MONICA AUGOSTO - GIT

What nerves control prehension of food?

- 1,2,5,12 and the cerebral cortex

what muscles are involved in mastication?

Masseter, temporalis and pterygoids

what nerves are involved in mastication?

5 and 7 (trigeminal and facial)

what muscle opens the jaw?

digastricus m.

what nerves control swallowing?

5,7,9,10,12 - all provide sensory and motor innervation except 12 (hypocglossal) - motor only

what are the clinical signs of oropharyngeal disease?

- dysphagia - difficulty swallowing

- ptyalism - overproduction of saliva

- halitosis

- odynophagia - pain when swallowing

what are the 4 types of dysphagia?

- oral, pharyngeal, cricopharyngeal, oesophageal

what type of dysphagia is a congenital abnormality in young dogs?

cricopharyngeal dysphagia

what are the 2 main categories of oropharyngeal disease?

inflammation or dysmotility

what is canine stomatitis?

inflammation of the tongue, gingiva, palate and buccal, vestibular and sublingual mucosa

how do you carry out an oral/oropharyngeal exam?

- examine teeth

- gums

- under tongue (esp. cats)

- watch animal eating

- haematology and biochemistry

- radiography

- biopsy for histopathology and to rule out neoplasia

how do you treat chronic ulcerative stomatitis in mouth?

- dental management

- hypoallergenic diet

- omega 3 and 6 fatty acid supplementation

- antibiotics (doxycycline)

- corticosteroids

- analgesics

how do you diagnose feline chronic gingivostomatitis?

- clinical signs (halitosis, ptyalism, blood-tinged saliva, etc)

- mature, middle aged cats or feline juvenile gingivitis in cats <3yrs old

- breed predisposition - Persian, Abyssinian, Siamese

- oral exam - ulceration, erythema

- haematology and biochemistry

- FeLV and FIV testing

- dental radiographs

- biopsy

- PCR and immunohistochemistry for FCV, FHV and candida albbicans

TREATMENT same as for dogs

what causes masticatory myositis?

production of autoantibodies IgG that taret type 2 myofibers

what are the clinical signs of masticatory myositis?

- inability to open the mouth

- reluctance to chew or eat

- pain and swelling oof masseter and temporalis muscles

- muscle atrophy

how do you treat masticatory myositis?

remember caused by an autoimmune response

- glucocorticoids - immunosuppressive dose in the acute phase

- azathioprine - immunosuppressant

- analgesics

- place a feeding tube

- risk of iatrogenic fracture if you force jaw open under general anaesthesia

what are the main clinical signs associated with oesophageal disease

- regurgitation

- retching, gagging, repeated swallowing

- dysphagia, odynophagia, ptyalism

megaoesophagus can occur secondary to what conditions?

- obstructions

- myasthenia gravis

- hypoadrenocorticism

- hypothroidism

- vagal nerve injury

- dysautonommia

how do you diagnose megaoesophagus?

- clinical history - regurgitation, weight loss, cough

- radiography

- contrast radiographs

- fluoroscopy

how do you treat megaoesophagus?

- treat underlying cause

- treat aspiration pnnneumonia if present

- feed from a heeigh and keep upright for 10 mins after eating

- feed little and often

- feed soft foods

- insert a feeding tube

- prokinetics (metoclopramide) do NOT aid motility but can increase LES pressure

- Sildenafil reduces oesophageal sphincter tone

list causes of oesophagitis?

- foreign body

- trauma

- infectious

- reflux

- oesophageal dysmotility

- BOAS

- some oral drugs - doxycycline in cats, NSAIDs

- ingestion of caustic substances

how do you diagnose oesophagitis?

- oesophagoscopy

- radiography

- haematology and biochemistry

how do you treat oesophagitis?

- proton pump inhibitors - omeprazole

- H2 blockers - cimetidine

- sucralfate - protectant

- metaclopramide to increase LES pressure

- diet management - frequent small meals, low fat high protein, gastrotomy, PEG feeding tube

what are the clinical signs of acute gastroenteritis?

acute vomiting and diarrhoea

acute abdominal pain

fever,anorexia,lethargy

what are the infectious causes of gastroenteritis?

- cnaine parvo

- feline panleukopenia

- giardia

- campylobacter

- salmonella

what are the non-infectious causes of gastroenteritis?

- foreign bodies

- intussusception

- gastric ulceration

- acute haemorrhagic diarrhoea syndrome

- ingestion of toxic or caustic substance

- some drugs - NSAIDs

what drugs are contraindicated for acute gastroenteritis?

- NSAIDs and corticosteroids

how do you diagnose acute gastroenteritis?

- abdominal radiographs and ultrasound

- abdominal palpation - pain or swelling

- haematology and biochemistry

- faecal analysis

- urinalysis

- faecal antigen for giardia and parvo

- abdominocentesis

- endoscopy

how do you treat acute gastroenteritis?

- treat underlying cause

- dietary management (fasting, little and often, bland diet, low fat content)

- anti-ulcer meds (sucralfate, H2 receptor antagonists - cimetidine, proton pump inhibitors)

- oral rehydration vs IV fluids

- anti-emetics (MAROPITANT)

- antibiotics can worsen diarrhoea

when are antibiotics indicated in diarrhoea cases?

- haemorrhagic diarrhoea

- diarrhoea with concurrent pyrexia and neutropenia

- if there is a known infectious cause - salmonella, campylobacter, E.coli

how do you test for parvovirus?

- Faecal ELISA antigen test - false negs early in course of disease and false positives after vaccination

- PCR assay - high Se and Sp

- immunofluorescent antibody assay (IFA) - detection and measurement of ABs to CPV

what gastric gland cells secrete HCl?

parietal cells

what triggers HCl release from parietal cells?

- gastric distension

- luminal peptides:

histamine

Ach

gastrin