Small animal GI Learning objectives (4: regurge and dysphagia; 5: dz of canine and feline stomach) Flashcards
Dysphagia and dz location
- seen in proximal esophagus dz
- oral dz
- pharyngeal dz
- cricopharyngeal dz
- achalasia: smooth muscle fibers don’t relax, opening stays closed
- neuromuscular dz
Regurge and dz location
- dz of esophageal body
- will be coupled with ptyalism
- distal esophagus could also be cause
- regurge
- ptylism
- inappetence
four basic causes of regurge
- inflammatory dz
- extraluminal compression
- intraluminal obstruction
- neuromuscular dz
Examples of regurge in inflamm dz
- esophagitis
- can lead to stricture
- myositis
- granuloma
examples of regurge in extraluminal compression
- vascular ring anomaly
- thymoma
- intrathoriacic tumors
- hilar lymphadenopathy
examples of regurge in intraluminal obstruction
- stricture
- foreign body
- tumor
- diverticulum
- intussusception
examples of regurge in neuromuscular dz
- dysmotility
- megaesophagus
- congenital or acquired
Primary peristaltic waves
- wave of relaxation in front of bolus and contraction behind it to propel it to stomach
- initiated by a food bolus
Secondary peristaltic waves
- clears residual material in esophagus after bolus gets to stomach
- initiated by residual food particles (I think)
Tertiary peristaltic contractions
- seen in esophageal dz
- disorganized contractions associated with chest pain
Esophagitis (inflamm dz)
Diagnosis
- survey radiographs (difficult to see)
- contract radiographs (stricture)
-
endoscopy
- don’t bx unless you suspect neoplasia
Management of Esophagitis
- Rest esophagus: feeding tube in severe cases
- sulcralfate
- cisapride/metaclopramide: inc LES tone
- omeprazole: reduce acid output
- pain meds
*abx only if there’s aspiration pneumonia
Extraluminal esophageal compression
Diagnosis
- radiographs (survey or contract)
- contrast CT
- endoscopy
Extraluminal esophageal compression
Management
- surgical ligation of PRAA or mass removal
- gaurded prognosis
Intraluminal/mural esophageal obstruction
Diagnosis
- contrast esophagram
- endoscopy
- rads (foreign body)
- superficial biopsy on peri-esophageal tumor
Intraluminal/mural esophageal obstruction
Management
- Balloon dilation then antacid
- possibly prokinetic after
- Gougienage: stretches => then antacid
- possibly prokinetic after
- stinting
- intralesional steroids (oral steroids NOT recommended)
- Mitomycin C
Megaesophagus/neuromuscular dysfunction
Diagnosis
- Congenital: poor prognosis
- survey rads
- aspiration pneumonia
- bloodwork
- acetylcholine receptor antibody test for neuromuscular check
- thyroid testing
Megaesophagus / neuromuscular dysfunction
Management
- symptomatic and supportive care
- fluids
- antibiotics for pneumonia (culture if possible)
- nutrition
*prognosis is always guarded
breeds predisposed to congenital megaesophagus
- german shepherd
- great dane
- irish setter
- mini schnauzer
- wire-haired terrier
Causes of acute gastritis
- gastric foreign body
- obstruction
- acute pancreatitis
- infectious disease
- systemic disease
Clinical presentation of acute gastritis
- vomiting
- lethargy
- depression
- polydipsia
- hematemesis
- cranial abdominal pain
Diagnosis of acute gastritis
- history
- PE
- abdominal rads
- biochemical tests to exclue other dz and resp to therapy
Management of acute gastritis
- rest GI
- 12-24 hours without food, restrict water if vomiting
- supportive care
- feed bland diet
- digestible
- low in fat
Causes of chronic gastritis
- inflammatory
- food responsive dz
- reflux
- helicobacter
- idiopathic
