Diseases of Digestive System Oral cavity Esophagus Stomach Small Bowel Large Bowel Liver Pancreas Rectum Anus

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Diseases of Digestive SystemOral
cavityEsophagusStomachSmall BowelLarge
BowelLiverPancreasRectumAnus

• Chapter 2

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ADVERSITY

• Adversity causes some men to break, others to
  break records.
• -William A. Ward

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Diseases of SI

• Often involves impairment of absorptive surface
  of SI (what is that?)
• Acute Diarrheaone of the ____________________
  seen types of diarrhea
• Causes(often accompanies acute gastritis)
• Diet change
• Stressful situations
• Drug therapy
• Signs (Duh?)
• __________ onset
• vomiting
• Normal appearance otherwise
• Dx
• Fecal to r/o parasites
• CBC (dehydration), Chem panel to r/o metabolic
  diseases

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Acute Diarrhea

• Rx
• Fluids for dehydration, electrolyte imbalance
  (SQ, IV, PO)
• NPO x 24 h water OK if no vomiting
• Intestinal absorbants/coating agents
• Loperamideopiod receptor inhibitor that slows
  gut motility
• Antibiotics (?)
• Bland diet after 24 h
• Hills I/D
• Boiled chicken/rice

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Parasite Diarrhea

• Signs
• Diarrhea
• ___________
• Poor hair coat
• Listlessness
• Dx
• ___________
• Tx
• Anthelmintics for parasites Fenbendazole/pyrantel
  
• Antiprotozoal medication for Giardia, Coccidia

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Giardia
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Viral Diarrhea

• Parvovirus
• Canine distemper virus
• Coronavirus
• Feline panleukopenia virus

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Parvovirus

• Seen mainly in young, ________ puppies
• Signs
• Diarrhea, usually with blood
• Vomiting
• Febrile
• Anorexia, depression
• Dx _____________(enzyme-linked immunosorbent
  assay) test
• Rx
• IV fluids
• Antidiarrheal therapy
• Antibiotics (Gram neg)
• Keep warm
• ___________________

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Parvovirus (coyote, cats)
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Parvovirus

• Client info
• Sick animals will infect other unprotected
  animals
• Parvo can be fatal
• Vaccinate for protection

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Diseases of LI

• Function is to________________, electrolytes
  store feces
• Inflammatory Bowel Disease (IBD)
• Signs
• Diarrhea with wt loss
• ? frequency of defecations, ? volume
• Tenesmus
• ? mucus
• Dx
• Fecal to r/o parasites
• Chem panel to r/o metabolic causes
• Biopsy of LI wall
• ? __________________________________

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Inflammatory Bowel Disease

• Rx
• ________________ a sulfa drug with
  anti-inflammatory effects
• Most effective against colitis
• Prednisone
• ______________, Tylosin
• Mesalaminea metabolite of Sulfasalazine in LI
  (actions unknown)
• Hypoallergenic diet
• Hills d/d, z/d, i/d
• Homemade diets
• Client info
• Treatment is often prolonged
• Goal of Rx is to control symptoms,
  _________________
• Animals with IBD need to be taken outside
  frequently for BMs

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Intussusception

• Cause usually unknown can result from parasites,
  FB, infection, neoplasia
• Signs
• Vom/diarrhea with or without blood
• Anorexia, depression
• Dx
• Palpation of ______________ in cranial abdomen
• Rx
• Surgical reduction/resection of necrotic bowel
• Restore fluid/electrolyte balance
• Restrict solid food x 24 h after Sx then bland
  diet
• x 10-24 d
• Client info
• Recurrence is infrequent
• Px depends on amt of ____________ removed
• Puppies should be treated for parasites to
  prevent intussusception

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Intussuception
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Megacolon

• Uncommon in dogs, more common in ____________
  (mostly idiopathic)
• Associated with Obstipation (intestinal
  obstruction, severe constipation)
• Signs
• Straining to defecate
• Must be distinguished from straining to
  __________ in male cats
• vomiting
• Weakness, dehydration, anorexia
• Small, hard feces or liquid feces
• With or without blood, mucus

Greater than length of lumbar vertebrae
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Megacolon

• Dx
• Palpation of distended colon filled with hard,
  dry feces
• Radiographs show colon ______________________
• Rectal palpation assures adequate pelvic opening
• Rx
• Warm water enema
• Animals can become hypothermic
• Manual removal under anesthesia
• Mucosal surface is delicate
• Client info
• Encourage water intake
• Salt food
• Always provide adequate supply
• High-fiber diet

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Megacolon

• Surgical removal

Suture ends at arrows
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Liver Diseases

