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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 DX
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
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
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
PE often normal - edema or ascities if protein losing enteropathy - mdb - fecal - xray - endoscopy/biopsy (looking for lymphotic- plasmacytic infiltrates)

2. What is the cause gastritis?
Common in intact older male dogs >8; atrophy of levator ani muscle causes herniation of rectum and pelvic organs into ischiorectal fossa
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
Mucosa is damaged - inflammation occurs - signs develop
Males have increased risk for melonoma and fibrosarcoma; dogs with pimented oral mucosa greater risk for melonoma

3. What is large inflammatory bowel disease: TX
Siamese - himalayans - abyssinians
Hepatomegaly or choleliths may be observed
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
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. Perianal fistula (anal fistula) TX
Males have increased risk for melonoma and fibrosarcoma; dogs with pimented oral mucosa greater risk for melonoma
Cyclosporin +/- ketoconazole - tacrolimus 0.1% topical - prednisone - azathioprine stool softeners(lactolose) antimicrobials (adjunct for seconary dermatitus)
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
Benign neoplasms (papilomas - epulides)

5. What is Chronic Enteropathies TX
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
NPO 24-36 hrs - fluid therapy - feed low fat diet ie hills i/d cot cheese - chicken/rice antiemetics(chlorpromazine - metoclopramide - cerinia
Unknown - but can result from parasites - foreign bodies - infections - neoplasia
young german shepherds have predisposition to pancreatic acinar atrophy; in cats EPI often caused by chronic pancreatitis

6. Exocrine pancreatic insufficiency (EPI) signs
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
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
CERTIFIABLE! OMG!
Mild to marked weight loss; polyphagia - coprophagia - pica - diarrhea - fatty stoo; foul smelling poop; flatulence

7. Portosystemic shunts DX: chem
Hypoproteinemia - hypoalbuminemia - decreased BUN - mildly increased ALT< ALP - increased serum bile acids - hyperammonemia
Increase fiber - soft canned food - salt food to increase water intake
Common; melanomas and squamous cell carcinomas are most common: also fibrosarcomas
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

8. Exocrine pancreatic insufficiency (EPI) TX
*gastric indiscretion (eating garbage) - spoiled food - change in diet - food allergy - infection(bacterial - viral - parasitic) - toxins - foreign object ingestion
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 $
Hepatomegaly or choleliths may be observed
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

9. 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
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
Rapidly growing tumors characterized by early bone involvement metastatisize to lungs
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

10. Gastric Dilation/Volvulus (GDV) TX
Single or multiple ulcerated sinuses that involve perianal tissue; often large breed dogs
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
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
Often non specific - chronic intermittent vomit/ -+/- diarrhea - listlessness - weight loss - older animals - Borygmus (gas sounds in intestine) - halitosis - flatulence - signs progressive over time

11. Feline Hepatic Lipidosis prevention
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)
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 $
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
Medical management seldom successful - low protein diet - lactilose - metronidazole - fluids - surgical ligation of shunt is preferred

12. What is Feline Hepatic Lipidosis? who gets it?
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
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)
Idiopathic - most common hepatopathy in cats adult - obese cats any age - sex - breed

13. What are signs of lymphatic plasmacytic stomatitis?
Anorexia - depression - weight loss - vomiting - dehydration - fever - jaundice - ascites - hepatomegaly
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
Inflamed gums - often with minor calculus
Diarrhea w/o weight loss - increased frequency of defecation w/ decreased fecal volume - tenesmus - hematochezia (frank blood) - increased mucus - +/- dsschezia and mild fever

14. What are contradictions with enema for mega colon or constipation?
Extract all premolars - molars - and retained roots - if still recurs remove remaining teeth; steroids
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 $
DO NOT USE PHOSPHATE ENEMAS IN CATS OR SMALL DOGS DO NOT MIX DOCUSATE AND MINERAL OIL
Hypoproteinemia - hypoalbuminemia - decreased BUN - mildly increased ALT< ALP - increased serum bile acids - hyperammonemia

