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Veterinary Technology Diseases Of Digestive System

Subjects : engineering, health-sciences, veterinary

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Answer 50 questions in 15 minutes.
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1. What are contradictions with enema for mega colon or constipation?
DO NOT USE PHOSPHATE ENEMAS IN CATS OR SMALL DOGS DO NOT MIX DOCUSATE AND MINERAL OIL
young german shepherds have predisposition to pancreatic acinar atrophy; in cats EPI often caused by chronic pancreatitis
Ulcerative - erosive neoplasms; invade bone and metastisize to regional lymph nodes
Irreversible - requires life long treatment; expensive (pancreatic enzyme replacements); give with every meal; most animals will regain weight and diarrhea will resolve

2. Perianal fistula (anal fistula) TX
Straining to defecate - vomiting - weakness - dehydration - anorexia - small hard feces+/- blood - mucus
PE often normal - edema or ascities if protein losing enteropathy - mdb - fecal - xray - endoscopy/biopsy (looking for lymphotic- plasmacytic infiltrates)
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
Cyclosporin +/- ketoconazole - tacrolimus 0.1% topical - prednisone - azathioprine stool softeners(lactolose) antimicrobials (adjunct for seconary dermatitus)

3. Portosystemic shunts DX: cbc - x- ray
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
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
Hypoproteinemia - hypoalbuminemia - decreased BUN - mildly increased ALT< ALP - increased serum bile acids - hyperammonemia
Cbc - microcytosis - target cells - poikilocytosis - mild regenerative anemia xray microhepatia

4. Gastric Dilation/Volvulus (GDV) DX
Parvovirus - distemper - coroavirus - feline panleukopenia
Most common diarrhea; change in diet - drug therapy - stressful situations causes disruption of normal bacterial flora signs abrupt onset diarrhea - +/- vomiting
Rapidly growing tumors characterized by early bone involvement metastatisize to lungs
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

5. What is Chronic Enteropathies TX (cont)
Cbc - leukocytosis - increased PCV chem - azotemia - increased ALT - mils hypocalcemia - hyperlipemia - normal to increased amylase and lipase4
Anorexia - depression - lethargy - weakness - ataxia - head- pressing - circling - pacing - blindness - seizures - coma - hypersalivation and bizarre aggressive behavior in cats
Treatment can be long and expensive - often not cured - monitor dogs and cats on long term antinflammatory therapy
Potassium supplement if < 3 mEq monitor ecg treat w/ lidocaine or procanimade * surgery

6. Cholangiohepatitis DX : bw
Cbc-- neutraophilia w/ left shift -- mild - regenerative anemia
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
Anorexia - depression - lethargy - weakness - ataxia - head- pressing - circling - pacing - blindness - seizures - coma - hypersalivation and bizarre aggressive behavior in cats
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

7. What is gastritis?
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
Common cause of vomiting in dogs
Anorexia - depression - lethargy - weakness - ataxia - head- pressing - circling - pacing - blindness - seizures - coma - hypersalivation and bizarre aggressive behavior in cats
Single or multiple ulcerated sinuses that involve perianal tissue; often large breed dogs

8. Intussusception signs are...
Cbc - leukocytosis - increased PCV chem - azotemia - increased ALT - mils hypocalcemia - hyperlipemia - normal to increased amylase and lipase4
Lubricates feces and reduces water reabsorption of lumen
Vomiting - anorexia - depression - diarrhea (often bloody)
*gastric indiscretion (eating garbage) - spoiled food - change in diet - food allergy - infection(bacterial - viral - parasitic) - toxins - foreign object ingestion

9. What is Chronic Enteropathies TX
Common cause of vomiting in dogs
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
CERTIFIABLE! OMG!
Most common diarrhea; change in diet - drug therapy - stressful situations causes disruption of normal bacterial flora signs abrupt onset diarrhea - +/- vomiting

10. Portosystemic shunts DX: chem
Surgical removal - chemo - radiation poor prognosis
NPO 24-36 hrs - fluid therapy - feed low fat diet ie hills i/d cot cheese - chicken/rice antiemetics(chlorpromazine - metoclopramide - cerinia
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

11. Intussusception cause
Treatment can be long and expensive - often not cured - monitor dogs and cats on long term antinflammatory therapy
Extract all premolars - molars - and retained roots - if still recurs remove remaining teeth; steroids
Unknown - but can result from parasites - foreign bodies - infections - neoplasia
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

