Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

VET433B > Week 5 - GI > Flashcards

Week 5 - GI Flashcards

1
Q

Where is the gallbladder located?

A

between quadrate and right medial lobes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

How many hepatic ducts do dogs and cats have?

A

Dogs → 2-7
Cats → 1-5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Where does the commons bile duct lie?

A

from first hepatic duct to major duodenal papilla

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What blood vessels supply the liver?

A

-Hepatic artery (20% of blood supply and 50% of O2) – more oxygenated blood

-Portal vein (80% of blood supply and 50% of O2)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the blood supply for the gallbladder?

A

Cystic artery (branch of hepatic artery)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Cholecystectomy is what?

A

Removal of gallbladder, stops at cystic duct

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the ductal anatomy for a dog and cat? What’s the main difference?

A

Dogs
-Major duodenal papilla: Exit for CBD + Pancreatic duct SEPARATELY
-Minor duodenal papilla:: Exit for accessory pancreatic duct (V. IMP)

Cats
-Major duodenal papilla: Exit for CONJOINED CBD + PD
-Minor duodenal papilla: Only present in 20% of cats

Major difference: only 20% of cats have minor duodenal papilla. so if you damage the major duodenal papilla, you’ll have ramifications

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are some pre-operative considerations for hepatic surgery?

A
  1. hemorrhage
    -Bleeding can be profuse and life-threatening
    -Check coagulation profiles
    -Blood type and cross-match patients
    -Consider pre-treatment in some patients
    -Be familiar with surgical techniques to prevent massive bleeding (e.g. use of stapling devices, pringle maneuver etc.)
  2. hypoglycemia
    -Rarely a major problem in hepatic resections
    -Can occur in very small or debilitated patients
  3. Anesthesia/drug metabolism
    -Avoid drugs that undergo hepatic metabolism or are hepatotoxic

4.Bacteria
-Significant proportion of cats and dogs have resident hepatic microflora of mostly enteric origin
-Bile cultures more likely to yield positive culture than hepatic parenchyma
–make sure to empty entire gallbladder to prevent leakage and so hole can heal without leakage
-Good empirical choices of antibiotics
–fluoroquinolone with amoxicillin-clavulanate or clindamycin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the 3 indications for liver surgery?

A
  1. Liver biopsy
    ‣ For investigation of diffuse hepatopathies or mass lesions
  2. Liver lobectomy
    ‣ Neoplasia
    ‣ Liver abscesses
    ‣ Liver lobe torsion
    ‣ Trauma
  3. intrahepatic portosystemic shunt
    ‣ Mostly treated using an interventional stent and coil approach
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the 4 techniques for a liver biopsy?

A
  1. SUTURE FRACTURE TECHNIQUE
    -for diffuse hepatopathy - look for a liver lobe with pointed margin
    -Blood vessels and bile ducts will be ligated
  2. PLACEMENT OF OVERLAPPING SUTURES
    -Helpful when areas that cannot be easily looped around need to be sampled
    -Overlapping suture bites are taken to prevent bleeding
  3. SKIN PUNCH TECHNIQUE
    -Skin punch used to harvest biopsy “cylinder”
    -Can fill biopsy holes with cores of gelatin sponge
  4. LAPAROSCOPIC LIVER BIOPSY
    -Subumbilical camera port, one instrument port in cranial left or right quadrant
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What should you consider when biopsying a mass lesion off the liver?

A

▸ Many are very vascular and might bleed profusely

▸ If possible biopsy using a suture ligation technique for
added security or consider fine needle aspirate to see how
much it bleeds

▸ Other option is to go straight to liver lobectomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are tumor types of the liver?

A

‣ Metastatic lesions (most common)

‣ Primary liver tumors
-Hepatocellular carcinoma/adenoma - better prognosis than others
-Bile duct tumors (cholangiocellular carcinoma)
-Mesenchymal tumors
-Neuroendocrine tumors (carcinoids)

-Liver tumors can be massive, nodular or diffuse

CS of tumors: anorexia, lethargy, inappetence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What does a liver resection entail?

A

▪ Can be partial or complete

▪ Performed with blunt dissection and suture ligation or surgical staplers
‣ Thoracoabdominal stapler (TA-Covidien Inc.)

