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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.
Don't refresh. All questions and answers are randomly picked and ordered every time you load a test.

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. Exocrine pancreatic insufficiency (EPI) DX
Increased serum trypsinogen - like immunoreactivity - pancreatic lipase immunoreactivity (cPLI) - and (fPLI)
Cbc normal; increased ALT; decreased total lipid serum; trypsin - likeimmunoreactivity levels are decreased
Older animals
Antibiotics - ursodeoxycolic acid - prednisone - fluid and electrolyte corrections - vitamin and nutritional support - S- adenosylmethioonie

2. Intussusception DX
Siamese - himalayans - abyssinians
Palpation of sausage- like mass in cranial abdomen; ultrasound shows multi- layered concentric rings representing large intestinal wall layers
Straining to defecate - vomiting - weakness - dehydration - anorexia - small hard feces+/- blood - mucus
Older animals

3. Feline Hepatic Lipidosis DX: Chem
PE often normal - edema or ascities if protein losing enteropathy - mdb - fecal - xray - endoscopy/biopsy (looking for lymphotic- plasmacytic infiltrates)
Palpation of sausage- like mass in cranial abdomen; ultrasound shows multi- layered concentric rings representing large intestinal wall layers
Most common diarrhea; change in diet - drug therapy - stressful situations causes disruption of normal bacterial flora signs abrupt onset diarrhea - +/- vomiting
Greatly increased ALP - increased ALT - AST - hyperbilirubinemia - hypoalbuminemia - increased serum bile acids

4. What is large inflammatory bowel disease: DX
Diarrhea w/o weight loss - increased frequency of defecation w/ decreased fecal volume - tenesmus - hematochezia (frank blood) - increased mucus - +/- dsschezia and mild fever
Mdb - fecal - xray - colonoscopy with biopsy ( histo will show lymphocytes and plasma cells in large intestinal lamina propria)
Siamese - himalayans - abyssinians
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

5. Portosystemic shunts signs
Common in intact older male dogs >8; atrophy of levator ani muscle causes herniation of rectum and pelvic organs into ischiorectal fossa
Mdb - fecal - xray - colonoscopy with biopsy ( histo will show lymphocytes and plasma cells in large intestinal lamina propria)
Anorexia - depression - lethargy - weakness - ataxia - head- pressing - circling - pacing - blindness - seizures - coma - hypersalivation and bizarre aggressive behavior in cats
Lubricates feces and reduces water reabsorption of lumen

6. 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
Single or multiple ulcerated sinuses that involve perianal tissue; often large breed dogs
Older obese dogs with history of recent fatty meal; painful abdomen - anorexia - depression - dehydration - vomiting - diarrhea - fever - shock and collapse
Clean teeth - antibiotics - oral antiseptics - daily brushing w/ antibacterial solutions - hard diet - rechecks

7. Gastric Dilation/Volvulus (GDV) DX
Surgical removal - chemo - radiation poor prognosis
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
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

8. Cholangiohepatitis DX : bw
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)
Hypoallergenic diets - low fat diets with high fiber; goal to control signs; may have frequent defecation chronically
Atypical immune response of unknown etiology?
Cbc-- neutraophilia w/ left shift -- mild - regenerative anemia

9. How to treat lymphatic plasmacytic stomatitis if condition recurs?
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
Extract all premolars - molars - and retained roots - if still recurs remove remaining teeth; steroids
Often non specific - chronic intermittent vomit/ -+/- diarrhea - listlessness - weight loss - older animals - Borygmus (gas sounds in intestine) - halitosis - flatulence - signs progressive over time
Mild to marked weight loss; polyphagia - coprophagia - pica - diarrhea - fatty stoo; foul smelling poop; flatulence

10. What is treatment for lymphatic plasmacytic stomatitis?
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
Lubricates feces and reduces water reabsorption of lumen
Weakness - collapse - depression - nausea - non - productive retching - hypersalivation - abdominal pain and distension - increased hr and resp
Clean teeth - antibiotics - oral antiseptics - daily brushing w/ antibacterial solutions - hard diet - rechecks

11. Diseases of Pancreas: what/causes
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
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
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
Irreversible - requires life long treatment; expensive (pancreatic enzyme replacements); give with every meal; most animals will regain weight and diarrhea will resolve

12. Diseases of the Liver: what is cholangiohepatitis?
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
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
Recurrence infrequent - prognosis depends on extent of damage - common in puppies with heavy parasitic infestation
Inflamed gums - often with minor calculus

