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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 Feline Hepatic Lipidosis? who gets it?
Idiopathic - most common hepatopathy in cats adult - obese cats any age - sex - breed
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
*gastric indiscretion (eating garbage) - spoiled food - change in diet - food allergy - infection(bacterial - viral - parasitic) - toxins - foreign object ingestion
DO NOT USE PHOSPHATE ENEMAS IN CATS OR SMALL DOGS DO NOT MIX DOCUSATE AND MINERAL OIL

2. Intussusception - what is it?
Common; melanomas and squamous cell carcinomas are most common: also fibrosarcomas
Mucosa is damaged - inflammation occurs - signs develop
Vomiting - diarrhea - stunted growth - PU/PD/ urate urolithiasis - hematuria - ammonium biurate crystals in sediment - dilute urine
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

3. Gastric Dilation/Volvulus (GDV) 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 $
Cause unknown; ascending biliary infections from GI tract and immune- mediated causes have been suggested; Persian cats predisposed; sometimes occurs in conjuction with pancreatitis and IBD in cats (Triaditis)
Anorexia - depression - lethargy - weakness - ataxia - head- pressing - circling - pacing - blindness - seizures - coma - hypersalivation and bizarre aggressive behavior in cats
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

4. what is acute diarrhea TX?
Supportive and symptomatic fluid and electrolyte therapy - NPO 24-48 hrs - water if no vomiting - pepto bismol or loperamide - antibiotics - bland low fat diet
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
Anorexia - depression - lethargy - weakness - ataxia - head- pressing - circling - pacing - blindness - seizures - coma - hypersalivation and bizarre aggressive behavior in cats
Common in intact older male dogs >8; atrophy of levator ani muscle causes herniation of rectum and pelvic organs into ischiorectal fossa

5. Intussusception DX
Surgical removal - chemo - radiation poor prognosis
Anorexia - depression - lethargy - weakness - ataxia - head- pressing - circling - pacing - blindness - seizures - coma - hypersalivation and bizarre aggressive behavior in cats
Disease of dogs 2-10 - large and giant breed - deep chested
Palpation of sausage- like mass in cranial abdomen; ultrasound shows multi- layered concentric rings representing large intestinal wall layers

6. What conditions are common with oral neoplasia?
Benign neoplasms (papilomas - epulides)
Cbc-- neutraophilia w/ left shift -- mild - regenerative anemia
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
Recurrence infrequent - prognosis depends on extent of damage - common in puppies with heavy parasitic infestation

7. What is Chronic Enteropathies DX
Anorexia - acute vomiting - +/- dehydration - +/- painful abdomen
Perineal swelling - tenesmus - dyschezia - constipation - possible urethral obstruction if bladder involved
Older obese dogs with history of recent fatty meal; painful abdomen - anorexia - depression - dehydration - vomiting - diarrhea - fever - shock and collapse
PE often normal - edema or ascities if protein losing enteropathy - mdb - fecal - xray - endoscopy/biopsy (looking for lymphotic- plasmacytic infiltrates)

8. Megacolon 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
Hypoproteinemia - hypoalbuminemia - decreased BUN - mildly increased ALT< ALP - increased serum bile acids - hyperammonemia
Surgical removal - chemo - radiation poor prognosis
CBC; nonregenerative anemia; stress neutrophilia lymphopenia

9. Feline Hepatic Lipidosis triggers
Subtotal colectomy if refractory to medical and dietary management; rehydrate and correct electrolyte imbalances before anesthsia
Idiopathic - most common hepatopathy in cats adult - obese cats any age - sex - breed
Extract all premolars - molars - and retained roots - if still recurs remove remaining teeth; steroids
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

10. What is the cause of cholangiohepatitis? who does it affect?
Cause unknown; ascending biliary infections from GI tract and immune- mediated causes have been suggested; Persian cats predisposed; sometimes occurs in conjuction with pancreatitis and IBD in cats (Triaditis)
Pancreas loses acinar cells followed by inadequate production of digestive enzymes; usually asymptomatic until 85-90% of secretory ability has been lost; lack of normal pancreatic secretions affect mucosal lining of small intestine and decrease absor
Clean teeth - antibiotics - oral antiseptics - daily brushing w/ antibacterial solutions - hard diet - rechecks
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

11. Exocrine pancreatic insufficiency (EPI) signs
Mucosa is damaged - inflammation occurs - signs develop
Older animals
Subtotal colectomy if refractory to medical and dietary management; rehydrate and correct electrolyte imbalances before anesthsia
Mild to marked weight loss; polyphagia - coprophagia - pica - diarrhea - fatty stoo; foul smelling poop; flatulence