▪ Need knowledge of hepatic anatomy and blood supply

▪ Can resect up to approximately 70% of the liver acutely

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How would you diagnose and treat a liver abscess?

A

▪ Uncommon, in older dogs with non-specific clinical signs: vomiting, lethargy, anorexia

▪ Can be single or multifocal

▪ Dx: Abdominal ultrasonography ± aspiration

▪ Micro-organisms: E. Coli, Staph spp. Enterococcus spp., Clostridium spp.

▪ Treatment:
‣ Medical: antibiotics and aspiration
‣ Surgical: lobectomy
‣ Drainage and alcoholization

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Biliary tract surgeries encompass what dz/pathologies?

A

-mucoceles
-bile peritonitis
-extra hepatic biliary obx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the 3 classifications for extra hepatic biliary obx?

A
  1. extraluminal
    -pancreatitis
    -neoplasia
  2. intraluminal
    -cholelithiasis
    -FB
    -neoplasia
  3. intramural
    -neoplasia

▪ Inflammatory (~70%)
- Cholangiohepatitis (93%)
- Cholecystitis (89%)
- Cholelithiasis (40%)
- Pancreatitis (47%)
- Hepatic lipidosis (28%)

▪ Neoplastic (~30%)
- pancreatic adenocarcinoma
- biliary adenocarcinoma

▪ Occasional
- diaphragmatic hernia, fluke, FB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

How do you diagnose EHBO?

A

▪ Hyperbilirubinemia
▪ Increased serum alkaline phosphatase, alanine
aminotransferase, gamma-glutamyl transferase
▪ Leucocytosis
▪ Hypoalbuminemia
▪ Urinalysis: Bilirubinuria or bilirubin crystals in the urine are
common.
▪ Coagulation profile: PT, PTT
▪ Fecal examination: Acholic feces, Trematode eggs - cats

▪ Plain radiography
-Cranial organomegaly
-Cholelithiasis – most radio-opaque
-peritonitis

▪ Abdominal ultrasound
-CBD & GB distension
-Note that distension doesn’t confirm obstruction
-Choleliths, neoplastic lesions, mucoceles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

How does bile peritonitis happen? What causes it?

A

-Trauma

-Ruptured gall bladder mucocele

-Necrotizing cholecystitis

-Secondary to all causes of EHBO

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Is bile peritonitis an emergency?

A

YES, it is an emergency

▪ Bile is an important adjuvant in peritonitis

▪ Causes chemical peritonitis

▪ Treatment of underlying leakage is imperative

▪ Thorough abdominal lavage

▪ Abdominal drainage – Open v. closed??

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

How do you DIAGNOSE bile peritonitis?

A

▪ Laboratory parameters:
-Hyperbilirubinemia

▪ Imaging
-Plain radiography
-Abdominal ultrasound

▪ Cytology of effusion
-bile pigments

▪ Abdominocentesis
-if bilirubin in effusion is ≥2X serum considered diagnostic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Examples of hepatic pathologies and coinciding surgeries:

A

▪ Cannot demonstrate patency of CBD
→ Biliary re-routing

▪ Functional EHBO but can catheterize
→ Biliary stenting/cholecystostomy

▪ Biliary mucocele/cholelithiasis/GB neoplasia or trauma
→ Cholecystectomy

▪ Traumatic injury to common bile duct
→ Primary closure or biliary rerouting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Why do mucoceles happen?

A

▪ Underlying lesion is cystic mucinous hyperplasia of gallbladder

▪ GB full of thick gel-like congealed bile

▪ C/S – from silent to EHBO ± rupture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is the treatment of choice for mucoceles?

A

▪ Cholecystectomy is treatment of choice

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

How do you DIAGNOSE a mucocele?

