Digestive System Disorders Flashcards

Question

broad categories of causes of hematemesis

Answer 1

- coagulopathy - alimentary tract lesion - extra-alimentary tract lesion; blood is swallowed and then vomited

Answer 2

- neoplasia; leiomyoma, carcinomas, lymphomas - pythiosis (esp. younger dogs in the southeastern US) - IBD - shock; hypovolaemic, septic shock (SIRS), post-GD/GDV, neurogenic shock, extreme or sustained exertion (common in select working animals) - hyperacidity; MCT, gastrinoma (rare) - Iatrogenic: NSAIDs, glucocorticoids - hepatic disease - hypoadrenocorticism - pancreatitis (uncommonly causes ulceration) - renal disease (uncommonly causes ulceration) - inflammatory diseases - gastritis (acute, AHDS, helico-bacter associated) - gastric-mucosal trauma from vigorous vomiting - gastric polyps - esophageal disease (tumours, severe esophagitis, trauma) - GB disease (tumours) - rare - bleeding oral lesions

Answer 3

1) distinguishing potentially resectable ulcers from widespread unresectable erosions in patients with life-threatening GI bleeding 2) localizing ulcers when considering surgical resection 3) determining the cause of GUE in patients with upper GI blood loss of unknown cause

Answer 4

- intolerance/allergy - poor-quality food - rapid dietary change (esp. pups/kittens) - bacterial food poisoning - dietary indiscretion

Answer 5

- helminths - protozoa; giardia, tritrichomonas (feline), coccidia

Answer 6

1. Viral - parvovirus - coronavirus - feline leukaemia virus - FIV - various others; rotavirus, canine distemper virus 2. Bacterial causes - Salmonella spp. - Clostridium perfringens (common and important in large bowel diarrhoea) - Verotoxin-producing E.coli - Campylobacter jejuni (uncommon) - Yersinia enterocolitica (questionable) 3. Rickettsial infection; salmon poisoning (regionally important)

Answer 7

- dietary related - AHDS - intussusception - ingestion of toxins; chemicals, heavy metals, various drugs (ABs, antineoplastics, anthelmintics, antiinflammatories, digitalis, lactulose), 'garbage can' - acute pancreatitis - hypoadrenocorticism

Answer 8

- weight loss is uncommon - polyphagia is rare to absent - frequency of bowel movements is sometimes very increased but often normal - volume of feces; sometimes decreased (because of increased frequency) but can be normal - hematochezia sometimes - mucus sometimes - tenesmus sometimes

Answer 9

- weight loss is expected - polyphagia sometimes - frequency of bowel movements is often near normal - volume of feces is often increased but can be normal volume - blood in feces causes melena and is rare - mucus is uncommon - tenesmus is uncommon but may occur later in chronic cases

Answer 10

- maldigestion - nonprotein-losing malabsorptive disease - protein-losing enteropathy

Answer 11

- parasitism (giardiasis, nematodes) - dietary responsive (food intolerance/allergy) - antibiotic-responsive enteropathy ('dysbiosis) - IBD - neoplastic bowel disease (esp. lymphoma) - fungal infections (regionally important); pythiosis, histoplasmosis

Answer 12

- dietary responsive (food allergy/intolerance) - parasitism; giardiasis - IBD; lymphocytic-plasmacytic enteritis - neoplastic disease (esp. lymphoma)

Answer 13

- intestinal lymphagiectasia - alimentary tract lymphoma - severe IBD - alimentary tract fungal infections (histoplasmosis, pythiosis) - chronic intussusception (esp. young dogs) - alimentary tract hemorrhage (ulceration, erosion, neoplasia, parasites) - unusual enteropathies (chronic purulent enteropathy, severe ectasia of mucosal crypts) - massive hookworm or whipworm infestation

Answer 14

- alimentary tract lymphoma (important) - severe IBD - alimentary hemorrhage; neoplasia, duodenal polyps, idiopathic ulceration

Answer 15

- dietary responsive (intolerance/allergy) - fibre-responsive - parasitism; whipworms, Heterobilharzia - bacterial diseases; clostridial colitis, histiocytic ulcerative colitis (Boxers and Frenchies) - fungal infections; histoplasmosis, pythiosis - IBD (uncommon in dogs) - neoplasia; lymphoma, adenocarcinoma

Answer 16

- dietary responsive (intolerance or allergy) - fibre-responsive - IBD - Tritrichomonas (esp. in exotic cats and catteries) - Feline leukaemia virus infection (+ infections secondary to it) - FIV infection (+ infections secondary to it)

Answer 17

Anal-rectal Disease - anal sacculitis - neoplasia; rectal adenocarcinoma, rectal polyp, colorectal leiomyoma or leiomyosarcoma - perianal fistulas - anal foreign body - rectal prolapse - anal-rectal trauma (FB, thermometer, enema tube, fecal loop, pelvic fractures) Colonic/intestinal disease - parasitism whipworms, hookworms (severe infections can involve the colon) - dietary responsive - clostridial collitis - AHDS - parvovirus enteritis - histoplasmosis - pythiosis - intussusception; ileocolic, cecocolic - IBD - colonic trauma - coagulopathy - colonic vascular ectasia

Answer 18

- dietary responsive (allergy or intolerance) - IBD - coccidia - rectal tumours

Answer 19

- hookworms - gastroduodenal tract ulceration/erosion; gastric or small intestinal tumour; lymphoma, adenocarcinoma, leiomyoma or leiomyosarcoma, polyp - ingested blood; oral lesions, nasopharyngeal lesions, pulmonary lesions, diet - hypoadrenocorticism - coagulopathies

Answer 20

- GI tumours; lymphoma, duodenal polyps, other tumours (MCT, adenocarcinoma) - coagulopathies; vit. K deficiency (intoxication or resulting from malabsorption)

Answer 21

- perineal inflammation or pain; anal sacculitis - rectal inflammation/pain; perianal fistulae, tumours, proctitis (primary or secondary to diarrhoea/prolapse), histoplasmosis/pythiosis - colonic/rectal obstruction; rectal neoplasia, granuloma, perineal hernia, constipation, prostatomegaly, pelvic fracture, other pelvic canal masses, rectal foreign object

Answer 22

- urethral obstruction - rectal obstruction; pelvic fracture, perineal hernia - constipation; abscess near rectum

Answer 23

Iatrogenic; - drugs; opiates, anticholinergics, carafate, barium sulfate Behavioural/Environmental causes - change in household/routine (esp. cats) - soiled litter box/no litter box - house training - inactivity Refusal to defecate - behavioural - pain in rectal/perineal area - inability to assume position to defecate; orthopedic problem, neurologic problem Dietary Causes - excessive fibre in dehydrated animals - abnormal diet; hair, bones, indigestible material (plants, plastic) Colonic obstruction - pseudocoprostasis - deviation of rectal canal: perineal hernia - intraluminal/intramural disorders; tumours, granuloma, cicatrix, rectal foreign body, congenital stricture - extraluminal disorders; tumours, granuloma, abscess, healed pelvic fracture, prostatomegaly, prostatic or paraprostatic cyst, sublumbar lymphadenopathy Colonic weakness - systemic disease; hypoK, hypoT, hypercalcaemia - localized neuromuscular disease; spinal cord trauma, pelvic nerve damage, dysautonomia, chronic/massive dilation of the colon causing irreversible stretching of the colonic musculature Misc - severe dehydration - idiopathic megacolon (esp. cats)

Answer 24

- lower motor neuron disease (eg. lumbosacral stenosis, caudal equina syndrome) - partial rectal obstruction - severe irritative proctitis

Answer 25

- food; not enough, poor quality, inedible - anorexia - dysphagia - regurgitation/vomiting - maldigestive disease (EPI) - malabsorptive disease (SI disease) - malassimilation; organ failure (cardiac, hepatic, renal, adrenal) - excessive utilization of calories; lactation, pregnancy, increased work, hyper T, fever/inflam, extremely cold environment - increased loss of nutrients; DM, PLE, PLN - Neuromusc disease; LMN - cancer cachexia

Answer 26

- inflammatory diseases anywhere in the body - dysphagia; nausea, metabolic disease, CNS, cancer cachexia, anosmia, psychological

Answer 27

- septic inflam; perforated gastric ulcer, intestines, devitalized intestines, ruptured GB, abscess/infection, pyometra - non-septic inflam; pancreatitis, pansteatitis, uroabdomen - organ distension/obstruction - ischemia; thromboemboli, torsions - abdo hemorrhage/neoplasia

