Revision questions for gastrointestinal disease

Question 1

Give an example of one functional disorder that might cause dysphagia and one morphological disorder that might cause dysphagia

Answer 1

Functional – neuromuscular disorder

Morphological – infection, obstruction, tumour

Question 2

Briefly explain the difference between vomiting and regurgitation

Answer 2

Vomiting is an active process involving the abdominal muscles and there is forceful explusion of stomach (and sometimes duodenal) contents that is partially/completely digested

Regurgitation is a passive process commonly associated with oesophageal disease where there is return of undigested food from the oesophagus

Question 3

List the clinical signs that may occur in a patient with Megaoesophagus

Answer 3

Regurgitation of undigested food immediately after or a few hours after eating

Weight loss

May lead to aspiration pneumonia which can cause respiratory signs such as cough or dyspnoea

(food in nasal passages may be present)

Question 4

What is the aetiology of Megaoesophagus?

Answer 4

Idiopathic is the most common

Congenital/hereditary idiopathic type observed in some breeds such as Irish setter, Great Dane, GSD, Lab, Shar Pei

May also be secondary to trauma, hypoT4, lupus, addisons, FB, or PRAA, myasthenia gravis

Question 5

Explain why a radiograph to diagnose MO should ideally be obtained in a patient that has not had sedation or anaesthesia

Answer 5

Sedation or GA will cause air to accumulate in the oesophagus leading to artefact on the radiograph

Question 6

List 3 primary causes of vomiting

Answer 6

Dietary indiscretion
Infectious disease
Inflammation
GDV
Foreign body
Pyloric stenosis
Tumour
Poisoning
Intussusception
Endoparasites

Question 7

List 3 systemic causes of vomitingHepatic failure

Answer 7

Renal failure
Severe infection e.g. Pyometra
Diabetes Mellitus
Pancreatitis
Drug reaction
Motion sickness

Question 8

Describe the clinical signs of gastric dilatation and volvulus

Answer 8

Restlessness and retching often after eating or exercise
Anterior abdominal swelling
Dyspnoea
Collapse
Shock
Death

Question 9

Describe the aetiology of megacolon

Answer 9

May be congenital or more commonly acquired
May be idiopathic or secondary to other disease such as spinal disease, pelvic fracture, dehydration
More common in cats

Question 10

Briefly explain the pathophysiology of pancreatitis

Answer 10

Pancreatic enzymes are activated prematurely within the pancreas or are unable to exit into the duodenum
The presence of these enzymes within pancreatic tissue results in autodigestion of the pancreatic tissue
This process causes inflammation and necrosis of the pancreas
This can lead to toxaemia an shock

Question 11

Describe how a case of acute pancreatitis might be diagnosed

Answer 11

Blood test – spec cPancreatic Lipase (dogs) or fPL(cats) if elevated would support diagnosis
Ultrasound imaging of pancrease to evaluate pancreatic architecture
Radiography of abdomen – non specific changes
Amylase , lipase, TLI are not specific enough to be diagnostic and can get false negatives and positives
Biopsy of tissue

Question 12

Name 2 breeds that are predisposed to exocrine pancreatic insufficiency

Answer 12

GSD, rough collie

Question 13

Describe the clinical signs typically seen in a dog with EPI

Answer 13

Polyphagia, wt loss, poor coat condition, flatulence, increased faecal volume, steatorrhea,

Question 14

Describe the techniques that might be used to diagnose liver disease in a patient

Answer 14

Blood biochemistry - liver profile (e.g. ALT, ALP), serum proteins
Radiography
Ultrasonography
Liver biopsy