Topic 13 - Diseases of the stomach in dogs and cats Flashcards

1
Q

Anatomy of the stomach. Name the most important structures:

A
  1. Cardia
  2. Fundus
  3. Corpus
  4. Antrum
  5. Pylorus
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2
Q

Function of cardia:

A

Opening from esophagus to stomach. Prevents reflux of ingesta

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3
Q

Function of fundus:

A

Dilates during gastric filling to accommodate the amount of ingesta.

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4
Q

Function of corpus:

A

Glands secrete the stomach acids

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5
Q

Name the stomach acids:

A

HCL
Pepsin
Lipase

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6
Q

Function of antrum:

A

Muscular area, grinds food

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7
Q

Function of pylorus:

A

Filter to limit size of food passing into the intestines and prevents reflux of duodenal content

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8
Q

Blood supply of stomach:

A

Coeliac artery and vein

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9
Q

Nerve innervating the stomach:

A

Vagus nerve
Cardillac plexus
Gastric nerve

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10
Q

Clinical signs of gastric disease:

A

1. Vomiting
2. Anorexia
3. Weight loss

4. Hematemesis = bloody vomit
5. Abdominal pain
6. Abdominal distention
7. Diarrhoea

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11
Q

Name disease of the stomach:

A
  1. Acute gastritis
  2. Gastric erosive-ulcerative disease
  3. Chronic gastritis
  4. Delayed gastric emptying and gastric motility disorders
  5. Gastric dilation-volvulus syndrome
  6. Gastric neoplasia
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12
Q

Acute gastritis

A

Inflamed stomach
Happens more often in dogs, than cats

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13
Q

Acute gastritis, causes:

A

Spoiled food
Contaminated food
Foreign body
Toxic plants
Chemicals
Bacteria, virus, parasites

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14
Q

Acute gastritis, clinical signs:

A
  • Acute vomiting
  • Loss of appetite
  • RARELY: fever, abdominal pain
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15
Q

Acute gastritis, how to diagnose:

A

By excluding other diseases:
- History and physical examination
- Improvement in 1-2 days
- If worsened after 1-3 days = carry out US, CBC, endoscopy

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16
Q

Acute gastritis, treatment:

A
  1. Fasting for 24 hours
  2. Antiemetics
  3. Fluid therapy or small amounts of cool water
  4. GI prescription diet: low fat and low fibre
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17
Q

Gastric erosive-ulcerative disease

A

Short = GEU
Stomach ulcers

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18
Q

Gastric erosive-ulcerative disease, predisposing factors:

A

Steroids
Metabolic disorders: Liver failure, acute pancreatitis
Toxins

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19
Q

Gastric erosive-ulcerative disease, how to diagnose:

A
  1. History
  2. Physical exam
  3. Lab exam
  4. Radiography
  5. Endoscopy
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20
Q

Gastric erosive-ulcerative disease, how to diagnose:

History

A
  1. Intermittent vomiting
  2. Haematemesis, melena
  3. acute onset of wekaness
  4. recent steroid/NSAID therapy
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21
Q

Gastric erosive-ulcerative disease, how to diagnose:

Physical exam

A

Often normal, but can be anaemic, abdominal pain and melena

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22
Q

Gastric erosive-ulcerative disease, how to diagnose:

Lab exam

A
  1. Anaemia
  2. Renal failure
  3. Liver disease
  4. Addisons
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23
Q

Gastric erosive-ulcerative disease, how to diagnose:

Radiography

A

Usually normal, but can see:
- peritonitis
- pneumopeitoneum

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24
Q

Gastric erosive-ulcerative disease, how to diagnose:

Endoscopy

A

We can do biopsy and differentiate between:
- superficial erosions
- benign ulcers
- mailgnant ulcers

