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Veterinary Technology Diseases Of Digestive System

Subjects : engineering, health-sciences, veterinary

Instructions:

Answer 50 questions in 15 minutes.
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Match each statement with the correct term.
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This is a study tool. The 3 wrong answers for each question are randomly chosen from answers to other questions. So, you might find at times the answers obvious, but you will see it re-enforces your understanding as you take the test each time.

1. Intussusception signs are...
Vomiting - anorexia - depression - diarrhea (often bloody)
Avoid stress in obese cats - early intervention essential - a cat that usually eats well and just stops is at risk - prevent obesity cure rate 60-65% - may be long and $
High protein - high calorie diet - feeding tube - (for up to 2 mos) - IV fluids - potassium supplementation - metaclopramide sq 15 min before feeding if vomiting occurs - wean cat off feeding tube
x- rays -- mild hepatomegaly ultrasound-- hyperechoic liver histopathology-- severley vacuolized hepatocytes

2. What is treatment for lymphatic plasmacytic stomatitis?
Many cats have underlying disease that interferes with local immunity in gingava' cats should be screened for disease
Anorexia - depression - weight loss - vomiting - dehydration - fever - jaundice - ascites - hepatomegaly
With stool softeners and enemas palliatively
Clean teeth - antibiotics - oral antiseptics - daily brushing w/ antibacterial solutions - hard diet - rechecks

3. Diseases of the Liver: what is cholangiohepatitis?
Avoid feeding one lg meal limit exercise after eating feed high quality - protein - low fat diet avoid easily fermentable food DX has 15-18% mortality rate; gastropexy no guarantee against future episodes
Excellent after surgical ligation; surgery yields best results if dog is less than one year - relapses may occur (more common in cats); animals with partial ligations of shunt may require low protein diet to avoid clinical signs of hepatic encephalop
Common hepatobiliary disorder of cats - less in dogs complex of disorders that involve cholangitis - cholangiohepatitis - and biliary cirrhosis - bile duct inflammation leads to hepatocyte involvement - progresses to cirrhosis
*gastric indiscretion (eating garbage) - spoiled food - change in diet - food allergy - infection(bacterial - viral - parasitic) - toxins - foreign object ingestion

4. Portosystemic shunts DX: cbc - x- ray
Anorexia - depression - weight loss - vomiting - dehydration - fever - jaundice - ascites - hepatomegaly
Cbc - microcytosis - target cells - poikilocytosis - mild regenerative anemia xray microhepatia
Diarrhea w/o weight loss - increased frequency of defecation w/ decreased fecal volume - tenesmus - hematochezia (frank blood) - increased mucus - +/- dsschezia and mild fever
Common cause of vomiting in dogs

5. Intussusception PX
Mucosa is damaged - inflammation occurs - signs develop
Recurrence infrequent - prognosis depends on extent of damage - common in puppies with heavy parasitic infestation
Subtotal colectomy if refractory to medical and dietary management; rehydrate and correct electrolyte imbalances before anesthsia
CBC; nonregenerative anemia; stress neutrophilia lymphopenia

6. What is Chronic Enteropathies DX
PE often normal - edema or ascities if protein losing enteropathy - mdb - fecal - xray - endoscopy/biopsy (looking for lymphotic- plasmacytic infiltrates)
Perineal swelling - tenesmus - dyschezia - constipation - possible urethral obstruction if bladder involved
Sulfasalizine (caution with cats and dry eye in dog with long term use) ( -Keratoconjunctivitis -KCS) - pred - metronidazole - azathioprine - tylosin - mesalamine(sim to sulfasalazine - anti inflammatory drug w/ free radicals
Surgical removal - chemo - radiation poor prognosis

7. Megacolon surgical (use caution)
Based on HX and PE; cbc/chem (cbc may indicate stress leukogram and dehydration)
Hypoallergenic diets - low fat diets with high fiber; goal to control signs; may have frequent defecation chronically
Common in intact older male dogs >8; atrophy of levator ani muscle causes herniation of rectum and pelvic organs into ischiorectal fossa
Use caution when removing feces from colon; manually use well lubricated gloved finger; x- ray after to ensure empty colon; use soothing ointment or cream around rectum post evacuation - and make sure patient is kept clean and dry after enema

