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Flashcards in SA GI (MR) Deck (200):
1

GI Functions?

Digestion
Absorption
Excretion
Water balance
Electrolyte and acid/base balance

2

Where does water absorption in the gut happen?

Small Intestine

3

What does LI do?

Form up feces Remove the rest of the water

4

TQ!!! Where is watery dxa from?

Small Intestine

5

What occurs in the GI?

Mechanical and Chemical Digestion Digestion& absorption – (•Carbs •Protein •Lipids •Vitamins) Fluid Balance Motility

6

Fluid Balance in GI: In healthy intestine how much of presented fluid does Jejumun absorb? Ileum? Colon?

• J-absorbs 50% • I- absorbs 75% of remaining half • C-absorbs 90% of remaining after ileum

7

Motility is what type of motion?

•Slow wave motion

8

TQ!!! What is the motion of the GI Controlled by? •Controlled by ANS + ENS, hormones

•Controlled by ANS + ENS, hormones

9

What are Segmental contractions?

Mixing not moving along

10

IF you give a promotility agent will you get dxa or constipation?

Constipation

11

With Reduced activity regarding Segmental contractions what will you see cx?

Dxa

12

What do Parastaltic contrations do?

Propel

13

With Reduced activity regarding Segmental contractions what will you see cx?

• Ileus

14

Fasted state is usually in what phase?

Quiescent Phase

15

What is Minor contractile activity? What phase?

•MMC migrating motor complexes – housekeeping Fasted

16

Dysphagia CX?

Abnormal Swallowing Halitosis Ptyalism Gagging and multiple swallowing attempts Abnormal prehension Weight loss Painful mouth Coughing – aspirating Hematemesis - vomit blood

17

What parts does it take to swallow?

Mouth tongue pharynx larynx UES Esophagus

18

Dysphagia Rule Outs?

Foreign bodies Ulceration Inflammation/Infection Uremia Feline Stomatits Glossitis Calicivirus, etc. Dental disease Fractures Sialoadenitis - inflamed salivary glands (Spiro Circa Lupi) Neuromuscular Dz Masses

19

Additional Dysphagia Ruleouts for Cat?

Eosinophilic granuloma Lymphocyitc/Plasmacytic gingivitis/pharyngitis

20

If you have a cat with oral ulcers, nasal, and ocular discharge is it most likely herpes or calici?

Calici like the mouth too

21

IF you have a cat with nasal and ocular discharge is is most likely herpes or calici?

Eye & nose = Herpes

22

What neuromuscular dzs can cause dysphagia?

Masticatory muscle myositis (MMM) Oropharyngeal dysphagia Cricopharyngeal achalasia and asynchrony Tetanus/Botulistm/Rabies - neuromuscular transmission Neurological dysfunction

23

What are the phases of Oropharyngeal dysphagia?

Oral phase Pharyngeal phase Cricopharyngeal phase

24

Paresis or paralysis of which Nerves can cause dysphagia? -

5 7 9 10 12

25

What types of Masses cause dysphagia?

Abscesss Neoplasia

26

What types of Neoplastic masses cause dysphagia?

Squamos Cell Carcinoma - Bad (Cats mostly) Malignant Melanoma – Bad FSA OSA Epulis (AA) Acanthomatous Amaloblastoma Plasmacytomas - usually benign

27

How should an animal be examined with mouth pain?

Complete PE - Pyrexia (can be systemic) Complete oral exam - specially teeth, under the tongue Palpate face and neck - Masses, FB, pain, SC emphysema Complete neurological exam Auscultation Thoracic Neck Observe animal eating if necessary

28

Do Blood work if? (2)

PE and CS indicate systemic involvement anesthesia is needed

29

Specific testing on cats?

FeLV/FIV MMM - 2M antibody titer

30

What is MMM?

Autoimmune disease against the masticatory muscles in cats.

