Stomach Flashcards
What conditions predispose to PICA?
- pancreatic exocrine insufficiency
- hepatic encephalopathy
- iron deficiency
What are the common clinical signs associated with a gastric foreign body?
- vomiting most common
- dehydration and lethargy
What is found on physical exam of a dog with a gastric FB?
- distended abdomen
- hematemesis
- melena
What laboratory findings can be present in a dog with a gastric FB?
- hemoconcentration or anemia
- azotemia
- alkalosis or acidosis
- hypokalemia
- hypochloremia
How can is a gastric FB diagnosed?
- radiographs
- ultrasound
- endoscopy
What is the treatment/therapy for a gastric FB?
- stabilize patient: fluids, gastroprotectants, analgesics
- lead (chelation), zinc (tranfusion)
- endoscopy or gastrotomy
Describe the gastrotomy procedure for removal of a FB
- ventral midline incision from xyphoid to pubis
- stab incision in center of vessels, then extend
- remove FB
- explore and lavage entire abdomen
- closure
Which is the layer of strength in the stomach?
submucosa
When is a single layer closure of a gastrotomy indicated?
- pyloric outflow tract
- reduced gastric volume
- thickened gastric wall
Which animals are predisposed to congenital pyloric stenosis?
- brachycephalic breeds
- siamese cats
What is congenital pyloric stenosis?
- gastric outflow obstruction
- hypertrophy of circular muscles
What are the clinical signs associated with congenital pyloric stenosis?
- intermittent vomiting
- abdominal distension without pain
- normal to decreased body condition
How is congenital pyloric stenosis diagnosed?
- radiographs
- ultrasound
- endoscopy
What is seen on radiograph of a congenital pyloric stenosis?
- gastric distension
- delayed gastric emptying
- apple core sign with contrast
How is congenital pyloric stenosis treated?
- Fredet-Ramstedt Pyloromyotomy
- Heinke-Mikulicz Pyloroplasty
Describe Fredet-Ramstedt Pyloromyotomy
- no lumen exposure
- isolate pylorus and make surgical incision through serosa and muscular layer
- creates bulge which opens pylorus
- leave to heal on its own
Describe Heinke-Mikulicz Pyloroplasty
- enters lumen of pylorus
- full thickness incision
- close in transverse orientation to help widen pyloric area
Which animals are predisposed to acquired pyloric stenosis?
small breeds
middle-aged males
What are the pathological classifications of acquired pyloric stenosis?
Grade 1 - muscular hypertrophy
Grade 2 - muscular and mucosal hypertrophy
Grade 3 - mucosal hyperplasia with muscular and submucosal inflammation
What are the treatment options for acquired pyloric stenosis?
- transverse pyloroplasty
- Y-U pyloroplasty
- Billroth 1: pylorectomy with gastroduodenostomy
Describe Y-U Pyloroplasty
- Y-shaped incision over pyloric antrum
- create full thickness antral flap
- pull flap down to base of the Y and suture it
Describe pylorectomy with gastroduodenostomy
resecting entire affected pylorus and attaching proximal duodenum to stomach
What are the clinical signs associate with gastric neoplasia?
- vomiting
- anorexia
- regurgitation
- melena
- hematemesis
- pain
- weight loss
- abdominal distension
What are the lab findings associated with gastric neoplasia?
- anemia
- acidosis
- hypochloremia
- hypokalemia
What is the most common gastric neoplasia in dogs?
gastric adenocarinoma
What are the treatment options for gastric neoplasia?
- gastrectomy
- Billroth 1 or 2
- chemotherapy
What are the indications for a gastrectomy?
- neoplasia
- ischemic injury
- ulcer
- trauma
Describe the Billroth 2 procedure
- removal of entire pyloric antral area, significant portion of stomach, and part or proximal duodenum
- side-to-side anastomosis of jejunum to stomach
What are the complications of Billroth 2?
- alkaline gastritis (secretions in blind sac mix with gastric secretions)
- blind loop syndrome (food enters blind sac)
- marginal ulceration (jejunum receiving pyloric secretions)
Describe the Roux-en-Y Anastomosis procedure
- resect significant portion of stomach up to proximal duodenum
- resect duodenum by pancreatic ducts and anastomose on jejunum
- stomach empties directly into duodenum
Describe the features of a gastric leiomyosarcoma
- smooth muscle origin
- affinity for cardia
- causes gastric uleration
Describe the features of a gastric leiomyoma
- benign, slow growing
- no metastasis
- may cause gastric outflow signs
What is Pythiosis?
fungal disease that mimics gastric adenocarcinoma
- rapid growth rate an extensive
How is pythiosis diagnosed?
- endoscopy
- ELISA/SNAP
- histopathology
What is seen on histopathology of pythiosis?
eosinophilic pyogranulomatous inflammation
How is pythiosis treated?
- resect as much tissue as possible
- anti-fungals
- immunotherapy
What is the prognosis for pythiosis?
guarded to poor
In which dogs do we more commonly see Pythiosis?
working/hunting dogs