Answer 28

- fractures - IVDD - diskospondylitis - abscesses

Answer 29

- pyelonephritis - UTIs - prostatitis - non-septic cystitis - cystic/ureteral obstruction/rupture - urethritis or obstruction - metritis - uterine or testicular torsion - neoplasm - mastitis (mimics abdo pain)

Answer 30

- post-op - iatrogenic; drugs (misoprostol, bethanechol) - adrenalitis (assoc. w/ hypoA) - heavy metal intox - vasculopathy; infarct, Rocky Mountain Spotted Fever Vasculitis

Answer 31

1. Tissue; pregnancy, infiltrative diseases, neoplasias, lipidosis, granulomas 2. Fluid; contained in organs, torsions, cysts, FF 3. Gas; free vs. contained in organs (dilation/obstructions/gas-producing bacteria) 4. Fat; lipoma, obesity 5. Weak Abdo muscles: hyperadrenocorticism 6. Faeces

Answer 32

- examining faeces for undigested food particles by staining thin fecal smears with the Sudan stain (for fat) or iodine (for starch and muscle fibers) is discouraged. - finding excessive amounts of undigested fecal fat is supposedly suggestive of EPI but this result have many false-positive and false-negative results - fecal analysis for proteolytic activity (faecal trypsin content) is rarely necessary to diagnose EPI caused by pancreatic duct obstruction (which is very rare) - faecal occult blood analyses are seldom useful (false positives from meat by-products, cimetidine, oral iron preparations, some veggies) *if desired need to feed meat-free for 3-4 days

Answer 33

- Clostridium perfringens - Salmonella spp. - E.coli - Campylobacter jejuni

Answer 34

- ELISA parvo test is very specific; however parvovirus may not be excreted in the feces for the first 24-48 hours after onset of CS + faecal shedding decreases substantially during the ensuring 7-14 days.

Answer 35

- Giardia, Cryptosporodium, Salmonella, C.perfringens enterotoxin A - enteric coronavirus, parvovirus +/- distemper virus

Answer 36

- giardia, cryptosporidium, Toxoplasma gondii, Tritrichomonas blagburni, C.perfringens enterotoxin A - coronavirus, +/or panleukopenia virus +/- C.jejuni, C.coli

Answer 37

1. Spores; finding excessive numbers of spore-forming bacteria was thought to strongly suggest clostridial colitis --> however neither specific nor sensitive 2. Uniform bacterial population; uncertain value, it shows that normal bacterial flora is disrupted but no cause/effect 3. Large spirochetes; often plentiful in diarrhoea but are not C.jejuni and are of uncertain pathogenicity 4. Fungal organisms; are rarely found by fecal examination 5. Leukocytes; indicate a transmural colonic inflammation instead of just superficial - however ddx. or cause not possible through just this

Answer 38

- intussusceptions - pancreatitis - abdominal infiltrative disease - small amounts of effusion not seen on rads - evaluating hepatic parenchyma - identifying abdominal neoplasia in animals with abdominal effusion

Answer 39

1. Fasted for 24 hours prior, faeces removed via enema 2. Pre-procedure rads to confirm stomach is empty 3. Liquid barium sulfate administered orally (8-10ml/kg in small dogs and cats, 5-8ml/kg in large dogs) 4. Animal should receive no motility-altering drugs that delay outflow 5. Immediately after 3 view Abdo rads --> then again at 15 and 30 minutes, then again hourly from 1 to 3 hours.

Answer 40

performed by administering barium via stomach tube then immediately removing it, then insufflating the stomach with gas until it is mildly distended

Answer 41

- if liquid barium does not enter the duodenum within 15 to 30 minutes after administration OR - if the stomach fails to almost completely empty within 3 hours

Answer 42

- a sterile catheter is inserted into the abdomen and warm, sterile physiologic saline solution (20ml/kg) is administered rapidly - the abdomen is massaged vigorously for 1-2 minutes and then some fluid is aspirated

Answer 43

- most sensitive and specific test for EPI - TLI assay detects circulating proteins produced by a normally functioning exocrine pancreas and is even valid in animals receiving pancreatic enzyme supplements orally - animals must be fasted overnight

Answer 44

- pancreatitis - renal failure - severe malnutrition

Answer 45

Dogs: 5.2-35ug/L Cats: 28-115ug/L

Answer 46

animals with signs suggestive of gastrinoma (chronic V+, weight loss, D+ in older animals, esp. if there is concurrent esophagitis or duodenal ulceration)

Answer 47

- gastrinoma - gastric outflow tract obstruction - renal failure - short-bowel syndrome - atrophic gastritis - receiving PPIs

Answer 48

can be measured in faeces as a marker for GI protein loss - it is rarely indicated but can be useful when trying to distinguish whether hypoalbuminaemia is at least partly due to a protein-losing enteropathy in a patient with known renal protein loss or hepatic insufficiency

Answer 49

leiomyomas

Answer 50

- adenocarcinoma - lymphoma - various inflammatory cells - spirochetes

Answer 51

- oesinophilic enteritis - lymphoma - histoplasmosis - protothecosis - giardiasis, bacteria or Heterobilharzia ova

Answer 52

- stomach - duodenum - jejunum - ileum - mesenteric LNs - liver - pancreas (in cats) + any obvious lesions/tumours

Answer 53

inflammation of the rectum's lining

Answer 54

refers to a scar, or the fibrous tissue that forms after a wound has healed

Answer 55

refers to care-giving behaviours, most notably vomiting or regurgitation by a female dog to feed her puppies

Answer 56

occurs when a significant portion of the small intestine is missing or damaged, leading to the inability to absorb enough nutrients from food - can be due to surgery, birth defects or disease affecting the SI

Answer 57

hypokalaemia hypochloraemia metabolic alkalosis

Answer 58

hypokalaemia +/- acidosis (typically)

Answer 59

- red OMM - warm extremities - strong, bounding femoral pulse

Answer 60

cats: 50ml/kg dogs: 90ml/kg

Answer 61

4-5ml/kg of hypertonic saline solution (ie. 7%) given over 10-20minutes Do not exceed 1ml/kg/min

Answer 62

because they are larger than albumin and persist in the IV space longer than albumin

Answer 63

'bland' (easily digested) diets are low in fat and fiber (both delay gastric emptying) and high in complex carbohydrates

Answer 64

- Hills Prescription Diet i/d - Imams Intestinal Plus Low-Residue - Purina CNM EN-Formula - Royal Canin GI High Energy - Royal Canin Canine Low Fat

Answer 65

- 1 part boiled white chicken/turkey meat without skin + 2 parts boiled/baked potato without skin - swap meats (boiled white fish, mutton, venison, rabbit, low-fat cottage cheese) - rice can be used instead of potato - not balanced diets but usually okay for 3-4 months in an adult dog otherwise require nutritionist to balance calcium and phosphorus

Answer 66

- Purina HA - Hill's z/d - Hypoallergenic Hydrolyzed Protein HP diets - Ultamino RC

Answer 67

- ultra low fat diets; because long-chain fatty acids enter and accumulate in lacteals, removing them from the diet helps prevent dilation and rupture of lacteals and subsequent intestinal lymphatic loss

Answer 68

improvement is typically evident within 3 weeks, although rare patients require 6+ weeks - critical that no treats/other foods (eg. flavoured toys, pills, medications) can be given during this time. - if signs resolve during this time, the diet should be continued for at least 4-6 weeks more to ensure cause and effect

Answer 69

- a commercial high-fibre diet may be used - add Psyllium hydrocolloid (metamucil) 1-2tsp/can of food - or add coarse, unprocessed wheat bran (1-4 tablespoons/can of food) - canned pumpkin pie filling in cats (1-3 tbsp/day) to lessen constipation if fibre responsive will usually see clinical improvement in 4-5 days

Answer 70

60kcal/kg/day

Answer 71

- tube leakage and peritonitis - tubes must be left in place for at least 7 - 10 days to allow an adhesion to form between the stomach and the abdominal wall

Answer 72

1. Maropitant - neurokinin-1 receptor antagonist 2. Serotonin receptor antagonists; ondansetron, metoclopramide 3. Phenothiazine derivatives; Chlorpromazine, Prochloperazine

Answer 73

- acid titrating drugs; aluminium/magnesium hydroxide - gastric acid secretion inhibitors (H2 receptor antagonists; ranitidine, famotidine) - PPIs; omeprazole, pantoprazole, esomeprazole

