Small Animal Flashcards
What are the three most common causes of oesophageal disease?
Oesophagitis
Oesophageal foreign body
Mega-oesophagus
What is the main clinical sign shown in oesophageal disease?
Regurgitation
What are oesophageal disorders characterised by?
Failure of transport and/or reflux
What are some other clinical signs that present with regurgitation?
Hypersalivation
Odynophagia (eating pain)
Anorexia
Dysphagia (swallowing difficulty)
Nasal discharge
Coughing
Describe the differences between regurgitation and vomiting
Vomiting
- Abdominal effort
- Prodromal nausea
- Usually digested food
- No swallowing pain
- Alkaline or acidic pH
Regurgitation
- Passive event
- No prodromal nausea
- Undigested food
- Possibly painful
- Alkaline pH
What is the first thing that should be done when presented with vomiting?
Define/refine the problem
Is it actually vomiting or regurgitation?
What would you find during a physical examination in oesophageal disease?
Nothing - usually normal
Could have aspiration pneumonia
What are the main things to be done when investigating oesophageal disease?
Diagnostic imaging - plain and contrast radiography
What 4 groups do the differential diagnoses for regurgitation fall into?
Anatomic
Obstruction
Oesophagitis
Motility Disorders
Describe aspiration pneumonia
No reflex closure of the larynx with regurgitation
Airway unprotected
Causes aspiration pneumonia
Can be life threatening
Describe the 3 ways oesophagitis can be caused
Chemical injury
- Corrosive agents
- Medications
Gastro-oesophageal reflux
- Anaesthesia
- Hiatal hernia
- Vomiting
- Feeding tubes
Oesophageal foreign bodies
What are the ways in which you can treat oesophagitis?
Dietary
- Small meals
- High protein-low fat food to minimise reflux
Sucralfate liquid
- Chemical bandage
Inhibitors of gastric acid secretion
- Protein pump inhibitors (omeprazole)
What is needed to investiage an oesophageal foreign body?
Endoscopy
What should be done with an oesophageal foreign body?
Endoscopic retrieval
Push to stomach
Potential for mucosal damage/perforation
Consider referral!
Should be considered an emergency
Describe vomiting
Forceful expulsion of GI contents from mouth
Not a disease but a symptom
Associated with a variety of diseases
Primitive mechanism to eliminate toxins
What are the two things that should be defined/refined with a vomiting problem?
Chronicity
- Acute
- Chronic
Lesion
- Primary
- Secondary
What are the primary causes of vomiting, which are acute/chronic?
Acute
- Dietary
- Infection
- Obstruction
- Motility disorders
- Gastric volvulus
Chronic
- Inflammatory disease
- Neoplasia
What are the secondary causes of vomiting?
Uraemia
Addison’s disease
Hepatic disease
Pancreatitis
Toxin ingestion
Drugs
What are the four things that could be done when working up animals with chronic vomiting?
Bloodwork - identify organ diseases
Urinalysis - kidney function
Imaging - obstructions or other involvements
Possibly endoscope if no other answer
What are the 6 problems that result in gastric ulceration and what are their causes?
Neoplasia
- Lymphoma
- Carcinoma
- Leiomyoma/sarcoma
Inflammation
- Gastritis
Iatrogenic
- NSAIDs
Systemic
- Hypoadrenocorticism
- Liver dysfunction
- Uraemia
- Mast cell tumour
- Gastrinoma
Hypotension
- Shock
- Disseminated intravascular coagulation
- Sepsis
Other
- Stress
- Spinal surgery
Describe the problems associated with small intestinal partial obstruction?
Vomiting
- Dehydration
- Electrolyte loss
Diarrhoea
- Weight loss
- Hypoalbumninaemia
Bacterial proliferation
Nutrient metabolism
- Maldigestion
- Malabsorption causing intestinal mucosal damage
What problems can be caused by gastrointestinal bleeding?