31

Imaging Radiographs

Thorax Soft tissue neck - only need 1 view bc of spine +/- dental - close lil ones +/- skull - not the same of dental, may not be close enough

32

What is more appropriate for skull?

CT/MRI

33

Which is better for Bone, CT or MRI

CT

34

Which is better for Soft Tissue CT or MRI?

MRI

35

Which exams might you have to Sedate a cat for?

Oral Pharyngeal Laryngeal

36

Contrast (Barium Swallow) studies you can perform to evaluate the oral cavity?

Esophogram Fluoroscopy

37

What is fluoroscopy?

A 3D real-time radiograph (like a movie)

38

Parts of Esophagus?

Upper Esophageal Sphincter Esophagus Lower esophageal sphincter

39

What type of muscle is Lower Esophageal Sphincter?

Smooth

40

Striation of Dog Esophagus? Cat?

Dog = All striated Cat = Distal portion striated

41

Innervation to Espphagus?

Vagus Somatic & Autonomic

42

What type of peristalsis occurs in espphagus?

1º and 2º (left over) peristalsis

43

What is 1º peristalsis stimulated by?

Stretch

44

TQ!!! The MOST COMMON clinical manifestation of ESOPHAGEAL disease is?

REGURGITATION!!! Hx with Regurgitation? Chronicity Recent anesthesia - #1 Reason for regurg Foreign body ingestion/removal Dysphagia Halitosis Hypersalivation Weight loss - Can be severe +/- coughing & dyspnea +/-depression & anorexia

45

Why does anesthesia commonly cause regurgitation?

Lower sphincter is relaxed, acid can splash up into esophagus causing esophagitis (destroys mucosal surface)

46

What does esophagus do when it's pissed?

Strictures!

47

How can you cause a cat esophagitis in a cat thru pilling?

Doxycycline very caustic

48

Is Regurgitation passive or active? Vomitting?

Regurg = passive Vom - Active

49

Is there Abdominal component/retching, bile, or Nausea with regurg? Vom?

R = NO V = Yes

50

Will food be digested with regurg? Vom?

R = May appear to be V = Maybe

51

What is Appetite like for regurg? Vom?

R = Usually ++ Vom = +/-

52

Which are you more likely to aspirate with, Regurg or Vom?

Regurgitation

53

Rule Outs for Regurgitation?

Megaesophagus/Esophageal weakness *Vascular Ring anomaly Esophageal Foreign Body Stricture, diverticula, fistulas - Pissed it off! Esophagitis Masses Hiatal Hernia GE Intussusception Lead Poisoning Canine Distemper

54

What is the vascular ring anomaly most often seen with regurgitation? Who gets it mostly? Where is it?

Persistent right aortic arch—most common GSD Cranial to heart

55

What are common causes of Esophagitis?

Post anesthesia GERD - Gastro Esophageal Reflux Dz Excessive acidity Lower Esophageal Sphincter Achalasia

56

Who gets Congenital Megaesophagus/Esophageal Weakness?

Any breed Danes Irish Setters Newfies ***GSD*** Shar Pei Labradors Dachshunds - can resolve at 6 months Rare in cats

57

Congenital Megaesophagus conditions?

***Vascular Ring Anomaly

58

Secondary acquired Megaesophagus/Esophageal Weakness causes?

***Myasthenia Gravis—systemic or focal esophageal Vascular Ring Anomaly Dysautonomia - RARE - ANS don't work right Polymyopathy/myositis Polyneuropathy/neuritis SLE - Systemic Lupus Erythematosus Addison's Toxic - Lead, OP, thallium Botulism Polyradiculoneuritis/Coonhound Familial canine dermatomyositis Familial reflex myoclonus Glycogen storage disease CNS disease Infection, neoplasia Hypothyroidism

59

What tumor like to occur in conjunction with Myasthenia Gravis and Megaesophagus?

***Thymoma***

60

Most common Esophageal masses?