Answer 74

Histamine-2 receptor antagonist; a competitive inhibitor of histamine - they prevent histamine from stimulating the gastric parietal cell

Answer 75

- bone marrow suppression - central nervous system problems - diarrhoea IV injections (esp. ranitidine) may cause nausea, vomiting or bradycardia

Answer 76

- limited - not shown to be as effective in preventing NSAID- induced ulcers in dogs as it is in people - PPIs appear to be as effective with less major adverse effects (abdominal cramping, diarrhoea, abortifacient)

Answer 77

to symptomatically treat diarrhoea; it excessive fluid or electrolyte losses or owners demand control of the diarrhoea at home

Answer 78

an overdose can cause narcotic intoxication (collapse, vomiting, ataxia, hypersalivation) which requires treatment with narcotic antagonists *dogs deficient in P-glycoprotein (MDR gene mutation) are at greater risk for CNS AEs

Answer 79

an acetylcholine analog that stimulates intestinal motility and secretion - produces strong contractions that can cause pain thus infrequently used

Answer 80

Bismuth subsalicylate is effective in many dogs with acute enteritis, probably because of the antiprostaglandin activity of the salicylate moiety. Disadvantages; turns stools black, tastes terrible, AKI risk

Answer 81

- a synthetic analog of somatostatin that inhibits alimentary tract motility and secretion of GI hormones and fluids - it has had limited use but might be helpful in selected animals with intractable diarrhoea or lymphangiectasia

Answer 82

a combination of sulfapyridine + 5-aminosalicylic acid used to treated colonic inflammation - colonic bacteria split the molecule and 5-aminosalicylic acid is 'deposited' on diseased colonic mucosa - respond in 3-5 days, but can take up to 2 weeks - gradually wean if signs resolve

Answer 83

- cyclosporine (atopica) - chlorambucil - azathioprine

Answer 84

starting dose 1mg twice weekly (if <3.2kg) or 2mg twice weekly for >3.2kg cat. - beneficial effects may not be seen for 4-5weeks - dose should be tapered over 2-3months - monitor for myelosuppression

Answer 85

- tylosin is commonly used - prepare to treat patient for 3 weeks before deciding that therapy for ARE has been unsuccessful - commonly ABs not required

Answer 86

- Amoxicillin, Metronidazole + Bismuth

Answer 87

administering a specific dietary substance to specifically increase or decrease the numbers of specific bacteria

Answer 88

- Lactobacillus - Bifidobacterium - Enterococcus

Answer 89

Hook Round Whip Giardia

Answer 90

- giardia - tritrichomonas in cats

Answer 91

Hook Round Physaloptera (in dogs) rpt in 2 weeks for dogs once only in cats

Answer 92

Drontal Plus Tapeworm Hook Round Whip Giardia (q24h 3 days)

Answer 93

Imidocloprid/moxidectin - topical Hook Round Whip

Answer 94

ivermectin + pyrantel hook round

Answer 95

Sentinel, Trifexis Hook Round Whip

Answer 96

TAPEWORMS 10mg/kg (double dose) for juvenile Echinococcus spp. or Spirometra

Answer 97

coccidia 30mg/kg for 10 days

Answer 98

coccidia, 50mg/kg day 1 then 27.5mg/kg q12h for 9 days

Answer 99

- Bisacodyl - Coarse wheat bran, psyllium, canned pumpkin pie filling - lactulose - dioctyl sodium sulfosuccinate

Answer 100

- irritative (bisacodyl) - bulk - osmotic

Answer 101

accumulations of saliva in subcutaneous tissues caused by salivary duct obstruction and/or rupture and subsequent leakage of secretions into subcutaneous tissues - most are traumatic, some are idiopathic

Answer 102

- large swelling found under the jaw or tongue, or in the pharynx - acute swelling may be painful but most are nonpainful - classically found in 2-4yr old dogs - GSheps, Mini.Poodles

Answer 103

- unknown, but apparently has occurred as an idiopathic event as well as secondary to chronic V+/regurg

Answer 104

- painless enlargement of one or more salivary glands (usually submandibular)

Answer 105

- surgical removal - treat underlying cause of vomiting if present - phenobarbital at anticonvulsant doses

Answer 106

- most malignant; melanoma, squamous cell carcinoma, fibrosarcoma - other; acanthomatous ameloblastomas (epulides), fibromatous epulides (in Boxers), oral papillomatosis, eosinophilic granulomas (Siberian Huskies and CKCS)

Answer 107

- gingiva; fleshy/ulcerated on rostral gingiva - tonsils; fleshy/ulcerated on one or (rarely) both tonsils - tongue margin (dogs); ulcerated - base of tongue (cats); ulcerated

Answer 108

tonsils commonly spread to local lymph nodes

Answer 109

Dogs; - if on gingiva or tongue margin; wide surgical resection +/- radiation + piroxicam for palliation - if on tonsils; piroxicam for palliation +/- chemotherapy - terrible prognosis Cats; - radiation palliatively - terrible prognosis

Answer 110

- gray, black or pink - can be smooth, usually fleshy on gum, tongue or palate - very early metastases to lungs; high met rate of 60-80%

Answer 111

- surgery +/- radiation for local control; surgical cure is extremely rare dt met rate - systemic control; carboplatin has been used with limited success

Answer 112

- pink and fleshy on palate or gums - malignant; very invasive locally - biologically high-grade, histologically low-grade tumours in young Labs, Goldens, GSheps have higher metastatic potential

Answer 113

- wide surgical resection +/- radiation in some cases

Answer 114

- pink and fleshy on gums or rostral mandible - benign, locally invasive into bone

Answer 115

surgical resection +/- radiation for gross microscopic disease *must remove associated tooth and dental ligament

Answer 116

- pink, fleshy, solitary or multiple on gums - benign

Answer 117

surgical resection, must remove associated tooth and dental ligament

Answer 118

- pink, fleshy, solitary or multiple on gums - benign

Answer 119

- pink, or white, cauliflower-like, multiple/seen anywhere - benign; BUT malignant transformation to squamous cell carcinoma may occur rarely

Answer 120

- fleshy or ulcerated growth on gingiva - malignant, locally invasive, rarely metastasizes

Answer 121

- surgical resection, must remove associated tooth and dental ligament

Answer 122

- nothing, surgical resection or cryotherapy

Answer 123

surgical resection and/or radiation or melphalan chemotherapy

Answer 124

- image the area; CT - perform a deep incisional biopsy to avoid misdiagnosis that often occurs if only the superficial, ulcerated, necrotic surface is obtained - if malignancy is possible, thoracic radiographs or CT should be performed for a met check -- very poor prognostic sign if present - FNA of regional LNs (if enlarged should be removed and submitted for histopath regardless of cytology)

Answer 125

melanomas may be amelanotic and can cytologically resemble fibrosarcomas, carcinomas or undifferentiated round cell tumours

Answer 126

Squamous cell carcinoma

Answer 127

cats can have sublingual squamous cell carcinomas and oesinophilic granulomas which mimic carcinoma but have a must better prognosis

Answer 128

- surgical excision is desirable but cats often do not tolerate aggressive oral surgery as well as dogs do - long term or permanent feeding tubes may be required

Answer 129

- uncertain cause - hypersensitivity reactions are thought to be responsible, and a genetic predisposition has been suggested

Answer 130

- the complex includes; indolent ulcer, eosinophilic plaque and linear granuloma - indolent ulcers are classically found on the lip or oral mucosa (esp. maxillary teeth) of middle-aged cats - eosinophilic plaque usually occurs on the skin of the medial thighs and abdomen - linear granuloma is typically found on the posterior aspect of the rear legs or young cats but may also occur on the tongue, palate and oral mucosa - severe oral involvement of an eosinophilic ulcer or plaque may produce dysphagia, halitosis and/or anorexia - eosinophilic granuloma may affect the chin and paw pads in addition to the mouth

Answer 131

- a deep biopsy specimen of the mass is required

Answer 132

- systemic antibiotics against Staphylococcus spp. (eg. amoxyclav, TMS) - if ABs ineffective, high dose glucocorticoids (2.2-4.4mg/kg/day) or cyclosporine - last resort; methylprednisolone acetate injections (20mg every 2-3 weeks as needed) but can cause diabetes mellitus, mammary tumours, uterine problems

Answer 133

- dental - ABs effective against anaerobic bacteria (eg. amoxicillin, Clindamycin, metronidazole) - brushing teeth + oral rinsing with veterinary chlorhex solution

Answer 134

- renal failure (primarily with severe, acute renal injury) - trauma; FB, causing agents, chewing on electrical cords - Immune-mediated; pemphigus - chronic ulcerative paradental stomatitis (esp. Maltese Terriers) - upper respiratory viruses (feline viral rhinotracheitis, feline Calicivirus) - infection secondary to immunosuppression (feline leukaemia virus, feline immunodeficiency virus( - tooth root abscesses - severe periodontitis - osteomyelitis - thallium intoxication (very rare)

Answer 135

- thorough teeth cleaning and aggressive AB therapy - systemic ABs effective against anaerobes and aerobes + oral rinses with antibacterial solutions

Answer 136

An idiopathic disorder, feline lymphcytic-plasmacytic gingivitis might be caused by feline calicivirus, Bartonella henselae, immunodeficiency from FeLV or FIV infection, or any stimulus-producing sustained gingival inflammation. Cats might have marked gingival proliferation dt excessive oral inflammatory response.

