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Y4 - Small Animals > Vomiting + stomach disease > Flashcards

Vomiting + stomach disease Flashcards

1
Q

What is the difference between primary + secondary vomiting?

A
  • Primary vomiting = underlying gastric disease
  • Secondary vomiting = non-GI disease
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2
Q

What can cause secondary vomiting (systemic/metabolic disease)?

A
  • infections = distemper, leptospirosis
  • pyometra
  • renal failure
  • hepatic disease
  • drugs = digoxin, erythromycin, morphine
  • ketoacidotic D.M.
  • hypoadrenocorticism
  • CNS disease
  • motion sickness
  • vestibular disease
  • neoplasia
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3
Q

What can cause chronic vomiting (2ary to intestinal / peritoneal disease)?

A
  • inflammatory bowel disease
  • intestinal neoplasia
  • small intestinal obstruction
  • pancreatitis
  • peritonitis
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4
Q

What primary gastric disease can cause chronic vomiting?

A
  • chronic gastritis
  • gastric retention disorders
  • gastric ulcers
  • gastric neoplasia
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5
Q

What diffuse GI disease involving stomach can cause chronic vomiting?

A
  • Inflammatory bowel disease
  • Alimentary lymphoma
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6
Q

What is the pathophysiology of gastric disease?

A
  • gastric outflow obstruction
  • gastroparesis
  • disruption of mucosal barrier
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7
Q

What are other signs of gastric disease?

A
  • Haematemesis
  • Nausea
  • hypersalivation
  • retching
  • anorexia
  • Melaena
  • Miscellaneous
  • belching
  • bloating
  • borborygmi
  • weight loss
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8
Q

How can you diagnose chronic vomiting?

A
  • Distinguish vomiting vs. regurgitation
  • Eliminate secondary causes = Hx, PE, laboratory analysis, imaging
  • Abdominal imaging = Plain radiography, Contrast radiography, Ultrasonography
  • Gastroscopy / coeliotomy
  • Symptomatic therapy
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9
Q

What would you do on Physical exam with chronic vomiting?

A
  • Oral examination = ulcers, linear foreign body
  • Abdominal palpation = pain, foreign body, intra-abdominal mass, distended stomach or bowel
  • Rectal examination = diarrhoea, melaena
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10
Q

What would you do on clinical pathology of chronic vomiting?

A
  • Electrolytes
  • Haematology
  • BAST - bile acid stim test
  • ACTH Stim
  • cPLI
  • Urinalysis
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11
Q

What would you check of radiographs?

A

Abdominal radiographs =
* foreign body
* abdominal mass
* intestinal obstruction
* peritonitis
* GDV

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12
Q

What would you check of ultrasonography?

A
  • foreign body
  • ulcers
  • thickening of gastric mucosa
  • loss of layering (suggests infiltration)
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13
Q

What are causes of chronic gastritis?

A
  • Generalised Inflammatory bowel disease
  • chronic gastric parasitism (eg. Physaloptera)
  • hairballs in cats
  • spiral bacteria - Helicobacter
  • Immune-mediated
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14
Q

What are clinical signs of chronic gastritis?

A
  • intermittent chronic vomiting (vague)
  • ± periodic early morning vomit with bile
  • ± poor appetite
  • ± gastric bleeding
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15
Q

How is chronic gastritis diagnosed?

A
  • Gastroscopy
  • Biopsy
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16
Q

What is Tx of chronic gastritis?

A
  • Removal of aetiologic agent if known
  • Diet = multiple small meals, low fat diet, ‘hypoallergenic’ diet
  • Acid blocker
  • Corticosteroids
17
Q

What is bilious vomiting?

A
  • Often occurs in dogs fed once daily (especially if fed in the morning)
  • Vomiting occurs overnight or in the morning
  • Vomitus often bile-stained fluid, not food
  • Presumably reflects abnormal inter-meal motility allowing bile-reflux into stomach
18
Q

How do you treat bilious vomiting?

A
  • Feed more often
  • Add prokinetics
19
Q

What are gastric retention disorders?

A
  • Retention of food for > 8 hours causing delayed vomiting of food
  • Anatomical outflow obstruction
  • Functional disorder = primary motility disorder / inflammatory disease =
  • inflammatory bowel disease
  • gastric ulcer
20
Q

What can cause anatomical outflow obstruction of the stomach?

A
  • Pyloric stenosis - congenital in brachycephalics
  • Neoplasia, polyp
  • CHPG (chronic hypertrophic pylorogastropathy) - toy breeds
  • Foreign body = rubber ball, peach stone, conker, sock etc
21
Q

How would you treat outflow obstruction of stomach?

A
  • Stenosis = surgery
  • CHGP = Surgery
  • FB = removal
22
Q

How would you treat gastric retention?

A
  • Treat underlying inflammatory disease
  • Prokinetics =
    -metaclopramide (stim gastric peristalsis)
  • ranitidine (H2 antagonist + prokinetic)
  • erythromycin (stim motilin receptors)
23
Q

What are causes of haemtemesis?

A
  • generalised bleeding
  • swallowed blood = oropharyngeal, nasal, pulmonary
  • severe gastritis
  • gastric ulcer
  • gastric neoplasia
  • duodenal disease
24
Q

What are signs of gastric ulcers?

A
  • haematemesis
  • melaena
  • anaemia
  • weight loss
  • pain
  • peritonitis etc. if perforated
  • Prayer posture - abdominal pain
25
Q

What can cause gastric ulcers?

A
  • NSAIDs
  • Corticosteroids
  • Head + spinal injuries = w corticosteroids, colonic ulcers / perforation
  • gastritis
  • metabolic = liver disease, uraemia
  • bile reflux
  • mastocytosis
  • gastrinoma (Zollinger-Ellison)
  • spiral bacteria (Helicobacter)
26
Q

How would you treat gastric ulcers?

A
  • Tx identifiable primary cause
  • Sucralfate
  • Acid blockers =
  • antacids
  • H2 antagonists - ranitidine, cimetidine
  • proton pump inhibitors - omeprazole
27
Q

What can be used to prevent gastric ulcers?

A

Misoprostol - synthetic PGE

28
Q

What is Tx of helicobacter?

A
  • Triple therapy =
  • 2 antibitoics + acid blocker =
    1. Amoxicillin
    2. Metronidazole
    3. Omeprazole
29
Q

What are gastric neoplasias in dogs / cats?

A
  • Dogs =
  • adenocarcinoma (75%) (belgian shepherds, collies, bull terriers)
  • lymphoma
  • polyps
  • leiomyoma / leiomyosarcoma
  • Cats =
  • lymphoma
  • adenocarcinoma
30
Q

What are signs of gastric adenocarcinoma? Dx?

A
  • suspect in older animal with =
  • chronic vomiting
  • anorexia and weight loss
  • haematemesis and melaena
  • anaemia
  • drooling saliva
  • Dx = contrast radiography, endoscopic biopsy / full thickness biopsy
31
Q

What is Tx of gastric adenocarcinoma?

A
  • Surgical resection - Hopleless prognosis = Euthanasia
32
Q

What should be done with other tumours?

A
  • Lymphoma = chemotherapy
  • Leiomyoma = Surgery
  • Polyp = surgical removal + histopath

Y4 - Small Animals (105 decks)

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