- complications
- antiviral drugs
Parvovirus - pathophysiology
intestinal crypt necrosis
destroy bone marrow cells and lymphoid tissue
bacterial transolaction + immunosupression = sepsis
Parvovirus - clinical findings
Vomiting anorexia fever lethargic dehydration
5-10 days incubation period!!
Parvovirus - diagnosis
- History + clinical signs
- Lab tests (leukopenia, anemia, decr K, decr, blood glucose, decr TP)
- Definite diagnosis (fecal ELISA)
- Abd US: intussusception; paralytic ileus?
Feline panleukopenia
- clinical findings
- diagnosis
- treatment
Clinical findings
- acute
- anorexia, fever, depression, dehydration
- vomiting, hemorrhagic diarrhea
- thickened painful intestinal loops
- neutropenia –> endotoxaemia, septicaemia
- virus shedding: 1-2 days
Dx/tx
- same as parvoviral enteritis
Bacterial enteritis - pathogens
Campylobacter - Zoonosis
Salmonella
Clostridium
Pathogenic E.coli
Bacterial enteritis - YOPI
isolate the animal if the owner is: young old pregnant immunocompromised
Small intestinal disorders causing diarrhea
- acute
- chronic
Acute
- unknown cause
- diet related (allergy, intolerance, overeating)
- AHDS
- infectious: CPV, FPV, CCoV, FIP, FIV, FeLV, campylobacteriosis, salmonellosis, histoplasmosis)
- Parasites: (isospora, giradia, toxocara, toxoscara, ancylostoma, diphylidium caninum, echinococcus)
- ileus
Chronic
- FRE
- ARE
- IRE/IBD
- lymphangiectasia
- Neoplasia
- Alim. tract parasites, fungi
- subileus
IBD - histological types
LPE (lymphocytic-plasmacytic enteritis)
EGE (eosinophilic gastroenteritis)
neutrophilic
Granulomatous
IBD - diagnosis
Non specific - blood tests Hypoproteinemia Leukocytosis (LPE) Eosinophilia (EGE) cobalamin and folate decr - Abd US
Specific
- endoscopy
- Diagnostic laparotomy
IBD - treatment
Deworming (fenbendazole) --> Diet (3w--> improve 12w) --> AB (4w --> improve keep on diet) --> immunosuppression (prednisolone, chlorambucil, cyclosporin, axathioprine (not for cat))
Lymphangiectasia - clinical signs
Ascites hydrothorax weight loss chronic diarrhea thromboembolia (rarely)
Lymphangiectasia - Diagnosis
Lab
- hypoproteinemia
- hypocholestrolaemia
- lymphopenia
- hypocalcemia
- hypomagnesiemia
Endoscopy
- mucosal edema
- rice grain nodules
Abd US
- mucosal thickening
streaks in submucosa
Spesific: intestinal biopsy –> histology
Lymphangiectasia - treatment
Protein loss
- ultra low fat diet
- if IBD –> hypoallergic
Inflammation
- corticosteroid
- if IBD CS + cyclosporin
Edema, ascites
- diuresis incr (spironolactone + furosemide
- oncotic p incr (colloid inf)
Neoplasm of the small intestines - types
alimentary lymphoma
intestinal adenocarcinoma
intestinal leiomyoma/leiomyosarcoma
GIST- GI stromal tumor
Neoplasm of the small intestines - Clinical signs
middle aged, older animals chronic diarrhea excess weight loss anorexia melena vomiting hematemesis
ileus - pathophysiology
intestinal spasm, ischemia -> pain impaired peristalsis -> vomiting Dehydration, hypovolemia hypoK HypoCl met alkalosis or met acidosis bacterial translocation endotoxemia -> septicaemia perforation ----> septic pretitonitis
Acute colitis - causes
Parasites
- trichuris vulpis
- tritrichomonas blagburni
Bacteria
- S. typhimurium –> zoonosis
- C. jejuni –> zoonosis
- Cl. perfringens, difficile
- Y. enterocolitica
- Brachyspira pilosicoli
Fungi
- histoplasma
- phythium insidosum
- Prototheca zopfii
Parasittic colitits - treatment
trichuris vulpis
- fenbendazole 50 mg/kg 3-5 day, 3 w, 3 m
tritrichomonas blagburni
- Ronidazole 30 mg/kg 14 days
Clostridium acute colitits
- diagnosis
- treatment
Dg: difficult
- spore in feces
- ELISa + PCR
Treatment:
- tylosin!! 20 mg/kg 2x
- fiber supplementation!!