Neoplasia - Esophageal or Extraesophageal Granulomas - Spirocerca lupi

61

What is Hiatal Hernia?

Stomach herniates thru diaphragm puts pressure on esophagus

62

What is Gastro-Esophageal intussusception?

stomach intussuscepts into esophagus

63

Diagnostic tests with Regurg?

Survey radiography Thoracic & Cervical Contrast radiography Fluoroscopy Endoscopy CBC/Chem?UA Fecal Neuromuscular Eval Brain CT/MRI CSF Analysis

64

Important to Evaluate Radiographs for?

Esophageal Dilation Air Displacement Foreign bodies Masses Pneumomediastinum Metastatic disease Aspiration pneumonia

65

Where on radiograph should you look for aspiration pneumonia?

Right Mainstem Broncus to RT middle lung lobe. Likely place for aspirated food to go

66

What two things like to happen together? Besties if you will?

Aspiration Pneumonia & Megaesophagus!

67

What will you likely see with Metastatic Dz?

Aspiration Pneumonia She said DING DING DING after this.

68

What is Pneumomediastinum a sign for? Where might it occur?

Fistulas Hole Between trachea and esophagus Hole Between Esophagus and mediasteinum

69

What should you be aware of with megaesophagus and Contrast radiography?

Aspiration always a risk

70

Why is barium + food better than just barium?

Esophagus works on Bolus

71

Fluoroscopy is a way to analyze what?

Function

72

Endoscopy is good because it allows? What therapeutic interventions can you perform with Endoscopy?

Direct visualization Assessment of severity of disease FB removal Balloon dilation

73

Why should you run CBC/CHEM/UA?

Allow for systemic evaluation

74

Fecal evaluation is checking for?

Spirocerca lupi

75

What Titers are you testing for to dx Myasthenia Gravis?

Acetylcoline antibody titers - Gold Standard

76

What test is for MMM?

2 n Ab Titer

77

What would Creatinine Kinase tell you in regards to regurgitation?

General Myositis or Myopathy

78

How would you Rule out Addisons?

ACTH stimulation test

79

Esophageal Dzs?

Neoplasia Strictures Diverticula

80

Parts of stomach?

Cardia Fundus Body Antrum

81

Nervous control of Stomach? Specifically?

Autonomic - Vagus and Ciliac plexus Enteric - Myenteric and submucosal plexus

82

How does stuff get moved along in stomach?

Peristalsis and MMC

83

What do Parietal cells do?

HCl - neuroendocrine stimulation of Gastrin Ach Histamine

84

Chief cells release?

Pepsinogen

85

Mucous cells release?

Bicarbonate

86

Phases of secretion?

Cephalic Gastric

87

What controls the Cephalic phase of secretion?

PNS - ACh

88

What controls the Gastric Phase of secretion

Gastrin

89

When you vomit what are you vomiting?

all the way down to SI HCl & HCO3- (more bicarb in SA)

90

What acid/base balance do find in your normal small animal vomiter? Why?

Metabolic Acidosis - You start vomiting from your SI Lots of bicarb in intestines More bicarb than acid leaves

91

What acid/base situation would a High GI Blockage create?

Hypochloremic Metabolic Alkalosis

92

Why is there a lot more chance of aspiration with aspiration than vomiting?

In vomiting epiglottis is coordinated to protect trachea

93

What is in control of Tightly coordinated reflex action of vomiting?

Vomiting center DA, histamine, Ach Chemoreceptor trigger zone (CRTZ) - Responds to toxins/drugs Limited BBB Direct stimulation to vomiting center from, CRTZ, higher CNS, vestibular center, GI tract, abdominal organs or peritoneum

94

You must differentiate between what situations with vomiting?

Acute vs. chronic Self limiting vs. life threatening systemic illness. GI vs. Non-GI causes

95

Minimum database for Self limiting vomiting?

