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BVetMed 1 > Alimentary - Maldigestion and Malabsorption > Flashcards

Alimentary - Maldigestion and Malabsorption Flashcards

1
Q

What are the exocrine functions of the pancreas

A

Fat, carbohydrate and protein breakdown

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2
Q

What does the pancreas secrete for fat digestion?

A

Pancreatic lipases - FA + monolycerides
Cholesterol esterases - for cholesterol esters
Phospholipases - splits FA from phospholipids

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3
Q

What does the pancreas secrete for carbohydrate digestion?

A

Amylase - hydrolyses starch and glycogen into disaccharides

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4
Q

What does the pancreas secrete for protein digestion?

A

Trypsin and chymotrypsin - to form polypeptides
Carboxypolypeptidases - to form amino acids

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5
Q

What is malassimilation?

A

Maldigestion of nutrients - often caused by pancreas not working

Malabsorption - where nutrients are digested by something is stopping it getting into body

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6
Q

What is malutilisation?

A

Where nutrients are digested and absorbed normally but something is stopping it from working as it should in the body e.g. cancer, diabetes

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7
Q

What happens if the pancreas isn’t working properly?

A

Protein, carb and fat maldigestion
Impaired assimilation of fat soluble vits
Impair absorption of B12/cobalamin
Bacteria build up

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8
Q

What are the fat soluble vitamins?

A

Vit A - retina and eyesight
Vit D - calcium metabolism
Vit E - protection from toxins
Vit K - activation of clotting factors

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9
Q

How does bacteria build up if the pancreas isnt working as it should?

A

The undigested chyme sits there and creates an environment for the overgrowth of SI bacterial.

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10
Q

What is the significance of B12?

A

The pancreas synthesises an intrinsic factor for cobalamin, which is absorbed by the SI. This is also taken up by bacteria.

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11
Q

What is exocrine pancreatic insufficiency?

A

The pancreas loses its exocrine function, so there is no enzymes or buffer.

Often need loss of 90% to see clinical signs

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12
Q

What breeds are more predisposed to EPI?

A

German shepherds
Rough coated collies
English setters
Chow Chows

Not confirmed in cats

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13
Q

What causes EPI?

A

Pancreatic acinar atrophy
Pancreatitis
Pancreatic hypoplasia
Pancreatic neoplasia

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14
Q

What is pancreatic acinar atrophy?

A

Cells die due to selectie destruction to autoimmune disease. Occurs in two stages:
1- subclinical, inflamed with T-cell infiltration and partial atrophy
2 - clinical, with 90% loss and severe end stage atrophy
Most common in dogs

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15
Q

What is pancreatitis?

A

Inflamed pancreas leads to both endo- and exocrine function of the pancreas being destroyed with fibrosis.

Show signs of EPI and diabetes

Seen in cats mostly but also dogs (S/M and cocker spaniels)

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16
Q

What is pancreatic hypoplasia?

A

Genetic and uncommon

An underdeveloped pancreas

17
Q

What is pancreatic neoplasia?

A

A rare and total loss of an area of the pancreas

18
Q

What are the clinical signs of EPI?

A

Weight loss with a good appetite
Increase faecal volume and decrease in consistency
Abnormal faeces (grey/yellow and cow pat like)
Flatulence
Coprophagia

19
Q

How is EPI diagnosed?

A

Tested for trypsin immunoreactivity, as pancreas leaks trypsin when working

20
Q

How is EPI treated?

A

No ability to repair so need to minic pancreatic actions

Avoid high fat, with high calorie and low fibre (as can absorb enzymes)
Feet 2+ meals a day
Enzyme replacement life long
Some require ABs
Might need B12, preferred oral as injection stings

21
Q

What are the three phases of digestion?

A

Luminal

Mucosal

Transport phase

22
Q

What causes malabsorption in the luminal stage?

A

-Dysmotility

  • EPI or inactivation due to gastric acid hypersecretion (low pH = enzyme deactivation)
  • Fat maldigestion due to EPI or liver disease (bile salt impairment)
23
Q

What is dysmotility?

A

Can be caused by hyperthyroidism

Leads to increase metabolic weight and a fast GI time so food passes to quickly to be absorbed

24
Q

What causes malabsorption in the mucosal stage?

A

-Brush border enzyme defciency

-Brush border protein transport deficiency

-Enterocyte defects

25
Q

What is brush border enzyme deficiency?

A

Enzymes at the enterocytes are no longer produced

Congenital - trehalase in cats with chronic diarrhoea

Acquired - relative lactose deficiency leading to oncotic diarrhoea

26
Q

What is brush border transport deficiency?

A

Defects in the transport proteins

Aquired - diffused SI disease from an infection

Congenital - intrinsic factor deficiency with altered transport e.g. E Coli or the structure e.g. Salmonella

27
Q

What are the enterocyte defects?

A

Problems with the cell itself.

Often seen in IBS and cancer. Altered structures can be caused by lytic infections e.g. Parvo or Rotovirus or a cell infiltration e.g. Johnes

28
Q

What causes malabsorption in the transport phase?

A

-Lymphatic obstruction with primary or secondary lymphangiectasia. Caused by infection, inflammation or neoplasia

  • Vascular compromise due to infection or vasculitis. Portal vein hyper tension can lead to hepatopathy.
29
Q

What are a infiltrative diseases of the gut wall?

A

Parasitic
IBS
Lymphangiectasia
GI lymphoma
Other diffuse neoplasia
Severe small intestine bacteria overgrowth
Dry feline infectious peritonitis
Deep mycoses

30
Q

What are clinical signs of malabsorption?

A

Weight loss with normal/increased appetite
Diarrhoea
Coprophagia

31
Q

How is malabsorption treated?

A

Depends on cause

32
Q

Why are gut issues often seen as a secondary disease?

A

They are often found due to a primary issue

33
Q

What are examples of primary issues that cause GI issues

A

Hepatic disease
Right side cardiac disease
Hyperthyroidism

34
Q

How does hepatic disease cause secondary gut issues?

A

Bile acids are integral to digestion and absorption of fats

Caused by inflammation, infection, neoplasia, toxicity and fibrosis of the liver

35
Q

How does portal vein hypertension cause GI issues?

A

Right side cardiac disease leads to blood flow issues around the liver/stomach

Caused by valvular disease, cardiac muscle disease or pericardial disease

36
Q

How does hyperthyroidism cause GI issues?

A

An increased GI transit time so less time for absorption to occur and weight loss due to increased metabolic rates

Treatments vary

BVetMed 1 (53 decks)

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