Answer 137

- hyporexia and/or halitosis are the most common signs - reddened gingiva around teeth +/- posterior pillars of the pharynx - proliferative gingiva that bleeds easily - dental neck lesions - teeth chattering

Answer 138

- proper cleaning and polishing of teeth + AB therapy against anaerobic bacteria - high dose glucocorticoids ( Pred 2.2mg/kg/day, methylprednisolone 10-20mg SQ, triamcinolone 0.2mg/kg PO SID) - in some cases multiple tooth extractions (esp. premolars and molars) may alleviate the source of the inflammation in which case it is important that the root and periodontal ligament also be removed *extraction of canines should be removed if possible - if required; chlorambucil or cyclosporine (2-4mg/kg PO BID)

Answer 139

- masticatory muscle myositis/atrophic myositis if an idiopathic immune-mediated disorder that affects muscles of mastication in dogs - in acute stages the temporalise and masseter muscles may be swollen and painful, however may dogs are not presented until the muscles are severely atrophied and the mouth cannot be opened

Answer 140

- histopathology w/ immunohistochemistry of the temporalise and masseter muscles confirms the diagnosis - finding antibodies to type 2M fibers strongly supports this diagnosis - also commonly have increased serum CK activity

Answer 141

- high dose Pred 2.2mg/kg/day +/- azathioprine 50mg/mg2 q48h typically controls acute disease but seldom helps patients with chronic disease that cannot open their mouths - once control achieved taper pred slowly to prevent recurrence - if mouth cannot be opened; gastrotomy tube - some clinicians may try to break adhesions but can cause mandibular fracture and is not recommended

Answer 142

- there is an inco-ordination between the cricopharyngeus muscles and the rest of the swallowing reflex which produces obstruction at the cricopharyngeal sphincter during swallowing (ie sphincter doesn't open at the right time) - cause is unknown but usually congenital, has a genetic basis in golden retrievers

Answer 143

- injection of the cricopharyngeal muscle with Botulism toxin - surgery; cricopharyngeal myotomy (good prognosis if cicatrix does not occur post-operatively)

Answer 144

- primarily an acquired disorder with neuropathies, myopathies and junctionopathies (eg. localized MG) seeming to be the main causes - inability to form a normal bolus of food at the base of the tongue and/or propel the bolus into the oesophagus is often associated with lesions of CNs IX or X - simultaneous dysfunction of the cranial oesophagus may cause food retention just caudal to the cricopharyngeal sphincter

Answer 145

- treat underlying cause - bypass the pharynx (gastrotomy tube)

Answer 146

- Mini Schnauzers - Great Danes - Dalmations - Chinese Shar-Peis - Irish Setters - Lab. Retrievers

Answer 147

- cisapride 0.1-0.5mg/kg (increased LES pressure to reduce concomitant gastroesophageal reflux) - feeding in vertical position and maintained for 5-10 minutes after - dietary modification (trial and error) - managing aspiration pneumonia when occurs

Answer 148

- typically respond to pyridostigmine, which is preferred to physostigmine and neostigmine

Answer 149

- if older than 13months at time of onset of CS because they are less likely to experience spontaneous remission - aspiration pneumonia

Answer 150

- tetracyclines - clindamycin - ciprofloxacin - NSAIDS

Answer 151

- PPIs (Omeprazole) - Cisapride 0.1-0.5mg/kg - Viscous lidocaine PO - sometimes gastrotomy feeding tube to protect the oesophagus while mucosa is healing and ensures a positive nitrogen balance

Answer 152

- dysautonomia in dogs and cats is an idiopathic condition that causes loss of autonomic nervous system function - in Key-Gaskell syndrome of cats it might be due to a clostridial toxin

Answer 153

- CS vary substantially - megaO and subsequent regurgitation - dysuria and distended urinary bladder - mydriasis and lack of pupillary light response - dry OMM, weight loss, constipation, vomiting, poor anal tone +/- anorexia

Answer 154

- pilocarpine 0.05% 1-2 drops in one eye; finding that the treated eye rapidly constricts whereas the untreated eye does not is consistent with dysautonomia - Bethanechol 0.04mg/kg SQ in dysuric dog with large urinary bladder causing urination is suggestive as well - definitive diagnosis req. histopathology of autonomic ganglia obtained at necropsy

Answer 155

- palliative; bethanechol 2.5-15mg daily to aid in urinary evacuation, ABs for aspiration pneumonia, prokinetics to lessen vomiting - prognosis is grim

Answer 156

Persistent right fourth aortic arch (PRAA) diagnosed via contrast esophagram

Answer 157

- surgical resection - conservative (dietary) management is inappropriate because dilation will probably progress

Answer 158

- guarded - some will have minimal to no improvement after surgery dt concomitant esophageal weakness - complication; post-surgical stricture may require ballooning or secondary surgery

Answer 159

- primary oesophageal sarcomas in dogs often dt Spirocerca lupi - carcinomas (unknown etiology) - leiomyomas and leiomyosarcomas often found at LES in older dogs - invasive thyroid carcinomas and pulmonary alveolar carcinomas - squamous cell carcinomas is the most common in cats

Answer 160

- surgical resection is rarely curative (except for leiomyomas near the LES) because of the advanced nature of most esophageal neoplasms when they are diagnosed - resection may be palliative - photodynamic therapy may be beneficial in dogs and cats with small superficial esophageal neoplasms

Answer 161

suspected to be Clostridium sp.

Answer 162

- several types (lymphocytic/plasmacytic, osinophilic, granulomatous, atrophic) - lymphocytic-plasmacytic gastritis might be an immune and/or inflammatory reaction to a variety of antigens; Helicobacter spp. and Physaloptera rara may produce a reaction in some patients - eosinophilic gastritis may present an allergic reaction, possible to food antigens - atrophic gastritis may be the result of chronic gastric inflammatory disease and/or immune mechanisms - Ollulanus tricuspis may cause granulomatous gastritis in cats

Answer 163

- sometimes responds to diet (low-fat, low-fibre, elimination diets) - glucocorticoids 2.2mg/kg/day - PPIs - rarely, azathioprine

Answer 164

- usually responds well to strict elimination diet - glucocorticoids if diet fails; pred 1.1-2.2mg/kg/day

Answer 165

- diets low in fat and fibre may help control signs - antacids, antiinflammatories, prokinetic therapy may treat atrophic gastritis - idiopathic granulomatous gastritis is idiopathic and doesn't respond well to diet or glucocorticoids

Answer 166

Non-H.pylori Helicobacter (NHPH) - H.felis, H.heilmanii, H.bizzozeronii, H.salomonis are the principal spirochetes in dogs and cats *unlike humans with H.pylori

Answer 167

gastric biopsy identified Helicobacter organisms on H&E stain, Giemsa stain, Warthin-Starry stain, as well as fluorescent in situ hybridization (FISH)

Answer 168

- combination of metronidazole, amoxicillin, bismuth (subsalicylate or subcitrate) for at least 14 days - in cats azithromycin and clarithryomycin have been substituted for bismuth - no benefit of PPIs

Answer 169

- responds well to treatment and has a good prognosis but recurrence by 6 months is common

Answer 170

Physaloptera rara is a nematode that has an indirect life cycle. A single P.rara attached to the gastric mucosa can cause intractable vomiting - affect animals usually otherwise healthy

Answer 171

- ova seldom found in faeces; require sodium dichromate or magnesium sulfate solutions to find the eggs - usually diagnosed on gastroduodenoscopy visualising parasites