12. How to treat megacolon with diet?
Cbc - microcytosis - target cells - poikilocytosis - mild regenerative anemia xray microhepatia
Increase fiber - soft canned food - salt food to increase water intake
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
CBC; nonregenerative anemia; stress neutrophilia lymphopenia

13. Feline Hepatic Lipidosis DX
Weakness - collapse - depression - nausea - non - productive retching - hypersalivation - abdominal pain and distension - increased hr and resp
DO NOT USE PHOSPHATE ENEMAS IN CATS OR SMALL DOGS DO NOT MIX DOCUSATE AND MINERAL OIL
x- rays -- mild hepatomegaly ultrasound-- hyperechoic liver histopathology-- severley vacuolized hepatocytes
Hypoproteinemia - hypoalbuminemia - decreased BUN - mildly increased ALT< ALP - increased serum bile acids - hyperammonemia

14. Gastric Dilation/Volvulus (GDV) TX (cont)
Prognosis uncertain and variable; tx may be prolonged and expensive; permanent damage to liver my occur
Anorexia - acute vomiting - +/- dehydration - +/- painful abdomen
Potassium supplement if < 3 mEq monitor ecg treat w/ lidocaine or procanimade * surgery
Increase fiber - soft canned food - salt food to increase water intake

15. What is gastritis TX?
Anorexia - acute vomiting - +/- dehydration - +/- painful abdomen
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)
Causes pain - bleeding - self mutilation - dyschezia - anal stenosis - tenesmus - incontinence - licking perianal area - foul odor to anal area
NPO 24-36 hrs - fluid therapy - feed low fat diet ie hills i/d cot cheese - chicken/rice antiemetics(chlorpromazine - metoclopramide - cerinia

16. Why is mineral oil and docusate enema for mega colon or constipation contraindicated?
Mdb - fecal - xray - colonoscopy with biopsy ( histo will show lymphocytes and plasma cells in large intestinal lamina propria)
Hypoproteinemia - hypoalbuminemia - decreased BUN - mildly increased ALT< ALP - increased serum bile acids - hyperammonemia
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
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)

17. Megacolon surgical
*gastric indiscretion (eating garbage) - spoiled food - change in diet - food allergy - infection(bacterial - viral - parasitic) - toxins - foreign object ingestion
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
Subtotal colectomy if refractory to medical and dietary management; rehydrate and correct electrolyte imbalances before anesthsia
Siamese - himalayans - abyssinians

18. Parasitic Diarrhea
Most common diarrhea; change in diet - drug therapy - stressful situations causes disruption of normal bacterial flora signs abrupt onset diarrhea - +/- vomiting
Diarrhea w/o weight loss - increased frequency of defecation w/ decreased fecal volume - tenesmus - hematochezia (frank blood) - increased mucus - +/- dsschezia and mild fever
Toxocara canis - Toxascaris leonina - and Toxocara cati (roundworms) - Trichuris vulpis -(whipworms) Ancylostoma caninum - Isopora spp (coccidia) - Capillaria aerophila - Giardia spp - Tritrichomonas foetus
Many cats have underlying disease that interferes with local immunity in gingava' cats should be screened for disease

19. Perianal fistula (anal fistula) signs
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)
Common; melanomas and squamous cell carcinomas are most common: also fibrosarcomas
Causes pain - bleeding - self mutilation - dyschezia - anal stenosis - tenesmus - incontinence - licking perianal area - foul odor to anal area

20. What is lymphatic plasmacytic stomatitis
Anorexia - depression - lethargy - weakness - ataxia - head- pressing - circling - pacing - blindness - seizures - coma - hypersalivation and bizarre aggressive behavior in cats
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 $
Atypical immune response of unknown etiology?
CBC; nonregenerative anemia; stress neutrophilia lymphopenia

21. How to treat lymphatic plasmacytic stomatitis if condition recurs?
Vomiting - diarrhea - stunted growth - PU/PD/ urate urolithiasis - hematuria - ammonium biurate crystals in sediment - dilute urine
Rule out other causes (MDB); fecal sample direct and float; HCT to monitor hydration
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
Extract all premolars - molars - and retained roots - if still recurs remove remaining teeth; steroids

22. Large inflammatory bowel disease: signs
Cbc-- neutraophilia w/ left shift -- mild - regenerative anemia
Diarrhea w/o weight loss - increased frequency of defecation w/ decreased fecal volume - tenesmus - hematochezia (frank blood) - increased mucus - +/- dsschezia and mild fever
Mucosa is damaged - inflammation occurs - signs develop
Disease of dogs 2-10 - large and giant breed - deep chested

