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Small animal > GIT > Flashcards

GIT Flashcards

1
Q

name 3 anti-emetics
which is also a pro-kinetic

A

Maropitant, metoclopramide, ondansetron
metacloprimide

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2
Q

name 3 gastroprotectants
which can’t be used in pregnant animals

A

Omeprazole, misoprostol*, sucralfate

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3
Q

how to further investigation each of the possible trigger zones for vomiting

A

Vomiting centre: neurological disease; neuro exam

Vestibular apparatus: vestibular disease; clinical and neuro exam

Chemoreceptor trigger zone: blood derangements; toxin history, bloodwork

Peripheral receptors: inflammation/distension; clinical exam, imaging

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4
Q

treatment for helicobacter

A

Triple therapy:
Amoxiclav, Metronidazole and a PPI (like Omeprazole)

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5
Q

signs of gastric carcinoma

A

Chronic vomiting
Haematemesis
Weight loss
Poor gastric layering on US (also reduced motility and enlarged LNs)

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6
Q

signs of gastric lymphoma

A

Chronic vomiting
Haematemesis
Weight loss

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7
Q

broad categories of chronic gastric vomiting

A
  • Inflammatory (chronic gastritis): From diet, idiopathic, infectious (Helicobacter)
  • Neoplastic (lymphoma, carcinoma, polyps)
  • Metabolic (billous vomiting, gastric ulceration, secondary gastroparesis)
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8
Q

broad categories of acute intestinal vomiting

A

Obstruction: Foreign Body, Intussusception
Toxin: Dietary indiscretion or Drugs (NSAIDs, steroids, antibiotics, chemotherapy)
Inflammatory: (Acute enteritis)
o Dietary indiscretion
o Idiopathic (Lymphocytic Plasmacytic/Eosinophilic)
o Infectious

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9
Q

signs of pancreatitis

A
  • Lethargy/weakness
  • Anorexia – suspect pancreatitis in any cat not eating normally
  • Vomiting
  • Diarrhoea
  • Abdominal pain
  • Ascites
  • Dehydration
  • Fever
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10
Q

dx of pancreatitis

A

cTLI and fTLI (trypsin like immunoreactivity): Increase rapidly in early stages of pancreatitis but decline quickly (low in chronic)

pancreatic lipase (cPL and fPL) = high

Amylase, lipase: Non-specific but high

US: Enlarged pancreas, peritoneal effusion, necrosis, fibrosis, duct dilation

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11
Q

diet for pancreatitis

A

high carb
low fat
enzyme supplements

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12
Q

signs and tx of megaoesophagus

A

regurgitation soon after eating
feed from height. Guarded prognosis.

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13
Q

what is hiatal hernia

A

BOAS breeds, like French Bulldogs.
Oesophagus and diaphragm are poorly attached = when breathing the diaphragm slides up = cranial stomach herniates into chest = Gastro-oesophageal reflux.
- See regurgitation, worse when excited

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14
Q

what is PPDH

A

Pericardio-peritoneal diaphragmatic hernia
A midline defect at birth, which allows abdominal contents to herniate into the pericardial sac!

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15
Q

name 3 causes of diarrhoea due to failure in digestion and absorption

A
  • EPI: inadequate secretion of pancreatic enzymes  maldigestion and steatorrhoea (fatty poop)
  • Biliary disease (choleliths (gall stones), cholestatic liver disease, extrahepatic biliary obstruction): failure of emulsification by lipase = maldigestion
  • Intestinal mucosal abnormalities (inflammation, viral/bacterial infection, neoplastic infiltration) = Malabsorption and maldigestion

all lead to osmotic diarrhoea

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16
Q

large v small intestinal diarrhoea

A

Small:
* Weight loss common (RARE)
* Watery/bulky faeces (VARIES)
* Increased volume (NORMAL/DECREASED)
* Defecate 1-3 times a day (OVER 6)
* No tenesmus (TENESMUS)
* No mucus (MUCUS)
* Melena (FRESH BLOOD)

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17
Q

Name an anti-motility drug
bulking agent
synbiotic

A

Opioids like Loperamide
Peridale granules
Pro-kolin

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18
Q

name some common infectious causes of diarrhoea

A

o Viral: Parvovirus, coronavirus, adenovirus, rotavirus, FeLV (from lymphoma)
o Bacterial: salmonella, campylobacter, E.coli, Clostridia (C.Perfringens, C.difficile),
o Parasitic: Helminths, Protazoa (Giardia, Tritrichomonas)

19
Q

signs of a parvovirus infection

A

infects rapidly driving cells (crypts, BM, lymphoid)
vomiting, fetid haemorrhagic diarrhoea, dehydration, Panleukopenia, anorexia, loss of mucosal barrier (septicaemia)

20
Q

dx of parvovirus

A
  • Diagnosis - faecal Ag SNAP test or PCR
  • Bloods: Panleukopenia,
21
Q

tx of clostridia

A

diarrhoea from enterotoxins
metronidazole

22
Q

tx of campylobacter

A

4-fluoroquinolones

23
Q

tx for giardia

A

snap test available
tx; fenbendazole

24
Q

what is FRE and ARE

A

food response enteropathy
- conduct food trial

antibiotic responsive / dysbiosis
- bacterial overgrowth common in many conditions
- responded to antibiotics
- treat primary cause