Answer 172

pyrantel pamoate or ivermectin

Answer 173

- vomiting; cats more commonly affected then dogs - spread via vomited material

Answer 174

- benign muscular pyloric hypertrophy (pyloric stenosis) - gastric antral mucosal hypertrophy - gastric foreign objects - iatrogenic gastric outflow obstruction - GD/GDV - Partial or intermittent chronic gastric volvulus - Idiopathic gastric hypomotility - Bilious vomiting syndrome

Answer 175

uncertain, some research suggests that gastrin promotes development of pyloric stenosis

Answer 176

- surgical correction; pyloroplasty (Y-U-plasty)

Answer 177

- antral mucosal hypertrophy is idiopathic - caused by proliferation of non-neoplastic mucosa that occludes the distal gastric antrum - different from benign muscular pyloric stenosis where normal mucosa is thrown up into folds secondary to submucosal thickening

Answer 178

Antral: older, small-breed dogs Pyloric: young, brachycephalics, Siamese cats

Answer 179

mucosal resection usually combined with pyloroplasty

Answer 180

- large, giant breed dogs with deep, narrow chests - purebred status - middle to older aged animals - first-degree relative with history of GDV - reported risk factors; eating a large meal, rapidly, once daily from an elevated platform, 'nervous dog', eating dry foods that have fats/oils listed at one of the first four ingredients

Answer 181

- the stomach is partially twisted because of the stretched hepatogastric ligaments (typically the pylorus rotates ventrally from the right side of the abdomen below the body of the stomach to become positioned dorsal to the gastric cardia on the left side). At this point, affected dogs are clinically normal and can pass fluids and solids into the intestines ---> subsequent aerophagia causes sufficient dilation gas and other gastric contents cannot pass into the intestines - splenic congestion and torsion may occur with the spleen on the right side of the abdomen - massive gastric distension obstructs the hepatic portal vein and posterior vena cava causing mesenteric congestion, decreased cardiac output, severe shock, DIC, endotoxaemia as well as putting pressure on the diaphragm inhibiting respiration - gastric blood supply (esp. short gastric vessels) may be impaired causing gastric wall necrosis

Answer 182

- tx being delayed more than 5-6hours after onset - hypothermia, hypotension, depression/comatose - preoperative cardiac arrhythmias - gastric wall necrosis - peritonitis - sepsis - DIC - combination of partial gastrectomy, splenectomy and post-op acute renal failure

Answer 183

with; 10% without; 50%

Answer 184

- appears to be caused by gastroduodenal reflux that occurs when the dog's stomach is empty for long periods of time (eg. overnight fast) - usually affects an otherwise normal dog that is fed once daily in the morning; usually vomits once a day late at night or in the morning just before eating

Answer 185

1. Drugs; NSAIDs, glucocorticoids 2. Stress; hypovolemia, sepsis, neurogenic shock (surgery, trauma, endotoxaemia), extreme exertion 3. Gastric neoplasms and other infiltrative diseases (pythiosis) 4. MCT and gastrinoma (typically in pancreas) paraneoplastic gastric acid secretion 5. Renal Failure 6. Foreign objects; rarely cause ulceration but can prevent healing

Answer 186

Dogs; adenocarcinoma, lymphoma, leiomyomas, leiomyosarcomas, stromal tumours Cats: lymphoma

Answer 187

submucosal mass pushing into the lumen, covered with relatively normal-appearing mucosa often with one or more obvious ulcers

Answer 188

thickened, ulcerative lesion with hard, black center

Answer 189

- mucosal lymphoma - nonscirrhous adenocarcinomas

Answer 190

- leiomyomas, leiomyosarcomas, stromal tumours

Answer 191

only in cats with lymphoma - rarely in dogs

Answer 192

- adenocarcinomas is very poor unless detected early - with early diagnosis, leiomyomas/sarcomas can be cured surgically - low-grade gastric lymphoma in cats might be comparable to Helicobacter-induced, MALT-associated lymphoma in people which benefits from ABs +/- surgery, but usually quite diffuse and req. chemo

Answer 193

Pythiosis is a fungal infection caused by Pythium insidiosum. Any area of the GI tract or skin can be affected. Typically causes intense submucosal infiltration of fibrous connective tissue and a purulent, eosinophilic, granulomatous inflammation causing GUE - prevents peristalsis causing stasis. Found in Gulf Coast area of SE USA.

Answer 194

- serology or seeing the organism cytologically or histologically - ELISA (antibodies) or PCR (antigen) - Biopsies should include submucosa because the organism is more likely to be there than in the mucosa. - Fungal hyphae that do not stain and appear as 'ghosts' with typical Romanowsky-type stains are suggestive of pythiosis

Answer 195

- complete surgical excision provides best chance for cure (usually not possible) - antifungals and immunotherapy has been associated with remission of signs but not expected to cure

Answer 196

- grim; usually spreads to root of mesentery, pancreas surrounding bile duct preventing surgical excision

Answer 197

bleach diluted in water (1:32), takes 10 minutes contact time

Answer 198

two types of parvoviruses infect dogs; - canine parvovirus-1 (CPV-1) is a relatively nonpathogenic virus that is sometimes associated with gastroenteritis, pneumonitis +/- myocarditis in puppies 1-3 weeks old - canine parvovirus-1 (CPV-2) is responsible for classic parvovirus enteritis (3 strains; CPV-2 a, b, and c). CPV-2 usually causes signs 5-12 days after the dog is infected via the fecal-oral route by destroying rapidly diving cells (eg. bone marrow progenitors and intestinal crypt epithelium)

Answer 199

- faecal PCR testing is sensitive and specific - POC testing; ELISA, immunochromatography, immunomigration *vaccination with a mod.live parvoviral vaccine may cause a weak positive result for 5-15 days after vaccination - shedding decreased rapidly and may be undetectable by 10-14 days post infection

Answer 200

1. Fluids; +/- KCl, Dextrose, Plasma/hetastarch 2. Antibiotics; for febrile/neutropenic dogs 3. Anti-emetics 4. Anthelmintics 5. Pro-biotics 6. PPIs for esophagitis 7. Nutritional therapy; small amounts, micro-enteral nutrition via NG tube 8. Monitoring

Answer 201

feline parvoviral enteritis (feline distemper, feline panleukopenia) is caused by feline panleukopenia virus (FPV) which is distinct from CVP-2b.

Answer 202

ELISA tests for fecal CPV are comparable to that in dogs but it is important to note that the test may be positive for only 1 to 2 days after infection; by the time the cat is clinically ill, this test may not be able to detect viral shedding in the feces.

Answer 203

- canine coronavirus invades and destroys mature cells on the intestinal villi, but the intestinal crypts remain intact thus villi regenerate more quickly than in parvovirus

Answer 204

- parvovirus - coronavirus - circovirus - rotavirus

Answer 205

- infections in adults are often asymptomatic, whereas kittens may have mild transient diarrhoea and fever - death is rare - disease is important because affected animals seroconvert and may become positive on FIP serologic analysis -->mutation may cause FIP

Answer 206

FeLV-associated panleukopenia is uncommon. The intestinal lesion histologically resembles that produced by feline parvovirus. The bone marrow and lymph nodes are not consistently affected as they are in cats with parvoviral enteritis. Rarely, there can be co-infection with FeLV and FPV.

Answer 207

- chronic weight loss, vomiting and diarrhoea are common - large-bowel disease type diarrhoea - anaemia

Answer 208

- histologic lesions resembling FPV in a cat with FeLV should be definitives - cats are typically neutropenia with chronic diarrhoea

Answer 209

symptomatic therapy + elimination of other problems that compromise intestines prognosis is poor dt FeLV-related complications

Answer 210

FIV may be associated with diarrhoea; acute FIV infection is associated with transient diarrhoea and terminal FIV may be associated with AIDS-like enteropathy which can produce chronic diarrhoea, severe weight loss and/or purulent colitis. Unclear pathogenesis.