23. Diseases of the Liver: what is cholangiohepatitis?
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
Supportive care: fluids and electrolyte balance; potassium if needed; NPO 3-4 days if vomiting; antiemetics; analgesia (Buprenorphine in cats; butorphanol in dogs) antibiotics: (enroflaxin - trimethaprin gluccocorticoids)
Based on HX and PE; cbc/chem (cbc may indicate stress leukogram and dehydration)
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

24. Megacolon DX
Hepatomegaly or choleliths may be observed
Parvovirus - distemper - coroavirus - feline panleukopenia
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
Vomiting - anorexia - depression - diarrhea (often bloody)

25. Perineal hernias TX
With stool softeners and enemas palliatively
Older animals
Common; melanomas and squamous cell carcinomas are most common: also fibrosarcomas
Males have increased risk for melonoma and fibrosarcoma; dogs with pimented oral mucosa greater risk for melonoma

26. Who is prone to lymphatic plasmacytic stomatitis?
NPO 24-36 hrs - fluid therapy - feed low fat diet ie hills i/d cot cheese - chicken/rice antiemetics(chlorpromazine - metoclopramide - cerinia
Siamese - himalayans - abyssinians
Cbc normal; increased ALT; decreased total lipid serum; trypsin - likeimmunoreactivity levels are decreased
Cbc-- neutraophilia w/ left shift -- mild - regenerative anemia

27. Who is most prone to oral neoplasia?
Subtotal colectomy if refractory to medical and dietary management; rehydrate and correct electrolyte imbalances before anesthsia
Older animals
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
Increased serum trypsinogen - like immunoreactivity - pancreatic lipase immunoreactivity (cPLI) - and (fPLI)

28. Totally useless facts about pancreas
young german shepherds have predisposition to pancreatic acinar atrophy; in cats EPI often caused by chronic pancreatitis
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
Inflamed gums - often with minor calculus
Cbc - microcytosis - target cells - poikilocytosis - mild regenerative anemia xray microhepatia

29. What are oral neoplasia melanomas?
Palpation of sausage- like mass in cranial abdomen; ultrasound shows multi- layered concentric rings representing large intestinal wall layers
Rapidly growing tumors characterized by early bone involvement metastatisize to lungs
Cbc-- neutraophilia w/ left shift -- mild - regenerative anemia
Cbc - microcytosis - target cells - poikilocytosis - mild regenerative anemia xray microhepatia

30. 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
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
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 $
CBC; nonregenerative anemia; stress neutrophilia lymphopenia

31. What is Chronic Enteropathies TX
Palpation of sausage- like mass in cranial abdomen; ultrasound shows multi- layered concentric rings representing large intestinal wall layers
Irreversible - requires life long treatment; expensive (pancreatic enzyme replacements); give with every meal; most animals will regain weight and diarrhea will resolve
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
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

32. Feline Hepatic Lipidosis TX
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
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
With stool softeners and enemas palliatively
Diarrhea w/o weight loss - increased frequency of defecation w/ decreased fecal volume - tenesmus - hematochezia (frank blood) - increased mucus - +/- dsschezia and mild fever

33. Feline Hepatic Lipidosis signs
Anorexia - depression - weight loss - spoadic vomiting - hepatomegaly - possible bleeding tendencies (petechiae - bleeding from gums0
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)
Atypical immune response of unknown etiology?
Unknown - but can result from parasites - foreign bodies - infections - neoplasia

34. Feline Hepatic Lipidosis prevention
Anorexia - depression - weight loss - vomiting - dehydration - fever - jaundice - ascites - hepatomegaly
Mucosa is damaged - inflammation occurs - signs develop
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
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 $

35. What is oral neoplasia squamous cell carcinoma?
Ulcerative - erosive neoplasms; invade bone and metastisize to regional lymph nodes
Cyclosporin +/- ketoconazole - tacrolimus 0.1% topical - prednisone - azathioprine stool softeners(lactolose) antimicrobials (adjunct for seconary dermatitus)
Siamese - himalayans - abyssinians
Based on HX and PE; cbc/chem (cbc may indicate stress leukogram and dehydration)

36. What are contradictions with enema for mega colon or constipation?
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
Most common diarrhea; change in diet - drug therapy - stressful situations causes disruption of normal bacterial flora signs abrupt onset diarrhea - +/- vomiting
DO NOT USE PHOSPHATE ENEMAS IN CATS OR SMALL DOGS DO NOT MIX DOCUSATE AND MINERAL OIL
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)

37. Gastric Dilation/Volvulus (GDV) signs
DO NOT USE PHOSPHATE ENEMAS IN CATS OR SMALL DOGS DO NOT MIX DOCUSATE AND MINERAL OIL
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
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