12. Who is at increased risk for oral neoplasia?
Debride ulcers and diseased tissue - possibly cryosurgery - may use medical tx first to decrease the size of the fistulas - then surgery
Straining to defecate - vomiting - weakness - dehydration - anorexia - small hard feces+/- blood - mucus
Males have increased risk for melonoma and fibrosarcoma; dogs with pimented oral mucosa greater risk for melonoma
Cbc-- neutraophilia w/ left shift -- mild - regenerative anemia

13. what is acute diarrhea DX?
Older obese dogs with history of recent fatty meal; painful abdomen - anorexia - depression - dehydration - vomiting - diarrhea - fever - shock and collapse
Disease of dogs 2-10 - large and giant breed - deep chested
PE often normal - edema or ascities if protein losing enteropathy - mdb - fecal - xray - endoscopy/biopsy (looking for lymphotic- plasmacytic infiltrates)
Rule out other causes (MDB); fecal sample direct and float; HCT to monitor hydration

14. What is gastritis DX?
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
Based on HX and PE; cbc/chem (cbc may indicate stress leukogram and dehydration)
Ulcerative - erosive neoplasms; invade bone and metastisize to regional lymph nodes
Weakness - collapse - depression - nausea - non - productive retching - hypersalivation - abdominal pain and distension - increased hr and resp

15. Cholangiohepatitis DX : chem
Cellular infiltrates in or near bile ducts; +/- portal triad fibrosis (definative diagnosis)
Subtotal colectomy if refractory to medical and dietary management; rehydrate and correct electrolyte imbalances before anesthsia
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)
Disease of dogs 2-10 - large and giant breed - deep chested

16. Gastric Dilation/Volvulus (GDV) prevention
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
Unknown - but can result from parasites - foreign bodies - infections - neoplasia
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
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

17. What is gastritis TX?
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
Potassium supplement if < 3 mEq monitor ecg treat w/ lidocaine or procanimade * surgery
NPO 24-36 hrs - fluid therapy - feed low fat diet ie hills i/d cot cheese - chicken/rice antiemetics(chlorpromazine - metoclopramide - cerinia
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

18. What are gastritis signs?
Antibiotics - ursodeoxycolic acid - prednisone - fluid and electrolyte corrections - vitamin and nutritional support - S- adenosylmethioonie
Anorexia - depression - weight loss - spoadic vomiting - hepatomegaly - possible bleeding tendencies (petechiae - bleeding from gums0
Anorexia - acute vomiting - +/- dehydration - +/- painful abdomen
Rule out other causes (MDB); fecal sample direct and float; HCT to monitor hydration

19. Feline Hepatic Lipidosis TX
Most common diarrhea; change in diet - drug therapy - stressful situations causes disruption of normal bacterial flora signs abrupt onset diarrhea - +/- vomiting
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
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
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

20. Large inflammatory bowel disease: signs
Clean teeth - antibiotics - oral antiseptics - daily brushing w/ antibacterial solutions - hard diet - rechecks
Cbc - leukocytosis - increased PCV chem - azotemia - increased ALT - mils hypocalcemia - hyperlipemia - normal to increased amylase and lipase4
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)
Diarrhea w/o weight loss - increased frequency of defecation w/ decreased fecal volume - tenesmus - hematochezia (frank blood) - increased mucus - +/- dsschezia and mild fever

21. What is megacolon? : who gets it?
Clean teeth - antibiotics - oral antiseptics - daily brushing w/ antibacterial solutions - hard diet - rechecks
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
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
Greatly increased ALP - increased ALT - AST - hyperbilirubinemia - hypoalbuminemia - increased serum bile acids

22. Diseases of Rectum/Anus perineal hernias (who gets it/what it is)
Common in intact older male dogs >8; atrophy of levator ani muscle causes herniation of rectum and pelvic organs into ischiorectal fossa
Extract all premolars - molars - and retained roots - if still recurs remove remaining teeth; steroids
Idiopathic - most common hepatopathy in cats adult - obese cats any age - sex - breed
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

23. Perianal fistula (anal fistula) SX
Debride ulcers and diseased tissue - possibly cryosurgery - may use medical tx first to decrease the size of the fistulas - then surgery
Cbc normal; increased ALT; decreased total lipid serum; trypsin - likeimmunoreactivity levels are decreased
Palpation of sausage- like mass in cranial abdomen; ultrasound shows multi- layered concentric rings representing large intestinal wall layers
CBC; nonregenerative anemia; stress neutrophilia lymphopenia

