Week 2 - Clinical Introduction to Gastroesophageal Disease - Small Animal (Winston)

Question 1

What are the Primary Clinical signs of gastroesophageal disease?

Answer 1

• Dysphagia
• Regurgitation
• Vomiting

Question 2

Definition:
Difficulty chewing and swallowing

Answer 2

Dysphagia

Question 3

Definition:
Is the passive expulsion of undigested food or fluid from the esophagus. It is influenced by mechanical events in the esophagus and is not a reflex

Answer 3

Regurgitation

Question 4

Definition:
Is the forceful expulsion of gastric and intestinal contents through the mouth.

Answer 4

Vomiting

Question 5

What are the secondary Clinical Signs of gastroesophageal?

Answer 5

• Anorexia
• Polyphagia
• Hypersalivation
• Retching
• Abdominal pain
• Bloat
• Weight Loss
• Melena
• Coughing/gagging

Question 6

(T/F) Nausea can be seen with both regurgitation and vomiting

Answer 6

False, only with vomiting

Question 7

Clinical Vomiting Syndromes: Gastrointestinal Bleeding
In Iron deficiency (chronic blood loss), the CBC will show….

Answer 7

Microcytic, hypochromic anemia

Question 8

What clinical syndromes is this that is associated with vomiting?
- is suggested by a pattern including food present in vomitus > 10 hours after eating (and regurgitation is ruled out)
- abdominal distention after eating;
- bloating
- belching
- projectile vomiting
- hypokalemic, hyponatremic, metabolic alkalosis
- projectile vomiting with mechanical causes

Answer 8

Delayed gastric emptying

Question 9

What are we able to see with a Small Bowel Gastroduodenoscopy (aka “Upper”)?

Answer 9

1. Esophagus
2. Stomach
3. Proximal duodenum

Question 10

What can we see with a Large Bowel Colonoscopy (aka “Lower”)?

Answer 10

1. Colon
2. Cecum
3. Distal Ileum

Question 11

When do we consider using gastrointestinal protectants?

Answer 11

• Gastroduodenal erosions or ulcers
• Reflux esophagitis
• Gastritis
• Hypersecretory states (gastrinoma)

Question 12

(T/F) Famotidine has a decreased efficacy (tolerance) in dogs over time (use < 10 days, in as little as 3 days)

Answer 12

True

Question 13

(T/F) Recent studies suggest ranitidine is NOT effective in raising gastric pH in dogs and cats

Answer 13

True

Question 14

What is more effective than H2 blockers to raise gastric pH in dogs and cats?

Answer 14

Proton Pump Inhibitors
- If administered for more than 3-4 weeks need to taper to prevent rebound of gastric acid hypersecretion

Question 15

List the GI Promotility Drugs:

Answer 15

• Metoclopramide (Reglan)
• Cisapride
• Erythromycin
• H2 receptor blockers*** not very good

Question 16

What is a non-invasive, atraumatic technique that is an alternative to surgery?

Answer 16

Gastrointestinal endoscopy

Question 17

(T/F) Sucralfate will non-specifically bind other oral drugs given concurrently, so separate from administration of the other medications by at least 1 hour

Answer 17

True

Question 18

Between Metoclopramide and Cisapride, which is a more effective promotility agent in dogs and cats?

Answer 18

Cisapride

Question 19

(T/F) Both cisapride and metoclopramide have anti-emetic properties

Answer 19

False, only metoclopramide

Question 20

(T/F) Cisapride is only available through compounding pharmacies

Answer 20

True

Question 21

The antibiotic _____________ binds to and stimulates motilin receptors so it is used therapeutically in dogs (cats) to increase GI motility in dogs (cats)

Answer 21

erythromycin