13. Feline Hepatic Lipidosis DX: CBC
Prognosis uncertain and variable; tx may be prolonged and expensive; permanent damage to liver my occur
CBC; nonregenerative anemia; stress neutrophilia lymphopenia
Single or multiple ulcerated sinuses that involve perianal tissue; often large breed dogs
Hepatomegaly or choleliths may be observed

14. what is acute diarrhea TX?
Increase fiber - soft canned food - salt food to increase water intake
Straining to defecate - vomiting - weakness - dehydration - anorexia - small hard feces+/- blood - mucus
Subtotal colectomy if refractory to medical and dietary management; rehydrate and correct electrolyte imbalances before anesthsia
Supportive and symptomatic fluid and electrolyte therapy - NPO 24-48 hrs - water if no vomiting - pepto bismol or loperamide - antibiotics - bland low fat diet

15. What is gastritis TX?
Cbc - leukocytosis - increased PCV chem - azotemia - increased ALT - mils hypocalcemia - hyperlipemia - normal to increased amylase and lipase4
Extract all premolars - molars - and retained roots - if still recurs remove remaining teeth; steroids
Inflamed gums - often with minor calculus
NPO 24-36 hrs - fluid therapy - feed low fat diet ie hills i/d cot cheese - chicken/rice antiemetics(chlorpromazine - metoclopramide - cerinia

16. Totally useless facts about pancreas
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
young german shepherds have predisposition to pancreatic acinar atrophy; in cats EPI often caused by chronic pancreatitis
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?

17. Portosystemic shunts DX: chem
Hypoproteinemia - hypoalbuminemia - decreased BUN - mildly increased ALT< ALP - increased serum bile acids - hyperammonemia
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
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
Mild to marked weight loss; polyphagia - coprophagia - pica - diarrhea - fatty stoo; foul smelling poop; flatulence

18. Who is prone to lymphatic plasmacytic stomatitis?
Anorexia - acute vomiting - +/- dehydration - +/- painful abdomen
Common cause of vomiting in dogs
Siamese - himalayans - abyssinians
PE often normal - edema or ascities if protein losing enteropathy - mdb - fecal - xray - endoscopy/biopsy (looking for lymphotic- plasmacytic infiltrates)

19. Diseases of Pancreas: who/signs
Recurrence infrequent - prognosis depends on extent of damage - common in puppies with heavy parasitic infestation
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
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

20. Describe docusate enema for mega colon or constipation.
Lubricates feces and reduces water reabsorption of lumen
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
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
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

21. What is Chronic Enteropathies TX (cont)
Weakness - collapse - depression - nausea - non - productive retching - hypersalivation - abdominal pain and distension - increased hr and resp
Most common diarrhea; change in diet - drug therapy - stressful situations causes disruption of normal bacterial flora signs abrupt onset diarrhea - +/- vomiting
Treatment can be long and expensive - often not cured - monitor dogs and cats on long term antinflammatory therapy
young german shepherds have predisposition to pancreatic acinar atrophy; in cats EPI often caused by chronic pancreatitis

22. Diseases of Large Intestine: large inflammatory bowel disease
Inflamed gums - often with minor calculus
Antibiotics - ursodeoxycolic acid - prednisone - fluid and electrolyte corrections - vitamin and nutritional support - S- adenosylmethioonie
Atypical immune response of unknown etiology?
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

23. Portosystemic shunts DX: cbc - x- ray
Irreversible - requires life long treatment; expensive (pancreatic enzyme replacements); give with every meal; most animals will regain weight and diarrhea will resolve
Cbc - microcytosis - target cells - poikilocytosis - mild regenerative anemia xray microhepatia
Increase fiber - soft canned food - salt food to increase water intake
Perineal swelling - tenesmus - dyschezia - constipation - possible urethral obstruction if bladder involved

24. What does mineral oil enema for mega colon or constipation do?
Recurrence infrequent - prognosis depends on extent of damage - common in puppies with heavy parasitic infestation
Increase fiber - soft canned food - salt food to increase water intake
With stool softeners and enemas palliatively
Lubricates feces and reduces water reabsorption of lumen

25. Chronic Enteropathies signs
Often non specific - chronic intermittent vomit/ -+/- diarrhea - listlessness - weight loss - older animals - Borygmus (gas sounds in intestine) - halitosis - flatulence - signs progressive over time
CERTIFIABLE! OMG!
Straining to defecate - vomiting - weakness - dehydration - anorexia - small hard feces+/- blood - mucus
Anorexia - acute vomiting - +/- dehydration - +/- painful abdomen

26. Perianal fistula (anal fistula) signs
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)
Cbc normal; increased ALT; decreased total lipid serum; trypsin - likeimmunoreactivity levels are decreased
Causes pain - bleeding - self mutilation - dyschezia - anal stenosis - tenesmus - incontinence - licking perianal area - foul odor to anal area
Increased serum trypsinogen - like immunoreactivity - pancreatic lipase immunoreactivity (cPLI) - and (fPLI)

27. Portosystemic shunts TX
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
Medical management seldom successful - low protein diet - lactilose - metronidazole - fluids - surgical ligation of shunt is preferred
Supportive and symptomatic fluid and electrolyte therapy - NPO 24-48 hrs - water if no vomiting - pepto bismol or loperamide - antibiotics - bland low fat diet
Irreversible - requires life long treatment; expensive (pancreatic enzyme replacements); give with every meal; most animals will regain weight and diarrhea will resolve

28. What is oral neoplasia?
Common in intact older male dogs >8; atrophy of levator ani muscle causes herniation of rectum and pelvic organs into ischiorectal fossa
Common; melanomas and squamous cell carcinomas are most common: also fibrosarcomas
Vomiting - anorexia - depression - diarrhea (often bloody)
Medical management seldom successful - low protein diet - lactilose - metronidazole - fluids - surgical ligation of shunt is preferred

29. Feline Hepatic Lipidosis signs
Cbc normal; increased ALT; decreased total lipid serum; trypsin - likeimmunoreactivity levels are decreased
Anorexia - depression - weight loss - spoadic vomiting - hepatomegaly - possible bleeding tendencies (petechiae - bleeding from gums0
Antibiotics - ursodeoxycolic acid - prednisone - fluid and electrolyte corrections - vitamin and nutritional support - S- adenosylmethioonie
CERTIFIABLE! OMG!

30. Cholangiohepatitis DX: radiology
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
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
Hypoproteinemia - hypoalbuminemia - decreased BUN - mildly increased ALT< ALP - increased serum bile acids - hyperammonemia
Hepatomegaly or choleliths may be observed

31. Megacolon DX
Irreversible - requires life long treatment; expensive (pancreatic enzyme replacements); give with every meal; most animals will regain weight and diarrhea will resolve
young german shepherds have predisposition to pancreatic acinar atrophy; in cats EPI often caused by chronic pancreatitis
Cbc-- neutraophilia w/ left shift -- mild - regenerative anemia
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

32. Perianal fistula (anal fistula) SX
Straining to defecate - vomiting - weakness - dehydration - anorexia - small hard feces+/- blood - mucus
Debride ulcers and diseased tissue - possibly cryosurgery - may use medical tx first to decrease the size of the fistulas - then surgery
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
Medical management seldom successful - low protein diet - lactilose - metronidazole - fluids - surgical ligation of shunt is preferred

33. Cholangiohepatitis DX: liver biopsy
Males have increased risk for melonoma and fibrosarcoma; dogs with pimented oral mucosa greater risk for melonoma
Cellular infiltrates in or near bile ducts; +/- portal triad fibrosis (definative diagnosis)
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
Potassium supplement if < 3 mEq monitor ecg treat w/ lidocaine or procanimade * surgery

34. Diseases of Pancreas: cbc and chem
Cbc - leukocytosis - increased PCV chem - azotemia - increased ALT - mils hypocalcemia - hyperlipemia - normal to increased amylase and lipase4
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
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)
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)

35. Megacolon signs are?
Males have increased risk for melonoma and fibrosarcoma; dogs with pimented oral mucosa greater risk for melonoma
Siamese - himalayans - abyssinians
Straining to defecate - vomiting - weakness - dehydration - anorexia - small hard feces+/- blood - mucus
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

36. How to treat megacolon with diet?
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
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
Increase fiber - soft canned food - salt food to increase water intake
Medical management seldom successful - low protein diet - lactilose - metronidazole - fluids - surgical ligation of shunt is preferred

37. Gastric Dilation/Volvulus (GDV) physiology
Hypoallergenic diets - low fat diets with high fiber; goal to control signs; may have frequent defecation chronically
Extract all premolars - molars - and retained roots - if still recurs remove remaining teeth; steroids
Lubricates feces and reduces water reabsorption of lumen
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

38. Feline Hepatic Lipidosis TX
Older animals
Mucosa is damaged - inflammation occurs - signs develop
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
NPO 24-36 hrs - fluid therapy - feed low fat diet ie hills i/d cot cheese - chicken/rice antiemetics(chlorpromazine - metoclopramide - cerinia

39. What is Feline Hepatic Lipidosis? who gets it?
Perineal swelling - tenesmus - dyschezia - constipation - possible urethral obstruction if bladder involved
Cbc - leukocytosis - increased PCV chem - azotemia - increased ALT - mils hypocalcemia - hyperlipemia - normal to increased amylase and lipase4
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
Idiopathic - most common hepatopathy in cats adult - obese cats any age - sex - breed

40. Perineal hernias TX
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
Palpation of sausage- like mass in cranial abdomen; ultrasound shows multi- layered concentric rings representing large intestinal wall layers
With stool softeners and enemas palliatively
*gastric indiscretion (eating garbage) - spoiled food - change in diet - food allergy - infection(bacterial - viral - parasitic) - toxins - foreign object ingestion

41. what is acute diarrhea DX?
Older animals
Rule out other causes (MDB); fecal sample direct and float; HCT to monitor hydration
Idiopathic - most common hepatopathy in cats adult - obese cats any age - sex - breed
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

42. Gastric Dilation/Volvulus (GDV) TX (cont)
Males have increased risk for melonoma and fibrosarcoma; dogs with pimented oral mucosa greater risk for melonoma
Toxocara canis - Toxascaris leonina - and Toxocara cati (roundworms) - Trichuris vulpis -(whipworms) Ancylostoma caninum - Isopora spp (coccidia) - Capillaria aerophila - Giardia spp - Tritrichomonas foetus
Common cause of vomiting in dogs
Potassium supplement if < 3 mEq monitor ecg treat w/ lidocaine or procanimade * surgery

43. What is gastritis?
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
Rule out other causes (MDB); fecal sample direct and float; HCT to monitor hydration
Common cause of vomiting in dogs
Cbc - microcytosis - target cells - poikilocytosis - mild regenerative anemia xray microhepatia

44. Intussusception cause
Increased serum trypsinogen - like immunoreactivity - pancreatic lipase immunoreactivity (cPLI) - and (fPLI)
Unknown - but can result from parasites - foreign bodies - infections - neoplasia
Rapidly growing tumors characterized by early bone involvement metastatisize to lungs
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)

45. Who gets Gastric Dilation/Volvulus (GDV)?
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
Disease of dogs 2-10 - large and giant breed - deep chested
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
NPO 24-36 hrs - fluid therapy - feed low fat diet ie hills i/d cot cheese - chicken/rice antiemetics(chlorpromazine - metoclopramide - cerinia

46. Intussusception signs are...
young german shepherds have predisposition to pancreatic acinar atrophy; in cats EPI often caused by chronic pancreatitis
Vomiting - anorexia - depression - diarrhea (often bloody)
Anorexia - depression - weight loss - spoadic vomiting - hepatomegaly - possible bleeding tendencies (petechiae - bleeding from gums0
Hypoproteinemia - hypoalbuminemia - decreased BUN - mildly increased ALT< ALP - increased serum bile acids - hyperammonemia

47. What is perianal fistula (anal fistula)? who does it affect?
Subtotal colectomy if refractory to medical and dietary management; rehydrate and correct electrolyte imbalances before anesthsia
Single or multiple ulcerated sinuses that involve perianal tissue; often large breed dogs
Common; melanomas and squamous cell carcinomas are most common: also fibrosarcomas
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

48. Exocrine pancreatic insufficiency (EPI) TX
Idiopathic - most common hepatopathy in cats adult - obese cats any age - sex - breed
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
Unknown - but can result from parasites - foreign bodies - infections - neoplasia
Anorexia - depression - weight loss - vomiting - dehydration - fever - jaundice - ascites - hepatomegaly

49. Exocrine pancreatic insufficiency (EPI) PX
Irreversible - requires life long treatment; expensive (pancreatic enzyme replacements); give with every meal; most animals will regain weight and diarrhea will resolve
Cyclosporin +/- ketoconazole - tacrolimus 0.1% topical - prednisone - azathioprine stool softeners(lactolose) antimicrobials (adjunct for seconary dermatitus)
Subtotal colectomy if refractory to medical and dietary management; rehydrate and correct electrolyte imbalances before anesthsia
Greatly increased ALP - increased ALT - AST - hyperbilirubinemia - hypoalbuminemia - increased serum bile acids

50. Megacolon Tx
x- rays -- mild hepatomegaly ultrasound-- hyperechoic liver histopathology-- severley vacuolized hepatocytes
Idiopathic - most common hepatopathy in cats adult - obese cats any age - sex - breed
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
With stool softeners and enemas palliatively