• High regenerative capacity damage must be severe
  for signs to appear
• Vague signs early anorexia, vom/diar, wt loss,
  PU/PD, fever
• Drug/Toxin induced Liver Disease
• Acute liver failure requires __________ of liver
  to be affected
• Susceptible to toxin ingestion (portal
  circulation)
• Some drugs have a Hx of liver toxicity
• _____________________________
• Phenobarbital
• others

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Drug/Toxin Induced Liver Disease

• Signs
• Acute onset
• Anorexia
• vomiting/, diarrhea/constipation
• PU/PD
• _________________ (maybe)
• Melena, hematuria, or both
• _________signs (depression, ataxia, dementia,
  coma, seizures)

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Drug/Toxin Induced Liver Disease

• Dx
• Hx of drug administration
• Painful liver on palpation
• Chem panel
• ? ______________(alanine aminotransferase)
• ? Total bilirubin, ? blood ammonia
• ? Serum bile acids
• Hypoglycemia, _________________________
• Radiographs show enlarged liver
• Liver biopsy (unless coagulopathy suspected)

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Drug/Toxin Induced Liver Disease

• Rx
• Antidotes
• Induce vomiting
• _______________________
• IV fluids
• Vit K for clotting
• Antibiotics
• Special diets (Hills k/d or u/d)

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Liver Tumors

• Primary and metastatic tumors are not uncommon in
  dogs and cats
• Metastatic tumors are ___________than primary
  tumors of liver
• Signs
• Anorexia, lethargy, wt loss
• PU/PD
• Vomiting/diarrhea (?)
• Abdominal distension, hepatomegaly
• Jaundice
• Dx
• Anemia, usually _________________
• Chem Panel
• ? serum albumin
• ? serum bilirubin, bile acids
• ? serum glucose
• Azotemia (? BUN, creatinine esp in cats)

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Liver tumors

• Dx
• X-ray Heptomegaly, Ascites (?)
• ________________ of liver
• Abdominocentesis may show tumor cells
• Rx
• Surgical removal is preferred treatment
• Single masses have good Px
• Multiple nodules/Diffuse disease have poor Px
• Chemotherapy doesnt help primary tumors better
  for metastatic lesions
• Client info
• Guarded to poor Px generally
• Survival time ___________________

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Portosystemic Shunts

• Shunts form between portal circ and systemic circ
  allowing blood to bypass liver Function of
  liverdetox blood
• Congenital or acquired
• By-passing liver, allows many toxins into
  systemic circulation
• ___________ is most affected by the circulating
  toxins

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Portosystemic Shunts
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Portosystemic Shunts

• Signs
• Dumb/numb, lethargic, depressed
• Ataxia, staggering
• _________________ (against a wall)
• Compulsive circling, apparent blindness
• Seizures, coma
• Bizarre behavior (esp cats)
• Signs often more pronounced shortly_____________

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Portosystemic Shunts

• Dx
• Chem panel
• ? serum protein, albumin (liver is usually small)
• ? BUN (liver converts ammonia ? urea)
• ? ALT (alanine aminotransferase), ALP (alkaline
  phosphatase)
• ? blood ammonia (from protein)
• X-rays
• Small liver
• Contrast material
• Inject into ______________
• By-passes liver

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Portosystemic Shunts

• Rx
• Medical management seldom very successful
• Low protein diet
• Sx
• Ligation of shunt
• Total ligation often causes ? liver BP
• ______________ may be more practical
• A second Sx can be performed after few months to
  close off shunt totally
• Client info
• Px often very good following ligation
• For best results, Sx should be performed before 1
  y old
• _______________ may develop, with relapse of signs

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Feline Hepatic Lipidosis

• Idiopathic (IHL) cause unknown
• Most common hepatopathy in cats
• _____________ of any age, sex or breed
• Stress may trigger anorexia
• Diet change,
• Boarding
• Illness,
• Environmental change

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IHL

• Anorexia prolonged for 2 weeks causes __________
  between breakdown of peripheral lipids and lipid
  clearance within liver
• Lipids accumulate in liver
• Other mechanisms proposed
• Early diagnosis and aggressive treatment
  important
• 60-65 of cases gt complete recovery

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IHL
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IHL
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IHL

• Clinical Signs
• Anorexia
• Obesity
• Wt loss (as much as 25 of body weight)
• Depression
• Sporadic vomiting
• __________________
• Mild hepatomegaly
• /- coagulopathies

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IHL

• Diagnosis
• CBC _________________ , stress neutrophilia,
  lymphopenia
• Biochem panel Increased ALP, ALT, bilirubin,
  Low albumin, Increase serum bile acids
• X-rays mild hepatomegaly
• US liver hyperechoic
• Liver biopsy severely vacuolized hepatocytes