A

▪ Primarily an ultrasonographic diagnosis

▪ Early lesion – bile sludge accumulation
- CAREFUL - Not all bile sludge
cases progress into mucocele

▪ Later – Classical stellate appearance (“kiwi” gall bladder)
-look like a kiwi

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What is post-op care after liver surgery?
▪ Continued fluid therapy ▪ Electrolytes and acid-base status ▪ Nutrition ▪ Antibiotic therapy ▪ Open abdominal drainage if deemed necessary
26
What are post-op complications after liver surgery?
▪ Further leakage of bile ▪ Peritonitis ▪ Hemorrage ▪ Pancreatitis ▪ Re-obstruction of biliary tree ▪ Ascending cholangiohepatitis with re-routing procedures ▪ Sepsis
27
What are the 3 functions of the colon?
1. Fermentation of and nutrient production from indigestible ingesta by colonic flora (mainly bacterial) * Vitamins * Short chain fatty acids * Etc. 2. Electrolyte and water absorption (mainly ascending & transverse) 3. Storage of feces (mainly descending colon)
28
What's the difference between constipation and obstipation?
* Constipation - infrequent, difficult evacuation of dry/hard feces (still productive) * Obstipation - severe constipation, unable to defecate (requires medical intervention)
29
What are some predisposing factors for feline constipation?
* Sedentary lifestyle * Obesity? * Hx of trauma * Dehydration - like from CKD, etc * Diet: some low fiber diets or diet high in indigestible material (e.g., bone fragments in cats that hunt) * Underlying cause (see next)
30
What are functional obstipation? (vs. Mechanical)
-issue with colon propelling feces * Neurologic disease -Pelvic trauma (neurologic) -Sacrocaudal luxations (AKA tail pull injuries) -Dysautonomia -Ganglionopathies (e.g., Hirschsprung's disease) * Dehydration -systemic disease (e.g., CKD, DM/DKA, chronic vomiting, neoplasia) -lack of water access or anorexia * Electrolyte changes (severe) -hypokalemia -hypercalcemia
31
What are mechanical obstipation? (vs. Functional)
-physical obx INTRALUMINAL * colorectal masses * Strictures * atresia ani in kittens * foreign bodies EXTRAMURAL * Orthopedic stenosis or fractures (trauma) * masses * pelvic trauma orthopedic, soft tissue * Manx sacral deformity
32
Underlying causes for CONSTIPATION
1. Idiopathic megacolon -a diagnosis of exclusion -cause unknown but suspected to be a disturbance in colonic smooth muscle contraction 2. Chronic enteropathy (anecdotally)
33
Top causes of feline OBSTIPATION
* Idiopathic megacolon (62%) * Orthopedic (23%) * Neurologic (11%) - hanging tail
34
What should a DIAGNOSTIC WORKUP for constipation/obstipation be?
* CBC * Chemistry panel (with lytes) * Urinalysis * History * Neurologic examination * Sedated rectal exam -Palpate for masses/ stricture/ stenosis -Palpate pelvis for fractures/ stenosis * Radiographs -Evaluation of amount and character of feces -Evaluation of fractures, stenosis, mass, FB * Abdominal ultrasound -extraluminal masses (similar to rads but better soft tissue detail) * (Colonoscopy/proctoscopy) -Intraluminal lesions (mass, stricture) * (Contrast radiographs) -Barium enema if colonoscopy not possible
35
Colonic diameter (at the biggest/most dilated point) / L5
<1.3 normal >1.5 megacolon
36
How do you treat an obstipated cat BEFORE manual deobstipation?
* Hospitalization -rehydration with iv fluid therapy -Serial warm water enemas 10ml/kg -Monitoring of electrolytes (especially with frequent enemas, plus cats almost always have hypokalemia) -if none of this works, THEN manually deobstipate
37
What is deobstipation?
-done under GA with e-tube bc the dilation of the colon can cause vomiting -manual evacuation of colon
38
How do you MEDICALLY MANAGE a constipated/obstipated animal?
Overall strategy: 1. First time offenders may require less aggressive intervention 2. Recurrent offenders warrant more aggressive treatment 3. Obstipated cats need to be hospitalized 4. Address any underlying disease 5. Lifestyle changes -increase physical activity to activate GI motility -Intentional weight loss -Diet -can give prokinetics (cisapride, serotonin 5-HT4 agonist) -fiber/laxatives -ensure hydration