8. Feline Hepatic Lipidosis DX
PE often normal - edema or ascities if protein losing enteropathy - mdb - fecal - xray - endoscopy/biopsy (looking for lymphotic- plasmacytic infiltrates)
Supportive care: fluids and electrolyte balance; potassium if needed; NPO 3-4 days if vomiting; antiemetics; analgesia (Buprenorphine in cats; butorphanol in dogs) antibiotics: (enroflaxin - trimethaprin gluccocorticoids)
Based on HX and PE; cbc/chem (cbc may indicate stress leukogram and dehydration)
x- rays -- mild hepatomegaly ultrasound-- hyperechoic liver histopathology-- severley vacuolized hepatocytes

9. Feline Hepatic Lipidosis signs
Anorexia - depression - weight loss - spoadic vomiting - hepatomegaly - possible bleeding tendencies (petechiae - bleeding from gums0
Potassium supplement if < 3 mEq monitor ecg treat w/ lidocaine or procanimade * surgery
Many cats have underlying disease that interferes with local immunity in gingava' cats should be screened for disease
young german shepherds have predisposition to pancreatic acinar atrophy; in cats EPI often caused by chronic pancreatitis

10. Portosystemic shunts TX
Chronic small intestinal inflammatory bowel disease (IBD) in dogs and cats chronic antigenic stimulation of the intestinal lumen (from many causes) causes and infiltration of lamina propria with lymphocytes and plasma cells (causes damage to mucosa a
Medical management seldom successful - low protein diet - lactilose - metronidazole - fluids - surgical ligation of shunt is preferred
Contraindicated because docusate will act as a surfacant on the mineral oil - allowing it to be absorbed by the colonic mucosa - and the mineral oil will prevent water from getting to feces
Unclear mechanism: diet and exercise - delayed gastric emptying - pyloric obstruction - aerophagia - and engorgement; possible gastric dysrhthmias; filling w/ air causes dilation (bloat); air filled stomach twisting on it axis causes volvulus

11. Diseases of Pancreas: what/causes
Possesses wetting and emulsifying properties - salts reduce surface tension and allow water and fat to penetrate the ingesta and formed feces - may have an effect on cells of the colonic mucosa allowing the ceels to more easily secrete water into lum
Inflammation of the pancreas; acute or chronic digestive enzymes are activated within the gland causes autodigestion - gland becomes inflamed resulting in tissue damage - high fat diets predispose - assoc w/ hepatic liidosis - drugs - parasites - tu
Most common diarrhea; change in diet - drug therapy - stressful situations causes disruption of normal bacterial flora signs abrupt onset diarrhea - +/- vomiting
Perineal swelling - tenesmus - dyschezia - constipation - possible urethral obstruction if bladder involved

12. Portosystemic shunts more signs
HX and pe demonstrate weak - shocky animal (long crt - abnormal mm) xray ecg - ventricular arrhthmia or sinus tach cbc/chem for correction of electrolye and ph imbalances - fluid therapy
Vomiting - diarrhea - stunted growth - PU/PD/ urate urolithiasis - hematuria - ammonium biurate crystals in sediment - dilute urine
Greatly increased ALP - increased ALT - AST - hyperbilirubinemia - hypoalbuminemia - increased serum bile acids
Supportive care: fluids and electrolyte balance; potassium if needed; NPO 3-4 days if vomiting; antiemetics; analgesia (Buprenorphine in cats; butorphanol in dogs) antibiotics: (enroflaxin - trimethaprin gluccocorticoids)

13. Feline Hepatic Lipidosis prevention
Fairly common in cats(middle- age to older cats); can occur from hypokalema - hypothyroidism - pelvic deformities; 62% of cases are idiopathic; believed to involve a defect in neurostimulation for colon evacuation
Parvovirus - distemper - coroavirus - feline panleukopenia
Avoid stress in obese cats - early intervention essential - a cat that usually eats well and just stops is at risk - prevent obesity cure rate 60-65% - may be long and $
Single or multiple ulcerated sinuses that involve perianal tissue; often large breed dogs

14. what is acute diarrhea DX?
Fairly common in cats(middle- age to older cats); can occur from hypokalema - hypothyroidism - pelvic deformities; 62% of cases are idiopathic; believed to involve a defect in neurostimulation for colon evacuation
Increased serum trypsinogen - like immunoreactivity - pancreatic lipase immunoreactivity (cPLI) - and (fPLI)
Rule out other causes (MDB); fecal sample direct and float; HCT to monitor hydration
DO NOT USE PHOSPHATE ENEMAS IN CATS OR SMALL DOGS DO NOT MIX DOCUSATE AND MINERAL OIL

