03 - stomach disorders

Question 1

(vomiting)

1. vomitus consists of contents from where?
2. projectile vomiting usually indicates what?
3. vomiting of undigested food more than 12 hours after eating suggests what?

Answer 1

1. stomach and duodenum
2. gastric outlet or upper small bowel obstruction
3. delayed gastric emptying

Question 2

(vomiting)

1. use what contrast for contrast studies if perforation is suspected?

Answer 2

1. aqeous iodide

Question 3

(vomiting)

1-3. 3 principles of symptomatic and supportive treatment?

Answer 3

1. fluid therapy (IV best)
2. withhold food for 12-24 hours -> highly digestible -> back to normal
3. anti-emetics (phenothiazines, metoclopramide, butorphanol)

Question 4

(acute gastritis)

common, usually mild and self-limiting

1-4. 4 causes?

Answer 4

1. foreign body -> mechanical irritation
2. dietary indescretion
3. irritants
4. drugs

Question 5

(acute gastritis)

1. Cx include acute onset of nausea and vomiting
2. dx supported by response by therapy in how many days?
3. tx?

Answer 5

2. 1-2
3. underlying cause, withhold food then bland, consider anti-emetic

Question 6

(gastric foreign bodies)

1. gastric FB more common in dogs, linear more common in cats
2. most common Cx?
3. what should be considered in all animals with acute vomiting?

Answer 6

2. acute onset vomiting

(some may present with chronic vomiting, also signs relating to FB zinc or lead)

3. gastric FB!

Question 7

(gastroduodenal ulceration and bleeding)

1. what 2 drugs cause?
2. what 4 conditions?
3. what 1 endocrine dz?
4. what 3 cancers?
5. what behavior?

Answer 7

1. NSAIDS, glucocorticoids
2. chronic gastritis, hepatic disease (mucosal blood flow), renal failure, neurologic disease
3. hypoadrenocorticism
4. gastric neoplasia, mast cell tumors, gastrinoma
5. stress

Question 8

(gastroduodenal ulceration and bleeding)

1. Cx?

Answer 8

1. anorexia, vomiting, hematemesis, abdominal pain, weight loss

Question 9

(gastroduodenal ulceration and bleeding)

(dx)

1. look at drug hx
2. lab eval may show what that would suggest chronic blood loss?
3. what is indicated if perforation is suspected?
4. endoscopy or laparotomy may be useful

Answer 9

2. regenerative anemia or microcytic hypochromic anemia
3. abdominocentesis

Question 10

(gastroduodenal ulceration and bleeding)

1. tx?

Answer 10

1. H2 blockers and sucralfate

Question 11

(Chronic Gastritis)

(lymphocytic-plasmacytic gastritis)

1. a common histologic diagnosis

Question 12

(Chronic Gastritis)

(lymphocytic-plasmacytic gastritis)

1. idopathic chronic gastritis usually attributed to what 3 things?

Answer 12

1. dietary allergy, occult parasitism, reation to bacterial antigens

Question 13

(Chronic Gastritis)

(lymphocytic-plasmacytic gastritis)

1-4. 4 infectious causes?

Answer 13

1. physaloptera, ollulanus tricuspis (cats), pythium insidiosum (dogs), helicobacter

(also enterogastric reflux or chronic mucosal irritation…)

Question 14

(Chronic Gastritis)

(lymphocytic-plasmacytic gastritis)

1. Cx include intermittent vomiting
2. vomiting associated with eating?

Answer 14

2. not consistently

Question 15

(Chronic Gastritis)

(lymphocytic-plasmacytic gastritis)

1. dx method of choice?

Answer 15

1. endoscopy

Question 16

(chronic gastritis)

(eosinophilic gastritis and granuloma)

1. this is usually diffuse
2. same clinical signs and stuff as the lymphocytic one

Question 17

(chronic gastritis)

(therapy)

1. treat underlying
2. dietary trial with what kind of food?
3. H2 blockers/promotiliy drugs may be indicated
4. what may be used if there is no response to dietary trial or H2 blockers?
5. what if helicobacter?

Answer 17

2. easily digestible, fat restricted, carb based diet with a novel protein source (feed frequent small meals)
3. prednisolone or azathioprine
4. abx

Question 18

(gastric outflow obstruction)

1. causes include FB, chronic hypertrophic pyloric gastropathy, congenital pyloric stenosis, pyloric mass, gastric dilatation-volvulus, or extrinsic compression

Question 19

(gastric outflow obstruction)

1. Cx?

Answer 19

1. projectile vomiting of undigested food, abdominal distension, belching, weight loss

Question 20

(gastric outflow obstruction)

(diagnosis)

1. labs unremarkable unless really bad -> then see what?

Answer 20

1. hypokalemia, hyponatremia, hypochloremia, metabolic alkalosis

Question 21

(gastric outflow obstruction)

1. what is the definitive tx?

Answer 21

1. sx

Question 22

(gastric motility disorders)

Question 23

(gastric motility disorders)

1. Cx simliar to what other disorder?

Answer 23

1. gastric outflow obstruction

Question 24

(gastric motility disorders)

1. treat underlying cause.
2. feed what kind of diet?

Answer 24

2. low in fat and high in digestible carbohydrate, small amounts frequently

(use promotility drugs as needed)

Question 25

(hypertrophic gastropathy) 1. cause unknown in most cases. Possible causes include stress in small breed dogs, chronic irritation from aspirin therapy, or hypergastrinemia 2. surgical excision may be necessary to relieve outflow obstruction.

Question 26

(gastric neoplasia) 1. most common in dogs? in cats? 2. 2 that are less common 3. what are the second most common gastric tumors in dogs?

Answer 26

1. adenocarcinoma, lymphoma 2. leiomyosarcoma and fibrosarcoma 3. leiomyomas (benign adenomatous polyps occur infrequently in dogs and cats)

Question 27

(gastric neoplasia) 1. Cx?

Answer 27

1. vomiting, hematemesis, anorexia, wt loss if benign maybe nothing unless obstruction occurs

Question 28

(gastric neoplasia) 1. most useful diagnostics?

Answer 28

1. radiography and endoscopy

Question 29

(gastric neoplasia) 1. treatment of choice?

Answer 29

1. removal by partial gastrectomy (with chemo if indicated)

Question 30

(gastric dilatation-volvulus) 1. GDV causes complete obstruction of gastric outflow, which impairs venous return thorugh what? causing what?

Answer 30

1. vena cava hypovolemic and endotoxic shock

Question 31

(gastric dilatation-volvulus) cause unknown 1. what dogs are predisposed?

Answer 31

1. older, large breed, deep chested dogs risk factors: genetics, lean body conformation, rapid eating, eating from raised bowl, eating one meal daily, exercise or stress after a meal, fearful temperment

Question 32

(GDV) 1. Cx?

Answer 32

1. acute abdominal distension, nonproductive retching, salivating, resp distress

Question 33

(GDV) 1. common lab abnormals?

Answer 33

1. hypokalemia and metabolic acidosis

Question 34

(GDV) 1. see enlargement of what organ (other than stomach)

Answer 34

1. spleen

Question 35

(GDV)

Question 36

(GDV) 1. prevention involves feeding frequent, small portions of food, and restricting exercise and access to water for 1 hour after eating