Haematemesis
Melaena
Describe the history and clinical signs associated with gastric foreign bodies
More common in younger animals
Previous/known foreign body ingestion
Vomiting
Lethargy
Abdominal pain
Depression
Anorexia
Dehydration
Abdominal pain
Gastric distension
Melaena/haematemesis
Dyspnoea
Describe the history and clinical exam of intestinal foreign bodies
History - persistent vomiting (frequently projectile)
Anorexia
Depression
No defecation
Clinical exam - dehydration
Depression
Abdominal pain
Intrabdominal mass
String around tongue
What are the five types of intestinal neoplasia?
Andenoma/adenocarcinoma
Lymphoma
Leiomyoma/leiomyosarcoma
Mast cell
Duodenal polyps
What are the presenting signs with intestinal neoplasia?
Partial obstruction
Chronic intermittent vomiting
Diarrhoea
Weight loss
What is intussusception?
Invagination of one portion of the GI tract into the lumen of an adjoining segment
What are the presenting signs of intussusception?
Palpable tumour mass
Dehydration
Depression
Abdominal pain
Protusion of intussusceptum from anus
How can intussusception be determined?
Ultrasound
- Parallel lines
- Concentric rings
Radiography
- Gas distension of loops of small intestine
When should intussusception be resected?
Irreducible
Ischaemic/injured intestines
Mass present
What are further treatments for intussusception?
Enteroplication
Treatment of underlying disease
What is the prognosis for intussusception treatment?
Good in young animals
6-27% recurrence in 3 days to 3 weeks post-op
What are the clinical signs of septic peritonitis?
Vomiting
Anorexia
Depression
Abdominal pain
Abdominal enlargement
Hypovolaemic shock
Pyrexia
Discharge from abdominal wound
Diarrhoea
Haematochezia, melaena and haematemesis
What is the single most important test for septic peritonitis?
Abdominocentesis
What is the treatment of septic peritonitis?
Pre-op stabilisation via antibiosis
Exploratory laporotomy - find and correct leak
Peritoneal lavage/drainage
Intensive post-op care with maintenance and nutrition
What should be done to gain more information about oral swellings?
Fine needle aspirations
What is the diagnosis when presented with an oral swelling and stringy serosanguineous fluid upon fine needle aspirate?
Salivary mucocoele - usually involves the salivary gland chains
Why must the mandibular salivary gland be removed with the sublingual salivary glands?
They form a chain and often share a duct system
Name the salivary glands
Parotid
- Opens adjacent to upper PM4
Mandibular
- Opens adjacent to frenulum
Sublingual
- Opens adjacent to frenulum and in sublingual recess
Zygomatic
- Opens caudal to parotid gland
Molar
- Opens in adjacent mucous membrane
When do salivary mucocoeles form?
When disruption of the gland and duct anatomy lead to saliva leaking into the tissues
Underlying cause not often known
What is the most common gland responsible for salivary mucocoeles?
Sublingual salivary glands
What clinical signs present with salivary mucocoeles and what do they depend on?
Painless swelling
Difficulty eating
Dyspnoea
Depend on location of swelling
What is a salivary mucocoele that forms under the tongue called?
Ranula
What are the three places in which large foreign bodies can lodge?
Thoracic inlet
Heart base
Caudal oesophagus
What is vascular ring anomaly?
Developmental anomaly of great vessels
Results in encircling of the oesophagus and trachea
What breeds is vascular ring anomaly most commonly seen in?
German Shepherds
Irish Setters
Persian cats
Siamese cats
What is the advised treatment for vascular ring anomalies?
Surgery to release oesophagus
Intercostal thoracotomy
What is hypomotility usually accompanied by?
Dilatation
What is general dilatation usually a result of?
Intestinal hypomotility
- Acute viral enteritis
- Electrolyte imbalance
- Drugs
What occurs with partial obstruction?
Some material retained while some water is absorbed
Some areas have large amount of material other areas not much
What is food remaining in the stomach 24h after ingestion evidence of?
Delayed gastric emptying
