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SAM 4 oral final :-( > 11. Diseases of the oral and pharyngeal cavities in dogs and cats. Ileus. > Flashcards

11. Diseases of the oral and pharyngeal cavities in dogs and cats. Ileus. Flashcards

1
Q

Physical exam( teeth, tongue, gum & salivary gland)

A
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2
Q

Dysphagia Clinical signs?

A

Dysphagia

CLINICAL SIGNS

Inappetence; Weight loss; Halitosis; Pawing at mouth;

Hypersalivation; Facial swelling; Oral haemorrhage; Nasal discharge;

Inability to swallow; Dropping food

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3
Q

Differential diagnosis of dysphagia?

A

DIFFERENTIAL DIAGNOSIS

§ Oral pain: Dental disease (FORL; Abscess); Oral ulcers;

Trauma; Fracture; Periodontitis; Osteomyelitis;

Retrobulbar abscess; Stomatitis; Glossitis; Gingivitis;

Pharyngitis

§ Pain when swallowing: Oesophageal disease/stricture

§ Oral mass: Neoplasia; Granuloma; Salivary gland disease;

Foreign body

§ Neuromuscular disease: Temporomandibular

myositis/joint disease; Masticatory muscle myositis;

Rabies; Tetanus; Botulism; Tick paralysis; Oral,

pharyngeal or cricopharyngeal dysfunction; Localised

myasthenia gravis; Cranial nerve abnormality

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4
Q

Diagnosis of dysphagia?

A

DIAGNOSIS

History, general & physical exam

§ Open/close mouth

§ Signs of systemic disease

§ Palpate masticatory muscle & temporomandibular joint

§ Cranial nerve function

Oral exam (if required; may require GA)

Imaging: Radiography; Endoscopy; CT; MRI

Biopsy; Histopathology

PCR; ELISA (viral diseases)

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5
Q

Periodontal disease?

A

Periodontal Disease

Inflammation of supporting structures surrounding the teeth

Affecting the gingiva, periodontal ligament or alveolar bone

Older animals > Younger animals; Small dogs > Large dogs

Predisposing factors: Non-abrasive foods; Rough tooth surface;

Malocclusion; Diabetes; Retroviral infection

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6
Q

Plaque formation?

A

PLAQUE FORMATION

Adheres to all surfaces of the tooth – Layers of bacteria, saliva & food particles. These become mineralised, forming a calculus.

Incisor Canine Premolar Molar

Cytokine release from anaerobic bacteria → Enter the tissue →

Stimulation of osteoclasts → Thinning bone within the socket.

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7
Q

Stages- Gingivitis ?

A

STAGES

Gingivitis

Reversible inflammation of marginal gum

§ Plaque in sulcus → Inflammatory response

§ Precursor to periodontitis → Treatment required

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8
Q

Stages - Periodontitis?

A

Periodontitis

Reversible inflammation of marginal gum & supra-alveolar tissue;

Loss of CT attachment & bone

Tooth loss occurs at 80% loss of tooth support

§ CSx: Halitosis; Discomfort when eating; Blood-tinged

saliva; Oronasal fistula → Nasal discharge

Maltese dog - Chronic ulcerative periodontitis syndrome

§ Tx: Plaque removal; Polish teeth; Scale under gums

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9
Q

Advanced Periodontitis?

A

Advanced Periodontitis

Heavy calculus build-up; Mostly above gum

Tooth mobility with supporting bone loss >50%

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10
Q

Preventing periodontitis?

A

Preventing periodontitis

§ Daily brushing of teeth

§ Chew toys; Bones

§ Dental diets

§ Oral rinses; Gels

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11
Q

Feline odontoclastic resorptive lesions(Forl)?

A

Feline Odontoclastic Resorptive Lesions (FORL)

Older cats > Younger Cats

Reactivation of odontoclast cells: These are stimulated to resorb tooth structure; These attack the roots, leading to cavities, gingival hyperplasia & pain

Aetiology: Unknown; Multifactorial

CLINICAL SIGNS

Reluctance to eat dry food; Pain with eating

Hyperplastic gingival tissue covers resorptive lesions on the crown

DIAGNOSIS

Visual examination & probing (may be covered by plaque & tartar)

Dental Radiology: May be indicated if there is gingivitis or

suspected retained roots

TREATMENT

Tooth extraction; Crown amputation of all affected teeth

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12
Q

Stomatitis?

