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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. What is Chronic Enteropathies TX (cont)
Treatment can be long and expensive - often not cured - monitor dogs and cats on long term antinflammatory therapy
Toxocara canis - Toxascaris leonina - and Toxocara cati (roundworms) - Trichuris vulpis -(whipworms) Ancylostoma caninum - Isopora spp (coccidia) - Capillaria aerophila - Giardia spp - Tritrichomonas foetus
Mucosa is damaged - inflammation occurs - signs develop
Rapidly growing tumors characterized by early bone involvement metastatisize to lungs

2. What is large inflammatory bowel disease: TX
Perineal swelling - tenesmus - dyschezia - constipation - possible urethral obstruction if bladder involved
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
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
Pred - azathioprine - metronidazole - intestinal protectants (sucralfate - H2 blockers) - vitamin therapy to replace fat- soluable vitamins - dietary modifications - limit carb - avoid lactose - low- fat diets - good quality protein diet

3. Feline Hepatic Lipidosis TX
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
Cyclosporin +/- ketoconazole - tacrolimus 0.1% topical - prednisone - azathioprine stool softeners(lactolose) antimicrobials (adjunct for seconary dermatitus)
Mdb - fecal - xray - colonoscopy with biopsy ( histo will show lymphocytes and plasma cells in large intestinal lamina propria)
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

4. What are gastritis signs?
NPO 24-36 hrs - fluid therapy - feed low fat diet ie hills i/d cot cheese - chicken/rice antiemetics(chlorpromazine - metoclopramide - cerinia
Atypical immune response of unknown etiology?
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
Anorexia - acute vomiting - +/- dehydration - +/- painful abdomen

5. What is dietary treatment of large inflammatory bowel disease?
Mucosa is damaged - inflammation occurs - signs develop
Hypoallergenic diets - low fat diets with high fiber; goal to control signs; may have frequent defecation chronically
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
Lubricates feces and reduces water reabsorption of lumen

6. Exocrine pancreatic insufficiency (EPI) DX
Cbc normal; increased ALT; decreased total lipid serum; trypsin - likeimmunoreactivity levels are decreased
Older obese dogs with history of recent fatty meal; painful abdomen - anorexia - depression - dehydration - vomiting - diarrhea - fever - shock and collapse
Older animals
Cellular infiltrates in or near bile ducts; +/- portal triad fibrosis (definative diagnosis)

7. Megacolon signs are?
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
Often non specific - chronic intermittent vomit/ -+/- diarrhea - listlessness - weight loss - older animals - Borygmus (gas sounds in intestine) - halitosis - flatulence - signs progressive over time
Straining to defecate - vomiting - weakness - dehydration - anorexia - small hard feces+/- blood - mucus
Diarrhea w/o weight loss - increased frequency of defecation w/ decreased fecal volume - tenesmus - hematochezia (frank blood) - increased mucus - +/- dsschezia and mild fever

8. Exocrine Pancreatic Insuffciency (what it is and then some...)
Vomiting - diarrhea - stunted growth - PU/PD/ urate urolithiasis - hematuria - ammonium biurate crystals in sediment - dilute urine
CERTIFIABLE! OMG!
Atypical immune response of unknown etiology?
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

9. Perianal fistula (anal fistula) signs
Debride ulcers and diseased tissue - possibly cryosurgery - may use medical tx first to decrease the size of the fistulas - then surgery
Weakness - collapse - depression - nausea - non - productive retching - hypersalivation - abdominal pain and distension - increased hr and resp
Causes pain - bleeding - self mutilation - dyschezia - anal stenosis - tenesmus - incontinence - licking perianal area - foul odor to anal area
Anorexia - depression - weight loss - vomiting - dehydration - fever - jaundice - ascites - hepatomegaly

10. Portosystemic shunts DX: cbc - x- ray
Parvovirus - distemper - coroavirus - feline panleukopenia
Males have increased risk for melonoma and fibrosarcoma; dogs with pimented oral mucosa greater risk for melonoma
Cbc - microcytosis - target cells - poikilocytosis - mild regenerative anemia xray microhepatia
Cbc normal; increased ALT; decreased total lipid serum; trypsin - likeimmunoreactivity levels are decreased

11. How to give enemas for mega colon or constipation?
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
Inflamed gums - often with minor calculus
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)
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

