Vomiting II

What is the most common sign of acute non-specific Gastroenteritis?

Sudden onset vomiting <7 days w/ no hematemesis

What are common causes of acute non-specific gastroenteritis?

Dietary indiscretion or intolerance

Drugs/ toxins in low doses

GI irritants

How should Acute non-specific gastroenteritis in a systemically well animal be tx?

Highly digestible diet (low fat, low fiber)

Anti-emetics

SC fluids

Empirical anthelminthics

What diets are not highly digestible?

GI biome

Royal Canine HP

Royal Canine GI

How should an acute non-specific Gastroenteritis in a systemically ill pt be worked up?

Minimum database

Imaging

Cortisol/ ACTH stime

Infectious dz testing

What is a parasitic cause of chronic gastritis in both dogs and cats?

Physaloptera -> transmitted via bug ingestion

How do you dx Physaloptera?

Happy pukers

Ova not in fecal float but can be in vomit

How is Physaloptera treated?

Fenbendazole

Pyrantal

What is a parasitic cause of Chronic gastritis in Cats?

Ollulanus tricuspis -> cat to cat transmission via vomitus ingestion

What are tx of Ollulanus tricuspis?

Fenbendazole,

Oxfendazole

Tetramisole

What are clinical signs of histoplasmosis?

Very sick,

Severe weight loss

Diarrhea

-exposure to chicken coops, bats, or starlings

What is Dx of Histoplasmosis?

Urine Ag testing

Cytology

What is tx of histoplasmosis?

Itraconazole + amphotericin B

- Guarded prognosis if GI involvement

What are clinical signs of Omycetes/ Pythiosis?

Very sick,

Vomiting

Wt loss,

Diarrhea

Hematochezia

How is Pythiosis going to be DX?

Anti-pythium Ab ELISA

How must Pythiosis going to be TX?

Aggressive sx resection

Itraconazole, amphotericin B, Terbinafine

How should Helicobacter be tx?

Amoxicillin

Metro

Bismuth (NOT for cats)

Name a few causes of GI ulcers?

Corrosive/ irritating substances

Decreased prostaglandins -> less mucosal healing (NSAIDs)

Decreased mucus/ bicarbonate

Inflammation/ gastritis

Hyperacidity (Gastrin/ histamine)

Decreased gastric blood flow

What physical signs would make you suspect a GI ulcer/ erosion?

Hematemesis

Melena

Pain

Anemia

Poss GI perforation

What lab work changes would we see in lab work w/ GI ulcers?

Unexplained high BUN

Regenerative anemia/ regeneration w/o anemia

Thrombocytosis

What are dx for GI ulcers/ erosions?

Traditional endoscopy -> wont go past duodenum

Capsule endoscopy -> Can assess entry SI

How do you tx GI ulcers symptomatically?

Anti-emetics

Analgesics

PPI

Sucralfate

Somatostatin

Sx if severe/ neoplastic

What is a sign of delayed GI emptying?

Vomitus containing undigested food long after eating - 8hrs

___ is functional delayed gastric emptying and ___ is structural?

Gastroparesisi

Obstruction -> Neoplasia/ pyloric stenosis

What breeds most commonly get Pyloric stenosis?

Brachycephalic

What is Bilious Vomiting syndrome?

vomiting bile (usually in the morning) because the stomach does't like to be empty for so long. Treat by giving a small meal late at night or acid suppression

What is a leiomyoma?

benign tumor of smooth muscle seen in older dogs

What is an adenomatous polyp?

Raised growth found in the pyloric antrum - benign

What is the most common GI neoplasia in dogs?

Adenocarcinoma

-focal tumors

What locations are most likely to see Adenocarcinomas in the GI?

angula incisura

Lesser curvature

Pylorus

SI

How is Adenocarcinomas of the GI tx?

Sx recession to alleviate clinical signs - POOR prognosis

What is the most common neoplasia in the GI of Cats?

Lymphoma

What animals will have indolent small T cell lymphoma?

Cats

What are indolent small T cells lymphoma in the GI?

Infiltrative slow progressing diffuse dz with a good prognosis - tx w/ low level chemo

What is intermediate/ large cell lymphoma of the GI?

Forms a tumor and is aggressive - Dogs

How is intermediate/ large cell lymphoma of the GI treated?

CHOP

-NOT sx

-POOR prognosis

What will we see in intestinal MCT?

More common in older cats in the SI w/ high malignancy that are diffuse/ focal

What is tx for intestinal MCT?

Chemo +/- sx

What is a Leiomyosarcoma?

SM malignant tumor

What are clinical signs of Leiomyosarcoma?

Paraneoplastic hypoglycemia

PU/PD

What is a GI stromal tumor?

Pacemaker cell organ -> interstitial cells of Cajal - good progonsis w/ sx

What are dx for GI neoplasia?

Normal blood work

US -cant diff the type of tumor

Biopsy