24. Gastric Dilation/Volvulus (GDV) TX
Diarrhea w/o weight loss - increased frequency of defecation w/ decreased fecal volume - tenesmus - hematochezia (frank blood) - increased mucus - +/- dsschezia and mild fever
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
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

25. Portosystemic shunts PX
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
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
Cbc - leukocytosis - increased PCV chem - azotemia - increased ALT - mils hypocalcemia - hyperlipemia - normal to increased amylase and lipase4

26. Portosystemic shunts more signs
Straining to defecate - vomiting - weakness - dehydration - anorexia - small hard feces+/- blood - mucus
Unknown - but can result from parasites - foreign bodies - infections - neoplasia
Vomiting - diarrhea - stunted growth - PU/PD/ urate urolithiasis - hematuria - ammonium biurate crystals in sediment - dilute urine
Vomiting - anorexia - depression - diarrhea (often bloody)

27. Perineal hernias signs
Unknown - but can result from parasites - foreign bodies - infections - neoplasia
Anorexia - depression - weight loss - vomiting - dehydration - fever - jaundice - ascites - hepatomegaly
Perineal swelling - tenesmus - dyschezia - constipation - possible urethral obstruction if bladder involved
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

28. What is oral neoplasia?
Supportive and symptomatic fluid and electrolyte therapy - NPO 24-48 hrs - water if no vomiting - pepto bismol or loperamide - antibiotics - bland low fat diet
Idiopathic - most common hepatopathy in cats adult - obese cats any age - sex - breed
Common; melanomas and squamous cell carcinomas are most common: also fibrosarcomas
Anorexia - depression - weight loss - vomiting - dehydration - fever - jaundice - ascites - hepatomegaly

29. How to treat lymphatic plasmacytic stomatitis if condition recurs?
Rule out other causes (MDB); fecal sample direct and float; HCT to monitor hydration
Siamese - himalayans - abyssinians
Disease of dogs 2-10 - large and giant breed - deep chested
Extract all premolars - molars - and retained roots - if still recurs remove remaining teeth; steroids

30. Cholangiohepatitis signs
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
Lubricates feces and reduces water reabsorption of lumen
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
Anorexia - depression - weight loss - vomiting - dehydration - fever - jaundice - ascites - hepatomegaly

31. What is treatment of oral neoplasia?
Medical management seldom successful - low protein diet - lactilose - metronidazole - fluids - surgical ligation of shunt is preferred
Rapidly growing tumors characterized by early bone involvement metastatisize to lungs
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
Surgical removal - chemo - radiation poor prognosis

32. 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
Single or multiple ulcerated sinuses that involve perianal tissue; often large breed dogs
Weakness - collapse - depression - nausea - non - productive retching - hypersalivation - abdominal pain and distension - increased hr and resp
*gastric indiscretion (eating garbage) - spoiled food - change in diet - food allergy - infection(bacterial - viral - parasitic) - toxins - foreign object ingestion

33. What are oral neoplasia melanomas?
CBC; nonregenerative anemia; stress neutrophilia lymphopenia
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
Many cats have underlying disease that interferes with local immunity in gingava' cats should be screened for disease
Rapidly growing tumors characterized by early bone involvement metastatisize to lungs

34. Megacolon DX
Anorexia - depression - lethargy - weakness - ataxia - head- pressing - circling - pacing - blindness - seizures - coma - hypersalivation and bizarre aggressive behavior in cats
Medical management seldom successful - low protein diet - lactilose - metronidazole - fluids - surgical ligation of shunt is preferred
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
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

35. What are causes of acute gastritis?
Anorexia - acute vomiting - +/- dehydration - +/- painful abdomen
With stool softeners and enemas palliatively
Idiopathic - most common hepatopathy in cats adult - obese cats any age - sex - breed
*gastric indiscretion (eating garbage) - spoiled food - change in diet - food allergy - infection(bacterial - viral - parasitic) - toxins - foreign object ingestion

36. Megacolon surgical
Hepatomegaly or choleliths may be observed
Supportive and symptomatic fluid and electrolyte therapy - NPO 24-48 hrs - water if no vomiting - pepto bismol or loperamide - antibiotics - bland low fat diet
Subtotal colectomy if refractory to medical and dietary management; rehydrate and correct electrolyte imbalances before anesthsia
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