39
What considerations should be made for a diet of a constipated/obstipated animal?
* Canned diet to increase water intake 2 strategies: Fiber: -High fiber diets -Fiber additions --psyllium 1teasp-1tblsp/meal --canned pumpkin 1-4 tblsp/ meal (careful with carb content!) Highly digestible (minimal residue) diet to reduce stool volume
40
What stool softeners can be given to cats?
* Miralax® powder (OTC) ~1/4 tsp/cat po bid * Lactulose syrup (Rx) ~0.5mL/kg po bid-tid * both are hyperosmotic polysaccharide laxatives * titrate “to effect” for a soft, but formed stool
41
Which part of the pancreas is responsible for glucose metabolism?
Endocrine - islet cells * α cells – glucagon (15-20%) * β cells – insulin, amylin (65-80% * δ cells – somatostatin (3-10%) * PP cells – pancreatic polypeptide * ɛ cells - ghrelin <1% (mainly produced by stomach)
42
What is the exocrine pancreas in charge of?
acinar cells and ducts * Digestive enzymes * Bicarbonate ions * Intrinsic Factor (IF) (in cats sole source, in dogs + stomach) - important for B12 * Bactericidal peptide
43
What's the difference between dogs and cats and their common bile ducts, pancreatitic ducts, and accessory pancreatic ducts?
DOGS -Common bile duct enter and pancreatic duct enter close but NOT MERGED at the major duodenal papilla CATS -Common bile duct and and pancreatic duct MERGE before opening at the major duodenal papilla Only 20% of cats have an accessory pancreatic duct. Most dogs have an accessory pancreatic duct.
44
There are two forms for pancreatitis:
Can be clinically indistinguishable ACUTE * fully reversible inflammation * neutrophilic inflammation * interstitial edema * necrosis (mesenteric fat necrosis) CHRONIC * Irreversible histopathologic changes * Lymphoplasmacytic inflammation * fibrosis * cystic acinar degeneration * can complication of acute pancreatitis * immune-mediated? * Cats > dogs *clinial course: subclinical or mild to shock, multi-organ failure, recurrent acute-on-chronic episodes, and death
45
Why doesn't the pancreas auto digest itself
There are protective mechanisms such that enzymes are as zymogens/proforms - they are activated via enterokinase.
46
Acute pancreatitis is the result of____________
trypsinogen activation -once trypsinogen converts to trypsin, it starts a cascade for the other enzymes to be activated 1. Autoactivation of cationic trypsinogen 2. Activation of zymogens by thrombin * Bacterial toxemia * Ischemia * Hypoxia 3. Apical block of zymogen granule secretion > colocalization of lysosomal proteases and zymogen granules 4. Biliary-pancreatic reflux > enterokinase entering
47
What perpetuates acute pancreatitis?
* Increased vascular permeability * Influx of neutrophiles * Loss of apical paracellular barriers
48
What is the pathway of acute pancreatitis?
1. zymogen activation 2. cell injury (bc activated zymogens are supposed to digest cells) 3. pain 4. systemic enzyme leakage and SIRS > MODS -multiple organ dysfunction (ARDS, AKI, DIC, arrythmias) 5. Shock, Poor perfusion, hypoxia
49
What are complications of acute pancreatitis?
* Acute kidney injury (AKI) * Systemic Inflammatory Response Syndrome (SIRS) * Multiple organ dysfunction syndrome (MODS) * Acute respiratory distress syndrome (ARDS) * Pseudocysts, necrosis, abscesses * Chronic pancreatitis * Exocrine pancreatic insufficiency (EPI) * Diabetes mellitus
50
Is pancreatitis sterile?
YES, inflammation occurs without microorganisms involvement
51
What is the etiology of pancreatitis?
*idiopathic *risk factors -breed - yorkie, mini schnauzer -Hypertriglyceridemia *Triglycerides > 862 mg/dL (> 9.7 mmol/L) 4.5x higher likelihood of having increased cPLI -Obesity *Obesity is associated with HT and marked increased cPLI, but not with clinical signs -Dietary Indiscretion *Access to trash and table scraps *high-fat diet ? -Endocrine Disoders *Cushing's *Hypothyroidism *Diabetes mellitus (DKA) -concurrent disease *chronic enteropathies -Drugs *documented in dogs: potassium bromide, phenobarbital, calcium, and L-asparaginase, many other single case reports
