1. “If there is no enemy within, the enemy outside can do us no harm.”
Don’t be your own enemy
“If there is no enemy within, the enemy outside can do us no harm.”
-Les Brown

2. DISEASES OF THE STOMACH

3. Stomach Diseases: Acute Gastritis
Spoiled food
Change in diet
Food allergy
Infections (bacterial, viral, parasitic)
Toxins (chemicals, plants, drugs, organ failure)
Foreign objects
Signs
Anorexia
Vomiting (maybe dehydration)
Painful abdomen
Hx of diet change, toxin ingestion, infection, parasites

4. Acute Gastritis Diagnosis History and Physical Exam CBC, Chem Panel
H2 blockers decrease the amount of gastric juice produced. Decrease amount of pepsin secreted.

5. Acute Gastritis Treatment NPO until vomiting stops
small sips of water every hour
Fluid therapy (SQ or IV)
Gradually start feeding
Bland food (Hill’s I/D, boiled chicken/rice)
Antiemetics
Cerenia (maropitant)
Regaln (metoclopramide)
Coating agents – sucralfate
H2 blockers
Antibiotics – rarely needed

6. Acute Gastritis Client info Avoid abrupt changes in diet
Gradually mix new food in with old
If pet vomit 2-3 times, NPO x 24 h; if it continues see vet
Dogs and cats do not need variety in the diet as some clients believe

7. Stomach Diseases: Gastric Ulceration
Cause: Usually a result of long- term NSAIDs (aspirin, ibuprofen, phenylbutazone)
Signs
Vary from asymptomatic to vomiting blood
Anemia
Melena
Anorexia
Abdominal pain
Septicemia if perforation occurs

8. Gastric Ulceration Diagnosis
X-ray using contrast medium (Barium) to show ulceration in stomach lining (caution if perforation is suspected)
Endoscopy

9. Gastric Ulceration Treatment Client info Fluid therapy for dehydration
NPO
Coating agents/ H2 blockers
Sucralfate
Cimetidine - H2 blocker (↓ HCl production)
Omeprazole –proton pump inhibitor (↓ HCl production)
Client info
Do not use NSAIDs without veterinary supervision
Give NSAIDs with meal/antacids
Antacids: Aluminium OH or Magnesium OH

10. Stomach Diseases: Gastric Dilatation/Volvulus
Primarily a disease of large, deep-chested dogs
Dilation - gas filled, Volvulus - twisted along longitudinal axis
Cause: Food/exercise? Etiology unclear
Signs
Abdominal pain/distension
Weakness, collapse, depression, nausea, salivation
Increased HR, RR – may lead to arrhythmias

11. Gastric Dilatation/Volvulus

12. Gastric Dilatation/Volvulus
Air filled stomach that twists along longitudinal axis. Pylorus passes under stomach and comes to rest above the cardia on the L side.
Simple dilation: air filled stomach, volvulus is twist.

13. Stomach Diseases: GDV Diagnosis
PE shows depressed, weak animal with poor perfusion (↑CRT)
X-rays show air filled stomach- “double-bubble”
Or “popeye arm”, or “smurf hat”
ECG may show ventricular arrhythmia or sinus tachycardia
CBC and Chem panel
electrolyte levels
pH imbalances
Lactate levels

14. Gastric Dilatation/Volvulus
Treatment goals
Decompress stomach
Pass stomach tube
18 gauge needle
Stabilize patient (fluids, electrolytes, ECG)
Antibiotics
Prepare for Surgery ASAP
Best view: R lateral view.

16. Gastric Dilatation/Volvulus

17. Gastric Dilatation/Volvulus
Post-Op
ECG
Blood pressure
Pain management
Monitor urine output
Antibiotics
Maintain fluids (oral, IV)

18. Gastric Dilatation/Volvulus
Client info
Avoid large meals
Limit exercise after meals
Feed high-quality diets
Tack-down procedure not 100% preventative
15 – 18% mortality rate

19. Stomach Diseases: Gastric Neoplasia
Most common malignant neoplasia in dogs is adenocarcinoma; in cats lymphoma
Signs
Wt. loss
Vomiting w/ or w/o blood
Obstruction
Usually seen in older animals
Diagnosis
Endoscopy and biopsy for diagnosis
X-ray with Barium contrast
Benign: polyps, gastric leiomyomas

20. Gastric Neoplasia Treatment Client info Surgery is treatment of choice
Many tumors are too far advanced (inoperable)
Chemotherapy
Radiation less successful for gastric tumors
Client info
Prognosis is poor; gastric neoplasia is a fatal disease
Supportive care, control of vomiting, good nutrition are needed for these animals