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Flashcards in SAM 2 TEST 2- intro + esophagus Deck (56):
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dysphagia

difficulty swallowing and or chewing

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ptyalism

excessive production of saliva, hypersalivation

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regurigatation

passive explosion of material from pharynx or esophagus

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vomiting

forceful explosion of stomach contents through the mouth

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hematemesis

blood in vomitus

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borborygmi

bowel sounds

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diarrhea

steatorrhea

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tenesmus

straining to defecate

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hematochezia

frank blood in or around stool

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obstipation

severe or complete (inability to pass stools) constipation

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dyschezia

painful defecation

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Canine Oral Papillomatosis 

Papillomavirus in dogs

Transmission via saliva, grooming, playing1-2 month’s incubation Mucosal surface – pale, smooth growths at first then rough and irregular

with fronds “Cauliflower Like” 

Will go away as pup’s immune system matures 

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EPULIDES 

EPULIDES – ODONTOGENIC NEOPLASM 

From periodontal ligament – seen mostly in dogs BENIGN – do not metastasize
On gingiva, near teeth, especially incisor
Firm & Irregular

+/- symptomatic
Older Dogs, rarely cats
Breed: ANY, Shetland Sheepdogs, Old English Sheepdogs 

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Peripheral Odontogenic Fibromaa 

(Fibromatous & Ossifying Epulis)

Non invasive, solitary, +/- pedunculated, non ulcerated Surgery Curative 

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Acanthomatous Ameloblastoma 

Invasive +/- bone destruction Often needs large resection including bone to be curative +/- RT 

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What is the number one oral maligant neoplasm in the dog?

Maligant melanoma - #1 in DOG 2/3 pigmented

1/3 unpigmented
Metastasis not uncommon – LNs, Lung 

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What is the number one malignant oral neoplasm in the cat?

Squamous cell carcinoma - #1 in Cat, #2 in Dog Ulcerated, erosive lesions 

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EOSINOPHILIC GRANULOMA COMPLEX 

Feline – any age

‘Rodent Ulcer’

Suspect hypersensitivity reaction Fleas/other insects, environment, diet 

Can occur together or separately & range in size Eosinophilic Plaque – not on face Eosinophilic Granuloma – lip or chin swelling Indolent Ulcer – ulcers of mouth 

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What's the treatment for eosinophilic granuloma complex?

What about the prognosis?

Minimum data base i.e. CBC, Chemistry, UA Evaluate lesions for infection
Impression smear and biopsy

Tx can include:
Food trial
Steroid – tapering course pending response Flea control
Pain management
Treat secondary infection 

Prognosis is good Recurrence is common 

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GINGIVOSTOMATITIS 

Severe chronic inflammation of gingiva and oral mucosa FELINE > CANINE
Abnormal immune response to plaque
Starts around a tooth; extends

Can be associated with: FIV 

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What's the treatment for gingivostomatitis?

Medical management with oral hygiene control

 Routine periodontal treatments

 Brushing

 Immune mod medications such as prednisone or other immune mod meds

* Full mouth extractions * +/- medications after 

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PHARYNGEAL DISEASE

Foreign Body

Inflammation or Infection
Primary or secondary to neoplasia or foreign body Abscess

Obstruction/Compression Salivary Gland disease

Neoplasia (i.e. salivary, thyroid, tonsilar) Lymphadenopathy 

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Odynophagia 

painful swallowing 

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What is one of the key things about pharyngeal disease?

Voice change

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If nothing seen on oral exam OR history lead you elsewhere ... 

Endoscopy: Assess caudal pharynx and soft palate Fluoroscopy: Assess function
CT scan of head, pharynx, cervical region, chest 

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Difficulty swallowing

Upper respiratory signs Nasal discharge

Stertor = ‘snore sound’ 

NASOPHARYNGEAL POLYP 

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If you are worried about polyps, what should you do?

SEDATED EAR EXAM

 

Inflammatory response – possibly to viral organisms Arises from middle ear

Penetrates into nasopharunx OR
Penetrates eardrum 

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What is the treatment for a nasopolyp?

GENTLE TRACTION removal for Nasopharyngeal

https://www.youtube.com/watch?v=VKz7pF4IkAI

Ventral Bullae Osteotomy Excellent prognosis with removal Possible Recurrence 

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What is the number one salivary disease in dogs?

Sialocele - ‘salivary mucocele’ #1 salivary gland disorder in dogs 

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SIALOCELE 

Accumulation of saliva in submucosal or subcutaneous tissues Trauma
Inflammation

Location Cervical # 1

Ranula (under tongue) Pharyngeal & Zygomatic – rare 

 

Small to large swelling +/- resp distress Usually non-painful with chronicity Mobile, soft, flocculent 

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What are the swelling locations for a siocele?

Parotid: Below Ear

Mandibular: Angle of Jaw

Zygomatic: Caudal to eye+/- retrobulbar swelling 

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What is the dx and treatment for siocele?

Systemic Evaluation
Aspirate for cytology and culture

Straw to light brown colored Viscous, non-odiferous fluid
No bacteria +/- if drained before

CT pending involvement 

 

Treatment Surgical removal WITH BIOPSY !