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IHL

• Treatment
• High protein, calorie dense diet
• Feeding tube usually required
• NG tube for short term liquid
• diets
• Gastrostomy tube best
• Esophagostomy tube
• Tubes can remain in place
• For up to _____________

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IHL

• Treatment
• IV fluids
• __________________ SQ 15 min prior to feeding
• Monitor weekly
• CE
• Avoid stress in obese cats
• Early intervention is essential
• Any cat that stops eating is at risk
• Cats do not respond well to ______________________
  _

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Pancreatic Dysfunction (Exocrine)

• Main function of Exocrine Pancreas ? secretion of
  ___________________
• Located along duodenum
• Dig enzymes secreted in an inactive form to
  protect pancreas tissue

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Pancreatic Dysfunction (Exocrine)

• PancreatitisInflammation of pancreas
• May be chronic or acute
• Develops when dig enzymes are activated within
  gland ? ______________
• More common in obese animal _________________
  may predispose animal to it
• Unpredictable results some recover well, others
  worsen and die
• Signs
• Older, obese dog or cat with Hx of recent
  high-fat meal
• Depression, anorexia, ______________
• abdominal pain
• Shock, collapse may develop
• Diarrhea
• Often seen post-holiday
• Table scraps of ham, gravy, etc

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Pancreatitis

• Dx
• CBC, Chem panel
• Leukocytosis
• ? PCV (means what?)
• Hyperlipidemia
• ? serum amylase, lipase
• _____________________
• Rx
• IV fluids, electrolytes
• NPO 3-4 d
• Antibiotics
• __________________ for pain
• Start back on low fat diet 1-2 d after vom stops
• Client info
• Avoid obesity/overfeeding
• Feed low-fat treats
• Px is difficult to assess

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Exocrine Pancreatic Insufficiency

• The pancreas stops making dig enzymes
• May occur spontaneously (G Shep) or due to
  chronic pancreatitis (cats)
• Signs
• Wt loss
• Polyphagia
• _________________, pica
• Diarrhea, fatty stool
• Flatulence
• Dx
• Normal CBC
• ? total lipids

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Exocrine Pancreatic Insufficiency

• Rx
• Supplement pancreatic enzymes with each meal
• Pancrezyme
• _____________________
• Low fiber diet
• Client info
• EPI is__________________ life-long treatment
• Pancreatic enzyme replacement is expensive
• With enzyme replacement, dog will regain weight,
  diarrhea will stop
• Must be given with every meal

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Perineal Hernia

• Intact male dogs atrophy of levator ani muscle
  rectum herniates
• Signs
• ____________ perianal swelling
• Tenesmus (feeling of full colon)
• Dyschezia (difficult defecation)
• Urethral obstruction
• If bladder is herniated
• Dx
• Rectal palpation reveals hernia sac

Intact male dogs gt 8 yrs
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Perineal Hernia

• Rx
• Stool softeners (Colace)
• Enemas
• Surgical repair Herniorrhaphy
• Castration
• Client info
• Keeping stool soft may help reduce straining
• True for all dogs
• _______________ recommended testosterone is
  suspected as a predisposing factor

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Perianal Fistula

• Exact etiology unknown thought to start as an
  inflammation of _______, _____________ glands
  around anus
• Bacteria grow well in the moist, warm region of
  these glands
• Infection invades into deeper tissues
• Most commonly affects __________________ (84 of
  dogs diagnosed)
• Signs
• Intact male, older (gt8 y)
• Tenesmus
• Dyschezia, pain on exam
• Fecal incontinence
• Bleeding, foul odor of perianal area

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Perianal Fistula

• DxPE to r/o anal sac disease/perirectal tumor
• Rx
• Medicalusually not successful
• Clip hair, keep clean
• Flush with saline
• Antibiotics
• Surgical________________ because of nerves/blood
  vessels
• Remove infected tissue
• Cryosurgery
• Laser surgery
• Cautery
• Client info
• Painfulbe cautious of biting
• many complications of Sx
• _____________________
• Anal stenosis

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Perianal Gland Adenoma

• Signs
• Intact male, older
• Single or multiple masses that may ulcerate
• ______________________________________
• Pruritis in anal area
• Bleeding
• Firm nodules in perianal skin
• DxPE, biopsy
• Rx
• Surgical removal
• Radiation
• Cryosurgery
• Castrationcauses regression of tumors
• Client info
• Gently cleanse area daily with baby wipes
• Castration at early age helps prevent it