PCV/TS/FeLV/FIV Fecal Float and smear, therapeutic de-worming Parvovirus ELISA if puppy NPO for a day Monitor for worsening signs over next day - may have to proceed to further diagnostics I usually DO NOT give anti-emetics - hide important clinical signs

96

Which drug should you NEVER give?

Centrine Anti-Ach Turns off gut - causes ileus! Bad for the dog! - CONSTIPATION! CX associated with Systemic Illness? Pyrexia Painful abdomen Masses Tympany Oral ulceration Icterus Ascites Wounds Melena Lethargy PU/PD Non-productive retching—GDV!

97

What is the only way to tell if it is vomiting over regurgitating?

Retching!

98

Continued vomiting, non-stable patient should do what diagnostic tests?

CBC/CHEM/UA Rule in/out many non-GI causes Fecal floatation and smear Let those results and your PE guide you to further dx

99

What diagnostics would you do if you suspect GDV? Tx?

Radiography Blood work CBC/CHEM/UA/VBG Lactate initial vs post stabilization Emergency stabilization and surgery

100

What is one of the VERY best ways you can decide whether you are doing the right tx?

Decreasing Lactate Levels

101

TQ!!! Primary Gastrointestinal Vomiting Rule Out List?

Dietary indiscretion/Diet change Motility disorders Ulcers Allergy-food Neoplasia Inflammation/ IBD Intussusception/Hiatal hernia/GDV Infection - Bacterial, Viral, Ricketsial, Fungal/fungal-like Parasites Colitis Toxins/Drugs Foreign body/ outflow obstruction/Hairballs/Obstipation

102

Life Threatening Signs with vomiting?

Life Threatening Signs? Unproductive vomiting, distended abdomen, shock/collapse

103

What happens with GDV? Who?

Gastric Dilatation and Volvulus Air trapped, vessels obstructed, progressive Giant breed dogs predisposed

104

TQ!!! Non- GI Vomiting Rule Out List?

Neoplasia i.e. MCT Renal disease/failure Hepatobiliary disease Peritonitis Pancreatitis Acid/Base disorders Hypoadrenocorticism Hyperthyroidism Sepsis DKA Hypercalcemia Pyometra Heartworm Drugs - NSAIDS, Anesthetics, Chemo, Opiods, ABX Toxins CNS disease/vestibular/abdominal epilepsy

105

If you are pretty sure you have perforation/foreign body should you do barium study?

No go to sx, if you’re pretty sure you aren't going to want barium in gut Hx Questions to ask with vomiting?

106

What is the best test for Pancreatitis?

PLI

107

Maldigestive dxa you might have ____Cobalamine?

Low

108

What can bacteria make?

Folate Consistent with over growth of

109

TLI stands for? What is it a test for?

Trypsin Light Immunoreactivity EPI ExoPancreatic Insufficiency

110

Best way to find Foreign Body?

Fingers-->Palpate Xray Ultra Sound Contrast Radiography Do not use barium if suspect perforation

111

Advantages of Endoscopy?

Non-invasive Visualize the mucosa biopsies - tiny

112

What will youdo with EVERY exploratory?

Biopsy

113

What is Physoloptera?

ONE worm will cause you to vomit till you die IH-grasshopper/cockroaches

114

If they keep vomitting and you dont know why what will you eventually have to do?

Biopsies Blood work and Imaging First!

115

Exocrine Pancreas Functions?

Digestive enzyme production - STORE INACTIVE FORM Bicarbonate production Neutralizes gastric acid Facilitates: Nutrient absorption Mucosal cell turnover Enzyme activation Inhibits Autodigestion via enzyme inhibitors Bacterial proliferation - SEVO

116

Where are Zymogens are activated? How?

in the intestines Cleaved from inactive to active forms by enterokinases

117

Defense mechanisms of exocrine pancreas?

