GI alimentary Flashcards by Millie Dinan

Characteristics of vomiting vs regurgitation

Vomiting: active process with retching, nausea/hypersalivation, often bile present

Regurgitation: passive with little/no retching or abdominal contraction, no nausea, generally no bile

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Where does vomiting vs regurgitation localise

Vomiting = stomach/small intestine
Regurgitation = oesophagus related

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If an animal brings up food then wants to eat it again what does this suggest

It is regurgitation; since not accompanied by nausea unlike vomiting

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Characteristics of small intestinal diarrhoea

Increased volume of watery faeces but normal frequency
If blood present = melaena since digested
Weight loss due to malabsorption
Vomiting
Weight loss
Appetite changes

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Characteristics of large intestinal diarrhoea

Normal or reduced volume but increased frequency with urgency
Can have fresh blood (haematochezia)
Usually no weight loss
Vomiting less common
Normal appetite
Usually normal colour

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What does trypsin like immunoreactivity test for

Exocrine pancreatic insufficiency which can be a cause of chronic diarrhoea

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What does measuring vit B12/folate assess for

Malabsorption

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What test do we do for giardia

Faecal ELISA (much more sensitive than egg count)

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What type of anaemia is typically seen with chronic disease

Normocytic, normochronic non-regenerative anaemia

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What type of anaemia would we see with chronic blood loss and iron deficiency

Microcytic, hypochromic, poorly/non-regenerative

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What additional features of a neutrophilia suggest an inflammatory cause (rather than stress leukogram)

Left shift and toxic change

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What are the 3 key biochemistry changes that are seen with vomiting/diarrhoea

Hypochloraemia: from loss in vomit
Hypokalaemia: loss in vomit/diarrhoea and reduced intake from anorexia
Metabolic alkalosis due to H+ loss in vomit

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What could be a cause of increased urea on bloods of a patient with diarrhoea

1) Pre-renal azotaemia (dehydration)
2) GI blood loss where blood acts as high protein meal

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What could be the cause of hypoalbuminaemia in patient with vomiting

1) Protein losing enteropathy (decreases in both albumin and globulin)
2) Malabsorption/maldigestion or inflammation

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Why might total hypocalcaemia but not ionised be low in diarrhoea cases

Due to hypoalbuminaemia

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Why might we see an ionised hypocalcaemia in diarrhoea

Due to vit D deficiency due to malabsorption, acute pancreatitis

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What could be a cause of high lipase in diarrhoea case

Detection of non-pancreatic lipase from intestine
Reactive change

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What things can cause decreased cholesterol (NB: this is significant)

1) Protein-losing enteropathy
2) Liver disease with shunting or reduced capacity
3) Hypoadrenocorticism

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What are two markers of intestinal absorption and what is different between them

Folate: absorbed in proximal small intestine (duodenum and jejunum)
Cobalamin (vitB12): absorbed exclusively in distal small intestine i.e ileum

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What can cause reductions in cobalamin

Distal SI malabsorption
Secondary to small intestinal dysbiosis as get increased use by the intestinal bacteria

[Rarer: exocrine pancreatic insufficiency, congenital deficiency in Border collies]

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What effect can dysbiosis have on folate levels

Falsely increased or normal levels since it is synthesised by some bacteria

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What can cause falsely elevated folate levels

Small intestinal dysbiosis
Haemolysed samples (since high levels in RBCs)

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What does absorption of cobalamin require binding of

Intrinsic factor

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Why do we test total iron binding capacity

Because may have a functional not true iron deficiency due to inflammation as mediators sequester iron

-This will be low in inflammation
- Vs often high in iron deficiency
-

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Indications for ultrasound guided aspirates

- Focal mass/thickening in GI tract [very low yield in diffuse change] - Presence of lymphadenopathy - Suspected hepatic/splenic infiltration since these are easier to sample

What might we do a faecal test to identify in young dog with acute haemorrhagic diarrhoea

Parvo

What age dogs do we see giardia in

Young

If an animal is bringing up white frothy material what does this mean

Probably saliva that has pooled in the oeseophagus; = regurgitation

What is cricopharyngeal achalasia

Where the upper oesophageal sphincter is out of sync with swallowing. So it is still contracted during swallowing and leads to severe dysphagia, distress, aspiration weiht loss