12. Perineal hernias signs
Parvovirus - distemper - coroavirus - feline panleukopenia
Perineal swelling - tenesmus - dyschezia - constipation - possible urethral obstruction if bladder involved
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
Vomiting - diarrhea - stunted growth - PU/PD/ urate urolithiasis - hematuria - ammonium biurate crystals in sediment - dilute urine

13. What is gastritis TX?
Treatment can be long and expensive - often not cured - monitor dogs and cats on long term antinflammatory therapy
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
NPO 24-36 hrs - fluid therapy - feed low fat diet ie hills i/d cot cheese - chicken/rice antiemetics(chlorpromazine - metoclopramide - cerinia
Mild to marked weight loss; polyphagia - coprophagia - pica - diarrhea - fatty stoo; foul smelling poop; flatulence

14. Feline Hepatic Lipidosis DX: Chem
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
Weakness - collapse - depression - nausea - non - productive retching - hypersalivation - abdominal pain and distension - increased hr and resp
Pred - azathioprine - metronidazole - intestinal protectants (sucralfate - H2 blockers) - vitamin therapy to replace fat- soluable vitamins - dietary modifications - limit carb - avoid lactose - low- fat diets - good quality protein diet
Greatly increased ALP - increased ALT - AST - hyperbilirubinemia - hypoalbuminemia - increased serum bile acids

15. Feline Hepatic Lipidosis DX: CBC
Lubricates feces and reduces water reabsorption of lumen
CBC; nonregenerative anemia; stress neutrophilia lymphopenia
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

16. Exocrine pancreatic insufficiency (EPI) TX
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)
Surgical removal - chemo - radiation poor prognosis
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)
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

17. Totally useless facts about pancreas
Unknown - but can result from parasites - foreign bodies - infections - neoplasia
Cbc-- neutraophilia w/ left shift -- mild - regenerative anemia
young german shepherds have predisposition to pancreatic acinar atrophy; in cats EPI often caused by chronic pancreatitis
Surgical reduction or resection of necrotic bowel fluids and electrolytes; broad spectrum antobiotics post surgery; no solid food for 24 hrs - then bland diet for 10-24 days to allow healing of intestinal walls

18. Why is mineral oil and docusate enema for mega colon or constipation contraindicated?
Pred - azathioprine - metronidazole - intestinal protectants (sucralfate - H2 blockers) - vitamin therapy to replace fat- soluable vitamins - dietary modifications - limit carb - avoid lactose - low- fat diets - good quality protein diet
Antibiotics - ursodeoxycolic acid - prednisone - fluid and electrolyte corrections - vitamin and nutritional support - S- adenosylmethioonie
Anorexia - depression - weight loss - vomiting - dehydration - fever - jaundice - ascites - hepatomegaly
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

19. Diseases of Pancreas: what/causes
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
CBC; nonregenerative anemia; stress neutrophilia lymphopenia
Males have increased risk for melonoma and fibrosarcoma; dogs with pimented oral mucosa greater risk for melonoma
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)

20. What is treatment for lymphatic plasmacytic stomatitis?
Inflamed gums - often with minor calculus
Clean teeth - antibiotics - oral antiseptics - daily brushing w/ antibacterial solutions - hard diet - rechecks
Based on HX and PE; cbc/chem (cbc may indicate stress leukogram and dehydration)
young german shepherds have predisposition to pancreatic acinar atrophy; in cats EPI often caused by chronic pancreatitis

21. Intussusception signs are...
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
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
Vomiting - anorexia - depression - diarrhea (often bloody)
Hepatomegaly or choleliths may be observed

22. Diseases of Pancreas: DX: tests
Increased serum trypsinogen - like immunoreactivity - pancreatic lipase immunoreactivity (cPLI) - and (fPLI)
Older animals
x- rays -- mild hepatomegaly ultrasound-- hyperechoic liver histopathology-- severley vacuolized hepatocytes
Straining to defecate - vomiting - weakness - dehydration - anorexia - small hard feces+/- blood - mucus

23. Cholangiohepatitis DX: radiology
Anorexia - depression - weight loss - vomiting - dehydration - fever - jaundice - ascites - hepatomegaly
Hepatomegaly or choleliths may be observed
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)
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

24. Portosystemic shunts PX
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
Hepatomegaly or choleliths may be observed
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
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

