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GI Emergencies Flashcards

(60 cards)

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1
Q

Medullary Vomiting Center

Input from

A
  • Chemoreceport trigger zone
  • Higher CNS centers
  • Vestibular System
  • Peripheral sensory receptors

Knowing which of these caused vomiting allows for appropriate treatment

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2
Q

Regurgitation

A
  • Not the same as vomiting
  • Indicates esophageal disorder
  • No nausea after
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3
Q

Regurgitation

Occurance

A

Occurs right after eating or drinking

Food undigested

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4
Q

Projectile Vomiting

Associations / Obstructions

A
  • Pyloric outflow obstuction
  • Significant proximal intestinal obstruction
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5
Q

Projectile Vomiting

causes

A
  • Pyloric thickening
  • Mass compressing pylorus
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6
Q

Assessment Questions

Vomiting

Color / Blood Present

A

Blood means erosion or ulceration in gut has not healed

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7
Q

Assessment Questions

Vomiting

Consistency

A
  • Fluid/Foamy/Thick
  • Thick implies ongoing dehydration
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8
Q

Hematochezia

A
  • Frank Blood
  • If significant, get characteristics

Watery, clotted, mixed with feces

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9
Q

Melena

A

Blood digested feces

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10
Q

Diarrhea and Puppies

Concern with Food Restrictions

A

Caution to withhold food for those under 6 months or for very small breeds

Can suffer hypoglycemia

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11
Q

Physical Exam

5 Vitals

A
  1. Temperature
  2. Pulse
  3. Respiration
  4. Blood Pressure
  5. Pain Score
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12
Q

5 Vitals

Blood Pressure

Doppler

A
  • Preferred
  • Allows flow / perfusion and BP to be assessed
  • Detects arrhythmias
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13
Q

5 Vitals

Blood Pressure

Oscillometric

A
  • Be sure accurate pulses detected
  • Correct cuff size used
  • Poor indicator of blood volume

only 10% of blood in arteries

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14
Q

Venous Volume

How to assess

A
  • 70% of blood in veins
  • Do if concerned for hypovolemia
  • Hold off jugular vein - if unable to palpate, highly likely they are hypovolemic
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15
Q

Abdomen Assessment

A

Auscultate before palpate
* palpate diminishes gut sounds

Look for distended superficial veins
* Veins indicate increased pressure

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16
Q

GDV

A

Gastric Dilation and Volvulus
* Unknown cause
* Suspect accumulation of gas in stomach causes distention and concurrent twisting
* Associated with many clinical diseases

Also known as bloat

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17
Q

GDV Patients

A
  • Typically seen in large, deep-chested dogs
  • Can occue in any size dog at any age
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18
Q

GDV

Signs

A
  • Retching
  • Vomiting: non-productive or only foam/phlegm
  • Restlessness
  • Abdominal distension
  • Recent feeding with new diet or change in schedule
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19
Q

GDV

Prep Supplies

A
  • IV catheter and fluids
  • Oxygen
  • Radiology
  • Stomach tubes / bucket
  • Surgery
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20
Q

GDV

Monitoring

A
  • Vital signs: especially HR, rhythm and pulse
  • Abdominal distension
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21
Q

GDV

Type of Shock

A

Obstructive Shock
* The stomach takes up room and compresses the vena cava, obstructing blood flow back to heart

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22
Q

GDV

Diagnosis / Presentation

A
  • General GDV signs
  • Often present in shock
  • Standing/spreading limbs
  • Hypersalivation
  • Tachycardia
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23
Q

GDV

Radiograph

A

Presents as an “inverted C” in the stomach region

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24
Q

GDV

Treatment

A
  • Large-bore IV catheter for fluid therapy
  • Analgesia
  • Trocharization of stomach*
  • Surgery