How do we treat cricopharyngeal achalasia

Via surgical cutting of the muscle controlling the sphincter

Which breed is over-represented with cricopharyngeal achalasia

Cocker spaniels

What are some differentials for neuromuscilar regurgitation

Idiopathic megaoesophagus, myasthenia gravis, myositis, myopathy, peripheral neuropathy, hypothyroidism, hypoadrenocorticism, toxicity

What are some differentials for regurgitation due to obstruction

Mural neoplasia Spirocerca lupi Oesophageal stricture Foreign body Extraluminal mass

What cause of regurgitation are seen in brachycephalics

Hiatal hernia But some regurgitation is just due to BOAS pressure changes not just hernia

Which breed post often has oesophageal foreign bodies

West highland white terriers

What is a tracheal stripe sign

Where we can see the dorsal wall of the trachea which suggests there is gas above it i.e in the oesophagus

What must we consider when choosing to sedate an animal for oeseophageal radiograph

SEdation causes reduction in muscle tone of oes so get appearance of megaoesophagus; cannot overinterpret gas presence in an anaesthetised/sedated patient

What is the most common vascular ring anomaly

Persistent right aortic arch

What does a bullfrog appearance of the oeseophagus on the side of the neck in puppies suggest is going on

Vascular ring anomaly

What considerations should we take with barium swallows

Risk of aspiration and wordening of any pneumonia present Use minimum amount and can suck it back out

Why do oesophageal strictures develop

Secondary to oeseophagitis Most cases are due to reflux during general anaesthestic

Treatment options for oesophageal strictures

* Balloon dilation * Bougienage - pushing increasing size tube through the stricture

Post-op considerations after treating oesophageal stricture

Feed lumpy food to avoid it reforming May need to repeat the procedure

Dietary management of oeseophageal disease

Small frequent low fat food meals Elevate food and water bowls Keep patient upright for 5-10 mins at least after eating

What food consistency is best for stricture vs muscle weakness vs dysphagia vs sensory deficit

Stricture or muscle weakness: liquid (unless post-op) Meatballs for dysphagia Firm food for sensory deficit

Medical treatment for oesophagitis

Protom-pump inhibitors e.g omeprazole to ensure any regurgitation is as benign as possible H2-receptor antagonists Sucralfate to bind to ulcerated mucosa

What extra tests might we do in suspected neuromuscular regurgitation

ACTH stim test to look for Addison's Acetyl-choline receptor antibodies to look for myasthenia gravis

What are causes of simple gasrtic dilation

Most common = overeating in young puppies; see discomfort 30 mins after eating milk Gas forming bacteria e.g C perfringens? Obstruction in pylorus/cardia stopping eructation

What is acute gastric dilation and volvulus

Life threatening condition in large deep chested dogs where the stomach swells and rotates Related to eating lots of dry dog food and exercise after eating

How can chronic gastric dilations predispose to GDV

By causing laxity of the hepatic ligament, making volvulus more likely [e.g associated with ulcers, lymphoma, uraemia]

What consequences are there of GDV

Splenomegaly due to congestion Pancreating ischaemia Get cardiac collapse, arrhythmias --> shock

How can we get stomach rupture

Via high pressure Edges of rupture look irregular and haemorrhagic

How can we get perforation of the stomach

Via ulcers

What are some types of gastritis

Catarrhal: mucus and inflammation, watery and red Erosive and ulcerative Fibrinour Haemorrhagic Necrotic Hypertrophic Lymphoplasmacytic

What is a common cause of erosive and ulcerative gastritis

Cutaneous mast cell tumours causing histamine release and gastric hyperacidity e.g in boxers and labs

What are some causes of haemorrhagic gastritis

Salmonellosis, clostridiosis, leptospirosis, neoplasm, uraemia, NSAIDs

What does proctitis mean

Inflammation of the rectum

What is enteritis

Inflammation of the small intestine

What is cecitis

Inflammation of the caecum

What does diarrhoea mean

Secretion of abnormally fluid faeces accompanied by increased volume and increased freq

What parasite can lead to haemorrhagic enteritis and anaemia

Ancylostoma caninum

What region of the gut does giardia typically affect

Duodenum

What region of the gut does coccidia tend to affect

Large intestine

What worm can lead to obstructions

Toxocara catii nematode

GI alimentary Flashcards

(65 cards)