L7: Diseases of the Canine and Feline Stomach Flashcards
(26 cards)
slide 3**
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acute gastritis mech.
-mucosal damage –> inc. permeability –> acid diffuses back into mucosa to cause gastritis –> ep. cells may necrose and cause erosions (hematemesis)
CS of acute gastritis
vomit lethargy depression polydipsia (usually w/o polyuria) hematemesis cranial abd. pain
differential diagnosis of acute gastritis
gastric FB - obstruction
acute pancreatitis
infectious dz
systemic dz
Dx of acute gastritis
- Hx and PE
- abd rads and biochemical tests excludes other diseases
- response to therapy
Tx of acute gastritis
- rest the GIT
- supportive care
- feed a “bland” diet
Q: what is the most effective for acute self limiting vomiting?**
brief fasting
other acute diseases
FB
Gastric Dilatation-Volvulus (surgical)
causes of chronic gastritis
- inflammatory (idiopathic): lymphoplasmacytic or eosinophilic
- food responsive disease
- reflux
- helicobacter?
chronic (LP) lymphocytic plasmacytic gastritis
- mainly idiopathic
- may be assoc. with food responsive disease
- CS: vomiting, hematemesis (vomit blood), appetite change (usually dec.), weight loss
- Dx of exclusion or biopsy
Tx of chronic (LP) lymphocytic plasmacytic gastritis
diet trial (hypoallergenic, novel protein)
acid reducers (omeprazole)
cisapride/metoclopramide
immunomodulation in moderate to severe disease (pred, azathioprine, chlorambucil
eosinophilic gastritis
-cause unknown
-eosinophils infiltrate mucosa
+/- peripheral eosinophilia
+/- ulcerated mucosa
-tx: dietary manipulation and/or corticosteroids, deworm, sucralfate
-Rottweilers predisposed
Helicobacter gastritis
-causes lymphoid hyperplasia
+/- chronic vomiting
-dx with Warthin-Starry stain on biopsy
(Helicobacter can be part of normal flora)
-not assoc. with ulceration in dogs/cats
-dx of exclusion
-tx controversial: amoxicillin, clarithromycin, metronidazole??
Q: why is helicobacter so significant in people?
A: gastric carcinoma
Reflux Gastritis (Bilous vomiting syndrome)
- defect in pyloric function or a gastric motility defect allows prolonged contact of bile w/ the mucosa (bile is a detergent which damages cells)
- CS: chronic vomiting of bile-stained material after prolonged fast, most often in early morning, vomitus contains bile-stained mucus and occasionally fresh blood
Tx of Reflux Gastritis
- increased feeding frequency
- cisapride or metoclopramide
- H2 receptor antagonists (cimetidine, ranitidine, famotidine)
- Proton pump inhibitor (omeprazole)
gastric ulcers mech. and CS
- circumscribed breaks in mucosa bathed by acid-pepsin –> mucosal barrier disrupted
- causes: ulcerogenic drugs, liver disease, tumors, protein-calorie malnutrition, +/- uremia or stress
- CS: vomiting +/- blood, depression, inappetance or anorexia, melena, anemia (usually Fe def. anemia)
Dx and Tx of gastric ulcers
Dx: contrast rads or endoscopy and biopsy
Tx: eliminate underlying cause, PPI’s, sucralate, H2 blockers, blood transfusion, endoscopy, surgery, (mostly supportive therapy to increase pH)
gastric outlet obstruction
causes: GDV, FB, congenital stenosis, acquired stenosis
CS: intermittent vomiting (maybe projectile, with increasing frequency), HypoCl, hypoK, metabolic alkalosis
-Dx: contrast rads, U/S, endoscopy, surgery
-Tx: surgery
Congenital stenosis: clinical presentation
Boxers, Bulldogs, Boston Terriers, cats
-signs usually start at weaning
Acquired stenosis: clinical presentation
- older, mostly male smaller breeds
- Lhaso Apso, Pekingese, Shih Tzu
gastric tumors
- uncommon
- char. by chronic vomiting, inappetance or anorexia, loss of body weight and condition, +/- sudden anorexia
- anemia, diarrhea, hematemesis
- most found in distal stomach of older male dogs
- dx: imaging, endoscopy
most common gastric tumor of dog
adenocarcinoma
most common gastric tumor of cats
lymphoma
