Disease

Question 0

What is cricopharyngeal achalasia?

Answer 0

Congeital. Lack of coordination of contraction of pharynx with food bolus and relaxation of upper oesophageal sphincter at the cricopharyngeus msucle. With achalasia with cricopharyngeal muscle remains constricted. Myotomy of the cricopharyneal muscle may be effective in some patients. Injection of botulinum toxin may be effective.

Question 1

What is masticatory muscle myositis?

Answer 1

An autoimmune idiopathic condition of masticatory muscles.Dysphagia, difficulty in mastication, moth may be open, masticatory muscles swollen, antibody titer to 2M fiber. Treat with immunosuppression.

Question 2

What is pharyngeal dysphagia/dysfunction?

Answer 2

Secondary to neuropathy or myopathy of various causes including lesions of cranial nerves (IX and X), normal food bolus is not propelled by the pharynx caudal to the oesophagus. Etiologies: focal myasthenia gravis, botulism toxicity, lead poisoning, acquired neuropathies and myopathies. Oesophagram.

Question 3

What is congenital megaoesophagus?

Answer 3

Generalised oesophageal dilation, potentially aspiration pneumonia, mild to dramatic cranial esophageal dilation. Cisapride may ameliorate signs of concurrent gastroesophageal reflux. No definite treatment for megaoesophagus. Feed from platform.

Question 4

What is acquired Megaoesophagues

Answer 4

Usually due to underlying neuropathy/myopathy/junctionopathy, associated with MG, lead toxicity, tetanus, botulism, dermatomyositis, dysautonomia, hypoadrenocorticism.

Question 5

What is esophagitis?

Answer 5

Inflammation of the esophageal mcuosa. Can occur secondary to something ingested, such as FB, caustic agent or drug (doyxcycline) also may occur with disease causing reflux, such as hiatal hernia or during anaeesthesia. Treat by depressing acid production with a proton pump inhibitor. Cisapride and sucralfate. May lead to strictures.

Question 6

What is a hiatal hernia?

Answer 6

Congenital abnormality of diaphragm that allows prolapse of the cardiac region of the stomach through the diaphragm into the thoracic cavity leading to oesophageal reflux. Treat as Esophagitis or surgery if patient is young.

Question 7

What is dysautonomia?

Answer 7

Loss of autonomic nervous system function due to unknown etiology. Regurgitation, dysuria and bladder distension, mydriasis, lack of PLR, dry mucous membranes, weight loss, constipation, vomiting, anorexia. Treat with bethanecol for urinary signs and prokinetics for GI signs. Treat Aspiration pneumonia as needed.

Question 8

What is vascular ring anomaly?

Answer 8

Congenital defect, persistent right aortic arch, regurgiation, cranial esophageal dilation with normal caudal oesophagus with focal narrowing at heart base. Surgical resection of abnormal vessel.

Question 9

What is an esophageal foreign body?

Answer 9

Ingested object that becomes lodged in oesophagus. CAuses regurgitation, anorexia, perforation. May see on radiographs, or esophagoscopy, endoscopic removal of object. Endoscoppic removal of object. Thoracotomy with esophageal and anastomosis may be required.

Question 10

What is an esophageal stricture?

Answer 10

A fibrous band of tissue that causes mild to marked narrowing of esophagus. May be more than one. Secondary to anything that damages the oesophageal mucosa and is most frequently described due to reflux under anaesthesia, FB or medication.

Question 11

What is acute gastritis?

Answer 11

Acute inflammation of the gastric mucosa usually due to dietary indescretion or drug reaction. (contaminated food, foreign body, NSAIDS.) H2 antagonist or PPI , atiemeti.

Question 12

What is haemorrhagic gastroenteritis?

Answer 12

Marked inflammation of the gastric and intestinal mucosa results in profuse Hematemesis or hematcocheeza. Clostridium has been implicated but not proven to be associated. Hemocencontraction with normal total protein highly suggestive in a patient with acute hematemesis. Fluid resuscitation. Oncotic suport. Antibiotics.

Question 13

What is idiopathic inflammatory gastritis?

Answer 13

Chronic gastritis includes infiltration of the gastric mucosa with various types of inflammatory cells, lymphoplasmacytic, lymphocytic, granulomatous or eosinophilic without an obvious underlying cause for inflammation. May be responsive to hypoallergenic diet, usually hydrolyzed protein diet. mmunosuppressive doses of corticosteroid.

Question 14

What is a gastric foreign body

Answer 14

Ingestion of foreign object could either cause signs compatible with acute gastritis or gastric outflow obstruction. May be acute or chronic. May be ulceration or damage to gastric mucosa.

