12. Diseases of the oesophagus in dogs and cats. Regurgitation and vomitus.

Question 1

causes of oesophagitis

Answer 1

caustic substances
gastro- oesophageal reflux
motility disorders
megaoesophagus
doxycycline
clindamycin
anaesthesia
froeign body

Question 2

clinical signs of oesophagitis

Answer 2

odynophagia (pain when swallowing)
regurgitation
salivation
food refusal
coughing
fever
dyspnoea

Question 3

diagnosis of oesophagitis

Answer 3

increased WBC
endoscopy
xray

Question 4

treatment of oesophagitis

Answer 4

omeprazole + prokinetics
sucralfate suspension
total parenteral nutrition

Question 5

gastro oesophagwal reflux (GOR)
definition

Answer 5

poor closure of the cardia
inflammation due to HCL, pepsin, trypsin, bile, HCO3

Question 6

causes of gastro oesophagwal reflux (GOR)

Answer 6

delayed gastric emptying
upper airway obstruction
hiatal hernia
anaesthesia
chronic vomiting

Question 7

clinical signs of gastro oesophagwal reflux (GOR)

Answer 7

reverse sneezing
chronic bronchitis
laryngitis
rhinitis
erucation

Question 8

diagnosis of gastro oesophagwal reflux (GOR)

Answer 8

clinical signs - history
endoscopy

Question 9

treatment of gastro oesophagwal reflux (GOR)

Answer 9

low fat diet
H2 receptor blockers
PPI
prokinetics
sucralfate

Question 10

what durgs enhance the closure of the cardia

Answer 10

metoclopramide
erythromycin

Question 11

clinical sings of oesophageal foreign body

Answer 11

regurgitation
salivation
abdominal distension
coughing, fever, dyspnoea

Question 12

diagnosis of gastro oesophagwal reflux (GOR)

Answer 12

clinical signs
thoracic xray
endoscopy
increased WBC

Question 13

treatment of oesophageal foreign body

Answer 13

endoscopic removal
surgery
gastric tubing
euthansia

Question 14

types of dysmotility/ oesophageal weakness

Answer 14

megaoesophagus
partial oesophageal dysmotility
dystonia
diverticulum

Question 15

causes of dysmotility/ oesophageal weakness

Answer 15

idiopathic
muscle atrophy
myasthenia gravis
Autoimmune
post anaesthesia condition
oesophagitis

Question 16

clinical signs of dysmotility/ oesophageal weakness

Answer 16

salivation
cough (bronchopneumonia)
fever
dyspnoea
weight loss

Question 17

diagnosis of dysmotility/ oesophageal weakness

Answer 17

fluroscopy, radiography

Question 18

treatment of dysmotility/ oesophageal weakness

Answer 18

special feeding
PEG (percutaneous endoscopic gastrotomy)

Question 19

Megaoeasophagus definition

Answer 19

persisten decrease of motility of the oesophagus

Question 20

what animal is Megaoeasophagus more common in

Answer 20

dogs > cats

Question 21

cause of Megaoeasophagus

Answer 21

normally idiopathic
may be caused by laryngeal paralysis
NB to check for aspiration pneumonia

Question 22

congenital Megaoeasophagus

Answer 22

mini schnauzer, great dane, dalmatian
shar pei, irish setter, lb

Question 23

clinical signs of congenital Megaoeasophagus

Answer 23

usually develops during the weaning phase
no treatment
poor porgnosis

Question 24

acquired Megaoeasophagus
Primary form

Answer 24

diagnosis by exclusion
large > toy breeds
treat using Bailey chair; sucralfate + bethanechol

Question 25

acquired Megaoeasophagus secondary form causes

Answer 25

myasthenia gravis Addison's lead poisoning oesophagitis hypothyroidism neuropathy snake bit

Question 26

what is myasthenia gravis

Answer 26

immune response against Ach receptors Focal/ generalised treat with pyridostigmine

Question 27

Spirocercosis cause

Answer 27

spirocercosis lupi - nematode causes parasitic nodules in the oesophagus, aortic aneurysms & spondylitis