Excellent prognosis 

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SIALADENITIS 

Inflammation of the salivary gland Trauma

Systemic infection
Secondary infection not uncommon – needs more aggressive

therapy
Painful, carrying head down
Ptyalism
Fever, lethargy
Mild cases without infection self-resolved 

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PHARYNGEAL TRAUMA 

Penetrating stick OR other cause wound Secondary Infection

Remaining splinters or
piece of foreign material

Draining tracts, abscess, swelling 

Bloody saliva
ACUTE: Dysphagia & oral pain +/- resp signs

CHRONIC: Anorexia, pyrexia,
retrobulbar swelling

History of playing with sticks, active or no known cause 

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pharygeneal trauma treatment and prognosis

Removal of foreign material Treatment for secondary infection Surgical repair of injured tissues

PROGNOSIS:
Best if airway or esophagus not injured & ACUTE cases Recurrence occurs if no FB found, esp. difficult with inflammation

Failed treatment with retained or migrating FBs, too short duraiton of antibiotics, permanent damage to oral or pharyngeal structures 

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Oral  Swallowing phase

Oral (CN 5, 7, 12)

 Prehend food and form bolus which moves to end of tongue 

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Pharyngeal- swallowing phase

Pharyngeal (CN 9, 11)
 Propel bolus along pharynx
 Closure of the larynx by epiglottis & inhibition of breathing  UES sphincter opens (cricopharyngeal muscle) 

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Esophageal- swallowing phases

Esophageal (CN 9, 10, SNS)  Bolus moves along into stomach 

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what are the clinical signs for oral swallowing phase issues?

ORAL: Dropping food and water; difficult to pick up 

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What are the CS for pharyngeal swallowing phase issues?

PHARYNGEAL: Retch, cough, gag, food expelled rapidly after attempting to swallow, repeated attempts to swallow 

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What are the CS for esophageal phase issues?

ESOPHAGEAL: Retch, gag, expel food quickly after eating or some time later 

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CRICOPHARYNGEAL ACHALASIA/DYSPHAGIA 

Rare
Genetic disorder in dog

Breeds: Cocker and Springer Spaniels

Acquired in adults associated with NM disorders

CxS: repeat attempt to swallow, followed by gag and regurgitation 

 

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Cricopharyngeal muscle 

- Involved in swallowing reflex
- Inability to relax muscle leads to inability to swallow food or liquid
- Prevents propulsion of food bolus from caudal pharynx into esophagus 

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What are treatment options for cricopharyngeal dysphagia?

SURGERY: Cricopharyngeal Myotomy or

Cricopharyngeal & Thyropharyngeal Myectomy

65 % success rate

Failure = lack of improvement, worsening, aspiration pneumonia

Pets with NM disorders – treat underlying disease Treat aspiration pneumonia 

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Esophagus in dog vs cat

Striated muscle entire length – DOG

Distal smooth muscle – CAT 

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ESOPHAGITIS 

Inflammation of the esophageal mucosa – can affect motility

Secondary to medications, foreign bodies, caustic toxins, gastrointestinal reflux from GA or GI dz

RADS: Unremarkable or transient dilation Endoscopy: Erythemic +/- edematous mucosa 

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how do we treat esophagitis?

TREATMENT

Pain management
Buprenorphine, Tramadol, Fentanyl patch

Sucralfate/Carafate
250 – 1 gram PO as slurry Q 6-8 hours

Antacid  PPI
Omeprazole 0.7=1.0 mg/kg PO BID

Monitor for strictures
Look for underlying disease (i.e. GERD) 

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treatment/managment of FB

GOAL

Remove per OS with FB retrieval

RISK

Perforationeffusion, pyothorax, surgery

Stricture
Fistulae or Diverticulae

No H2 blockers if pushed into stomach

+/- Sucralfate
+/- Pain management Feed small frequent meals

Monitor for stricture and esophagitis signs 

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ESOPHAGEAL DIVERTICULAE 

Small lesions do not cause overt clinical signs

Larger lesions associated with impactions, esophagitis, rarely rupture and pyothorax

Diagnosis with radiographs with contrast or fluoroscopy with contrast

Secondary to trauma or congenital Tx: Surgery 

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What is the most common type of megaesophagus?

Idiopathic aquired

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Congenital megaesphagus

CONGENITAL

Abnormal NM innervation
< 6 months old
Breeds: SharPei, Fox Terrier, German Sheperd, Labs, Danes, Irish Setter, Mini Schnauzer, Newfie Siamese cats

May improve with time No genetic test 

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VASCULAR RING ANOMALY 

Development abnormality
3rd, 4th, or 6th aortic arch and others
Abnormal vessel entraps the thoracic esophagus

#1 = Persistent right aortic arch

DOG > CAT

Breeds: Boston, Irish Setter, German Shepard, Persian, Siamese 

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SPIROCERCA LUPI 

Cystic nodules (larva) in esophageal wall – also gastric wall and aorta

Fistula to lumen allows eggs to pass into alimentary tract NO fistula = no eggs = cannot detect in fecal evaluation

Cystgranulomasarcoma with mets Not always, more in Hounds
Can be incidental finding at necropsy

WHERE

Southern US; tropical and subtropical regions (Greece, India, Japan, SA, Israel) 

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What is the treatment for spiraceri lupi?

TREATMENT

Keep dogs from eating things

Monthly preventatives in edemic regions (moxidectin/imidacloprod in Europe)

Often too advanced to treat

Meds:

Doramectin (0.4 mg/kg, SQ) every 2 weeks for 6 weeks then monthly until granuloma resolves

Ivermectin (0.6 mg/kg, SQ, two doses 2 wk apart) combined with prednisolone (0.5 mg/kg, PO, bid for 2 wk and then tapered) 

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HIATAL HERNIA 

Movement of abdominal contents through esophageal hiatus in diaphragm

Congenital Acquired

TYPE 1: Sliding – intermittent displacement of LES and gastric fundus into thorax TYPE 2: Gastric fundus displacement only

BREEDS: Shar Pei, Bull Dogs – English & French 

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