Question 15

What is gastric dilation volvulus?

Answer 15

A breed related and dependent upon body conformation. The stomach dilates excessively with gas and may twist on its axis. May also incur splenic torsion. Results in compromised vascular return and can lead to cardiac output, shock and death. Compromised vascular return and can lead to decreased cardiac output, shock and death. Additionally decreased blood supply to the stomach and or spleen may result in gastric wall necrosis and splenic infarction.

Question 16

What is gastroduodenal ulceration/erosioon?

Answer 16

When there is a breakdown in the normal gastroprotective mechanisms of the mucosal layer. The acid in the gastric lumen can damage the underlying mucosal layer causing erosions and ulcerations. One of the most common causes is NSAIDS, teroids, lymphoma, gastrinoma etc.

Question 17

What is helicobacter gastritis?

Answer 17

Helicobacter is a normal inhabitant. In certain patients however it triggers chronic gastritis that seems to respond to treatmeent for helicobacter. Combination therapy with metronidazole, amoxicillin and either bismuth salicylate or famotidine has been used sucessfully to ameliorate signs.

Question 18

What is parasitic gastritis?

Answer 18

Phslaloptera rara (dog) and Ollulanus tricuspis (cats) Signs: Chronic vomitin. May see worms in vomitus. Otherwise may see parasite during endoscopic examination. For physaloptera, pyrantel pamoate or ivermectin. for ollulanus, fenbendazole may work.

Question 19

What is pyloric stenosis?

Answer 19

The muscles of the pyloric sphincter become hypertrophied due to an unknown cause but potentially related to gastrin. Vomiting may be projectile. Hypcholermic metabolic alkalosis may occur secondary to loss in vomitis of hydrochloric acid. Surgical pyloroplasty.

Question 20

What is gastric antral mucosal hypertrophy?

Answer 20

Excessive mucosal thickening of the pylorus (versus submucosal/muscular thickening of pyloric hypertrophy). Underlying cause unknown. Signs consistent with gastric outflow obstruction. Surgical pyloroplasty and mucosal resection. Seen in small breed dogs.

Question 21

What is acute enteritis?

Answer 21

Acute inflammation of the intestinal mucosa, usually due to dietary indiscretion or drug reaction. Give a H2 antagonist or PPi, antiemetic such as maropitnt.

Question 22

What is dietary responsive diarrhoea?

Answer 22

Most likely related to a food related hypersensitivity causing inflammation in the intestinal mucosa. Strict feeding of hydrolyzed protein diet.

Question 23

What is antibiotic responsive diarrhoea?

Answer 23

Small intestinal bacterial overgrowth though diarrhoea may be responsive to antibiotics without a confirmed overgrowth. Derangement in the normal GI flora, favouring a more pro inflammatory population of bacteria. Tylosin or metronidazole.

Question 24

What is inflammatory bowel disease?

Answer 24

Idiopathic inflammation of the GI mucosa that may affect any segment of intestine. Genetics, gut microbiome and diet. Lymphocytic plasmacytic infiltration of the intestinal mucosa is most frequently described. Eosinophilic infiltration may be present. Severely affected patients may lose protein into the gut.

Question 25

What is intestinal lymphangiectasia?

Answer 25

Obstruction of the lymphatic system of the intestinal mucosa causes lacteal dilation and rupture with secondary inflammation. Proteins and fats leak into the intestinal submucosa and lumen and may lead to granuloma formation. typically panhypoproteinamic and hypocholesterolemic. Pick a dietary therapy appropriate for this and IBD.

Question 26

What is intestinal FB/obstruction?

Answer 26

Ileo-caecal junction, but any small segment may be affected. Distended or plicated loops of bowel may be present on abdominal palpation. Linear foreign bodies may appear as bunched, plicated bowel.

Question 27

What is intussussception?

Answer 27

One segment of bowel telescopes into an adjacent section resulting in intestinal obstruction. Can be intermittent or persistent. Ileocolic intussusceptions are most common. Seen as a complication of acute enteritis.

Question 28

What is parvovirus?

Answer 28

Canine parvovirus 1 is relatively non pathogenic, canine parvovirus 2 causes classic parvovirus. Feline parvovirus is caused by feline panleokopenia virus. Virus attacks crypt cells of intestinal villus causing villus atrophy and collapse. ELISA for CPV 2 in fees more sensitive if shedding.

Question 29

What is coronavirus?

Answer 29

Infects mature epithelial cells at the villus tip, so signs are less severe than with parvovirus. Typically milder than parvovirus enteritis, rarely causes haemorrhagic diarrhoea.