15. What is dietary treatment of large inflammatory bowel disease?
Occurs when smaller - proximal segment of intestine at ileocolic junction invaginates into larger - more distal segment of large intestine telescoping effect causes partial to complete blockage and compromises blood supply - causing necrosis
Treatment can be long and expensive - often not cured - monitor dogs and cats on long term antinflammatory therapy
Hypoallergenic diets - low fat diets with high fiber; goal to control signs; may have frequent defecation chronically
Cbc-- neutraophilia w/ left shift -- mild - regenerative anemia

16. What are signs of lymphatic plasmacytic stomatitis?
Inflamed gums - often with minor calculus
Cause unknown; ascending biliary infections from GI tract and immune- mediated causes have been suggested; Persian cats predisposed; sometimes occurs in conjuction with pancreatitis and IBD in cats (Triaditis)
Anorexia - acute vomiting - +/- dehydration - +/- painful abdomen
*gastric indiscretion (eating garbage) - spoiled food - change in diet - food allergy - infection(bacterial - viral - parasitic) - toxins - foreign object ingestion

17. What is lymphatic plasmacytic stomatitis
Rapidly growing tumors characterized by early bone involvement metastatisize to lungs
Excellent after surgical ligation; surgery yields best results if dog is less than one year - relapses may occur (more common in cats); animals with partial ligations of shunt may require low protein diet to avoid clinical signs of hepatic encephalop
Emergency!! decompress stomach(18 g needle) - stabilize patient - prep for surgery stomach tube treat shock bicarbonate if total carbon dioxide <12 mEq IV antibiotics targeted against gram-/anaerobes - cefoxtin - ampicillin
Atypical immune response of unknown etiology?

18. What is oral neoplasia squamous cell carcinoma?
Older animals
Ulcerative - erosive neoplasms; invade bone and metastisize to regional lymph nodes
Antibiotics - ursodeoxycolic acid - prednisone - fluid and electrolyte corrections - vitamin and nutritional support - S- adenosylmethioonie
Rapidly growing tumors characterized by early bone involvement metastatisize to lungs

19. Cholangiohepatitis signs
Supportive care: fluids and electrolyte balance; potassium if needed; NPO 3-4 days if vomiting; antiemetics; analgesia (Buprenorphine in cats; butorphanol in dogs) antibiotics: (enroflaxin - trimethaprin gluccocorticoids)
Common cause of vomiting in dogs
Common; melanomas and squamous cell carcinomas are most common: also fibrosarcomas
Anorexia - depression - weight loss - vomiting - dehydration - fever - jaundice - ascites - hepatomegaly

20. Gastric Dilation/Volvulus (GDV) DX
NPO 24-36 hrs - fluid therapy - feed low fat diet ie hills i/d cot cheese - chicken/rice antiemetics(chlorpromazine - metoclopramide - cerinia
Cause unknown; ascending biliary infections from GI tract and immune- mediated causes have been suggested; Persian cats predisposed; sometimes occurs in conjuction with pancreatitis and IBD in cats (Triaditis)
HX and pe demonstrate weak - shocky animal (long crt - abnormal mm) xray ecg - ventricular arrhthmia or sinus tach cbc/chem for correction of electrolye and ph imbalances - fluid therapy
Disease of dogs 2-10 - large and giant breed - deep chested

21. Perianal fistula (anal fistula) TX
Anorexia - depression - lethargy - weakness - ataxia - head- pressing - circling - pacing - blindness - seizures - coma - hypersalivation and bizarre aggressive behavior in cats
Extract all premolars - molars - and retained roots - if still recurs remove remaining teeth; steroids
Cyclosporin +/- ketoconazole - tacrolimus 0.1% topical - prednisone - azathioprine stool softeners(lactolose) antimicrobials (adjunct for seconary dermatitus)
Cbc-- neutraophilia w/ left shift -- mild - regenerative anemia