25. Feline Hepatic Lipidosis prevention
DO NOT USE PHOSPHATE ENEMAS IN CATS OR SMALL DOGS DO NOT MIX DOCUSATE AND MINERAL OIL
Common cause of vomiting in dogs
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
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 $

26. Perianal fistula (anal fistula) SX
Hypoallergenic diets - low fat diets with high fiber; goal to control signs; may have frequent defecation chronically
Debride ulcers and diseased tissue - possibly cryosurgery - may use medical tx first to decrease the size of the fistulas - then surgery
Cbc-- neutraophilia w/ left shift -- mild - regenerative anemia
young german shepherds have predisposition to pancreatic acinar atrophy; in cats EPI often caused by chronic pancreatitis

27. Feline Hepatic Lipidosis DX
Mucosa is damaged - inflammation occurs - signs develop
Benign neoplasms (papilomas - epulides)
x- rays -- mild hepatomegaly ultrasound-- hyperechoic liver histopathology-- severley vacuolized hepatocytes
Rapidly growing tumors characterized by early bone involvement metastatisize to lungs

28. What is the etiology of Gastric Dilation/Volvulus (GDV)
Vomiting - diarrhea - stunted growth - PU/PD/ urate urolithiasis - hematuria - ammonium biurate crystals in sediment - dilute urine
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)
Common; melanomas and squamous cell carcinomas are most common: also fibrosarcomas
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

29. Intussusception cause
Unknown - but can result from parasites - foreign bodies - infections - neoplasia
Treatment can be long and expensive - often not cured - monitor dogs and cats on long term antinflammatory therapy
Vomiting - anorexia - depression - diarrhea (often bloody)
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)

30. What is large inflammatory bowel disease: DX
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
Straining to defecate - vomiting - weakness - dehydration - anorexia - small hard feces+/- blood - mucus
Mdb - fecal - xray - colonoscopy with biopsy ( histo will show lymphocytes and plasma cells in large intestinal lamina propria)
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

31. What are Portosystemic shunts?
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
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
Irreversible - requires life long treatment; expensive (pancreatic enzyme replacements); give with every meal; most animals will regain weight and diarrhea will resolve

32. Gastric Dilation/Volvulus (GDV) physiology
Hypoallergenic diets - low fat diets with high fiber; goal to control signs; may have frequent defecation chronically
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
Anorexia - depression - weight loss - spoadic vomiting - hepatomegaly - possible bleeding tendencies (petechiae - bleeding from gums0
young german shepherds have predisposition to pancreatic acinar atrophy; in cats EPI often caused by chronic pancreatitis

33. Portosystemic shunts more signs
Vomiting - diarrhea - stunted growth - PU/PD/ urate urolithiasis - hematuria - ammonium biurate crystals in sediment - dilute urine
PE often normal - edema or ascities if protein losing enteropathy - mdb - fecal - xray - endoscopy/biopsy (looking for lymphotic- plasmacytic infiltrates)
Older obese dogs with history of recent fatty meal; painful abdomen - anorexia - depression - dehydration - vomiting - diarrhea - fever - shock and collapse
Pe - distended colon is filled with firm - packed feces - x- ray show colon width greater than length of lumbar vertebra - mdb (possible dehydration - increased hct

34. Diseases of Small Intestine acute diarrhea what/why/ causes/signs
Antibiotics - ursodeoxycolic acid - prednisone - fluid and electrolyte corrections - vitamin and nutritional support - S- adenosylmethioonie
Most common diarrhea; change in diet - drug therapy - stressful situations causes disruption of normal bacterial flora signs abrupt onset diarrhea - +/- vomiting
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
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

35. What are signs of lymphatic plasmacytic stomatitis?
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)
Inflamed gums - often with minor calculus
Medical management seldom successful - low protein diet - lactilose - metronidazole - fluids - surgical ligation of shunt is preferred
Common cause of vomiting in dogs

36. Megacolon Tx
Mucosa is damaged - inflammation occurs - signs develop
Irreversible - requires life long treatment; expensive (pancreatic enzyme replacements); give with every meal; most animals will regain weight and diarrhea will resolve
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
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

37. Diseases of Large Intestine: large inflammatory bowel disease
Cellular infiltrates in or near bile ducts; +/- portal triad fibrosis (definative diagnosis)
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
Debride ulcers and diseased tissue - possibly cryosurgery - may use medical tx first to decrease the size of the fistulas - then surgery
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)

