Clinical Manifestations of GI disease in Small Animals (TV4102, Lecture 19 Notes)

List relevant manifestations of GI disease

- Retching/gagging (unproductive vomit attempt)

- Halitosis

- Ptyalism (thick, ropey saliva strands)

- Vomiting (active expulsion of stomach contents) or regurgitation (passive discharge of oesophageal contents)

- Diarrhoea

- Constipation

- Tenesmus

- Weight loss

- Abdominal distension

- Melaena

- Haematochezia

- Dysphagia

- Dyschezia

List diseases causing retching/gagging

- GI foreign bodies

- Gastroenteritis

- Dietary changes

- Oseophageal disorders

- CND disorders

Discuss forms of dysphagia

Oral dysphagia - cannot prehend food, typically self-limiting.

e.g. trigeminal neuropathy

Pharyngeal dysphagia - repeated swallowing attempts, high risk of aspiration pneumonia.

e.g. cricopharyngeal achalasia/asynchroncy, foreign bodies, phenobarbital-associated sialoadenosis or Spirocerca lupi

Oesophageal dysphagia - food accumulation in oesophagus with regurgitation, high risk of aspiration pneumonia.

e.g. megaesophagus, polyradiculoneuritis, polymyositis, hypothyroidism, hypoadrenocorticism, organophosphate or lead/heavy metal toxicity

Discuss diagnosis of swallowing disorders

- History

- CBC and biochemistry

- Electrolytes and T4

- Radiographs

- Fluoroscopy (swallow studies identify type of dysphagia)

- Acetylcholine receptor antibody titer

List causes for ptyalism

- Nausea

- Neurological

- Hepatic encephalopathy

- Oesophageal foreign body

- Phenobarbital-associated sialoadenosis

Compare and contrast vomiting and regurgitation

List extra- and intra-gastrointestinal vomiting causes

Extra-GI

- Kidney disease

- Hepatic disease

- Brain disease

- Hypoadrenocorticism

- Hyperthyroidism

- Pancreatitis

- Hypercalceamia

- Diabetic ketoacidosis

- Pyometra

- Endotoxemia

Intra-GI

- Dietary indiscretion

- Parasites/infection

- Food intolerance

- Neoplasia

- Inflammatory bowel disease

Discuss diagnosis of vomiting

List causes of diarrhoea

- Malabsorptive

- Secretory

- Motility

- Osmotic

List extra- and intra-gastrointestinal diarrhoea causes

Extra-GI

- Chronic hepatitis

- Portal hypertension

- Kidney disease

- Brain disease

- Hypoadrenocorticism

- Hyperthyroidism

- Exocrine pancreatic insufficiency

- Pancreatitis

Intra-GI

- Dietary indiscretion

- Parasites/infection

- Inflammatory bowel disease

Discuss acute diarrhoea

- Less than 2-weeks

- Due to dietary indiscretion or infection

- Typically self-limiting

Discuss diagnosis of chronic diarrhoea

Discuss melaena

- Black tarry faeces

- Indicating digested blood from mouth to small intestine

- Due to blood ingestion (e.g. respiratory lesions or diet), inflammatory processes, infection, traumatic/ischaemia, post-surgery, drug-induced, neoplasia or metabolic (e.g. hypoadrenocorticism or uraemia)

Discuss diagnosis of melaena

Discuss haematochezia

- Undigested blood from colon, rectum or anal glands

- Due to acute haemorrhagic diarrhoea syndrome, inflammatory process (e.g. colitis), infection, traumatic/ischaemia, drug-induced, neoplasia, vascular, metabolic or bleeding disorders

List causes for abdominal distension

The 7 Fs;

- Faeces

- Flatulence (gas)

- Foetus

- Fat

- Fluid

- Food

- 'Flipping' big mass/organ