Answer 211

- detection of FIV antibodies + diarrhoea allow presumptive diagnosis

Answer 212

-- supportive treatment - guarded to poor prognosis; survival time months

Answer 213

- caused by Neorickettsia helminthoeca - dogs are infected when eating fish (esp. salmon) infected with fluke (Nanophyetus salmincola) that carries the rickettsia - the rickettsia spreads to the intestines and most LNs causing inflammation - found in the US Pacific NW (because intermediate host snail Oxytrema silicula) lives there

Answer 214

- initial fever - hyporexia -- weight loss +/- V+/D+ - D+ is typically small bowel but may become bloody - lymphadenomegaly

Answer 215

- history + finding Nanophyetus spp. ova in feces is suggestive - finding rickettsia in FNAs/biopsies of enlarged LNs is confirmatory

Answer 216

- symptomatic - Rickettsia; tetracycline, oxytetracycline, doxycycline, enro - Fluke: praziquantel

Answer 217

- most dogs respond favourably within 24 hours - untreated has a poor prognosis

Answer 218

- diagnosed in animals younger than 6 months living in crowded conditions or as a nosocomial infection - mucoid D+, anorexia +/- fever - usually self limiting

Answer 219

C.jejuni most commonly Sometimes C.upsaliensis

Answer 220

erythromycin 11-15mg/kg PO q8h, Enrofloxacin 5mg/kg PO q24h or neomycin 15mg/kg PO q12h should be treated for at least 1 to 3 days beyond resolution of clinical signs, assuming they respond within 5 days

Answer 221

- culture of salmonella spp. from normally sterile areas (eg. blood) confirms it is causing disease but simply identifying it in faeces does not allow confident diagnosis - Salmonella can be identified in faeces by culture or PCR (faster and more sensitive than faecal culture)

Answer 222

- if not too bad; supportive only - if febrile/septic --> quinolones, potentiated sulfa drugs, amoxicillin, chloramphenicol

Answer 223

Clostridium perfringens and Clostridium difficile can be found in clinically normal dogs. For C.perfringens to produce disease, environmental conditions must be appropriate for the bacteria to produce toxin

Answer 224

- finding spore-forming bacteria on fecal smears, culturing the bacteria from faeces and detecting C.perfringens enterotoxin are neither sensitive nor specific for disease due to C.perfringens. - must use ELISA to first check for bacterial antigen, then if positive, use ELISA to check for toxin A and B

Answer 225

- amoxicillin 22mg/kg PO BID or tylosin 20mg/kg PO SID + dietary modification; high-fiber - consider fecal transplant or probiotic therapy

Answer 226

metronidazole

Answer 227

Several strains that produce different syndromes; - Enterotoxigenic E.coli - acute feline and canine diarrhoea - Adherent-invasive E.coli (AIEC) - histiocytic ulcerative colitis (Boxers, Frenchies)

Answer 228

- Yersinia enterocolitica - Aeromonas hydrophila - Plesiomonas shigelloides

Answer 229

Histoplasma capsulatum; mycotic infection that may affect the GI, resp and/or reticuloendothelial systems, as well as bones and eyes

Answer 230

- colon most severely affected segment; diffuse, severe, granulomatous, ulcerative mucosal disease --> bloody stools, PLE, intermittent fever +/- weight loss - sometimes forms focal colonic granulomas or involves SI

Answer 231

- ELISA for antigen shed in urine - cytologic preparations of colonic mucosal scraping to ID yeast (sometimes revealed in rectal scrapings) - fecal culture for the yeast is unreliable

Answer 232

- itraconazole itself or preceded by lipid emulsion amphotericin B; for 4-6 months - if multiple organ system or CNS involvement - poor prognosis

Answer 233

- may occur anywhere in the alimentary tract - rectal lesions often cause partial obstruction - fistulae may develop, resembling perianal fistulae and the dog may be presented for constipation and/or hematochezia - in rare cases infarction of mucosa/vessels with subsequent ischaemia

Answer 234

complete surgical excision is preferred - no medication have been consistently effective; but temporary benefit seen with itraconazole, amphotericin B, terbinafine

Answer 235

Prototheca zopfii is an alga that invades tissue. Appears to be acquired from the environment, and some type of deficiency in the host's immune system might be necessary for the organism to produce disease. Principally involves skin, colon and eyes but may disseminate through the whole body.

Answer 236

- demonstrating the organism from biopsy or mucosal cytology - grows well if cultured - may be shed in urine in disseminated disease

Answer 237

no drug works consistently; can try high dose amphotericin B + tetracycline prognosis is poor, relapse is common

Answer 238

Trichuris vulpis; acquired through ingestion of ova, adults burrow into the colonic and cecal mucosa causing inflammation +/- PLE

Answer 239

hypoadrenocorticism by causing severe hyponatremia and hyperkalemia

Answer 240

fenbendazole for 3 months

Answer 241

Dogs: Toxocara canis and Toxascaris leonina Cats: Toxocara cati and Toxascaris leonina Ingest ova or paratenic host, T.canis transplacentally, T.cati transmammary, T.leonina can use intermediate host. Tissue migration of immature forms can cause hepatic fibrosis and pulmonary lesions. Adults live in SI lumen and migrate against flow of ingesta. Can cause eosinophilic infiltrates in the intestinal wall.

Answer 242

- D+, stunted growth, poor haircoat, poor weight gain in young - runts with potbellied appearance

Answer 243

- pyrantel; treated at 2 to 3 week intervals - puppies can be treated from 2 weeks old - bitches; high dose fenbendazole 50mg/kg/day PO from day 40 gestation until 2 weeks post-partum can reduce somatic roundworm burden and lessen transplacental transmission to puppies - new born puppies; treated with fenbendazole 100mg/kg for 3 days; which kills more than 90% of prenatal larvae - preweaning kittens treated at 6,8,10 weeks - preweaning puppies treated at 2,4,6,8 weeks

Answer 244

Ancylostoma and Uncinaria spp. in dogs > cats. ingestion of ova or transcolostral or freshly hatched larvae may also penetrate the skin - adults live in SI lumen; plugs of intestinal mucosa +/- blood are ingested, can be found in the colon in severe infections

Answer 245

- blood loss/iron deficiency anaemia, melena, Frank faecal blood, D+, failure to thrive - peracute transmammary transmission in puppies can cause death before ova are found in the faeces (5-10 days old)

Answer 246

various anthelmintics; should be repeated in 3 weeks to kill parasites entering the intestinal lumen from the tissues

Answer 247

Dipylidium caninum; infected by eating an intermediate host (lice/fleas)

Answer 248

- anal irritation associated with shed segments - rarely can cause intestinal obstruction

Answer 249

Praziquantel and episprantel, control of intermediate hosts (fleas and lice)

Answer 250

Strongyloides stercoralis - young puppies in crowded conditions - parasites produce motile larvae that penetrate unbroken skin/mucosa; infested from own/contaminated faeces

Answer 251

- asymptomatic or mucoid haemorrhagic D+ and lethargy - resp. signs if parasites penetrate lungs

Answer 252

finding larvae in fresh faeces; direct fecal exam or Baermann sedimentation

Answer 253

fenbendazole for 5 days

Answer 254

Cystoisospora spp. are the coccidia infecting cats and dogs - infested by ingesting infective oocysts from the environment - coccidia invade and destroy villous epithelial cells

Answer 255

- very common in pups/kittens - asymptomatic or large volume watery D+

Answer 256

- fecal flotation - oocysts

Answer 257

TMS 10 - 20 days Toltrazuril, amprolium, ponazuril

Answer 258

Cryptosporidium spp. may infect animals that ingest sporulated oocysts - thin-walled oocysts are produced which can rupture in the intestine and produce autoinfection --> infests the brush border of the SI epithelial cells and causes D+

Answer 259

- oocysts on fecal float - immunofluorescence assay (IFA), ELISA or PCR C.parvum is the smallest and easy to miss on faecal exam

Answer 260

- anytime cryptosporidiosis is diagnosed one should look for causes of immunosuppression in the host - treat with tylosin, azithromycin - uncertain prognosis, many young dogs with cryptosporidiosis related D+ die or are euthanized - cats can be asymptomatic

Answer 261

- infected with protozoan Giardia when they ingest cysts shed from infected animals often via water - found in SI - interfere with digestion (unknown mechanism)

Answer 262

- asymptomatic to severe D+; persistent, intermittent or self-limiting - D+ can begin 5 days after exposure before cysts appear in the faeces - D+ is cow-patty like without Blood or mucus typically

Answer 263

- finding motile trophozoites in fresh faeces or duodenal washes - finding cysts with faecal float (w/ zinc sulfate solution) or IFA - or finding giardial antigens in feces using ELISA or PCR at least 3 faecal exams should be done over 7 - 10 days before ruling out giardia

Answer 264

1) environmental decontamination; quaternary ammonium compounds, pine tars 2) bathing patient to remove cysts from hair 3) drugs; metronidazole 7 days, fenbendazole 5 days or febantel 5 days + praziquantel