Physical separation of zymogens Distance between the site of enterokinase release and zymogens Presence of enzyme inhibitors within the pancreas and within the circulation within acinar cells

118

Who gets pancreatitis the most? Age Sex Breed

Middle – Old Females Yorkies Obese

119

TQ!!! What HISTORY is the most helpful to dx Pancreatitis?

Hx of HIGH FAT MEAL!

120

What parts of body does pancreatitis cause inflammation?

WHOLE BODY

121

What causes the Inflammatory disease with Pancreatitis?

Activation of digestive enzymes within pancreas Maintained and exacerbated by inflammatory cytokines and free radical production Vascultitis and edema Multisystem involvement Mild to Severe

122

What is Triaditis?

Pancreatitis Cholangiohepatitis Inflammatory Bowel Dz

123

CX of Pancreatitis?

Depression Anorexia Vomiting Diarrhea Shock Abdominal pain +/- Icterus Prayer position Any or none

124

Who can exibit VERY non-specific signs?

Cats even less specific

125

Additionally, What can the results of pancreatitis lead to? (i.e. you digested your pancreas)?

Hepatic Lipidosis Diabetes mellitus Thromboembolism Toxoplasmosis - can go wild DIC

126

What position is a sign of pancreatitis?

Prayer

127

Acute Pancreatitis Bloodwork: Chemistry results?

Hysper or Hypoglycemia Hypocalcemia Elevated liver enzymes Esp ALP Bile duct obstruction Hypercholesterolemia/ Hypertriglyceridemia/ hyperlipidemia Bilirubinemia Renal or pre-renal azotemia Amylase and Lipase

128

Acute Pancreatitis Bloodwork: CBC?

Hemoconcentration Anemia Thrombocytopenia Neutrophilia w/ left shift UA Bilirubinuria Hemoglobinuria Concentrated USG

129

Dx of Acute Pancreatitis: Classic changes?

Clinical Signs History Blood work Cytology Imaging Advanced Testing

130

What Cytology can you do to confirm dx acute pancreatitis?

DPL • DX peritoneal lavage

131

What might you see on diagnostic imaging to suggest acute pancreatitis?

Ground-glass appearance = loss of cranial abdomen detail

132

On Advanced testing what can you look for to confirm acute pancreatitis?

TLI - Trypsin-like immunoreactivity PLI - Pancreatic Lipase immunoreactivity—PLI

133

Why is TLI helpful in dx of acute pancreatitis?

May elevate prior to amylase and lipase PLI more helpful than TLI, also it is species specific

134

How sensitive/specific is PLI in Dogs? Cats? How is test run?

Dogs = 82% Cats = 100% Sensitive & Specific Snap test available (CPL)

135

What is the Test of choice for Pancreatitis?

PLI

136

If you suspect Pancreatitis should you confirm dx or tx the patient for pancreatitis before confirmation?

TX!!!

137

What might you see on radiographs with pancreatitis

Loss of cranial abdominal detail

138

What might you see on Abdominal Ultrasound with Pancreatitis?

Duedonum looks like bacon with ileus Decreased peristalsis Mixed pancreatic echogenicity Peripancreatic hyperechogenicity Cranial abdominal mass Free abdominal fluid - Ca+fat = soap

139

Where does Parvo like to hit the intestines?

Crypts (Paneth and Stems)

140

Where does Corona Virus hit the intestines?

Villus

141

How much of the small intestines are Duodenum? feature?

10% length Major and minor papilla (dogs)

142

Villi, microvilli, mucosal folds Increase the surface area by how many times?

600X Crypt/villus unit

143

Which part is the Majority of SI?

Jejunum

144

Where in SI is Ileum?

Last 12 inches

145

What are the SI reasons the dxa occura?

decreased surface area & decreased function = no where for water to go = dxa! Luminal disturbances Villous atrophy Enterocyte dysfunction Microvillar membrane damage Brush border membrane disease Mucosal barrier disruption Hypersensitivity Mucosal inflammation Neoplasia Nutrient delivery blockade

146

Why do we give Lactulose?