52
What are some CS of pancreatitis?
Lethargy Hyporexia Vomtining Diarrhea Weight loss Dyspnea
53
What are some physical exam findings of pancreatitis?
*Dehydration *Hypothermia or hyperthermia/pyrexia *Abdominal pain (30% in cats) *Icterus *Abdominal mass/ cranial abdominal organomegaly
54
What will US usually look like with ACUTE PANCREATITIS?
*Pancreatic enlargement *Hypoechoic pancreas *Hyperechoic surrounding mesentery *Abdominal effusion *Cysts or abscesses *Sensitivity 11-67% (severity-, machine-, and operator-dependent) -enlarged hypoechoic pancreas with hyperechoic surrounding mesentery is classic for acute pancreatitis
55
What will US usually look like with CHRONIC PANCREATITIS?
*Hyperechoic or mixed echogenicity *Dilated common bile duct *Enlarged pancreas *Irregular margins *Pancreatic nodular hyperplasia can be normal in older cats and dogs!! *Very unspecific remember -- never make a diagnosis of pancreatitis based on imaging findings alone!
56
What does a CBC usually look like with pancreatitis?
* Nonregenerative anemia -GI hemorrhage -Anemia of inflammatory disease * Increased PCV? -dehydration * Leukocytosis/leukopenia - +/- toxic change/left shift * Thrombocytopenia -consumption
57
What does a Chemistry usually look like with pancreatitis ?
* elevated ALT, ALP -direct insult by digestive enzymes, hypoxia * hyperbilirubinemia -biliary obstruction * Hypercholesterolemia and/or hypertriglyceridemia -biliary obstruction, pre-existing
58
What happens to calcium with pancreatitis?
HYPOCALCEMIA *Pancreatic lipase: Pancreatic lipase reacts with mesenteric fat to generate free fatty acids > free fatty acid > chelate calcium salts > precipitation of calcium soaps (saponification) *Hypoalbuminemia *Hypovitaminosis D (concurrent enteropathy!)
59
What is the cPLI?
*Quantitative and qualitative test (SNAP) available for testing for PANCREATITIS *Sensitivity ranges from 64-93% *Specificity 74% *No correlation with disease severity *Increases reported with other diseases including Cushing’s disease, IVDD, IMHA
60
In addition to cPLI, Precision PSL also tests for pancreatitis measuring what?
*1,2-o-dilauryl-rac-glycero glutaric acid (6’ methyl resorufin)-ester (DGGR) *Reference range 24-140 IU/L *Sensitivity 93% *Specificity 53% *Moderate correlation with spec cPL **Severe outliers noted with Boxers**
61
What is the greyzone PLI references?
CAT 3.6-5.3 DOG 201-399
62
A diagnosis of pancreatitis is based on what?
combo of: signalment clinical signs laboratory findings imaging findings
63
How do you TREAT ACUTE pancreatitis?
Fluid therapy *balanced isotonic crystalloids -LRS, Plasmalyte *colloidal support -Hetastarch Nutrition *Enteral feeding should be prioritized *Oral, NG/NE tube, E tube *Appetite stimulants --Capromorelin (EntyceⓇ) – ghrelin receptor agonist --Mirtazapine *Combine with anti-emetic Antiemetics *5HT3 antagonists *ondansetron 0.2-0.5 mg/kg IV q 12-24h *NK1 antagonists *maropitant 1 mg/kg SQ q 24h Analgesics *partial & full μ-agonists *buprenorphine 0.005-0.01 mg/kg SQ q 4-6h *methadone 0.1-0.5 mg/kg SQ q 2-4h
64
How do you treat CHRONIC pancreatitis?
treatment of concurrent/underlying conditions: -hypertriglyceridemia *low-fat diet *omega-3 fatty acids (fish-oil) *gemfibrozil, benzafibrate, etc. -chronic enteropathy *history, chemistry panel *cobalamin, folate
65
Controversial or NOT recommended pancreatic treatment
1. antimicrobials -pancreatitis is usually sterile 2. steroid -no benefits seen in humans 3. NSAIDs -may potentially cause pancreatitis 4. acid suppressants -not indicated unless evidence of ulceration is present 5. plasma transfusion -controversial but usually not indicated unless patient is actively bleeding from DIC 6. surgical intervention -not indicated unless pancreatic abscess is present
66