22. Feline Hepatic Lipidosis DX: CBC
Enlarged stomach pushes against diaphragm - making breathing difficult blocks venous return thru hepatic portal vein and caudal vena cava increased pressure on gastric wall causes ischemia and necrosis Spleen may be involved (congestion) *hypovolemic
Older obese dogs with history of recent fatty meal; painful abdomen - anorexia - depression - dehydration - vomiting - diarrhea - fever - shock and collapse
CBC; nonregenerative anemia; stress neutrophilia lymphopenia
HX and pe demonstrate weak - shocky animal (long crt - abnormal mm) xray ecg - ventricular arrhthmia or sinus tach cbc/chem for correction of electrolye and ph imbalances - fluid therapy

23. Portosystemic shunts signs
Inflammation of the pancreas; acute or chronic digestive enzymes are activated within the gland causes autodigestion - gland becomes inflamed resulting in tissue damage - high fat diets predispose - assoc w/ hepatic liidosis - drugs - parasites - tu
Common; melanomas and squamous cell carcinomas are most common: also fibrosarcomas
Anorexia - depression - lethargy - weakness - ataxia - head- pressing - circling - pacing - blindness - seizures - coma - hypersalivation and bizarre aggressive behavior in cats
Cbc-- neutraophilia w/ left shift -- mild - regenerative anemia

24. Why do cats get lymphatic plasmacytic stomatitis?
High protein - high calorie diet - feeding tube - (for up to 2 mos) - IV fluids - potassium supplementation - metaclopramide sq 15 min before feeding if vomiting occurs - wean cat off feeding tube
Single or multiple ulcerated sinuses that involve perianal tissue; often large breed dogs
Many cats have underlying disease that interferes with local immunity in gingava' cats should be screened for disease
Unclear mechanism: diet and exercise - delayed gastric emptying - pyloric obstruction - aerophagia - and engorgement; possible gastric dysrhthmias; filling w/ air causes dilation (bloat); air filled stomach twisting on it axis causes volvulus

25. Totally useless facts about pancreas
Vomiting - anorexia - depression - diarrhea (often bloody)
young german shepherds have predisposition to pancreatic acinar atrophy; in cats EPI often caused by chronic pancreatitis
Benign neoplasms (papilomas - epulides)
Anorexia - depression - lethargy - weakness - ataxia - head- pressing - circling - pacing - blindness - seizures - coma - hypersalivation and bizarre aggressive behavior in cats

26. Megacolon Tx
Ulcerative - erosive neoplasms; invade bone and metastisize to regional lymph nodes
Anorexia - depression - lethargy - weakness - ataxia - head- pressing - circling - pacing - blindness - seizures - coma - hypersalivation and bizarre aggressive behavior in cats
Subtotal colectomy if refractory to medical and dietary management; rehydrate and correct electrolyte imbalances before anesthsia
Stool softeners - Ducolax - docusate - lactulose - enemas - Cisapride - correct dehydration and electrolyte imbalances - antibiotics to protect against sepsis thru damaged colonic wall - treat any underlying disease

27. What is the cause gastritis?
Greatly increased ALP - increased ALT - AST - hyperbilirubinemia - hypoalbuminemia - increased serum bile acids
Older obese dogs with history of recent fatty meal; painful abdomen - anorexia - depression - dehydration - vomiting - diarrhea - fever - shock and collapse
Rapidly growing tumors characterized by early bone involvement metastatisize to lungs
Mucosa is damaged - inflammation occurs - signs develop

28. Diseases of Small Intestine acute diarrhea what/why/ causes/signs
Pancreas loses acinar cells followed by inadequate production of digestive enzymes; usually asymptomatic until 85-90% of secretory ability has been lost; lack of normal pancreatic secretions affect mucosal lining of small intestine and decrease absor
Lubricates feces and reduces water reabsorption of lumen
Extract all premolars - molars - and retained roots - if still recurs remove remaining teeth; steroids
Most common diarrhea; change in diet - drug therapy - stressful situations causes disruption of normal bacterial flora signs abrupt onset diarrhea - +/- vomiting

29. Cholangiohepatitis DX: liver biopsy
Anorexia - depression - lethargy - weakness - ataxia - head- pressing - circling - pacing - blindness - seizures - coma - hypersalivation and bizarre aggressive behavior in cats
Fairly common in cats(middle- age to older cats); can occur from hypokalema - hypothyroidism - pelvic deformities; 62% of cases are idiopathic; believed to involve a defect in neurostimulation for colon evacuation
Cellular infiltrates in or near bile ducts; +/- portal triad fibrosis (definative diagnosis)
Causes pain - bleeding - self mutilation - dyschezia - anal stenosis - tenesmus - incontinence - licking perianal area - foul odor to anal area

