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9- SA- Gastrointestinal and Hepatic Disease > Approach to vomiting/ regurgitation > Flashcards

Approach to vomiting/ regurgitation Flashcards

1
Q

What is acute vomiting more likely to be caused by

A

toxic
obstructive
inflammatory
infectious

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2
Q

what is chronic vomiting more likely to be caused by

A

chronic inflammatory
chronic infectious
metabolic/ endocrine
neoplastic

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3
Q

List 2 causes of acute vomiting due to the cerebral cortex

A

head trauma
sudden changes in ICP- inter cranial pressure

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4
Q

List 3 causes of acute vomiting linked to the vestibular system

A

motion sickness
idiopathic vesicular disease
otitis interna

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5
Q

List 4 causes of chronic vomiting linked to the GI tract

A

chronic inflammatory e.g. gastritis
mucosal insult e.g. dietary intolerance
infectious
obstructive

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6
Q

What is the difference between vomiting and regurgitation

A

Reg- passive motion - ejection from the oesophagus
vomiting is active - ejection of food from stomach

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7
Q

define dysphagia

A

failure to prehend/ bite and initially swallow

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8
Q

List 3 things that can cause dysphagia

A

Pain
failure of neuro-muscular control
obstruction

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9
Q

what failures of neuro-muscular control can result in dysphagia

A

cranial nerves disease (5, 7, 9, 10, 12)
CNS disease
masticatory myositis
botulism
myasthenia gravis

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10
Q

which breeds are predisposed to congenital megaoesophagus

A

Labrador
newfoundland
Shar-pei

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11
Q

describe the physiology of vomiting

A

active reflex mediated via the emetic centre that can be stimulated by the CRTZ, GIT, cerebral cortex or vestibular system

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12
Q

what is the CRTZ

A

chemoreceptor trigger zone

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13
Q

what acute issues can trigger CRTZ voiting

A

metabolic/ endocrine disease
toxins/drugs

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14
Q

what chronic issues can trigger cerebral cortex vomiting

A

neoplasia/SOL (space occupying lesions)
CNS disease

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15
Q

List the chronic issues that can trigger vestibular system vomiting

A

chronic vestibular damage
otitis interna
neoplasia
cerebellar disease

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16
Q

List the chronic issues that can trigger CRTZ vomiting

A

metabolic/endocrine disease

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17
Q

Describe the physiology of regurgitation

A

passive expulsion of food from the pharynx or oesophagus

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18
Q

what is masticatory myositis

A

antibodies form against the muscles used for mastication

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19
Q

List the 3 causes of regurgitation

A

dilation of the oesophagus
obstruction - intraluminal, mural or extramural
neuro-muscular disorder

20
Q

what can previous regurgitation under anaesthetic be an indicator for

A

oesophagitis or stricture

21
Q

Name 2 mural causes of regurgitation

A

neoplasia
inflammation

22
Q

list 3 extramural causes of reguritation

A

vascular ring anomaly
hiatal hernia
space occupying lesion (neoplasia)

23
Q

what breeds are predisposed to vascular ring anomalies

A

GSD
irish setter
great dane

24
Q

what animals are predisposed to intussusception

A

juveniles and puppies with recent diarrhoea

25
Q

what breeds are predisposed to oesophageal FBs

A

terrier breed (WHWT) and spaniels

26
Q

what breeds are predisposed to GI/ intestinal FBs

A

labradors
spaniels

27
Q

which are more prone to doxycycline induced oesophagitits dogs or cats

A

cats

28
Q

what is a vascular ring anomaly

A

persistant right aortic arch constricts the oesophagus

29
Q

Describe how to manage an animal with abnormal swallowing

A

trial and error different food types to find one that works well

30
Q

describe how to manage megaoesophagus

A

omeprazole
feed from a height
feed in small bits
consider a feeding tube

31
Q

what can be a problem with giving omeprazole to animals with megaoesophagus

A

risk of worsened aspiration

32
Q

describe how to manage oesophagitis

A

pain relief
feeding tube placement (bypass the oesophagus)

33
Q

how does maropitant work

A

NK1 antagonist - helps with centrally mediated vomiting

34
Q

describe how metoclopramide works

A

dopamine and histamine receptor antagonist
helps with centrally mediated vomiting

35
Q

what should you rule out before giving any drugs for vomiting

A

a foreign body

36
Q

How does omeprazole work and what is it used for

A

protein pump inhibitor
useful for gastric ulceration and reduction in ICP (reduced CSF production)

37
Q

How does misoprostol work and what is it used for

A

prostaglandin analogue
increases mucosal blood flow and therefore healing

38
Q

when should we not use misoprostol

A

in pregnant animals

39
Q

List 4 gastroprotectants

A

omeprazole
misoprostol
cimetidine - H2 receptor antagonists
sucralfate

40
Q

Describe how cimetidine work and what it is used for

A

histamine receptor antagonists
reduce acid secretion

41
Q

how does sucralfate work and what does it do

A

polyionic surfactant
binds to damage mucosa and provides a ‘bandaid’

42
Q

what is misoprostol commonly used for

A

NSAID toxicity

43
Q

describe a hiatal hernia

A

diaphragm and oesophagus are poorly attached - this means as the patient breathes the diaphragm slides over the oesophagus and part of the stomach may protrude through

44
Q

how can we diagnose hiatal hernias

A

fluroscopy

45
Q

what is PPDH

A

pericardio-peritoneal diaphragmatic hernia

46
Q

which animals more commonly have PPDH cats or dogs

A

cats

47
Q

what is a pericardio-peritoneal diaphragmatic hernia

A

midline defect at birth which allows abdominal contents to herniate into the percardial sac

9- SA- Gastrointestinal and Hepatic Disease (14 decks)

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