GI 1 Flashcards
(47 cards)
4yo FS mixed breed, 2 year history of vomiting once a month, now every other week. good appeite, no weight loss. on dry kibble. what kinds of history questions do you want to ask?
age and breed, travel hx, any medications, recent illness, past treatments, other pets in the house, diet and treats, weight or appetite changes, what home remedies have been tried, ask about the presenting complaint specifically.
what is the most important part of the GI workup?
getting a good history
what is the difference between dietary indiscretion and dietary intolerance?
dietary indiscretion: recent and sudden diet change, usually acute, table scraps or free roaming behavior, ingestion of hair, low quality poor digestible diet
dietary intolerance: also called an allergy, inability to digest something, difficult digestion, usually chronic with no urgency markers
if a patient presents for dysphagia, the problem is likely where?
oral cavity, larynx, upper esophagus
what history questions are important to ask if a present presents with dysphagia?
trouble grabbing food, trouble chewing, difficulty or painful swallowing, immediate return of food bolus
difference between vomiting and regurgitation?
vomiting: active, will see nausea, GI material from stomach or proximal intestine
regurg: passive, no nasuea, GI material from esophagus, issue with swallowing or esophageal disease
how to tell small vs large bowel diarrhea?
small: large volumes, no tenesmus, melena, weight loss often
large: small volumes, tenesmus, mucus, fresh blood
often the only clinical signs cats will show is
hyporexia/anorexia
what diseases are you worried about if a cat is anorexic?
hepatic lipidosis, inflammatory bowel disease
how do you tell if something is acute or chronic?
acute: a few days
chronic: lasting more than 2-3 weeks
acute GI disease is sometimes _____
self limiting–>acute things may not need as aggressive diagnostics compared to chronic things
difference between primary and secondary GI disease?
primary: disease within the GI tract
secondary: disease outside the GI tract
true or false: many GI cases will not have a specific diagnosis
true! this is why theraputic trials are so helpful
list some differentials youd put on your list if the main problem with your patient was regurgitation
esophagitis, hiatal hernia, ring anomalies, neoplasia, foreign bodies, megaesophagus, GERD, MG
list some differentials for primary GI disease
gastroenteritis, dietary indiscretion, dietary intolerance, lymphangiectasia, helicobacter, infections, neoplasia, protein losing enteropathy, inflammatory bowel disease, foreign body, obstruction, allergy, ARD/SIBO
true or false: GI ulcers are not common in cats and dogs unless there is a predisposing factor
true
how do you decide whether to do a theraputic trial vs a diagnostic test?
you can consider a theraputic trial if there are no GI urgency markers
list the GI urgency markers
unstable patient (heart, brain, lungs, kidneys)
marked or rapid weight loss
concerning PE findings such as a painful abdomen
hypoproteinemia
adbominal effusion
hypovolemia, hypotension, hypoperfusion
anorexia if prolonged (more than 1-2 days)
non stop vomiting
which of the following is a GI urgency marker: chronic vomiting, chronic diarrhea, acute hematochezia
none!
if a patient has no GI urgency markers, how should you proceed?
do a theraputic trial, and if that doesn’t work, then consider diagnostics.
what are the 6 steps to a theraputic trial?
- check for GI urgency markers, if none, then can consider a theraputic trial
- eliminate simple things first: like a young dog with diarrhea, deworm them
- eliminate dietary factors: could do a diet trial
- treat symptoms: give cerenia, probiotics, etc
- ensure hydration
- if problems dont resolve or continute, do a diagnostic workup
briefly describe treatments for the following:
acute vomiting
acute diarrhea
chronic vomiting
chronic diarrhea
acute vomiting: NPO trial, GI diet, pre/pro biotics, antiemetic, deworm
acute diarrhea: probiotics, GI diet, deworm, antibiotic
chronic vomiting: elimination diet, deworm, pre/probiotics
chronic diarrhea: elimination diet, probiotics, fiber if large bowel, deworm, antibiotics
what is the difference between a GI diet and an elimination diet?
GI diet: usually for ACUTE conditions, highly digestible or low in fat, 100% digestion and absorption happens in proximal GI, usually eat it for 1 week and slowly transition the feed
elimination diet: aims to eliminate the offending dietary component (can be protein but not always), usually hydrolyzed diets or novel protein diets, make sure pet is only eating it and nothing else, takes 6-8 weeks to know if it works
what medication should you use for anti-parasitic treatment for a patient with GI disease?
fenbendazole