38. Cholangiohepatitis DX : bw
Common cause of vomiting in dogs
Cbc-- neutraophilia w/ left shift -- mild - regenerative anemia
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
Vomiting - diarrhea - stunted growth - PU/PD/ urate urolithiasis - hematuria - ammonium biurate crystals in sediment - dilute urine

39. Chronic Enteropathies signs
Parvovirus - distemper - coroavirus - feline panleukopenia
Medical management seldom successful - low protein diet - lactilose - metronidazole - fluids - surgical ligation of shunt is preferred
Hepatomegaly or choleliths may be observed
Often non specific - chronic intermittent vomit/ -+/- diarrhea - listlessness - weight loss - older animals - Borygmus (gas sounds in intestine) - halitosis - flatulence - signs progressive over time

40. Chronic Enteropathies
Straining to defecate - vomiting - weakness - dehydration - anorexia - small hard feces+/- blood - mucus
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
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
Cbc - microcytosis - target cells - poikilocytosis - mild regenerative anemia xray microhepatia

41. Megacolon surgical
Older obese dogs with history of recent fatty meal; painful abdomen - anorexia - depression - dehydration - vomiting - diarrhea - fever - shock and collapse
Common; melanomas and squamous cell carcinomas are most common: also fibrosarcomas
Subtotal colectomy if refractory to medical and dietary management; rehydrate and correct electrolyte imbalances before anesthsia
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

42. Intussusception - what is it?
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
Common; melanomas and squamous cell carcinomas are most common: also fibrosarcomas
Lubricates feces and reduces water reabsorption of lumen
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

43. Feline Hepatic Lipidosis triggers
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
Males have increased risk for melonoma and fibrosarcoma; dogs with pimented oral mucosa greater risk for melonoma
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
Cellular infiltrates in or near bile ducts; +/- portal triad fibrosis (definative diagnosis)

44. What is lymphatic plasmacytic stomatitis
Atypical immune response of unknown etiology?
Cyclosporin +/- ketoconazole - tacrolimus 0.1% topical - prednisone - azathioprine stool softeners(lactolose) antimicrobials (adjunct for seconary dermatitus)
Hypoproteinemia - hypoalbuminemia - decreased BUN - mildly increased ALT< ALP - increased serum bile acids - hyperammonemia
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 $

45. What conditions are common with oral neoplasia?
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
Antibiotics - ursodeoxycolic acid - prednisone - fluid and electrolyte corrections - vitamin and nutritional support - S- adenosylmethioonie
Irreversible - requires life long treatment; expensive (pancreatic enzyme replacements); give with every meal; most animals will regain weight and diarrhea will resolve
Benign neoplasms (papilomas - epulides)

46. Cholangiohepatitis TX
Common cause of vomiting in dogs
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
DO NOT USE PHOSPHATE ENEMAS IN CATS OR SMALL DOGS DO NOT MIX DOCUSATE AND MINERAL OIL
Antibiotics - ursodeoxycolic acid - prednisone - fluid and electrolyte corrections - vitamin and nutritional support - S- adenosylmethioonie

47. Gastric Dilation/Volvulus (GDV) TX (cont)
Increase fiber - soft canned food - salt food to increase water intake
Ulcerative - erosive neoplasms; invade bone and metastisize to regional lymph nodes
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
Potassium supplement if < 3 mEq monitor ecg treat w/ lidocaine or procanimade * surgery

48. Gastric Dilation/Volvulus (GDV) TX
With stool softeners and enemas palliatively
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
Single or multiple ulcerated sinuses that involve perianal tissue; often large breed dogs
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

49. What are causes of acute gastritis?
*gastric indiscretion (eating garbage) - spoiled food - change in diet - food allergy - infection(bacterial - viral - parasitic) - toxins - foreign object ingestion
Debride ulcers and diseased tissue - possibly cryosurgery - may use medical tx first to decrease the size of the fistulas - then surgery
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
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)

50. Cholangiohepatitis DX : chem
Vomiting - anorexia - depression - diarrhea (often bloody)
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)
Medical management seldom successful - low protein diet - lactilose - metronidazole - fluids - surgical ligation of shunt is preferred
Common; melanomas and squamous cell carcinomas are most common: also fibrosarcomas