Answer 265

- trichomoniasis in cats is caused by Tritrichomonas blagburnii; animals infected by faecel-oral route - dogs are rarely affected; T.blagburnii or T.foetus

Answer 266

- large bowel diarrhoea - exotic breed cats (somalis, Bengals, ocicats) - can resolve spontaneously

Answer 267

- ID motile trophozoite by examining fresh feces diluted with warm saline solution - PCR most sensitive test available - colonic mucosal biopsies

Answer 268

- ronidazole 30mg/kg PO SID for 10 - 14 days - routine environmental hygiene

Answer 269

Heterohilharzia Americana infects dogs and lives in the liver - ova laid in the veins end up in the intestinal wall and liver where they elicit a granulomatous inflammation - primarily found in Gulf Coast states and southern atlantic coast states

Answer 270

- large bowel + hepatic disease - D+, hematochezia, weight loss, PLE may occur, granulomatous reactions can be associated with hypercalcaemia

Answer 271

finding ova in faeces or mucosal biopsy specimens - faecal PCR

Answer 272

- fenbendazole + praziquantel will kill the parasite and ova - prognosis varied depending on granulomatous reaction

Answer 273

canine EPI is caused by pancreatic acinar cell atrophy or destruction due to pancreatitis

Answer 274

chronic SI diarrhoea, ravenous, weight loss +/- steatorrhea (grey stools)

Answer 275

an all-inclusive term that includes dietary allergy (a hyperimmune response to a dietary antigen) and a dietary intolerance (a non-immune-mediated response to a dietary substance)

Answer 276

within 3 weeks, but can be longer

Answer 277

a syndrome in which there are many E.coli or similar enterics coupled with an intestinal host defense that is not capable of maintaining tolerance and subsequently has an abnormal response to these bacteria. presumably enterocytes are damaged by deconjugation of bile acids, fatty acid hydroxylation, generation of alcohols, increased permeability, generation of inflammatory cytokines +/- other MOA

Answer 278

- tylosin 20mg/kg PO SID (often effective) - metronidazole 15mg/kg PO SID sometimes effective - combination of metro + enro (7mg/kg q24h) if prior therapy has failed *should treat for 3 weeks before judging effect *faecal transplantation

Answer 279

1. eliminate parasites 2. dietary trials (hydrolyzed 3 weeks --> novel if no response for 3 weeks) 3. +/- Cobalamin supplementation, even if levels not measured. 4. Antibiotics added (tylosin - 3 weeks) 5. Further; probiotics, fecal transplant 6. GI biopsies 7. Immunosuppressives/steroids

Answer 280

IBD is defined as an idiopathic inflammation affecting any portion of the canine or feline small or large intestine. The cause is believed to involve an inappropriate response by the intestinal immune system to bacterial and/or dietary antigens that evolves into a self-perpetuating state of inflammation. lymphocytic-plamacytic enteritis (LPE) is the most commonly diagnosed form of canine and feline IBD

Answer 281

- well-differentiated small cell lymphocytic lymphoma - severe Lymphocytic-plasmacytic enteritis (LPE)

Answer 282

- usually dietary + ARE that also requires antiinflammatories - Pred 2.2mg/kg/day PO - if not responsive to pred; consider cyclosporine, chlorambucil, azathioprine, budesonide

Answer 283

- cats can have complete resolution of CS with cobalamin supplementation - antimicrobials/diet elimination trials are difficult because cats are fussy and difficult to medicate - cats are less likely to have alimentary histoplasmosis and are more resistent to iatrogenic hyperadrenocorticism than dogs - thus glucocorticoid therapy is commonly used

Answer 284

it is better in colonic than SI

Answer 285

requires excluding other causes (parasites, diet/fibre responsive, clostridial/fungal/algal colitis) + demonstrate colonic mucosal inflammation

Answer 286

- caused by adherent-invasive E.coli and may reflect immune system idiosyncrasies in the commonly affected breeds - principally affects Boxers and French Bulldogs

Answer 287

- histopathology; finding PAS-positive macrophages in the mucosa (usually deeper mucosa)

Answer 288

- antibiotic responsive disease; but usually resistant to multiple ABs - colonic mucosal biopsy for culture is strongly recommended - critical to treat for 8 weeks; stopping prior to this is associated with recurrence of infection and development of resistance to the ABs used

Answer 289

- lymphangiectasia - alimentary tract lymphoma - severe chronic IBD - in puppies; hookworm and chronic intussusception

Answer 290

IL primarily affects dogs. Lymphatic obstruction causes dilation and rupture of intestinal lacteals with subsequent leakage of protein, lymphocytes and chylomicrons into the intestinal submucosa, lamina propria and lumen. Because these proteins may be digested and resorbed, there must be sufficient loss so that the intestine's ability to resorb the protein is exceeded. Rupture of lymphatics in the intestinal wall or at the mesenteric border can produce lipogranulomas, which exacerbate lymphatic obstruction. Many severely symptomatic patients only have segmental disease. Most cases are idiopathic.

Answer 291

yorkshire terriers, soft-coated wheaten terriers, lundehunds

Answer 292

- severe hypoalbuminemia, hypocholesterolaemia +/- panhypoproteinaemia - +/- lymphopaenia - US: hyperechoic intestinal mucosal striations - definitive diagonsnis requires histopath (surgical biopsies sometimes required), but gross endoscopic appearance can also be diagnostic *feed fat the night before can make ID easier

Answer 293

- underlying cause rarely identified - diet; ultra-low-fat diet essentially devoid of long-chain fatty acids helps prevent further intestinal lacteal engorgement and subsequent protein loss; in early diagnosed cases this diet alone will cause in increase in serum albumin in 7-12 days - +/- prednisolone 1.1-2.2mg/kg/day PO or cyclosporine 3-5mg/kg PO BID

Answer 294

- predisposition to PLE and PLN - cause is uncertain; but possible food hypersensitivity

Answer 295

- probably has a genetic basis or predisposition, and intestinal bacteria may play an important role - it is an intense lymphocytic-plasmacytic SI infiltrate often associated with villous clubbing, mild lacteal dilation, gastric rugal hypertrophy, lymphocytic gastritis +/- gastric mucosal atrophy

Answer 296

- a severe form of LPE that waxes and wanes, particularly when the animal is stressed - weight loss, SI D+, v+ and hyporexia are commonly seen - basenjis at 3-4 yrs

Answer 297

- diet modification (highly digestible elimination diet) - antimicrobials - immunosuppressive therapy (cyclosporine/glucocorticoids)

Answer 298

- most animals die 2-3 years after diagnosis - poor prognosis for recovery, but some can be maintained - in a few dogs; GI lymphoma develops

Answer 299

- prone to severe enteropathy as well as other immune system abnormalities --> exaggerated inflammatory reactions in the GIT - also recognized as often having extremely low serum cobalamin levels

Answer 300

small intestinal biopsy; eosinophilic and lymphocytic-plasmacytic intestinal infiltrates are typically found

Answer 301

- elimination diets - antimicrobial drugs - anti-inflammatory/immunosuppressive drugs typically used - cobalamin supplementation is also reasonable

Answer 302

most affected dogs die within 3 months of diagnosis

Answer 303

classically produces a hypokalaemic-hypochloremic metabolic alkalosis +/- some degree of lactic acidosis from poor perfusion

Answer 304

- occurs when massive resection (75-90%) of SI results in the need for special nutritional therapy until the intestines are able to adapt

Answer 305

- severe weight loss and intractable diarrhoea (typically without mucus or blood) which occurs shortly after eating

Answer 306

- prevention 1. Highly digestible diet; low-fat cottage cheese, potato, 3-4 meals/day 2. Opiate antidiarrhoeals; loperamide 3. PPs 4. Antibiotics if required to control the large bacterial populations that occur in the SI

Answer 307

- lymphoma - adenocarcinoma - leiomyoma/ leiomyosarcoma/stromal tumour

Answer 308

- cause is uncertain; FeLV might be involved in cats - LPE has been suggested to be prelymphomatous (esp in cats) - more common in cats than dogs - different forms of alimentary lymphoma; lymphoblastic lymphoma is found in dogs and cats, well-differentiated SCL primarily in cats, large granular lymphocyte lymphoma is rare, very severe form in cats

Answer 309

demonstrate neoplastic lymphocytes - FNAs, squash/imprint cytology - histopath is the most reliable

Answer 310

- is difficult; poor quality endoscopic biopsies are notorious for resulting in erroneous diagnosis of LPE instead of SCL - finding lymphocytes in the submucosa is not specific for lymphoma - in some cases, finding lymphocytes in organs where they should not be found (liver) allows diagnosis of SCL