37. Gastric Dilation/Volvulus (GDV) TX (cont)
CBC; nonregenerative anemia; stress neutrophilia lymphopenia
Potassium supplement if < 3 mEq monitor ecg treat w/ lidocaine or procanimade * surgery
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
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

38. Exocrine pancreatic insufficiency (EPI) TX
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
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
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
Disease of dogs 2-10 - large and giant breed - deep chested

39. Exocrine pancreatic insufficiency (EPI) signs
Mild to marked weight loss; polyphagia - coprophagia - pica - diarrhea - fatty stoo; foul smelling poop; flatulence
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
Often non specific - chronic intermittent vomit/ -+/- diarrhea - listlessness - weight loss - older animals - Borygmus (gas sounds in intestine) - halitosis - flatulence - signs progressive over time
Males have increased risk for melonoma and fibrosarcoma; dogs with pimented oral mucosa greater risk for melonoma

40. Megacolon signs are?
Supportive and symptomatic fluid and electrolyte therapy - NPO 24-48 hrs - water if no vomiting - pepto bismol or loperamide - antibiotics - bland low fat diet
Straining to defecate - vomiting - weakness - dehydration - anorexia - small hard feces+/- blood - mucus
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

41. Intussusception DX
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
Palpation of sausage- like mass in cranial abdomen; ultrasound shows multi- layered concentric rings representing large intestinal wall layers
Antibiotics - ursodeoxycolic acid - prednisone - fluid and electrolyte corrections - vitamin and nutritional support - S- adenosylmethioonie
Often non specific - chronic intermittent vomit/ -+/- diarrhea - listlessness - weight loss - older animals - Borygmus (gas sounds in intestine) - halitosis - flatulence - signs progressive over time

42. Totally useless facts about pancreas
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
young german shepherds have predisposition to pancreatic acinar atrophy; in cats EPI often caused by chronic pancreatitis
Treatment can be long and expensive - often not cured - monitor dogs and cats on long term antinflammatory therapy
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

43. Feline Hepatic Lipidosis DX: Chem
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
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
Diarrhea w/o weight loss - increased frequency of defecation w/ decreased fecal volume - tenesmus - hematochezia (frank blood) - increased mucus - +/- dsschezia and mild fever
Greatly increased ALP - increased ALT - AST - hyperbilirubinemia - hypoalbuminemia - increased serum bile acids

44. Feline Hepatic Lipidosis DX: CBC
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
CBC; nonregenerative anemia; stress neutrophilia lymphopenia
Cellular infiltrates in or near bile ducts; +/- portal triad fibrosis (definative diagnosis)

45. Feline Hepatic Lipidosis prevention
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 $
Surgical removal - chemo - radiation poor prognosis
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)
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

46. Diseases of the Liver: what is cholangiohepatitis?
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
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
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
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

47. Who gets Gastric Dilation/Volvulus (GDV)?
Irreversible - requires life long treatment; expensive (pancreatic enzyme replacements); give with every meal; most animals will regain weight and diarrhea will resolve
Males have increased risk for melonoma and fibrosarcoma; dogs with pimented oral mucosa greater risk for melonoma
Atypical immune response of unknown etiology?
Disease of dogs 2-10 - large and giant breed - deep chested

48. Diseases of Pancreas: DX: tests
Cyclosporin +/- ketoconazole - tacrolimus 0.1% topical - prednisone - azathioprine stool softeners(lactolose) antimicrobials (adjunct for seconary dermatitus)
Increased serum trypsinogen - like immunoreactivity - pancreatic lipase immunoreactivity (cPLI) - and (fPLI)
CERTIFIABLE! OMG!
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

49. Portosystemic shunts TX
Cbc - leukocytosis - increased PCV chem - azotemia - increased ALT - mils hypocalcemia - hyperlipemia - normal to increased amylase and lipase4
Anorexia - depression - weight loss - vomiting - dehydration - fever - jaundice - ascites - hepatomegaly
Medical management seldom successful - low protein diet - lactilose - metronidazole - fluids - surgical ligation of shunt is preferred
Recurrence infrequent - prognosis depends on extent of damage - common in puppies with heavy parasitic infestation

50. Who is prone to lymphatic plasmacytic stomatitis?
Siamese - himalayans - abyssinians
Toxocara canis - Toxascaris leonina - and Toxocara cati (roundworms) - Trichuris vulpis -(whipworms) Ancylostoma caninum - Isopora spp (coccidia) - Capillaria aerophila - Giardia spp - Tritrichomonas foetus
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