30. Exocrine pancreatic insufficiency (EPI) TX
Treatment can be long and expensive - often not cured - monitor dogs and cats on long term antinflammatory therapy
Supplement pancreatic enzymes - give pancrezyme or Viokase-V - chopped - raw pig or ox pancreas; low fiber diet with high digestibility; rx: chain tryglyceride vitamins antibiotic therapy prednisone
Often non specific - chronic intermittent vomit/ -+/- diarrhea - listlessness - weight loss - older animals - Borygmus (gas sounds in intestine) - halitosis - flatulence - signs progressive over time
Unknown - but can result from parasites - foreign bodies - infections - neoplasia

31. Perianal fistula (anal fistula) signs
Unknown - but can result from parasites - foreign bodies - infections - neoplasia
Hypoproteinemia - hypoalbuminemia - decreased BUN - mildly increased ALT< ALP - increased serum bile acids - hyperammonemia
Causes pain - bleeding - self mutilation - dyschezia - anal stenosis - tenesmus - incontinence - licking perianal area - foul odor to anal area
Idiopathic - most common hepatopathy in cats adult - obese cats any age - sex - breed

32. Viral Diarrhea
Sulfasalizine (caution with cats and dry eye in dog with long term use) ( -Keratoconjunctivitis -KCS) - pred - metronidazole - azathioprine - tylosin - mesalamine(sim to sulfasalazine - anti inflammatory drug w/ free radicals
Parvovirus - distemper - coroavirus - feline panleukopenia
Debride ulcers and diseased tissue - possibly cryosurgery - may use medical tx first to decrease the size of the fistulas - then surgery
Anorexia - depression - weight loss - vomiting - dehydration - fever - jaundice - ascites - hepatomegaly

33. Gastric Dilation/Volvulus (GDV) signs
Cbc normal; increased ALT; decreased total lipid serum; trypsin - likeimmunoreactivity levels are decreased
Weakness - collapse - depression - nausea - non - productive retching - hypersalivation - abdominal pain and distension - increased hr and resp
Extract all premolars - molars - and retained roots - if still recurs remove remaining teeth; steroids
Mdb - fecal - xray - colonoscopy with biopsy ( histo will show lymphocytes and plasma cells in large intestinal lamina propria)

34. Describe docusate enema for mega colon or constipation.
Cbc - microcytosis - target cells - poikilocytosis - mild regenerative anemia xray microhepatia
Anorexia - depression - weight loss - vomiting - dehydration - fever - jaundice - ascites - hepatomegaly
Enlarged stomach pushes against diaphragm - making breathing difficult blocks venous return thru hepatic portal vein and caudal vena cava increased pressure on gastric wall causes ischemia and necrosis Spleen may be involved (congestion) *hypovolemic
Possesses wetting and emulsifying properties - salts reduce surface tension and allow water and fat to penetrate the ingesta and formed feces - may have an effect on cells of the colonic mucosa allowing the ceels to more easily secrete water into lum

35. What is megacolon? : who gets it?
Irreversible - requires life long treatment; expensive (pancreatic enzyme replacements); give with every meal; most animals will regain weight and diarrhea will resolve
Hypoproteinemia - hypoalbuminemia - decreased BUN - mildly increased ALT< ALP - increased serum bile acids - hyperammonemia
Mild to moderate increase in ALT - normal to increased ALP - mild to moderate increase in GGT - normal to increased fasting serum bile acids - hypoalbuminemia -(later stages) - decreased BUN(later stages)
Fairly common in cats(middle- age to older cats); can occur from hypokalema - hypothyroidism - pelvic deformities; 62% of cases are idiopathic; believed to involve a defect in neurostimulation for colon evacuation

36. What is large inflammatory bowel disease: TX
Sulfasalizine (caution with cats and dry eye in dog with long term use) ( -Keratoconjunctivitis -KCS) - pred - metronidazole - azathioprine - tylosin - mesalamine(sim to sulfasalazine - anti inflammatory drug w/ free radicals
Contraindicated because docusate will act as a surfacant on the mineral oil - allowing it to be absorbed by the colonic mucosa - and the mineral oil will prevent water from getting to feces
Vomiting - diarrhea - stunted growth - PU/PD/ urate urolithiasis - hematuria - ammonium biurate crystals in sediment - dilute urine
Surgical removal - chemo - radiation poor prognosis

