STOMACH

Question 1

List the different types of gastritis

Answer 1

• Acute
• Haemorrhagic
• Idiopathic inflammatory
• Helicobacter
• Parasitic

Question 2

How is helicobacter gastritis treated?

Answer 2

Combo of metronidazole, amoxicillin + bismuth salicylate

Question 3

Which parasites are likely to cause gastritis in dogs and cats?

Answer 3

D =physlaloptera rare

C =ollularus tricuspis

Question 4

List possible causes of gastroduodenal ulceration/erosion

Answer 4

• NSAIDs
• liver disease/portal hypertension
• steroids
• uraemic ulceration
• shock/sepsis

Question 5

What are the clinical signs of gastroduodenal ulceration and how is it diagnosed and treated?

Answer 5

CLIN SIGNS: V+, anorexia, haematemesis, abdo pain
DIAGNOSIS: u/s -> thickened irreg. areas of mucosa w/ air penetrating mucosal wall, endoscopic view of ulcer
TREATMENT: Surgical- resect ulcer
Medical- treat underlying cause, PPI +sucralfate

Question 6

Describe the pathogenesis of gastric dilatation + volvulus syndrome

Answer 6

1. aerophagia/bacterial proliferation/failure to eructate/pass gas into intestine -> stomach distends + fills w/ gas
2. stomach fills w/ fluid (food/gastric secretion/transudate/blood)
3. 90-360 degree CLOCKWISE rotation (pylorus -> l, v; fundus-> r)
4. spleen rotates (-> r, dorsal) -> congestion -> infarction, ischaemia
   CAUSES: increased intragastric pressure -> gastric wall necrosis -> perforation
   CVC pressure -> reduced venous return -> cardiac arrhythmias -> shock (endotoxic/septic)
   diaphragmatic compression -> poor ventilation

Question 7

What are the clinical signs of GDV?

Answer 7

• persistent V+
• severely bloated
• tympanic abdo
• cardiac arrhythmias
• collapse
• panting

Question 8

What are the complications of GDV?

Answer 8

-heart arrhythmias
-gastric wall necrosis
-peritonitis
LONG TERM: hypomotility + recurrence

Question 9

What is the prognosis for GDV:

Answer 9

Survival rates…
gastric wall necrosis - 66%
gastric wall intact - 90-95%
no treatment - 10%

Question 10

How is GDV treated?

Answer 10

1. Stabilisation: IVFT shock doses, gastric decompression (percutaenous or orogastric tube), analgesis, oxygen therapy, iv antibiotics, treat arrhythmias
2. Immediate surgery: decompress + reposition stomach, assess stomach + spleen for necrosis (green/green/black w/ thin wall = not viable-> partial gastrectomy, red/H+ = compromised -> gastric wall invagination)
3. Prevent recurrence: tube gastrostomy w/ mushroom tipped tube or incisional gastropexy (perm. adhesion of stomach to body wall to prevent pylorus moving), avoid single large meals, restrict exercise before/after feeding