- amoxicillin, metronidazol, ampicillin
Treatment of colitits
Diet
- novel protein
- highly digestible
- high fiber
NSAIDs
- not in cat
- SE: KCS
- mesalazine, balsalazode, olsalazine
Anti-inflam/ immunosuppressive
- prednisolone
- budesonide
- chlorambucil
- cyclosporin
- azathioprine
AB
- metronidazol
- tylosin
Acute Pancreatitis - Diagnosis
Signalment, history, clinical findings Diagnostic imaging - US!!! Lab Pancreas spesific lab tests
Acute Pancreatitis - Risk factors
Genetics
- miniature schnauzer
Food
- High fat diet
Hyperlipidaemia
- pbesity, DM, cushings
Drugs
- phenobarbital, sulfonamides, tetracyclines, furosemide
Toxins
- organophosphates, zinc
Pathogenes
- Babesiosis, leishmania
Pancreatic trauma
Abdominal surgery
ischemia, perfusion decr
duodenal reflux, ductal hypertension
Acute Pancreatitis - clinical findings
Vomiting Anorexia, lethargy Abdominal pain Sometimes: fever, diarrhea, jaundice, dyspnoe --> dehydration, shock incr HR,RR, CRT, dry mm
Acute Pancreatitis - Lab results
Hematology
- WBC and CRP incr
- PCV normal or incr
- PLT normal or decr
- APTT, PTT, Ddimer - petechia
Biochemistry
- Hyperglycemia, hypocalcemia, hypokalemia, hyponatremia, metabolic acidosis
- azotemia
- incr cholestrol, hyperlipidemia
- incr liver enzymes and bilirubin
PLI - spesific and sensitive
Acute Pancreatitis- treatment
Fluid therapy
- crystalloids, colloids, HAES, plasma transfusion (DIC)
Analgesia
- Opioids: butorphanol –> buprenorphine –> fentanyl
- NO NSAIDS!
Antiemetics
- Maropitant
- Ondansetron
- metoclopramide
Manage complications
- Gastric acid protectants: omeprazole, pantoprazole
- AB: Amox-Clav, flurokinolon+metronidazole, cefalosporin(3rd gen)
- low dose corticosteroids - critical cases
- Surgical intervention
Special nutrition
- Prevent malnutrition, feed entercytes, keep pancreas in rest, feed asap, highly digestible, low fat
- use enteral feeding if it is possible
Chronic pancreatitis - symptoms
months-years no appetite vomiting colitis recurrent postprandial pain recurrent acute episodes = severe AP Most common cause of EHBO end stage --> DM, EPI
Chronic pancreatitis
- diagnosis
- treatment
Diagnosis
- cPLI
- US
Treatment
- low fat diet,life long
- analgesia, PO
- replace of functional deficiency
- EPI, DM treatment
Feline pancreatitis- causes
Trauma, ischemia + concurrent disorders
+ IBD, cholangitis (triaditis), DM, lipidosis hep
Feline pancreatitis- Symptoms
acute - non spesific
- > 7 years
- vomiting, abd pain
- anorexia, lethargy, hypothermia
- diarrhea, dehydration, icterus, dyspnoe
Chronic
- less characteristic
weight loss
Feline pancreatitis- diagnosis
lab
specific fPL
US sensitivity decr
Feline pancreatitis- treatment
Acute
- same as in dog + ab incr, no feeding tube
Chronic
- improve appetite (mirtaxapine) B12
- steroids
- SAMe - antioxidant
EPI - symptoms
Chronic disease
alert good general state
Polyphagia weight loos, cachexia
diarrhea: pale soft feces (clay like), steatorrhea
Other
- Rough hair
- dysphagia, coprophagia, flatulence
EPI- diagnosis
TLI decr
trypsin like immunoreactivity
EPI- treatment
Pancreatic enzyme substitution - life long
Diet
- highly digestable, moderate fat, NO fiber!
Cobalamin suppl
AB therapy - if ARE develops
Fluid therapy
- maintenance dose
- replacement
- extra losses
maintenance dose: 2-3 (4) ml/kg/h
- 80Bw^0,75 (cat), 132Bw^0,75 (dog)
replacement dose: %* kg* 10/day
extra losses: 200- 1000/day
Calcualtion of Resting energy requirement (RER)
70*Bw^0,75
or if less than 2 kg or more than 30 kg, use this
30*Bw + 70
Consequences of total parenteral nutrition
Thrombophlebitits
metabolic abnormalities
sepsis