Question 28

clinical signs of Spirocercosis

Answer 28

regurgitation vomiting weight loss coughing dyspnoea sudden death

Question 29

diagnosis of Spirocercosis

Answer 29

faecal examination endoscopy

Question 30

treatment of Spirocercosis

Answer 30

imidacloprid / moxidectin surgery

Question 31

prevention of Spirocercosis

Answer 31

milbemycin

Question 32

persistent right aortic arch definition

Answer 32

extraluminal compression of the oesophagus by the lig arteriosum a vascular ring anomaly

Question 33

cause of persistent right aortic arch

Answer 33

congenital g. shepherds

Question 34

clinical signs of persistent right aortic arch

Answer 34

regurgitation coughing dyspnoea weight loss

Question 35

diagnosis of persistent right aortic arch

Answer 35

survey & contrast radiography endoscopy

Question 36

differential of persistent right aortic arch

Answer 36

stricture intraluminal obstructiontr

Question 37

treatment of persistent right aortic arch

Answer 37

surgery

Question 38

Regurgitation vs Vomiting comes from

Answer 38

Regurgitation - from mouth / pharynx / oesophagus Vomiting - from stomach / small intestine

Question 39

Regurgitation vs Vomiting activity

Answer 39

Regurgitation - passive, no nausea Vomiting - active, wretching, heaving

Question 40

Regurgitation vs Vomiting content

Answer 40

Regurgitation - undigested food, no bile (eating content) Vomiting - un / digested food, chyme, bile (no eating of content)

Question 41

expectoration

Answer 41

expulsion of material from the respiratory tract

Question 42

how to distinguish Regurgitation and Vomiting

Answer 42

history clinical exam palpation of distended oesophagus th. xray endoscopy fluroscopy

Question 43

causes of vomiting

Answer 43

metabolic diseases endocrine diseases toxins / drugs dietary causes abdominal diseases gastric diseases small intestine diseases large intestine diseases

Question 44

metabolic diseases causing vomiting

Answer 44

renal disease hepatobiliary disease electrolyte / acid base derangements

Question 45

endocrine diseases causing vomiting

Answer 45

hypoadrenocorticism hyperthyroidism diabetic ketoacidosis

Question 46

toxins / drugs causing vomiting

Answer 46

heavy metals ethylene glycol NSAIDS, AB, chemotherapy

Question 47

dietary causes causing vomiting

Answer 47

allergy intolerance

Question 48

abdominal diseases causing vomiting

Answer 48

pancreatitis peritonitis neoplasia

Question 49

gastric diseases causing vomiting

Answer 49

gastritis GDV foreign body delayed gastric emptying neoplasia

Question 50

small intestine diseases causing vomiting

Answer 50

IBD obstruction parasites neoplasia infection

Question 51

large intestine diseases causing vomiting

Answer 51

constipation colitis

Question 52

history of vomiting patient

Answer 52

duration food in vomit > 8hrs after ingestion acute / chronic

Question 53

physical exam of vomiting patient

Answer 53

oral exam mucosa cardiac arrhythmia abdominal palpation rectal examination

Question 54

lab d of patient with vomiting

Answer 54

CBC neutrophilic leucocytosis biochemical tests acid base status hyperkalaemia anaemia neutropenia eosinophilia hypoproteinaemia

Question 55

what to see in xray of vomiting patient

Answer 55

foreign body distention displacement delayed gastric emptying penetrating ulcers masses deep ulceration pyloric obstruction

Question 56

symptomatic treatment of vomiting

Answer 56

antiemetics fluid therapy dietary antacids protectives

Question 57

antiemetics

Answer 57

maropitant phenothiazines metoclopramide ondansetron

Question 58

fluid therapy

Answer 58

0.9% saline K supplementation

Question 59

dietary treatment for vomiting

Answer 59

NPO for 24hrs low fat, single protein source, chcicken and rice

Question 60

antacids

Answer 60

H2 receptor antagonists - ranitidine PPI - omeprazole

Question 61

protectives

Answer 61

sucralfate - provide barrier to acid penetration. inactivates pepsin, absorbs bile acids, stimulated PG synthesis Misoprostol - contraindicated in pregnant animals