25
Q

what is SRE

A

Steroid responsive enteropathy
- characterised by cellular infiltrate in mucosal layer on a biopsy
- due to loss of GALT tolerance = uncontrolled inflammation

lymphocytic plasmocytic most common
then eosinophilic

Tx: Prednisalone +/- metronidazole, coalbamin supplements
low protein diet, highly digestible

26
Q

lymphangiectasia (PLE) patho
dx tx

A

like lymphangiectasia
villus lymphatics dilate due to inflammation = lymph leaks into GIT = lipid malabsorption and diarrhoea

low albumin and globulins
white spots on villus

If lymphangiectasia is primary - low fat diet, IVFT, albumin/colloids

27
Q

what is feline triaditis

A

CE/IBD + Pancreatitis + Cholangiohepatitis

28
Q

signs of dehydration

A

tacky MM, sunken eyes, skin tent

29
Q

signs of hypovolaemia and sepsis

A

H: Pale MM, increased CRT, weak pulses, tachyP, tachyC, cold extremities

S: Red MM, decreased CRT, poor pulses, tachyP, tachyC, pyrexia

30
Q

key things to test in hypovolaemic patients

A

BP and lactate = indicator of perfusion

31
Q

how to differentiate sepsis V hypovolaemia

A

give 3x fluid boluses every 15 minutes
should see increased perfusion…
… if not, dog is septic

32
Q

sepsis treatment

A

Dobutamine vasodilator
Plasma transfusion

33
Q

how to calculate fluid needed

A

deficit % X body weight (over 24 hour period)
+
maintenance (2ml/kg/hour)
+
ongoing losses

34
Q

steps to deal with toxin exposure

eaten
skin
already metabolised

A

Eaten
* Induce emesis : Apomorphine
* Gastric decontamination: Stomach lavage + Activated charcoal adsorbent

Skin exposure
* Wash skin with water
* Lipid based soap for lipid based contaminants

If metabolised
* Dilute with IVFT. (Lipid infusion for lipid soluble compounds)

35
Q

treatment approach depending on what area of the body is effected

(Neuro, heatpci, AKI, CAR, GIT, haematological)

A
  • Neuro: Seizure control - diazepam, Levetiracetam, phenobarbital, propofol
  • Hepatic: Supportive nature. SAMe, USD acids, Silybin
  • AKI: IVFT +/- diuretics, dialysis

CAR: Anti-arrythmics (lidocaine, amiodarone), beta-blockers,
Blood pressure management (IVFT, vasopressor, anti-hypertensives)

  • GIT- Anti-emetic if irretractable vomiting
    Diarrhoea = IVFT, diet

Haematological
- Clotting: Give vitamin K1 and plasma
- Anaemia: Give packed RBC or whole blood

36
Q

specific treatments:
NSAIDs
Aspirin
Paracetamol
Warfarine

A

NSAIDs Tx: Prostaglandin analogue: Misoprostol

Aspirin: same as above but also inhibits Thromboxane so may see thrombocytopenia so need blood transfusion

Paracetamol: N-acetyl cysteine, liver and AKI support
BROWN MM

Warfarin: Vitamin K and fresh frozen plasma

37
Q

signs of paracetamol and chocolate and pyrethroids

A

P CS: Brown mm, jaundice, abdominal pain, vomiting, signs of hypoxia

C CS: Hyperactivity, D/V, tachy dysrhythmias, seizures, coma

P CS: acts on neurones (tremors, ataxia), hypersalivation, vomiting

38
Q

what causes slug poisining thing

A

Metaldehyde
shake and bake - tremors and high temperature

39
Q

What lateral mesenteric structures can be used to visualise dorsal structures in laparotomies

A

Pull duodenum from right to left
Pull ascending colon from left to right

allows visualisation of kidneys and ovaries

40
Q

what side do PEG tubes come out of

A

left side = where greater curvature of stomach is

41
Q

where to make incision fro gastrotomy

A

Gastric body
separates into seromuscular and submucosal mucosal (can do as inverting suture pattern)

42
Q

what Side fo make incision during intestinal surgery

A

anti-mesenteric border
try avoid Peyers Patches

43
Q

Enterotmy for FB removal process

A

orthogonal x-rays to localise
- proximal to obsutrciton = distended
- distal = empty
- incites through unaffected bowl and milk proximal material
close- single layer, drape ometilise and non-cutting needle

44
Q

feline idiopathic megacolon

A

CS: recurrent constipation, hypomotility
causes; often idiopathic but can be spinal/sacral deformity
Tx: lactulose laxatives, soapy enemas, high fibre

surgery; subtotal colonectomy. antibiotics before, no enema before. Slow to heal and risk of breakdown. Try maintain illeal-caecal junction

Small animal (11 decks)

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