37. Diseases of Large Intestine: large inflammatory bowel disease
Anorexia - acute vomiting - +/- dehydration - +/- painful abdomen
Causes pain - bleeding - self mutilation - dyschezia - anal stenosis - tenesmus - incontinence - licking perianal area - foul odor to anal area
Very similar to small intestine diseases - excessive number of inflammatory cells in mucosa - unknown etiology - likely multi factorial - colonic inflammation disrupts mucosal integrity and results in decreased absorption of water and electrolytes
Mild to moderate increase in ALT - normal to increased ALP - mild to moderate increase in GGT - normal to increased fasting serum bile acids - hypoalbuminemia -(later stages) - decreased BUN(later stages)

38. Diseases of Pancreas: who/signs
Older obese dogs with history of recent fatty meal; painful abdomen - anorexia - depression - dehydration - vomiting - diarrhea - fever - shock and collapse
Cbc - leukocytosis - increased PCV chem - azotemia - increased ALT - mils hypocalcemia - hyperlipemia - normal to increased amylase and lipase4
Single or multiple ulcerated sinuses that involve perianal tissue; often large breed dogs
Contraindicated because docusate will act as a surfacant on the mineral oil - allowing it to be absorbed by the colonic mucosa - and the mineral oil will prevent water from getting to feces

39. What is gastritis?
Common; melanomas and squamous cell carcinomas are most common: also fibrosarcomas
Contraindicated because docusate will act as a surfacant on the mineral oil - allowing it to be absorbed by the colonic mucosa - and the mineral oil will prevent water from getting to feces
Common cause of vomiting in dogs
Hypoallergenic diets - low fat diets with high fiber; goal to control signs; may have frequent defecation chronically

40. Diseases of Pancreas: DX: tests
Lubricated red rubber feeding tube inserted and enema solution injected: pre- fabricated pet enemas are available: include warm - soapy water (avoid hexachlorophene); docusate (emollient); mineral oil(lubricant)
Increased serum trypsinogen - like immunoreactivity - pancreatic lipase immunoreactivity (cPLI) - and (fPLI)
Mucosa is damaged - inflammation occurs - signs develop
Ductus venosus remains patent after birth - the blood from abdominal viscera will continue to bypass liver - liver is unable to filter deleterious and toxic substances

41. What is Feline Hepatic Lipidosis? who gets it?
Surgical removal - chemo - radiation poor prognosis
Idiopathic - most common hepatopathy in cats adult - obese cats any age - sex - breed
Weakness - collapse - depression - nausea - non - productive retching - hypersalivation - abdominal pain and distension - increased hr and resp
CBC; nonregenerative anemia; stress neutrophilia lymphopenia

42. Megacolon signs are?
Greatly increased ALP - increased ALT - AST - hyperbilirubinemia - hypoalbuminemia - increased serum bile acids
Supplement pancreatic enzymes - give pancrezyme or Viokase-V - chopped - raw pig or ox pancreas; low fiber diet with high digestibility; rx: chain tryglyceride vitamins antibiotic therapy prednisone
Straining to defecate - vomiting - weakness - dehydration - anorexia - small hard feces+/- blood - mucus
Many cats have underlying disease that interferes with local immunity in gingava' cats should be screened for disease

43. Cholangiohepatitis DX : bw
Avoid feeding one lg meal limit exercise after eating feed high quality - protein - low fat diet avoid easily fermentable food DX has 15-18% mortality rate; gastropexy no guarantee against future episodes
Weakness - collapse - depression - nausea - non - productive retching - hypersalivation - abdominal pain and distension - increased hr and resp
Pancreas loses acinar cells followed by inadequate production of digestive enzymes; usually asymptomatic until 85-90% of secretory ability has been lost; lack of normal pancreatic secretions affect mucosal lining of small intestine and decrease absor
Cbc-- neutraophilia w/ left shift -- mild - regenerative anemia

44. How crazy Dr C is to think we can learn all of this SH*T!!!!!!
Extract all premolars - molars - and retained roots - if still recurs remove remaining teeth; steroids
Inflammation of the pancreas; acute or chronic digestive enzymes are activated within the gland causes autodigestion - gland becomes inflamed resulting in tissue damage - high fat diets predispose - assoc w/ hepatic liidosis - drugs - parasites - tu
Many cats have underlying disease that interferes with local immunity in gingava' cats should be screened for disease
CERTIFIABLE! OMG!