15. Gastric Dilation/Volvulus (GDV) TX (cont)
Atypical immune response of unknown etiology?
Toxocara canis - Toxascaris leonina - and Toxocara cati (roundworms) - Trichuris vulpis -(whipworms) Ancylostoma caninum - Isopora spp (coccidia) - Capillaria aerophila - Giardia spp - Tritrichomonas foetus
Potassium supplement if < 3 mEq monitor ecg treat w/ lidocaine or procanimade * surgery
Ulcerative - erosive neoplasms; invade bone and metastisize to regional lymph nodes

16. Intussusception signs are...
Older obese dogs with history of recent fatty meal; painful abdomen - anorexia - depression - dehydration - vomiting - diarrhea - fever - shock and collapse
Vomiting - anorexia - depression - diarrhea (often bloody)
Recurrence infrequent - prognosis depends on extent of damage - common in puppies with heavy parasitic infestation
Siamese - himalayans - abyssinians

17. Cholangiohepatitis TX
Antibiotics - ursodeoxycolic acid - prednisone - fluid and electrolyte corrections - vitamin and nutritional support - S- adenosylmethioonie
Perineal swelling - tenesmus - dyschezia - constipation - possible urethral obstruction if bladder involved
Unknown - but can result from parasites - foreign bodies - infections - neoplasia
Common; melanomas and squamous cell carcinomas are most common: also fibrosarcomas

18. Who is most prone to oral neoplasia?
Surgical removal - chemo - radiation poor prognosis
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
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
Older animals

19. What is the cause of cholangiohepatitis? who does it affect?
Surgical removal - chemo - radiation poor prognosis
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
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)
Extract all premolars - molars - and retained roots - if still recurs remove remaining teeth; steroids

20. What are causes of acute gastritis?
Cyclosporin +/- ketoconazole - tacrolimus 0.1% topical - prednisone - azathioprine stool softeners(lactolose) antimicrobials (adjunct for seconary dermatitus)
*gastric indiscretion (eating garbage) - spoiled food - change in diet - food allergy - infection(bacterial - viral - parasitic) - toxins - foreign object ingestion
Atypical immune response of unknown etiology?
Medical management seldom successful - low protein diet - lactilose - metronidazole - fluids - surgical ligation of shunt is preferred

21. Who is prone to lymphatic plasmacytic stomatitis?
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
Siamese - himalayans - abyssinians
Extract all premolars - molars - and retained roots - if still recurs remove remaining teeth; steroids
Inflamed gums - often with minor calculus

22. Intussusception PX
Recurrence infrequent - prognosis depends on extent of damage - common in puppies with heavy parasitic infestation
Mucosa is damaged - inflammation occurs - signs develop
Often non specific - chronic intermittent vomit/ -+/- diarrhea - listlessness - weight loss - older animals - Borygmus (gas sounds in intestine) - halitosis - flatulence - signs progressive over time
Antibiotics - ursodeoxycolic acid - prednisone - fluid and electrolyte corrections - vitamin and nutritional support - S- adenosylmethioonie

23. Megacolon surgical (use caution)
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)
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
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
Causes pain - bleeding - self mutilation - dyschezia - anal stenosis - tenesmus - incontinence - licking perianal area - foul odor to anal area

24. Exocrine pancreatic insufficiency (EPI) DX
Clean teeth - antibiotics - oral antiseptics - daily brushing w/ antibacterial solutions - hard diet - rechecks
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
CERTIFIABLE! OMG!
Cbc normal; increased ALT; decreased total lipid serum; trypsin - likeimmunoreactivity levels are decreased

25. Why is mineral oil and docusate enema for mega colon or constipation contraindicated?
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
Recurrence infrequent - prognosis depends on extent of damage - common in puppies with heavy parasitic infestation
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

26. How to treat lymphatic plasmacytic stomatitis if condition recurs?
Cbc normal; increased ALT; decreased total lipid serum; trypsin - likeimmunoreactivity levels are decreased
Extract all premolars - molars - and retained roots - if still recurs remove remaining teeth; steroids
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
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