Answer 311

- immunohistochemistry (staining for CD3 and CD79a) has been used - clonality testing with PCR to diagnose SCL in some cases - finding lymphocytes where they should not be found (ie. liver)

Answer 312

- prednisolone and chlorambucil; usually respond well

Answer 313

- good prognosis if surgical excision is possible, but mets to regional LNs are common -post-op chemo does not appear to substantially affect survival time

Answer 314

- more common in dogs than cats - diffuse intestinal thickening or focal circumferential mass lesions - scirrhous carcinomas have very dense fibrous connective tissue that often requires surgery to get diagnostic sample

Answer 315

- intestinal hemorrhage - iron deficiency anaemia - obstruction +/- hypoglycaemia (paraneoplastic)

Answer 316

- scirrhous carcinomas - leiomyomas/leiomyosarcomas - stromal tumours

Answer 317

- surgical excision may be curative if no mets - if mets, chemo is palliative but prognosis is poor

Answer 318

- hematochezia, tenesmus, rarely obstruction - detected during rectal exam - resemble adenocarcinomas but very large

Answer 319

- histopath > cytology because epithelial dysplasia may be present in benign lesions causing a false-positive cytologic diagnosis of carcinoma - most colonic neoplasms arise near the recumt thus digital exam is the best screening test

Answer 320

complete surgical excision is curative; transanal pull-through rectal amputation is beneficial in selected cases. - many cases do not respond well due to late diagnosis and extensive local invasion plus distance mets to regional LNs

Answer 321

much of the intestine is typically devitalised by the time surgery if performed

Answer 322

cause unknown, some suggest that whipworm-induced typhlitis may be responsible

Answer 323

typhlectomy is curative and prognosis is good

Answer 324

- occurs when massive resection of SI results in the need for special nutritional therapy until the intestines are able (if able) to adapt - usually caused if 75-90% of SI is resected - large numbers of bacteria may also reach the upper SI, esp. if ileocolic valve is removed

Answer 325

Prevention! - diet: highly digestible frequent small meals (3-4x/day) (low fat cottage cheese, potato) - opiate antidiarrheals (loperamide) + PPIs may help to lessen diarrhoea - antibiotics may be required to control the large bacterial populations that can occur

Answer 326

- neoplastic proliferation of lymphocytes with uncertain cause; FeLV might be involved in cats - LPE has been suggested to be prelymphomatous (esp. in cats)

Answer 327

- lymphoblastic lymphoma (LL) - well-differentiated small cell lymphoma (primarily in cats) - large granular lymphocyte lymphoma (rare, severe, found in cats)

Answer 328

- can be grossly normal looking - nodules, masses, diffuse intestinal thickening, dilated sections of intestine that are not obstructed and/or focal constrictions are possible

Answer 329

- require demonstration of neoplastic cells; FNAs, imprints, squash cytology preparations - diagnosis tends to be relatively easy in the dog/cat

Answer 330

- poor quality endoscopic biopsy samples (eg. too superficial, having excessive artefact) are notorious for resulting in erroneous diagnosis of LPE instead of SCL - finding lymphocytes in organs where they should not be found (ie. liver) can allow diagnosis of SCL

Answer 331

- finding lymphocytes in other organs (liver) - immunohistochemistry (eg. staining for CD3 and CD79a) has been used to help distinguish SCL from LPE. - clonality testing with PCR appears necessary to accurately diagnose SCL in some cases

Answer 332

prednisolone and chlorambucil; generally good response

Answer 333

prognosis is poor with LL, but many cats with SCL will have a high quality of life for years.

Answer 334

- more common in dogs - intestinal thickening or focal circumferential mass lesions

Answer 335

- surgical excision; prognosis good is complete excision is possible but often Mets to regional LNs - post-op chemo does not appear to substantially affect survival time

Answer 336

usually from a distinct mass in the SI or stomach

Answer 337

- leiomyomas - leiomyosarcomas - stromal tumours - scirrhous adenocarcinomas

Answer 338

if surgical excision is curative - good, but Mets make prognosis poor - chemo can be palliative

Answer 339

- adenocarcinoma - rectal polyps

Answer 340

- epithelial dysplasia may be present in benign lesions causing a false-positive cytologic diagnosis of carcinoma

Answer 341

- complete surgical excision is curative; transanal pull-through rectal amputation is beneficial in selected cases - often late diagnosis with Mets to regional LNs and extensive local invasion - can palliative with radiotherapy

Answer 342

- complete excision via surgery (everting the rectal mucosa)

Answer 343

- reposition mucosa, place a purse-string suture for 1-3 days (large enough to allow defecation) - sometimes epidural anaethetic is required

Answer 344

- occurs when the pelvic diaphragm (ie. coccygeus and levator Ani muscles) weakens and the rectal canal deviates laterally

Answer 345

- older, small breed intact male dogs esp. Boston terriers, corgis, boxers, pekingeses - dyschezia, constipation, perineal swelling, urinary bladder herniation into this defect may cause a potentially fatal post renal uremia

Answer 346

impacted anal crypts and/or anal sacs have been hypothesized to become infected and rupture unto deep tissues - an immune-mediated mechanism is likely

Answer 347

rectal pythiosis

Answer 348

- immunsuppressive therapy; cyclosporine or topical tacrolimus +-/ ABs

Answer 349

- paraneoplastic hypercalcaemia causing hyporexia, weight loss, vomiting and polyuria-polydipsia is common - Mets to sublumbar LNs common and occurs early, further Mets are rare

Answer 350

- arise from modified sebaceous glands - perianal gland adenomas have testosterone receptors - male hormones appear to stimulate their growth; rare tumours but are usually large, infiltrative, ulcerated masses with high met potential

Answer 351

- pelvic canal obstruction caused by malaligned healing of old pelvic freactures - benign rectal strictures - dietary indiscretions (bones, hair, paper) - itiopathic megacolon - any perineal or perianal disease that causes pain/obstruction

Answer 352

biopsy specimen including the submucosa is required to confirm he lesion is benign and fibrous and not fungal/neoplastic

Answer 353

- balloon dilation - pred 1.1mg/kg/day PO after dilation to impede stricture reformation

Answer 354

- a feline disease - cause unknown; may involve behaviour or altered colonic neurotransmitters

Answer 355

- multiple warm water retention/cleansing enemas over 2-4 days - add fibre to a moist diet (metamucil/pumpkin pie filling) - osmotic laxatives +/- prokinetic drugs (Cisapride) If this therapy fails; can consider subtotal colectomy

Answer 356

- fair to guarded; many cats respond well to medical therapy if treated early

Answer 357

- GIT perforation/devitalisation caused by neoplasia, ulceration (NSAIDs, steroid induced), intussusception, foreign objects, dehiscence of suture lines - biliary tract leakage; GB rupture - pyometra

Answer 358

- perforation due to lymphosarcoma is an important cause - GIT perforation/devitalisation

Answer 359

finding a plasma glucose concentration that is >38mg/dL more than the peritoneal fluid conc. strongly suggest septic peritonitis

Answer 360

primary bacterial peritonitis (spontaneous); in which there is no identifiable source of infection - gram positive organisms tend to be more common

Answer 361

- iatrogenic (caused by abdominocentesis) - traumatic (eg. MVA trauma, splenic torsion, splenic hematoma) - coagulopathy (eg. ingestion of vit.K antagonist) - malignancy (eg. hemangiosarcoma, hepatocellular carcinoma)

Answer 362

- found in older dogs; esp. GSheps, Labs, Goldens - anemia, abdominal eff., periodic weakness or collapse from poor peripheral perfusion

Answer 363

poor; because tumours Mets early - chemo may be used as an adjuvant post-op

Answer 364

abdominal carcinomatosis involves widespread military peritoneal carcinomas that can originate from various sites - intestinal and pancreatic adenocarcinomas are common causes of carcinomatosis

Answer 365

- intracavitary chemo can be palliative but generally there is no effective treatment for the disorder and the prognosis is grim

Answer 366

- often causes bicavitary effusion - tumours may appear as fragile clots adhering to the peritoneal surface of various organs

Answer 367

- fluid cytology is rarely diagnostic because reactive mesothelial cells are notorious for mimicking malignancy - laparoscopy/laparotomy is typically required for a definitive diagnosis

Answer 368

pyogranulomatous (Macs and nondegenerate neutrophils) with a relatively low NCC (<10000/uL)