A

Stomatitis

Inflammation of the oral mucosa

Classification:

According to lesion: According to localisation:

  1. Simple (catarrhalis) 6. Gingivitis
  2. Ulcerative 8. Periodontitis
  3. Ulcerative &

pseudomembranous

  1. Glossopalatine arch
  2. Ulcerative & necrotising 12. Faucitis

(caudal)

  1. Proliferative
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13
Q

Causes of stomatitis?

A

CAUSES

Systemic disease: Uraemia; DM

Immune-mediated disease: Systemic lupus erythematosus (SLE);

Pemphigus foliaceus; Idiopathic vasculitis

Traumatic, physical or Chemical: Foreign body; Injury; Tartar;

Acids; Heavy metal salts; Pesticides

Chronic immunosuppressive therapy

Pathogens

§ Viral: FeLV; FIV; FIP; FCV; FHV; FPV; Distemper virus

§ Bacteria: Bartonella henslae

§ Fungal: Candidiasis; Cryptococcus neoformans

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14
Q

Clinical signs of stomatitis?

A

CLINICAL SIGNS

  1. Anorexia 15. Local reddening
  2. Dysphagia 17. Erosions
  3. Salivation/Drooling 19. Ulcers
  4. Pain when eating 21. Vesicles
  5. Difficult opening

mouth

  1. Plaque
  2. Enlarged LNs 25. Bloody saliva
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15
Q

Specific types of stomatitis?

A

SPECIFIC TYPES OF STOMATITIS

§ Feline chronic gingivostomatitis

§ Feline eosinophilic granuloma complex (FEGC)

§ Ulcerative stomatitis

§ Canine eosinophilic granulomas (Siberian huskie)

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16
Q

Ulcerative stomatitis?

A

ULCERATIVE STOMATITIS

Predisposed: Maltese terrier; King Charles Cavalier Spaniel

Clinical signs: Dysphagia

Diagnosis: History; Physical exam; Haematology; Biochemistry;

Urinalysis; PCR; ELISA; Biopsy

Differential diagnosis: Palatine ulcers usually caused by overgrooming in cats (Feline gingivitis stomatitis); Neoplasia

Vincent-type: Acute ulcerative-necrotising stomatitis

17
Q

Feline Chronic Gingivostomatitis?

A

FELINE CHRONIC GINGIVOSTOMATITIS

Inflammation & proliferation of the gingiva & oral mucosa

May lead to faucitis/caudal stomatitis; Relatively common

Cause: Unknown; Multifactorial; Hypersensitivity (Calicivirus)

§ Viral: FCV; FHV-1; FIV; FLV

§ Bacterial: Bartonella henslae

Diagnosis

PCR; Biopsy & histopathology: Diffuse lymphocytic infiltration in

mucosa

Clinical signs (same as stomatitis)

  1. Anorexia 27. Local reddening
  2. Dysphagia 29. Erosions
  3. Salivation/Drooling 31. Ulcers
  4. Pain when eating 33. Vesicles
  5. Difficult opening

mouth

  1. Plaque
  2. Enlarged LNs 37. Bloody saliva

Treatment

27

§ Dental prophylaxis

§ Extraction

§ Antibiotics: Clindamycin; Metronidazole; Amoxiclav

§ Anti-inflammatories; Pain relief

§ Cyclosporin (immunosuppressant)

18
Q

Masticatory muscle myositis?

A

MASTICATORY MUSCLE MYOSITIS

Immune attack on the masseter muscle

Predisposed: Doberman; Rottweiler

Clinical signs

§ Acute → Inflammation: Dysphagia; Pain; Localised

swelling; Exophthalmos

§ Chronic → Fibrosis: Ø Mouth opening; Bilateral atrophy

Diagnosis: CSx; Biopsy; Histopathology; Serum 2M-antibodies

Treatment

§ Immunosuppression: Prednisolone

§ Nutrition: Naso-oesophageal tube; Gastric tube

19
Q

Diseases of the tongue?