27. Perianal fistula (anal fistula) signs
Straining to defecate - vomiting - weakness - dehydration - anorexia - small hard feces+/- blood - mucus
Causes pain - bleeding - self mutilation - dyschezia - anal stenosis - tenesmus - incontinence - licking perianal area - foul odor to anal area
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 $
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)

28. Feline Hepatic Lipidosis DX
Many cats have underlying disease that interferes with local immunity in gingava' cats should be screened for disease
x- rays -- mild hepatomegaly ultrasound-- hyperechoic liver histopathology-- severley vacuolized hepatocytes
Vomiting - anorexia - depression - diarrhea (often bloody)
Atypical immune response of unknown etiology?

29. what is acute diarrhea DX?
Males have increased risk for melonoma and fibrosarcoma; dogs with pimented oral mucosa greater risk for melonoma
Unknown - but can result from parasites - foreign bodies - infections - neoplasia
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
Rule out other causes (MDB); fecal sample direct and float; HCT to monitor hydration

30. What is the etiology of Gastric Dilation/Volvulus (GDV)
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
Siamese - himalayans - abyssinians
Rule out other causes (MDB); fecal sample direct and float; HCT to monitor hydration
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

31. Cholangiohepatitis DX: liver biopsy
CBC; nonregenerative anemia; stress neutrophilia lymphopenia
Cellular infiltrates in or near bile ducts; +/- portal triad fibrosis (definative diagnosis)
CERTIFIABLE! OMG!
*gastric indiscretion (eating garbage) - spoiled food - change in diet - food allergy - infection(bacterial - viral - parasitic) - toxins - foreign object ingestion

32. What is Chronic Enteropathies TX (cont)
Treatment can be long and expensive - often not cured - monitor dogs and cats on long term antinflammatory therapy
Supportive and symptomatic fluid and electrolyte therapy - NPO 24-48 hrs - water if no vomiting - pepto bismol or loperamide - antibiotics - bland low fat diet
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
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

33. Chronic Enteropathies signs
Palpation of sausage- like mass in cranial abdomen; ultrasound shows multi- layered concentric rings representing large intestinal wall layers
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
Males have increased risk for melonoma and fibrosarcoma; dogs with pimented oral mucosa greater risk for melonoma
Often non specific - chronic intermittent vomit/ -+/- diarrhea - listlessness - weight loss - older animals - Borygmus (gas sounds in intestine) - halitosis - flatulence - signs progressive over time

34. Cholangiohepatitis DX : bw
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
Cbc-- neutraophilia w/ left shift -- mild - regenerative anemia
NPO 24-36 hrs - fluid therapy - feed low fat diet ie hills i/d cot cheese - chicken/rice antiemetics(chlorpromazine - metoclopramide - cerinia
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

35. What is oral neoplasia squamous cell carcinoma?
Anorexia - depression - weight loss - spoadic vomiting - hepatomegaly - possible bleeding tendencies (petechiae - bleeding from gums0
Ulcerative - erosive neoplasms; invade bone and metastisize to regional lymph nodes
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
Surgical removal - chemo - radiation poor prognosis

36. Gastric Dilation/Volvulus (GDV) signs
Hypoallergenic diets - low fat diets with high fiber; goal to control signs; may have frequent defecation chronically
Weakness - collapse - depression - nausea - non - productive retching - hypersalivation - abdominal pain and distension - increased hr and resp
Subtotal colectomy if refractory to medical and dietary management; rehydrate and correct electrolyte imbalances before anesthsia
Irreversible - requires life long treatment; expensive (pancreatic enzyme replacements); give with every meal; most animals will regain weight and diarrhea will resolve

37. Describe docusate enema for mega colon or constipation.
Common; melanomas and squamous cell carcinomas are most common: also fibrosarcomas
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 $
Common cause of vomiting in dogs

38. Diseases of Large Intestine: large inflammatory bowel disease
Prognosis uncertain and variable; tx may be prolonged and expensive; permanent damage to liver my occur
Anorexia - depression - weight loss - spoadic vomiting - hepatomegaly - possible bleeding tendencies (petechiae - bleeding from gums0
Hypoallergenic diets - low fat diets with high fiber; goal to control signs; may have frequent defecation chronically
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