What are the 3 different clinical syndromes of gastric dilation/volvulus?
-Gastric dilation -Gastric dilation/volvulus - torsion -Chronic volvulus
67
The fundus is normal on which side of the stomach/body? How about pylorus?
Fundus - Left Pylorus - Right this is flipped with GDV
68
What are some intrinsic and extrinsic factors that contribute to GDV development?
INTRINSIC FACTORS -Increased thoracic depth to width ratio (deep chested dogs) -First-degree relatives affected -increasing age -underweight dogs EXTRINSIC FACTORS -Dogs fed once daily -Dogs fed from a raised food bowl -Behavior that promotes aerophagia -stress -Happy” or “easygoing” dogs are protected
69
Which breeds are more disposed to developing GDV?
-great danes -irish setters -standard poodles -weimaraners -rottweilers
70
Common signalment for GDVs
▸ Large and Giant breeds predominate ▸ 10 months to 14 years ▸ No sex predilection
71
CS of GDV
▸ Retching, non-productive vomiting ▸ Hypersalivation ▸ Restlessness ▸ Abdominal distention ▸ Weakness ▸ Collapse
72
PE findings of GDV
▸ Distended, tympanic cranial abdomen ▸ Splenomegaly ▸ Hypovolemic shock - pale, dry mucous membranes - weak pulses - prolonged capillary refill time - tachypnea - arrhythmias
73
Lactate is a biomarker associated with _____________
global hypoperfusion If >6mmol/L at presentation associated with higher chance of gastric necrosis
74
Lactate has an effect on prognosis:
Final prognosis WORSE in dogs with: ▸ final lactate >6.4mmol/L (after fluid resuscitation) ▸ change in absolute lactate ≤4mmol/L ▸ % change in lactate ≤42.5% ▸ Initial Lactate <4mmol/L may be associated with fewer complications ▸ Initial Lactate of >6mmol/L may increase GN and complications ▸ DON’T USE LACTATE AS A REASON NOT TO DO SURGERY
75
How do you DIAGNOSE a GDV?
▸ Clinical signs ▸ Plain radiography -Right lateral (lay animal on the right side) -Ventrodorsal view
76
How do you TREAT/MANAGE GDV?
▸ SURGICAL EMERGENCY!! ▸ Hemodynamic stabilization ▸ Gastric decompression ▸ Surgical management -Correction of rotation ± gastric necrosis -Prophylactic gastropexy ▸ Post-operative management
77
How do you implement gastric decompression for GDV?
OROGASTRIC TUBE --reach last rib ▸ Use no or mild sedation -opioid ± diazepam/midazolam -avoid acepromazine ▸ Administer oxygen TROCARIZATION - Aseptically prepare an area in the right or left paracostal space at site of greatest tympany - 18g over the needle catheter - Perform stabbing motion - Remove stylet - Can usually hear or smell gastric contents
78
When you open up the abdomen -- what do you do to the stomach in a GDV?
-untwist the stomach -asses viability once decompressed -any possible gastric resection
79
What type of suture patterns should you use for GDV?
-simple continuous - simplest and quickest open gastropexy and has been shown to be highly against recurrence of GDV
80
Gastropexy should be done on ______ side for a GDV
RIGHT -take bites only in seromuscular layer
81
Post-Op care for GDVs
▸ Fluid therapy ▸ Analgesics ▸ Gastric wall protection -H2 receptor antagonists -Coating agents -Proton pump inhibitors ▸ Antibiotics ▸ Promotility agents (bc post-op ileum) - e.g metoclopramide
82
Post-Op complications for GDVs
▸ Cardiac arrythmias ▸ Aspiration pneumonia ▸ DIC ▸ Pancreatitis ▸ Hypoproteinemia ▸ Post-operative ileus and regurgitation ▸ Ongoing gastric necrosis ▸ Dehiscence of gastric resection site
83
What is Acute Abdomen?
-Any animal the presents to the hospital with acute abdominal pain, or unstable condition due to abdominal disease
84
What causes Acute Abdomens?
-Pancreatitis -Peritonitis -Pyometra -Prostatitis -Pyelonephritis -Trauma -Abdominal Hernia -Sepsis -Neoplasia -GI obstruction -GI perforation -GI torsion -Infarctions -The list goes on an on and on!
85
What are the 6 signs of perfusion on PE?
-Mentation -Mucous membrane color -Capillary refill time -Heart rate -Pulse quality -Extremity temperature

VET433B (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions