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SAM final topics > Topic 12 - Diseases of the oesophagus in dogs and cats. Regurgitation and vomitus > Flashcards

Topic 12 - Diseases of the oesophagus in dogs and cats. Regurgitation and vomitus Flashcards

1
Q

Name disease of oesophagus

A
  1. Oesophagitis
  2. Gastro-oesophageal reflux
  3. Motility disorders
  4. Spirocercosis
  5. Hiatal hernia
  6. Persisten Right Aortic Arch
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2
Q

Clinical signs of oesophagel disease

A

Dysphagia
Odynophagia
Salivation
Regurgitation
Appetite
Aspiration pneumonia
Cachexia and weight loss

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3
Q

Dysphagia, definition

A

Difficulty swallowing

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4
Q

Odynophagia, definition

A

Painful swallowing

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5
Q

Appetitie, increased or decreased?

A

Increased = motility disorders no pain, but food cannot enter stomach

Decreased = inflammation gastritis, enteritis

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6
Q

Aspiration pneumonia

Cause
Clinical signs

A

Cause: by regurgitation

clinical signs: coughing, fever, dyspnoea, pulmonary crackles (auscultation)

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7
Q

Methods to diagnose esophageal disease

A
  1. Physical exam
  2. Laboratory exam
  3. Radiography
  4. Endoscopy
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8
Q

Findings upon physical examination

A
  1. Distended esophagus w/ gas, fluid, foreign body
  2. Aspiration pneumonia
  3. Inflamed salivary glands
  4. Neurological issues
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9
Q

Findings upon laboratory exams and what it might indicate:

A
  1. ⭡ WBC = pneumonia, pleuritis, foreign body
  2. ⭡K, ⭣Na, ⭣volume = addisons
  3. ⭡AST, ⭡Creatinine kinase = polymyositis
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10
Q

Findings upon Radiography

A

Foreign body
PRAA = persistent right aortic arch
Megaesophagus

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11
Q

Findings upon endoscopy

A

Megaesophagus

Can see dilation with chyme or saliva

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12
Q

Oesophagitis, definition:

A

Inflammation of the esophagus

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13
Q

Oesophagitis, causes:

A
  1. Gastroesophageal reflux
  2. Anaesthetics
  3. Persistent vomiting
  4. Foreign body
  5. Doxycycline
  6. Motility disorder
  7. Megaesophagus
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14
Q

Why can doxycycline cause esophagitis?

A

Used to treat leptospirosis or other infections in cats, it is a locally irritating drug

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15
Q

Esophagitis, clinical signs:

A

Odynophagia
Regurgitation
Salivation
Food refusal
Coughing
Fever
Dyspnea

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16
Q

How to diagnose Esophagitis

A
  1. By symptoms
  2. ⭡ WBC
  3. Endoscopy
  4. Radiography
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17
Q

Treatment of esophagitis

A
  1. Protect the injured and inflamed mucosa from acid
    = omeprazole/pantoprazole
  2. Keep the feed from coming in contact with irritated mucosa, feed parentally or with intubation
  3. Treat aspiration pneumonia
    = Antibiotics + mucolytics
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18
Q

Prognosis of esophagitis:

A

Usually good, but it depends on background.
Untreated = megaesophagus

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19
Q

Gastro-Esophageal reflux

A

Short: GOR

It is one of the most common causes for esophagitis, BUT esophagitis can also lead to GOR

GOR = insufficient closure of cardia of stomach, acids in the stomach will reach the base of esophagus and cause inflammation

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20
Q

Causes for Gastro-Esophageal reflux

A
  1. Delayed gastric emptying
  2. Obstruction
  3. Hiatal hernia = stomach pushes through where the esophagus goes through diaphragm
  4. Anaesthesia = opens the cardia of stomach
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21
Q

Clinical signs of Gastro-Esophageal reflux:

A

Same as esophagitis, but also
1. Reverse sneezing
2. Chronic bronchitis
3. Laryngitis
4. air/gas from stomach comes out the mouth

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22
Q

How to diagnose Gastro-Esophageal reflux:

A
  1. Look at symptoms
  2. Endoscopy
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23
Q

Differential diagnosis of Gastro-Esophageal reflux:

A

Esophagitis
Hiatal hernia
Stricture

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24
Q

What is esophageal stricture?

A

localised narrowing that leads to regurgitation because the food cannot enter the stomach

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25
Treatment for Gastro-Esophageal reflux:
Increase the cardia tone and gastric motility 1. Low fat diet, avoid late night feeding 2. Prokinetics = helps the passing of chyme from the stomach to the intestines 3. Enhance the cardia closure or increase the tone ⭢ antiemetic
26
Prognosis of Gastro-Esophageal reflux
usually good
27
What is chyme?
a thick semifluid mass of partially digested food and digestive secretions that is formed in the stomach and small intestine during digestion
28
Motility disorders types:
1. Megaesophagus 2. Partial esophageal dysmotility 3. Dysautonomia 4. Diverticulum
29
Dysautonomia
Neurological issue
30
Diverticulum
Localised dilation of the esophagus
31
Causes for motility disorders:
Might be due to: 1. muscle dystrophy 2. Auto-immune disease 3. Post-Anaesthesia 4. Esophagitis
32
Clinical signs of motility disorders:
1. Regurgitation 2. Salivation 3. Coughing, fever, dyspnoea 4. Weight loss⭢ it is a chronic issue
33
How to diagnose motility disorders
1. Fluoroscopy 2. Radiography
34
Treatment for motility disorders:
1. Special feeding: keep the dog in vertical positin when feeding, small meals, change consistency 2. Treat esophagitis and underlying issue 3. Antibiotics for aspiration pneumonia
35
Megaesophagus
Esophageal hypomotility with a secondary dilation Can be congenital or acquired
36
Congenital megaesophagus:
Found in some breeds: 1. Miniature schnauzers 2. Great danes 3. Dalmations 4. Shar pei 5. Irish setter 6. Labrador
37
Acquired megaesophagus:
Can come from: 1. Idopathic background - 70-80% of the cases 2. Lead poisining 3. Esophagitis 4. Addisons
38
Esophageal foreign body, clinical signs:
- Regurgiation - Salivation - Distended abdomen - Coughing, fever, dyspnoea ⭢ if aspiration pneumonia
39
Esophageal foreign body, diagnosis:
Thoracic radiography Endoscopy
40
Esophageal foreign body, treatment:
1. Endoscopic removal⭢ inform owner of risk of perforation. This is unsuccesful in 30-70% of the cases 2. Next we can do is **surgery or gastric tubing** to push foreign body downwards ⭢ easy to perforate 3. Last choice is euthanasia
41
Spirocercosis:
Parasitic disease ⭢ spirocerca lupi The dog might have swallowed a **dung beetle**, the larva enters the aortic wall. The last stage of larvae enters the esophagus ⭢ obstrcution, regurgitation, vomitus
42
Clinical signs of Spirocercosis:
Vomiting, regurgitation Weight loss Coughing Dyspnoea
43
How to diagnose Spirocercosis:
Faecal examination Endoscopy
44
Treatment for Spirocercosis:
Moxidectin Surgical removal
45
Prevention for Spirocercosis:
Moxidectin, Milbemycin
46
Hiatal hernia:
The stomach goes through the diaphragm and into the thorax
47
Treatment for hiatal hernia
Surgery
48
Persistent Right Aortic Arch
Short: PRAA an embryonic branch that does not regress and instead wraps around the esophagus putting pressure on it
49
Clinical signs of PRAA
Regurgitation, coughing, especially in young dogs
50
Diagnose PRAA
X-ray with contrast Endoscopy
51
Treatment PRAA
Surgery
52
Main difference of vomitus and regurgitation
Vomiting = the ejection of contents of the stomach and upper intestine Regurgitation = the ejection of contents of the esophagus
53
Signs of regurgitation:
1. NO nasuea 2. Passive backflow 3. Undigested food 4. NO bile 5. Eating back the content
54
Signs of vomitus:
1. Nausea 2. Undigested or digested food 3. Bile 4. Active muscle contrations Can be acute or chronic
55
Causes for acute vomitus, non-life threathening:
1. Gastric disease 2. Infections: giardia
56
Causes for acute vomitus, life threathening:
1. Metabolic disorders: acute hepatic disease 2. Endocrine disorders: Addisons 3. Toxins 4. Diet: allergy 5. Abdominal disease: acute pancreatitis 6. Gastric disease: foreign body 7. Small intestines disease: obstructions, parasites 8. Large intestinal disease: constipation, colitis 9. Infections: Parvo, distemper, leptospirosis, pyometra
57
What makes vomiting, a chronic disease?
If the animal has been vomiting for more than 1-2 weeks
58
Causes for chronic vomiting
1. Metabolic disorders: renal disease 2. Endocrine disorders: Addisons 3. Toxins/drugs 4. Diet: allergy 5. Abdominal disease: pancreatitis 6. Gastric disease: foreign body, gastritis 7. Small intestines disease: obstructions, parasites 8. Large intestinal disease: constipation, colitis 9. Neurological disease: epilepsy, vestibular disease
59
Steps for physical examination for vomiting:
1. Oral examination 2. Mucous membranes: icterus 3. Cardiac arrythmia 4. Abdominal palpation: pain, gas distention, abdominal mass 5. Rectal examination: constipation, melena
60
How to diagnose cause for vomiting:
1. CBC, biochemistry 2. Radiography 3. US 4. Gastroduodenoscopy
61
Findings on CBC, indications:
Normal = gastric disease Anaemia = bleeding Neutropenia = parvo Neutrophilic leukocytosis = acute pancreatitis Eosinophilia = parasites, addisons
62
Findings on biochemistry, indications:
Hypoproteinaemia = IBD, chronic renal failure Hypokalaemia = CKD Hyperkalaemia = Addisons AKI/CKD
63
Findings on radiography, vomitus:
Foreign body Abnormalities in GIT
64
Findings on US, vomitus:
Dilated stomach with fluid Thickened gastric wall Examine abdominal organs
65
Findings on gastroduodenoscopy, vomitus:
**Most useful !!** Direct visualisation for biopsy and histopathology
66
Treatment for vomitus:
1. Antiemetics: maropitant 2. Fluids 3. Dietary changes 4. Antacids 5. Protectives

SAM final topics (14 decks)

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