39. What is gastritis?
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
Straining to defecate - vomiting - weakness - dehydration - anorexia - small hard feces+/- blood - mucus
Causes pain - bleeding - self mutilation - dyschezia - anal stenosis - tenesmus - incontinence - licking perianal area - foul odor to anal area
Common cause of vomiting in dogs

40. Totally useless facts about pancreas
young german shepherds have predisposition to pancreatic acinar atrophy; in cats EPI often caused by chronic pancreatitis
CERTIFIABLE! OMG!
Anorexia - depression - weight loss - vomiting - dehydration - fever - jaundice - ascites - hepatomegaly
Hypoallergenic diets - low fat diets with high fiber; goal to control signs; may have frequent defecation chronically

41. Cholangiohepatitis signs
Common in intact older male dogs >8; atrophy of levator ani muscle causes herniation of rectum and pelvic organs into ischiorectal fossa
Cellular infiltrates in or near bile ducts; +/- portal triad fibrosis (definative diagnosis)
Anorexia - depression - weight loss - vomiting - dehydration - fever - jaundice - ascites - hepatomegaly
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

42. 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
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)
Idiopathic - most common hepatopathy in cats adult - obese cats any age - sex - breed

43. What are gastritis signs?
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
Anorexia - acute vomiting - +/- dehydration - +/- painful abdomen
Antibiotics - ursodeoxycolic acid - prednisone - fluid and electrolyte corrections - vitamin and nutritional support - S- adenosylmethioonie
Inflamed gums - often with minor calculus

44. Perianal fistula (anal fistula) SX
Older obese dogs with history of recent fatty meal; painful abdomen - anorexia - depression - dehydration - vomiting - diarrhea - fever - shock and collapse
Anorexia - depression - lethargy - weakness - ataxia - head- pressing - circling - pacing - blindness - seizures - coma - hypersalivation and bizarre aggressive behavior in cats
Debride ulcers and diseased tissue - possibly cryosurgery - may use medical tx first to decrease the size of the fistulas - then surgery
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

45. Gastric Dilation/Volvulus (GDV) DX
Greatly increased ALP - increased ALT - AST - hyperbilirubinemia - hypoalbuminemia - increased serum bile acids
Anorexia - depression - weight loss - vomiting - dehydration - fever - jaundice - ascites - hepatomegaly
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

46. Intussusception 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
Older animals
Greatly increased ALP - increased ALT - AST - hyperbilirubinemia - hypoalbuminemia - increased serum bile acids
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

47. How to give enemas for mega colon or constipation?
Mdb - fecal - xray - colonoscopy with biopsy ( histo will show lymphocytes and plasma cells in large intestinal lamina propria)
CERTIFIABLE! OMG!
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)
Antibiotics - ursodeoxycolic acid - prednisone - fluid and electrolyte corrections - vitamin and nutritional support - S- adenosylmethioonie

48. Portosystemic shunts signs
Anorexia - depression - lethargy - weakness - ataxia - head- pressing - circling - pacing - blindness - seizures - coma - hypersalivation and bizarre aggressive behavior in cats
Supportive and symptomatic fluid and electrolyte therapy - NPO 24-48 hrs - water if no vomiting - pepto bismol or loperamide - antibiotics - bland low fat diet
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
Anorexia - depression - weight loss - vomiting - dehydration - fever - jaundice - ascites - hepatomegaly

49. Gastric Dilation/Volvulus (GDV) physiology
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
Perineal swelling - tenesmus - dyschezia - constipation - possible urethral obstruction if bladder involved
Vomiting - anorexia - depression - diarrhea (often bloody)
Unknown - but can result from parasites - foreign bodies - infections - neoplasia

50. Gastric Dilation/Volvulus (GDV) prevention
Single or multiple ulcerated sinuses that involve perianal tissue; often large breed dogs
Cbc normal; increased ALT; decreased total lipid serum; trypsin - likeimmunoreactivity levels are decreased
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
CERTIFIABLE! OMG!