Constipated Cats PSS Dogs

147

What are the mechanisms of dxa? (2)

Osmotic Secretory Describe Osmotic Dxa? Decreasee solute absorption - water goes with it Diet - unabsorbed nutrients in lumen

148

Osmotic dxa is often caused by?

Medicines Decreased solute absorption

149

Who gets secretory dxa?

Horses the most

150

What causes secretory dxa?

Hyper-secretion of ions Toxins - Bacterial or chemical Intestinal inflammation Rare in small animals

151

What does administration of DSS cause?

Secretory Dxa

152

Dysmotility types?

Primary (rare)
Hypermotility (rare) Hypomotility/ileus
Secondary
Exudative
Mixed

153

What type of dysmotility is the most common?

Secondary

154

What are the causes of secondary dysmotility?

Drugs Hyperthyroidism
Exterotoxigenic
Hypomotility (more common)
Peristalsis vs Segmental

155

What dysmotility is more common, hyper or hypomotility?

HYPO

156

What causes exudative dysmotility?

Increased permeability
Damage to mucosal barrier
Leakage of blood proteins

157

Clinical manifestation of intestinal dz is? (2)

Either Dxa or Constipation

158

What must you evaluate History and PE to determine?

Chronic vs. acute chronic intermittent
Self-limiting potentially fatal systemic disease.
Small intestinal vs. Large intestinal or Diffuse

159

Can you lose enough fluid from dxa to die?

YES!

160

TQ!!! What is the most important thing to determine with small animals regarding DXA?

Small Intestinal vs Large Intenstinal

161

Causes of Acute enteritis?

Dietary Parasitic Infectious Intussusception Hypoadrenocorticism

162

Dietary Causes of Acute enteritis?

Dietary - Allergies/changes/ Indescretion

163

Parasitic Causes of Acute enteritis?

Helmiths
Protozoa (Giardia, Tritrichomonas, Coccidia)

164

Infectious Dz Causes of Acute enteritis?

Parvo
Corona
FeLV/FIV
Bacterial overgrowth
Rickettsia

165

Causes of Chronic Enteritis?

Same as Acute
Neoplasia
Fungal infections
Pythiosis, histoplasma
Lymphangectasia
Breed Specific Enteropathies
Systemic Dzs
Malabsorptive Dzs & Maldigestive Dzs

166

What fungal infections cause chronic enteritis?

Pythiosis
Histoplasma

167

What breeds are prone enteropathies causing chronic enteritis?

Basenji
Wheaten
Shar Pei
Yorkies

168

Systemic diseases causing chronic enteritis?

Pancreatitis
Hyperthyroidsm
Hepatic disease
Renal Dz
Parasites
Antibiotic Responsive Enteropathies

169

What is Lymphangectasia?

Dialation of the lacteals don't absorb things as well

170

What Malabsorptive diseases cause chronic enteritis?

ABE/SIBO - Antibiotic Resistant Enteropathies Dietary IBD

171

What Maldigestive diseases cause chronic enteritis?

ExoPancreatic Insufficiencies - TLI test

172

Causes of LARGE INTESTINAL Dxa?

Dietary
Fiber Responsive
Parasites - Giardia, whips
Bacteria Clostridium
Histiocytic ulcerative colitis
Fungal
IBD
Neoplasia
FeLV/FIV

173

Describe Histocytic Ulcerative Colitis?
Who is prone?
How to cure?

Antibiotic Responsive Enteropathy (ARE)
Prone - Boxers, Frenchies
Cure - Enrofloxin

174

TQ!!! Differentiating Small Bowel vs. Large bowel diarrhea: What is the volume of Small Bowel vs Large Bowel Dxa?

Small = A LOT MORE Large = normal to Increased

175

TQ!!! Differentiating Small Bowel vs. Large bowel diarrhea: Mucus?

