Small Animal Flashcards by Matthew Lawrance

What are the three most common causes of oesophageal disease?

Oesophagitis

Oesophageal foreign body

Mega-oesophagus

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What is the main clinical sign shown in oesophageal disease?

Regurgitation

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What are oesophageal disorders characterised by?

Failure of transport and/or reflux

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What are some other clinical signs that present with regurgitation?

Hypersalivation

Odynophagia (eating pain)

Anorexia

Dysphagia (swallowing difficulty)

Nasal discharge

Coughing

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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

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What is the first thing that should be done when presented with vomiting?

Define/refine the problem

Is it actually vomiting or regurgitation?

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What would you find during a physical examination in oesophageal disease?

Nothing - usually normal

Could have aspiration pneumonia

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What are the main things to be done when investigating oesophageal disease?

Diagnostic imaging - plain and contrast radiography

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What 4 groups do the differential diagnoses for regurgitation fall into?

Anatomic

Obstruction

Oesophagitis

Motility Disorders

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Describe aspiration pneumonia

No reflex closure of the larynx with regurgitation

Airway unprotected

Causes aspiration pneumonia

Can be life threatening

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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

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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)

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What is needed to investiage an oesophageal foreign body?

Endoscopy

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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

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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

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What are the two things that should be defined/refined with a vomiting problem?

Chronicity

Acute
Chronic

Lesion

Primary
Secondary

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What are the primary causes of vomiting, which are acute/chronic?

Acute

Dietary
Infection
Obstruction
Motility disorders
Gastric volvulus

Chronic

Inflammatory disease
Neoplasia

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What are the secondary causes of vomiting?

Uraemia

Addison’s disease

Hepatic disease

Pancreatitis

Toxin ingestion

Drugs

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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

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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

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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