Gastrointestinal emergencies

Question 1

Where can the problem occur?

Answer 1

Anywhere from oral cavity to anus

Question 2

What are the most common additional diagnostic tests we can perform?

Answer 2

Clinical pathology
Radiograps
ultrasound
endoscope
exploratory laparotomy

Question 3

What should you never forget to check?

Answer 3

String check

Question 4

Where can problemsoccur before even getting to the stomach?

Answer 4

Oral cavity and esophagus

Question 5

What can occur in young animals, that have foreign bodies/dietary indisecretions and infectious?

Answer 5

Predominate

Question 6

In older animals we see gastroenteral emergencies often secondary to _____ disease and _____

Answer 6

Organ disease and neoplasia

Question 7

What is the difference between vomitting and regurgitation?

Answer 7

Vomitting: active expulsion of the GI contents
forceful contraction of the abdomen and diaphragm

Regurgitation: No active expulsion of fluid or food
no nausea prior
typically an esophageal disorder

Question 8

What are the signs before vomiting occurs?

Answer 8

Nausea

Question 9

True or false: during regurgitation the food is digested

Answer 9

False
the food is undigested

Question 10

What does yellow mixed with green color mean?

Answer 10

Old and new bile,often seen with pancreatitis

Question 11

What does brown vomit mean?

Answer 11

Reflux of fecal material further down the gastrointestinal tract, or a dog that ingests feces

Question 12

What does frank blood in vomit often indicate?

Answer 12

Ulceration in esophagus,stomach or upper duodenum

Question 13

What does coffee ground type vomit indicate?

Answer 13

Digested hemoglobin

Question 14

What does white fluids vomit mean?

Answer 14

Gastric or esophageal in origin

Question 15

What does yellow and white vomit mean?

Answer 15

Gastric fluid mixed with bile from the duodenum

Question 16

What does green fluid vomit mean?

Answer 16

Presence of bile recently from the duodenum

Question 17

What do you tell the owner if they refuse to come in when there pet has been vomiting?

Answer 17

Remove the food for 12 hours and water for 3-4 hours
small amounts of water should be reintroduced first
than if improvement seen,offer 1-2 tablespoon of a bland diet

Question 18

When a patient has diarrhea, what can be the infectious causes?

Answer 18

Viral- Parvo or corona
Bacterial
fungal
parasitic
Rickettsial

Question 19

If the stool looks like rasberry jam
common in middle age canines
What could this dog have?

Answer 19

Hemorrhagic gastroenteritis

Question 20

If a dog has parvo what precautions do we need to take?

Answer 20

Isolation precautions

Question 21

What can gastrointestinal ulcers be secondary to? what meds can we give?

Answer 21

Secondary to neoplasia
NSAIDS and steroids

Question 22

What is an acute abdomen stabilizing the GI patient defined as?

Answer 22

Sudden onset of pain in the abdomen from a variety of gastrointestinal diseases

Question 23

What should you check on the patient?

Answer 23

Hydration status and compare weight to previous

Question 24

What do you watch for?

Answer 24

Perfusion abnormalities

Question 25

What does fluid therapy include? (Fluid type)

Answer 25

Balanced electrolyte solution ( LRS, normosol-R, plasma lyte)

Question 26

What diagnostic tests do you run? (Acute abdomen)

Answer 26

CBC, chem and consider radiographs/abdominal ultrasound

Question 27

What is the general treatment?

Answer 27

Treat the pain, but avoid NSAIDS in case of gastric ulceration Opioids are ideal but can slow down gut motiity enternal nutritions should be started ASAP, antiemetics may be prescribed Parenteral nutrition may be required - dextrose mixed with amino acids

Question 28

What are the common foreign bodies found in dogs?

Answer 28

stones, socks, underwear, toys, plastic wrap and bags, corn cobs, apple cores fruit pits

Question 29

what are the common foreign bodies found in cats?

Answer 29

jewelery ( shiny), coins needles, thread, toys

Question 30

Why should you always look under a cats tongue?

Answer 30

Look for thread wrapped around it

Question 31

What foreign bodies are often very serious and what can they lead to.

Answer 31

Linear foreign bodies can lacerate the intestine

Question 32

what can mimic a foreign body?

Answer 32

A tumor

Question 33

What is the diagnosis for a foreign body?

Answer 33

X-ray, abdominal palpation, history, abdominal ultrasound

Question 34

What can animals present when having a foreign body?

Answer 34

Shock

Question 35

What is the treatment for foreign bodies?

Answer 35

Hydration is critical, surgery is often needed

Question 36

Are young or older animals predisposed to Intussusception and what condition can it be due to?

Answer 36

Young animals parasitism

Question 37

How to diagnose Intussusception?

Answer 37

Contrast radiography or abdominal unltrasound

Question 38

What are the signs of a Gastric dilation volvulus?

Answer 38

-Retching -Repeated unsuccessful attempts to vomit -Rapidly progressing depression and weakness -abdominal distention -increased resp rate - pale oral MM

Question 39

When can GDV often occur?

Answer 39

-Occurs often after eating and drinking and then getting exercise

Question 40

Which size of dog breed is GDV more common in?

Answer 40

Large breed dogs, deep chested

Question 41

What is the treatment for GDV?

Answer 41

-Flow by oxygen -fluids -decompression of stomach, stomach tube or needle decompression -antibiotics - surgery

Question 42

What is the post op care for GDV?

Answer 42

-EKG, high risk of ventricular arrhythmias within first 12-24 hours - fluids -analgesia, opioids not NSAIDS - nutrition, glutamine needed to keep enterocytes healthy

Question 43

What are the preventions for GDV?

Answer 43

Feed small meals Avoid meals right after intense exercise Avoid raised food bowl Prophylactic tacking of the stomach during neuter or spay

Question 44

What is the cause for hemorrhagic gastroenteritis (HGE)?

Answer 44

Parvovirus, or idiopathic

Question 45

What is the presentation of HGE?

Answer 45

Bloody diarrhea and vomiting

Question 46

What is the diagnosis for HGE?

Answer 46

Parvo snap test CBC for anemia Chem- look at the proteins

Question 47

What is the treatment for HGE?

Answer 47

Supportive care: iv fluids, synthetic colloids Watch BP,HR and weigh the patient

Question 48

What is pancreatitis?

Answer 48

Pancreatitis is the activation of pancreatic enzymes that lead to auto digestion of the pancreas and para-pancreatic tissue

Question 49

What will pancreatitis trigger?

Answer 49

Trigger the inflammatory process through neutrophils activation and production of cytokines and free radicals

Question 50

What happens if we leave pancreatitis unchecked?

Answer 50

This will lead to systemic inflammatory response syndrome

Question 51

What is the history for pancreatitis?

Answer 51

Anorexia, abdominal pain and intermittent vomiting. Diarrhea may also be present

Question 52

How do we diagnose pancreatitis?

Answer 52

Abdominal ultrasound, pancreatic lipase test

Question 53

What is the treatment for pancreatitis?

Answer 53

Supportive fluids Pain management

Question 54

What is the diagnosis for peritonitis?

Answer 54

Finding bacteria in fluid from an abdominocentesis

Question 55

Infection may be introduced from an ____ penetrating wound or from ______ injury?

Answer 55

External and internal

Question 56

What is the treatment for peritonitis?

Answer 56

Supportive care and treating underlying condition Fluids resuscitation, antibiotic, analgesia Culture the fluid May require open abdominal drainage