45. Cholangiohepatitis DX : chem
Most common diarrhea; change in diet - drug therapy - stressful situations causes disruption of normal bacterial flora signs abrupt onset diarrhea - +/- vomiting
Idiopathic - most common hepatopathy in cats adult - obese cats any age - sex - breed
Mild to moderate increase in ALT - normal to increased ALP - mild to moderate increase in GGT - normal to increased fasting serum bile acids - hypoalbuminemia -(later stages) - decreased BUN(later stages)
Mucosa is damaged - inflammation occurs - signs develop

46. How to treat megacolon with diet?
NPO 24-36 hrs - fluid therapy - feed low fat diet ie hills i/d cot cheese - chicken/rice antiemetics(chlorpromazine - metoclopramide - cerinia
Mdb - fecal - xray - colonoscopy with biopsy ( histo will show lymphocytes and plasma cells in large intestinal lamina propria)
Benign neoplasms (papilomas - epulides)
Increase fiber - soft canned food - salt food to increase water intake

47. How to give enemas for mega colon or constipation?
NPO 24-36 hrs - fluid therapy - feed low fat diet ie hills i/d cot cheese - chicken/rice antiemetics(chlorpromazine - metoclopramide - cerinia
Lubricated red rubber feeding tube inserted and enema solution injected: pre- fabricated pet enemas are available: include warm - soapy water (avoid hexachlorophene); docusate (emollient); mineral oil(lubricant)
Most common diarrhea; change in diet - drug therapy - stressful situations causes disruption of normal bacterial flora signs abrupt onset diarrhea - +/- vomiting
Cbc normal; increased ALT; decreased total lipid serum; trypsin - likeimmunoreactivity levels are decreased

48. Feline Hepatic Lipidosis triggers
Stress - diet changes - boarding - illness; enviro. change resulting in anorexia >2 wks - imbalance occurs between breakdown of peripheral lipids; lipid clearance w/in liver occurs; excess fat accumulation w/in hepatocytes
Diarrhea w/o weight loss - increased frequency of defecation w/ decreased fecal volume - tenesmus - hematochezia (frank blood) - increased mucus - +/- dsschezia and mild fever
Cyclosporin +/- ketoconazole - tacrolimus 0.1% topical - prednisone - azathioprine stool softeners(lactolose) antimicrobials (adjunct for seconary dermatitus)
Ductus venosus remains patent after birth - the blood from abdominal viscera will continue to bypass liver - liver is unable to filter deleterious and toxic substances

49. What is the cause of cholangiohepatitis? who does it affect?
Mild to marked weight loss; polyphagia - coprophagia - pica - diarrhea - fatty stoo; foul smelling poop; flatulence
Cause unknown; ascending biliary infections from GI tract and immune- mediated causes have been suggested; Persian cats predisposed; sometimes occurs in conjuction with pancreatitis and IBD in cats (Triaditis)
Pancreas loses acinar cells followed by inadequate production of digestive enzymes; usually asymptomatic until 85-90% of secretory ability has been lost; lack of normal pancreatic secretions affect mucosal lining of small intestine and decrease absor
Greatly increased ALP - increased ALT - AST - hyperbilirubinemia - hypoalbuminemia - increased serum bile acids

50. What are causes of acute gastritis?
Supportive care: fluids and electrolyte balance; potassium if needed; NPO 3-4 days if vomiting; antiemetics; analgesia (Buprenorphine in cats; butorphanol in dogs) antibiotics: (enroflaxin - trimethaprin gluccocorticoids)
CBC; nonregenerative anemia; stress neutrophilia lymphopenia
*gastric indiscretion (eating garbage) - spoiled food - change in diet - food allergy - infection(bacterial - viral - parasitic) - toxins - foreign object ingestion
Mild to moderate increase in ALT - normal to increased ALP - mild to moderate increase in GGT - normal to increased fasting serum bile acids - hypoalbuminemia -(later stages) - decreased BUN(later stages)

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