Small: not so much Large: YES - Frequent

176

TQ!!! Differentiating Small Bowel vs. Large bowel diarrhea: Melena?

Small: Maybe Large: Nope

177

TQ!!! Differentiating Small Bowel vs. Large bowel diarrhea: Hematochezia?

Small: Nope

178

TQ!!! Differentiating Small Bowel vs. Large bowel diarrhea: Steatorrhea?

Small: Yes Large: Nope

179

TQ!!! Differentiating Small Bowel vs. Large bowel diarrhea: Undigested Food?

Small: Maybe Large: Nope

180

TQ!!! Differentiating Small Bowel vs. Large bowel diarrhea: Color?

Small: variable Large: usually normal - already digested

181

TQ!!! Differentiating Small Bowel vs. Large bowel diarrhea: Defecation Urgency?

Small: Rare Large: Usually

182

TQ!!! Differentiating Small Bowel vs. Large bowel diarrhea: Defecation Tenesmus?

Small: Nope Large: Frequent

183

TQ!!! Differentiating Small Bowel vs. Large bowel diarrhea: Defecation Frequency?

Small 3 X Normal Large: > 3X Normal

184

TQ!!! Differentiating Small Bowel vs. Large bowel diarrhea: Defecation Dyschezia (painful)?

Small: Nope Large: Yes

185

TQ!!! Differentiating Small Bowel vs. Large bowel diarrhea: weight loss?

Small: Usually Large: Rare

186

TQ!!! Differentiating Small Bowel vs. Large bowel diarrhea: Flatulence?

Small: Can be Large? Absent

187

TQ!!! Differentiating Small Bowel vs. Large bowel diarrhea: Halitosis?

Small: Yes Large: Nope

188

History taking for Dxa?

Indoor/outdoor
Vaccination and deworming status
Access to garbage
Travel history
Previous episodes
Drugs
Diet/changes
Duration
Severity
Progression
Response to previous therapy

189

Complete Physical exam for DXA do you have to do a rectal?
What else?

OMG YES!!!
Oral exams - Esp. under the tongue
Abdominal Palpation
Hydration status

190

What can you find on Careful abdominal palpation?

Thickened bowel loops
Masses
Effusions
Pain
Hydration status

191

May have to observe defecation attempts: what will you look for?

Dyschezia
Tenesmus - urge to go w/ empty bowel
Evaluate feces

192

Fecal Evaluation for?

Color Consistency Odor +/- malabsorption Blood Steatorrhea +/- malabsorption

193

TQ!!! Fecal Tests to Run on Dxa Patients?

Fecal floatation
Cytology +/- Parvo - puppy < 6 mo with dxa or vom +/-
Culture - salmonella in horses
SA not that common
alpha-protease inhibitor - PLE

194

What should you run for fecal float?

Sheather's Zinc sulfate or Giardia Ag
Baermann - larval lung worm

195

What Cytology should you run on fecal for dxa?

Direct smear – histoplasmosis
Rectal scraping Blood work for Dxa?
Min DB - CBC/CHEM/UA/VBG /FeLV/FIV/Parvo

196

Additional Diagnostics for Dxa?

Abdominal Radiographs
Contrast Radiography Barium
Abdominal Ultrasound
FNA/BX
GI panel
PLI
TLI
Cobalamin
Folate

197

What will Cobalamin levels be with malabsorpitve diseases?

LOW

198

What will Folate levels be with intestinal bacterial overgrowth?

HIGH

199

Endoscopy Advantages?

Minimally Invasive
Can initiate some therapies sooner
Limited for most of the SI anatomically - Dog into Duad,
Cats into Jej Mucosal Biopsy )(Bx)

200

Surgery needed to?
Pros & Cons

Bx of more sites
Full thickness bx
Evaluate all abdominal organs
Potential for correction – obstructions
Risk of dehiscence
Longer recovery time
More expensive