A

Diseases Of The Tongue

§ Glossitis: Superficial/Deep (ulcer); See stomatitis

§ Strangulation of tongue: Foreign body – Particularly root

of tongue

§ Tumour

§ Trauma

§ Congenital macroglossia (rare)

20
Q

Diseases of the salivary glands?

A

Diseases Of The Salivary Glands

SIALOCELE

Enlargement associated with a salivary gland due to accumulation of

saliva within the surrounding tissue

Large; Non-painful; Soft; Ranula under the tongue

Cause: Idiopathic; Trauma

Clinical signs: Dysphagia; Gagging

Treatment: Surgical removal of gland/ducts

SIALOADENTIS
Inflammatory response with Ø evidence of infection

Mildly painful, bilateral enlargement of glands; Typically secondary

to prolonged vomiting/regurgitation

Clinical signs: Dysphagia; Gagging; Fever

Treatment: Glucocorticoids; Antibiotics

SIALOADENOSIS

Bilateral, large, non-inflammatory enlargement; Non-painful

Clinical signs: Retching; Gulping; Ptyalism

Diagnosis: FNA (but not characteristic)

21
Q

Oral neoplasia?

A

Oral Neoplasia

Dog: Malignant melanoma > Squam. cell carcinoma > Fibrosarcoma

Cat: Squam. Cell carcinoma > Fibrosarcoma

MALIGNANT MELANOMA

Older medium sized dogs; Rare in cats

Metastasis is common: Submandibular LNs & lung

Bad prognosis

Treatment: Surgery; Intralesional chemotherapy; Radiotherapy

SQUAMOUS CELL CARCINOMA

Cats > Dogs

Ulcerative & locally invasive into the surrounding bone; Sublingual

or rostral

Highly metastatic if located in the caudal mouth

Treatment: Removal of nose; Chemotherapy; Maxillary/Mandibular

removal – Removal not well tolerated in cats

FIBROSARCOMA

Older large breed dogs; Retrievers

Originate from gingiva or palate; Locally invasive

Treatment: Excision; Radiotherapy

22
Q

EPULIS?

A

EPULIS

Most common benign oral tumour

Older large breed dogs

Acanthomatous epulis

§ Arise from the periodontal ligament; Invades bone

§ Treatment: Surgical removal → Extend to bone margins

Fibromatous epulis

§ Arise from dental laminar epithelium; Not very invasive

§ May progress to fibrosarcoma

§ Treatment: Surgical removal → Ø Bone margins

Papillomatosis

23
Q

Ileus?

A

Ileus

Disruption of the normal propulsive GI motor activity → Blockage of nutrient delivery

Predisposed: Young dogs > Old dogs; Large breeds > Small breeds

Classification

Mechanical ileus Functional ileus

  1. Intraluminal 39. Paralytic
  2. Intramural 41. Vascular bowel

disease

  1. Extramural 43. Spastic bowel

segment

FOREIGN BODY ILEUS

Cause: Solid/cavitary object; Linear foreign body; Trichobezoar

Pathophysiology

§ Intestinal spasm & ischaemia → Pain

§ Impaired peristalsis → Vomiting; Dysbiosis

§ Fluid, acid-base & electrolyte imbalance → Dehydration;

Hypovolaemia; Hypokalaemia; Hypochloraemia; Met.

acidosis/alkalosis

§ Impaired gut barrier integrity → Bacterial translocation;

Endotoxemia; Septicaemia; Perforation; Septic peritonitis

HISTORY & CLINICAL SIGNS

§ Ø Appetite; Depressed; Vomiting

§ “Praying position” of the dog (see Fig 11.2)

§ Dehydration → Shock

§ Abdominal pain

May also

be seen in cases of GDV, gastric dilation & pancreatitis.

Abdominal palpation: Foreign body; Wide intestines; Bunching of

intestines (in linear foreign body cases); Ø Faeces

Chronic (subileus): Ø Appetite; Weight loss; Intermittent vomiting;

Chronic diarrhoea

DIAGNOSIS

§ Plain radiography

§ Contrast radiography: Foreign body; Gas; Fluid; Wide

intestines; Dysmotility

§ Abdominal ultrasonography: Gas; Fluid; Wide intestinal

loops; Pendular movement

§ Exploratory laparotomy

SAM 4 oral final :-( (50 decks)

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