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25
If there is a perforation of the stomach, which contrast is dangerous/would you use?
Dangerous = barium sulfate Use: iodine compound
26
Gastric erosive-ulcerative disease, treatment:
1. Elimination of predisposing factor 2. Supportive 3. Blood transfusion 4. Surgery
27
Gastric erosive-ulcerative disease, supportive treatment:
Diet Fluids
28
Chronic gastritis, causes:
Quite common! Can be idiopathic Can have the same causes as acute gastritis Specific causes
29
Chronic gastritis, specific causes:
1. Heliobacter 2. Parasites 3. Dietery agents 4. Foreign materials 5. Fungus
30
Chronic gastritis, symptoms:
1. intermittent vomiting, with no response to symptomatic treatment 2. anorexia 3. weight loss 4. abdominal pain 5. hematemesis, melena
31
Chronic gastritis, how to diagnose:
1.Endoscopy w/biopsy and histopathology 2. Lab tests 3. Radiography 4. Histology
32
Chronic gastritis, how to diagnose: ## Footnote Radiography
Check for foreign body, mass lesions, delayed gastric emptying
33
Chronic gastritis, treatment:
1. Elimination and provocation diet 2. Anti-parasitic therapeutic trial 3. Heliobacter elimination trial 4. Immunosuppressice therapy 5. Antacids 6. Gastroprotectants 7. Surgical resection of large masses
34
Chronic gastritis, how to diagnose: ## Footnote Lab tests
Not diagnostic, but used for exclusion - metabolic disease - anaemia - leuckocytosis
35
Delayed gastric emptying, causes:
Gastric outflow obstruction or gastric motility disorders
36
Gastric outflow obstrution, causes:
- Pyloric stenosis - Foreign body - Gastric ulcer - Neoplasia - External compression: abdmonial mass
37
Gastric motility disorder, causes:
- Idiopathic - Constipation - Liver failure - Post-GDV
38
How to diagnose delayed gastric emptying:
1. History 2. Physical exam 3. Lab test 4. Radiography 5. Endoscopy
39
How to diagnose delayed gastric emptying: ## Footnote History
Vomiting
40
How to diagnose delayed gastric emptying: ## Footnote Physical exam
Normal or abdominal tympany
41
How to diagnose delayed gastric emptying: ## Footnote Lab test
Normal or hypochloremic metabolic alkalosis
42
How to diagnose delayed gastric emptying: ## Footnote Radiography
Fluid distended stomach
43
How to diagnose delayed gastric emptying: ## Footnote Endoscopy
Confirms gastric outflow obstruction If no evidence of this = gastric motility disorder
44
What is pyloric stenosis?
A condition blocking food from entering the small intestine
45
Pyloric stenosis, causes
Can be congenital or acquired
46
Pyloric stenosis, congenital:
Mucosal layer is thickened. Seen in: young-middle aged, small breed, brachycephalic
47
Pyloric stenosis, acquired:
Mucosal and muscular layer is affected, or only the mucosal layer Seen in: Old males, small breeds (maltese, shi-tzu)
48
How to diagnose pyloric stenosis
1. We observe projectile vomiting 6-8 hours after eating 2. Radiography is NOT useful 3. Endoscopy: see narrowed pyloric lumen or thickened mucosa
49
pyloric stenosis, treatment:
Surgery Pyloroplasty = widen the opening
50
Idiopathic gastric motility disorder, signs:
Abdominal discomfort: bloating, chronic vomiting
51
Idiopathic gastric motility disorder, how to diagnose:
Elimination of obstructive or metabolic disorders
52
Idiopathic gastric motility disorder, treatment:
Frequent feeding with: - Liquid - Low fat - Low fibre
53
Gastric dilation and volvolus, types:
1. Dilation without torsion 2. Dilation with torsion 3. Volvolus without evidence of dilation
54
Gastric dilation without torsion:
Seen in young dogs. They are eating too fast
55
Gastric dilation with torsion:
Seen in deep chested breeds, which exercise too quickly after feeding. The stomach rotates around longitudinal axis 90 or 180 degrees
56
Gastric volvolus without evidence of dilation
Rare Chronic form
57
Gastric dilation and volvolus, consequences:
1. Thoracic organ compression 2. Cardiogenic shock 3. Systemic hypertension 4. Bacteremia 5. Portal hypertension
58
Gastric dilation and volvolus, clinical signs:
1. Weak pulse 2. Increased CRT 3. cyanotic membrane 4. Weakness, sign of shock 5. Drum-like gas tympany 6. Barrel-like distention
59
Gastric dilation and volvolus, treatment:
1. Gastrocentesis: quick, relieve stomach ASAP 2. Orogastric tube: slower, needs anaesthesia 3. Vein catetherisation: fluid 4. **NO** glucocorticoids, causes shock
60
Gastric neoplasia
Not very common in dogs and cats Can be: - Adenocarcinoma **dog** - Lymphoma **cat**
61
Gastric neoplasia, clinical signs:
Weight loss Vomiting Anorexia Melena Haematemesis
62
Gastric neoplasia, how to diagnose:
Endoscopy US Biopsy Histopathology
63
Gastric neoplasia, treatment:
Adenocarcinoma = surgery Lymphoma = chemotherapy