Gastric diseases Flashcards
(40 cards)
What is the pacemaker of the stomach?
The pacemaker of the stomach is the interstitial cells of Cajal (ICCs), located in the greater curvature of the stomach near the mid-region (gastric antrum).
These specialized cells generate slow waves, which regulate the rhythmic contractions of the stomach, aiding in digestion and gastric motility.
gastric acid is especially needed for the absorption of
the absorption of minerals such as calcium and iron require a low pH
gastric hypomotility is defined as
ingesta remaining in the stomach for 8 or more hours
Give low fat diet to aid digestion.
Main 4 signs of gastric disease:
- Vomiting
- Anorexia
- Weight loss
- Melena
Localization of vomiting. (3)
Stomach
Small intestine (can even be large intestine related)
Extragastrointestinal
Diet for cats with pancreatitis.
Cats need 10x more fats than dogs.
Cats with pancreatitis do NOT require a low fat diet like dogs with it do.
Hydrolyzed diets can be chosen for cats if needed.
Diagnosing gastric dz. (6)
- anamnesis/examination
- blood samples (most acute gastric dz do not yet change bloods but chronic can cause electrolyte changes or hypoglycemia in puppies, increased LAC in GDV)
- X-ray
- ultrasound
- endoscopy
- diagnostic laparotomy
All of the pictured cases had the same signs.
Vomiting due to metabolic disturbances can cause what biochemical changes? (5+)
Hemoconcentration vs anemia
Imbalance in electrolytes
Acid-base imbalances
✓ Metabolic alkalosis (can indicate obstruction of the stomach which causes acid sequestration in the gastric lumen)
✓ Metabolic acidosis (vomiting, + diarrhea causes bicarbonate loss)
Dehydration
Pre-renal azotemia
3 antiemetics
Maropitant
Ondansetron
Metoclopramide
Maropitant mechanism and dose.
- Neurokinin 1 (NK-1) receptor antagonist
- Inj 1 mg/kg/day
- PO 2 mg/kg/day (acute cases)
- Use lower doses for liver patients.
Ondansetron mechanism, dose and route.
- Not technically approved for vet use.
- 5-HT3-receptor antagonist
- 0.1 – 0.2 BID-QID IV
- Low bioavailability PO in dogs (less 10%)
- Can cause decreased intestinal motility?
Metoclopramide mechanism, dose and route.
- Antiemetic and also prokinetic
- Injectable approved for vet usage
- Dopamine receptor antagonist
- 0.5-1 mg/kg/day, divided in 2 or 3 doses IM IV or 1-2 mg/kg/24h constant rate infusion
Antacids and small animal gastroenterology.
Antacids have no true indications in small animal gastroenterology!
Sucralfate mechanism, dose and route.
- adheres to damaged gastric mucosa for hours
- may interfere with other PO medications
- 0.5 – 1 g/dog PO TID-QID
- Give 30-45 min before food
Name 2 prokinetics:
cisapride
metoclopramide
3 gastric acid blocker groups:
Histamine2 receptor antagonists
Proton pump inhibitors (PPI)
Prostaglandin analogues
Name 3 Histamine2 receptor antagonists.
- cimetidine
(5-10 mg/kg PO or IV for dogs) - famotidine
(1mg/kg q12h, gastric rebound hyperacidity if used for longer time) - ranitidine
(0.5 – 5 mg/kg q8-12 h, prokinetic effect?)
Name 4 Proton pump inhibitors (PPI) and indications for use (4).
ome-, esome-, lanso-, pantoprazole
- 1.25 mg/kg q12 h PO and IV
Are the most potent gastric acid inhibitors.
Indications: erosive esophagitis // gastric ulcers due to NSAIDs//mast cell tumours and gastrinoma.
- NB rebound gastric acid hypersecretion if given for a long time
- NB PPIs must be tapered down in dogs and cats after prolonged use (50% per week)
Name 1 Prostaglandin analogue used as a gastric acid blocker.
Effects of it?
- misoprostol (1-5 μg/kg PO q 8 h)
- increases gastric mucus & bicarbonate production
- prevents NSAID-induced gastric ulcers
- inhibits proton pump
Tx of acute gastritis. (3)
- fluid therapy (e.g. Ringers lactate, NOT NaCl as it’s not enough)
- modify diet, the GI tract needs nutrients (low fat, easily digested)
- gastroprotectants
- kaolin pectin 2-3x/day if diarrhea (give 1-2 h after food cause it coats the GI tract mucosa)
Possible causes of chronic gastritis. (5)
Do Histology!
- Idiopathic (diagnosis of exclusion; e.g. hypo diet that doesn’t see response)
- Lymphocytic plasmacytic eosinophilic gastritis
of which plain LP is “easiest”
- Granulomatous (worst one)
Other forms:
- atrophic (indicates very chronic, bad prognosis)
- hypertrophic gastritis (Basenji)
3 clinical signs of chronic gastritis.
- vomiting (bile/food/blood)
- anorexia
- weight loss
Tx the primary cause!
Tx of Idiopathic lymphocytic plasmacytic gastritis. (5)
- anthelminthics
- diet (low fat, hydrolyzed)
- prednisolone
- azathioprine (Fel chlorambucil is safer!)
- cisapride prokinetic
7+ causes of gastric ulcers/erosions:
- NSAIDs
- Corticosteroids
- Stress (sepsis, shock, neurological diseases)
- Paraneoplastic syndrome
- IBD
- Liver and kidney diseases
- Foreign body
- Others like severe uremia.
Complication: peritonitis !
Erosions are just smaller than full ulcers.
