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Published byLeon Oswin Kennedy Modified over 9 years ago
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“Winning (success) takes work!” “The will to win is not nearly as important as the will to prepare to win.” -Bobby Knight
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Diseases of Digestive System Oral cavity Esophagus Stomach Small Bowel Large Bowel Liver Pancreas Rectum Anus Chapter 2
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Esophageal Disease Esophageal obstruction Ingestion of _______________object (bones, play objects) Degree of damage depends on size, shape, time in esophagus Surgical removal is least desirable → _______________________ Signs Exaggerated swallowing movements Increased salivation restlessness Retching Anorexia Hx of chewing on foreign objects Esophageal endoscopy
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Esophageal Obstruction Dx Endoscopy Radiography 6-mo old St Bernard What is your diagnosis?
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Esophageal Obstruction 3 mo kitten What is your diagnosis?
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Esophageal Obstruction 2 yr old cat What is your diagnosis?
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Esophageal Obstruction 8 yr male cat
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Interesting stuff 7 mo old Pug
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Esophageal Obstruction Dx: Radiographs and endoscopy Rx Prompt removal is important ____________x 24 h to allow for healing Resume feeding with soft foods Remove using______________, Sx Client info Limit access to bones and small objects Strings and needles are hazards for cats Px is good if serious damage to esophagus can be prevented
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Diseases of Digestive System Oral cavity Esophagus Stomach Small Bowel Large Bowel Liver Pancreas Rectum Anus Chapter 2
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Mucosa -> muscularis -> serosa
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Stomach Diseases Acute Gastritis Commonly seen in ___________(cats to lesser degree) Spoiled food ____________ Food allergy Infections (bacterial, viral, parasitic) Toxins (chemicals, plants, drugs, organ failure) Foreign objects Signs Anorexia Vomiting (+/- dehydration) ________________________ Hx of diet change, toxin ingestion, infection, parasites
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Acute Gastritis Dx Hx and PE CBC, Chem Panel to assess dehydration, metabolic imbalance, organ failure Rx NPO until vomiting stops 4-6 sips of water q1h Fluid therapy (SQ or IV) Gradually start feeding ______________(Hill’s I/D, boiled chicken/rice) Antiemetics ________________ (Cerenia) Metoclopramide (Reglan): caution with foreign bodies Coating agents Sucralfate _______________ (famotidine, ranitidine, cimetidine) Antibiotics—often prescribed, rarely needed (flora disrupted: forti flora)
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Acute Gastritis Client info Avoid abrupt changes in diet Gradually mix new food in with old (1 wk) If pet vomit 2-3 times,_____________ ; if it continues see vet Dogs and cats do not need variety Avoid objects that can be swallowed (treat like a baby)
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Immune-Mediated Inflammatory Bowel Disease (Chronic gastritis, Enteritis, Colitis) Seen in____________, less common in dogs Accumulation of __________________ in lining of stomach, SI, LI Signs Chronic vomiting, wt loss Diarrhea, straining to defecate, ____________in stool Dx Fecal to r/o parasites CBC, Chem panel, urinalysis to r/o metabolic disorder FeLV, FIV to r/o those diseases Endoscopy stomach SI and colon, and ___________ for definitive diagnosis
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Rx What is the Rx for any Immune-mediated Disease? ______________—immunosupressant (organ transplants) _______________________—inhibits immune system response ________________ —a sulfa drug with anti-inflammatory/ antibacterial effects Most effective against colitis Metronidazole Prednisone _____________________ diet Free from preservative, additives Highly digestible protein (rabbit, lamb, duck, chicken) Homemade diets with rice base Some commercial diets are available Immune-Mediated Inflammatory Bowel Disease (Enteritis, Colitis)
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Inflammatory Bowel Disease Client info Definitive dx is through biopsy _____________________ (special diet, frequent medical monitoring) Immunosupressive drugs have side-effects (PU/PD/PP, wt gain, skin/urinary infections) Use lowest dose that provides effect
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Gastric Ulceration Usually a result of long-term NSAIDs (aspirin, ibuprofen, phenylbutazone) Signs Vary from asymptomatic to ___________ Anemia, edema ________________________ Anorexia Abdominal pain Septicemia if perforation occurs Dx X-ray using ______________ (Ba) to show ulceration in stomach lining (caution if perforation is suspected) Endoscopy
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Gastric Ulceration Rx Fluid therapy for dehydration NPO (as before) Coating agents/antacids Cimetidine— ______________ (↓ HCl production) Omeprazole—↓ HCl production (proton-pump inhibitor) Client info Do not use NSAIDs without veterinary supervision Give NSAIDs with meal/antacids
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Gastric Dilatation/Volvulus Primarily a disease of _________, ____________dogs (2-10 yrs) Dilation—gas filled; Volvulus—twisted along longitudinal axis Food/exercise? Etiology unknown Signs Abdominal pain/distension Weakness, collapse, depression, nausea, salivation Increased __________– may lead to arrhythmias Dx PE shows dilation, poor perfusion (↑ cap refill) X-rays show air filled stomach- ________________________ ECG may show vent arrhythmia or sinus tachycardia CBC and Chem panel necessary to assess electrolyte levels
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Gastric Dilatation/Volvulus
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Rx Goals ____________ stomach Pass stomach tube 18 gauge needle Stabilize patient (fluids, electrolytes, ECG) Rx for shock IV fluids Corticosteroids Antibiotics Prepare for Sx R lateral view
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Gastric Dilatation/Volvulus
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Sx: Laparoscopic correction and surgical correctionLaparoscopic correction surgical correction FYI FYI Post-Op ECG Blood pressure Pain management Monitor urine output Antibiotics Maintain fluids (oral, IV)
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Client info __________________ meals Limit exercise after meals Feed high-quality protein diet Tack-down procedure not 100% preventative Gastric Dilatation/Volvulus
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Gastric Neoplasia Most common malignant neoplasia in dogs is ____________; in cats ______________________________ Signs Wt loss Vomiting w/ or w/o blood Obstruction Usually seen in older animals Dx Endoscopy and biopsy for diagnosis X-ray with Barium contrast
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Rx _________________ is TOC (treatment of choice) Many tumors are too far advanced (inoperable) Chemotherapy Radiation less successful for gastric tumors Client info Px is poor; gastric neoplasia is a fatal disease Supportive care, control of vom, good nutrition are needed for these animals Gastric Neoplasia
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