38. Describe docusate enema for mega colon or constipation.
Straining to defecate - vomiting - weakness - dehydration - anorexia - small hard feces+/- blood - mucus
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
Older animals
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

39. Intussusception signs are...
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
Diarrhea w/o weight loss - increased frequency of defecation w/ decreased fecal volume - tenesmus - hematochezia (frank blood) - increased mucus - +/- dsschezia and mild fever
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)
Vomiting - anorexia - depression - diarrhea (often bloody)

40. Perianal fistula (anal fistula) SX
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
Rule out other causes (MDB); fecal sample direct and float; HCT to monitor hydration
Older obese dogs with history of recent fatty meal; painful abdomen - anorexia - depression - dehydration - vomiting - diarrhea - fever - shock and collapse
Debride ulcers and diseased tissue - possibly cryosurgery - may use medical tx first to decrease the size of the fistulas - then surgery

41. Gastric Dilation/Volvulus (GDV) DX
Anorexia - depression - weight loss - spoadic vomiting - hepatomegaly - possible bleeding tendencies (petechiae - bleeding from gums0
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
Cellular infiltrates in or near bile ducts; +/- portal triad fibrosis (definative diagnosis)
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)

42. Megacolon signs are?
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
Straining to defecate - vomiting - weakness - dehydration - anorexia - small hard feces+/- blood - mucus
Extract all premolars - molars - and retained roots - if still recurs remove remaining teeth; steroids
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

43. What are signs of lymphatic plasmacytic stomatitis?
DO NOT USE PHOSPHATE ENEMAS IN CATS OR SMALL DOGS DO NOT MIX DOCUSATE AND MINERAL OIL
Recurrence infrequent - prognosis depends on extent of damage - common in puppies with heavy parasitic infestation
Unknown - but can result from parasites - foreign bodies - infections - neoplasia
Inflamed gums - often with minor calculus

44. Megacolon surgical (use caution)
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
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
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
Mdb - fecal - xray - colonoscopy with biopsy ( histo will show lymphocytes and plasma cells in large intestinal lamina propria)

45. Portosystemic shunts DX: cbc - x- ray
Most common diarrhea; change in diet - drug therapy - stressful situations causes disruption of normal bacterial flora signs abrupt onset diarrhea - +/- vomiting
Older obese dogs with history of recent fatty meal; painful abdomen - anorexia - depression - dehydration - vomiting - diarrhea - fever - shock and collapse
Cbc - microcytosis - target cells - poikilocytosis - mild regenerative anemia xray microhepatia
Common; melanomas and squamous cell carcinomas are most common: also fibrosarcomas

46. Portosystemic shunts more signs
Supportive care: fluids and electrolyte balance; potassium if needed; NPO 3-4 days if vomiting; antiemetics; analgesia (Buprenorphine in cats; butorphanol in dogs) antibiotics: (enroflaxin - trimethaprin gluccocorticoids)
Vomiting - diarrhea - stunted growth - PU/PD/ urate urolithiasis - hematuria - ammonium biurate crystals in sediment - dilute urine
Idiopathic - most common hepatopathy in cats adult - obese cats any age - sex - breed
Atypical immune response of unknown etiology?

47. Diseases of Pancreas: DX: tests
Increased serum trypsinogen - like immunoreactivity - pancreatic lipase immunoreactivity (cPLI) - and (fPLI)
Idiopathic - most common hepatopathy in cats adult - obese cats any age - sex - breed
Disease of dogs 2-10 - large and giant breed - deep chested
Often non specific - chronic intermittent vomit/ -+/- diarrhea - listlessness - weight loss - older animals - Borygmus (gas sounds in intestine) - halitosis - flatulence - signs progressive over time

48. Exocrine pancreatic insufficiency (EPI) 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
young german shepherds have predisposition to pancreatic acinar atrophy; in cats EPI often caused by chronic pancreatitis
Idiopathic - most common hepatopathy in cats adult - obese cats any age - sex - breed
Surgical removal - chemo - radiation poor prognosis

49. How to give enemas for mega colon or constipation?
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)
Treatment can be long and expensive - often not cured - monitor dogs and cats on long term antinflammatory therapy
Anorexia - depression - lethargy - weakness - ataxia - head- pressing - circling - pacing - blindness - seizures - coma - hypersalivation and bizarre aggressive behavior in cats
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

50. Perineal hernias signs
Perineal swelling - tenesmus - dyschezia - constipation - possible urethral obstruction if bladder involved
Palpation of sausage- like mass in cranial abdomen; ultrasound shows multi- layered concentric rings representing large intestinal wall layers
Older animals
young german shepherds have predisposition to pancreatic acinar atrophy; in cats EPI often caused by chronic pancreatitis