Question 30

What is campylobacter diarrhoea?

Answer 30

Campylobacter jejuni and upsaliensis can normally be found in intestinal tract but can also cause large bowel diarrhoea. Young animals under 6 mth also seen with raw food diet or immunosuppressive patients. May see comas or seagul shaped organisms on direct fecal smear. Erythromicin most efective. B lactams not effective.

Question 31

What is salmonellosis?

Answer 31

Salmonella typhimurium most commonly associated with disease. May be from other animals shedding or contaminated/undercooked food. Diarrhoea is usually small bowel, my be acute or chronic. Culture of salmonella from normal sterile areas would be definitive for salmonella septicaemia. Antibiotics should not be used unless patient is septicemic because it may prolong shedding.

Question 32

What is clostridial diarrhoea?

Answer 32

C perfringens and C. difficile most freq cause diarrhoea. May cause acute haemorrhagic diarrhoea or chronic small or large bowel diarrhoea. Tylosin or metronidazole usually effective.

Question 33

What is granulomatous colitis?

Answer 33

Also known as histiocytic ulcerative colitis. Caused by adherent and invasive E. coli which causes granuloamtous inflammation of the colonic mucosa. Fluoroquinolones Are the treatment of choice and usually result in improvement in clinical signs within days.

Question 34

What is giardiosis?

Answer 34

Ingestion of giardia cysts from infected animals/water. ELISA of feces for giardia proteins. Trophozoites may be visible on zinc sulfate floatation. Fenbendazole and albendazole also effective. Resistance and reinfection may occur so environmental decontamination should be performed.

Question 35

What is cryptosporidiosis?

Answer 35

Ingestino of cryptosporidium parvum oocysts which are from other infected animals but may be incontaminated water. PCR most sensitive test. Paromomycin has been used with success but associated with renal failure in cats and may not stop shedding.

Question 36

What is trichomoniasis?

Answer 36

Tritrichomonas foetus colonises surface of colonic mucosa. Seen in cats. Ronidazole is effective but can cause neurologic signs in some patients. Infections may be self limmiting. Cats can be chronic carriers and have recrudescence of disease in times of stress.

Question 37

What is coccidiosis?

Answer 37

Isospora sp are ingested and infective oocysts destroy epithelium. Infective oocysts destory epithelium. Oocysts may be detected via fecal floatation. Treat with sulfadimethoxine or trimethoprim.

Question 38

What are whipworms?

Answer 38

Trichulris vulpis is transmitted via fecal oral route. Large bowel diarrhoea, hypoproteinaemia, hyponatreamia and hyperkalaemia. Fenbendazole may also be used.

Question 39

What are roundworms?

Answer 39

Toxacara canis (dog) and cati (cat) and toxascaris leonina are infectious via fecal oral route. Small bowel diarrhoea, stunted growth, pyrantel is effective and safe in young patients. Repeated 2,4,6,8,12 and 16 weeks of age. Treat pregnant bitches at day 40.

Question 40

What are hookworms?

Answer 40

Ancylostoma caninum is transmited via fecal oral route. Treat with pyrantel and fenbendazole. Moxidectin treatment of bitches at day 55 reduces transcolostral infection.

Question 41

What are tapeworms?

Answer 41

Dipylidium caninum most common, but taenia spp also seen in wildlife. Fleas and lice intermediate host. Praziquantel and other anthelmintics are effective.

Question 42

What is short bowel syndrome?

Answer 42

Occurs with surgical resectio of small intestine. The remaining small intestine is unable to absorb adequate nutrition from a normal diet and may develop small intestinal bacterial overgrowht. Signs are most severe after resection, but with time the remaining small bowel may be able to compensate and clinical signs may decrease with time. Dietary modification of highly digestible, low fat diet.

Question 43

What is megacolon?

Answer 43

Idiopathic, constipation and obstipation. Treat with lactulose enemas along with oral lactulose. Manual de opstipation which requires general anaesthesia.May require subtotal colectomy.

Question 44

What is a perineal h ernia?

Answer 44

Upon weakening of the coccygeus and levator ani muscles, the rectum and occasionally other organs are pushed externally through the pelvic canal. Dyzchezia and tenesmus which may precede the hernia. Constipation and perineal swelling may also b seen.

Question 45

What is perineal fistula?

Answer 45

Cause likely imune mediated and a subset of inflammatory bowel disease. Classically GSD. Draining tracts around anus may be seen. Diagnosis via physical examination. Hypoallergenic hydrolyzed diets often beneficial. Affected dogs often also need immunosuppression.