Test 3. 2 Flashcards
where to place feeding tube in neck
left side
differences between dysphagia, regurg and vomiting
three forms of megaesophagus
congenital
acquired idiopathic
acquired secondary
megaesophagus
* tracheal stripe sign on bottom
what are some breeds that get megaesophagus
young animals with history of regurg
* mini schnauzer
* wirehaired fox terrier
* german shepherd
* great dane
* newfi
What might cause congential megaesophagus
- defect in afferent innervation- can’t sense distention
- motor fuction decreased
- Lower esophageal sphrincter not opening- achalasia
what are some 2nd acquired causes of megaesophagus
myasthenia gravis
addisions, hypothyroid
esophagitis
FB
lead, botulism
how to work up 2nd acquired megaesophagus
- blood work
- Xray
- acetylcholine receptor antibody titer: M. gravis
- ACTH stim: addisions
- ∓ endoscope: esophagitis, FB, cancer
resting cortisol > 2
rule out addisions
resting cortisol < 2
need to do ACTH to test for addisions
idiopathic megaesophagus occurs in
middle age to older dogs
* large breeds: shepherd, golden, irish setter, great dane
Most common form in dogs
how to treat megaesophagus
- feed upright- high calories, low fat (decrease acid)
- gastric feeding tube
- sucralfate- GERD
- anti-acid: omeperazole, famotidine
- prokinetic work on smooth muscle- dogs have skeletal muscle- so not helpful
can you give prokinetic drugs for megaesophagus?
not helpful in dogs, cause they work on smooth muscle and the esophagus of a dog is all skeletal muscle
- may be helpful in cats, but megaesophagus is very rare in cats
megaesophagus leading to aspiration pneumonia- air bronchogram on L lateral in R middle lobe over the heart
why are esophageal FB emergencies
can cause pressure necrosis quickly
* need to remove either by endoscopy or pushed into stomach
how to treat esophageal FB
- emergency- need to pull out or push into stomach
- gastrostomy tube if esophageal damage
- antacids, sucralfate
- anti-inflammatories may help reduce stricture formation- prednisione taper
what can cause GERD
- persistant vomiting
- abnormal LES function: megaesophagus or hiatal hernia
- prolonged anesthesia
what two drugs can cause esophagitis
doxy in cats
clindamycin
- if med gets stuck, recommend liquid or give water after
how to treat esophagitis
sucralfate slurry
antacids
prokinetics
low fat diet
feeding tube
antibiotics where bacterial translocation possible
the esophagus lies to the — of the trachea in the cervical portion. This is clinically relevant because esophagostomy tubes must always be placed in the
left
The — esophagus contains skeletal muscle throughout its length, while the — esophagus contains skeletal muscle proximally and smooth muscle in the distal 1/2 to 1/3 of its length
dog
feline
clinical signs for congential megaesophagus occur
at weaning- when switching to real food
— is a proton pump inhibitor used for gastic acid suppression
omeperazole
pantoprazole
— is a H2 blocker that is used for gastic acid suppression
famotidine
prokinetics such as — will — tone of the LES
cisapride, metoclopramide
increase