*releasing gas from the stomach

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25
GDV Surgery | Step 2
Make sure the stomach wall looks healthy, nice and pink * not black and bruised * can become necrotic due to stretched out capillaries as stomach distends
26
GDV Surgery | Step 1
Untwist the stomach
27
GDV | Post-op Monitoring
Essential to monitor EKG * VPC may occur up to 24 hours after surgery
28
VPC
Ventricular Premature Contraction * abnormal heart rhythm
29
Parvo
* Acute viral gastroenteritis * Life-threatening * Require isolation protocol for treatment
30
Parvo | Symptoms
* Vomiting or Diarrhea* * Fever * Dehydration * Abdominal discomfort / pain * Shock or Hypovolemia * Increased CRT * Pale MM * Tachycardia * Weak Pulse | *Often seen with blood
31
Parvo | What does it do to the GI tract
* Rapidly attacks dividing cells* * Causes lining of intestines to die and slough off * May cause patient to become septic - toxins enter blood stream from damaged GI mucosa | * intestines lining made of very rapidly dividing cells
32
Parvo | Patients
* Typically seen in young unvaccinated puppies * Can be seen in unvaccinated adult dogs
33
Parvo | Lifespan in Environment
Can last in the environment for 6 months * disinfectant should stay on surface for 10-15 minutes to kill virus
34
Parvo | Question for Owners
* Ask if animal has gotten into garbage, toxins or foreign bodies * Also good to ask about vaccine status
35
Parvo | Expected Lab Results
* CBC: decreased WBC * PCV / TP: increased (due to dehydration) * BG: hypoglycemia
36
Parvo | Preparations
* IV catheters and fluid* * Purple top tubes: CBC, PCV, TP, blood glucose * Parvo test * Fecal * Radiology * Antibiotics, Antiemetics, Analgesics | *colloids better
37
Parvo | Feeding
Use of a Nasogastric Tube * trickle feed a liquid diet - small amounts * can also use to aspirate stomach bile
38
Parvo | Monitors
* Mentation and Vitals * PCV, TP, Blood Glucose * Urination * Vomiting / Diarrhea
39
Pancreas | Exocrine
Produces enzymes for digestion 1. amylase 2. lipase 3. trypsin
40
Pancreas Testing
Cpli and Fpli * canine and feline pancreatic lipase
41
Trypsin
Breaks down/digests protein
42
Lipase
Breaks down/digests fats
43
Amylase
Breaks down/digests carbohydrates
44
Pancreas | Endocrine
Produces insulin
45
Pancreatitis
* Usually associated with vomiting and acute abdominal pain * May lead to shock and death * Often occurs is middle-aged overweight dogs
46
Pancreatitis | Serum
In regards to dogs showing signs of vomiting and anorexia for 8+ hours * serum will be lipemic (fatty/pink or white)
47
Pancreatitis Testing | CBC and Chemistry
* May see some elevated WBC due to inflammation * But otherwise normal
48
Pancreatitis | Phone Screening
* Vomiting * Lethargy * Recent meal of fatty or spicy foods
49
Pancreatitis | Signs
* Vomiting / Lethargy * Fever * Dehydration * Severe abdominal pain * Variable degrees of depression * Variable degrees of shock
50
Pancreatitis | Lab Results
* CBC: elevated, immature neutrophils * Elevated pancreatic enzymes: Amylase and Lipase * CPL: elevated or abnormal
51
AHDS
Acute Hemorrhagic Diarrhea Syndrome * formally HGE * Acute onset of vomiting / diarrhea often with blood * Seen in young adult, smaller breed dogs ## Footnote *Hemorrhagic Gastroenteritis
52
AHDS | Symptoms / Presentation
* Depression * Dehydration * Absence of abdominal pain * Hypovolemic shock may develop
53
AHDS | Lab Results
* PCV: highly elevated * Blood glucose: low * Altered coagulation parameters * Stress leukogram
54
AHDS | Other Diagnosis
* Parvo * Intestinal parasite * GI ulceration from meds * Lead poisonings * Salmonella
55
Diaper Rash Cream
Be aware of use if patient is able to ingest it * contains zinc
56
Monitoring Fluid Therapy | Weight
With puppies and kittens, take a weight every 6 hours * kidneys not fully working, easy to overload
57
Urine Specific Gravity | While on IV fluids
* Want around 1020-1030 * Dehydration will cause it to be high * If below 1020, back off of fluids
58
PCV / TP | With Dehydration
Both will become elevated
59
PCV | Normal Ranges
* Puppies = mid thirties * Adult Dogs = mid forties * Adult Cats = mid forties
60
Panleukopenia
* Caused by parvo virus * Similar to K9 parvo, but vomiting is more common than diarrhea * Very contagious * Treat aggressively * Less likely to survive than parvo puppies | For cats

Emergencies (8 decks)

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