Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
236 Cards in this Set
- Front
- Back
|
Which of the following is not considered dietary indiscretion:
A: diet change B: poor quality diet - Old Roy C: regular BID feeding of Hills Science Diet D: table scraps E: foreign body F: hair G: toxin |
C: regular BID feeding of Hills Science Diet
|
|
|
What is considered part of the GI physical exam?
|
Oral/pharyngeal exam
Palpation of cervical area Abdominal palpation Digital rectal exam |
|
|
Inflammation of gingiva and perialveolar gums is AKA:
|
Gingivitis
|
|
|
What is gingivitis usually associated with?
|
Calculus and periodontal disease
Also: Plasmacytic lymphocytic pharyngitis/stomatitis |
|
|
Plasmacytic lymphocytic pharyngitis/stomatitis is usually seen in what animal?
|
Cats
|
|
|
What are the clinical signs you would expect with a dog with gingivitis?
|
Anorexia
Weight loss Halitosis Oral bleeding Dysphagia Ptyalism PU/PD |
|
|
What is ptyalism?
|
Drooling
|
|
|
True/false: Bacterial infection is usually secondary to periodontal disease, leading to gingivitis.
|
True
|
|
|
Gingivitis is possible with immunosuppression. Give some examples of immunosuppressive conditions associated with gingivitis.
|
Felv/FIV
Diabetes mellitus Neutropenia Glucocorticoids and other immunosuppressive drugs |
|
|
You are presented with a dog who has bad halitosis, some bleeding gums, and ptyalism. What is on your R/O list for causes?
|
Periodontal disease
Idiopathic Immunosuppression Caustic Foreign material Viral Uremia Diabetes mellitus Immune mediated skin disease |
|
|
You are presented with a dog for vaccines. You notice during your physical exam that the dog appears to have gingivitis. What is your first diagnostic step?
|
Clean the teeth!
|
|
|
You are presented with a dog for vaccines. You notice during your PE that it appears to have gingivitis. You of course scheduled it for a dental. After a month, the dog still has extreme halitosis, ptyalism, and is now PU/PD. What is your next diagnostic step?
|
Bloodwork - CBC, chem, UA
If that doesn't show anything and the dog is not immunosuppressive, might want to do a mucosal swab |
|
|
You are presented with a 15 year old cat for a dental. It of course will need half its teeth pulled. What are a few antibiotics of choice?
|
Clindamycin
Amoxicillan Tetracycline |
|
|
You have a cat diagnosed with lymphocytic plasmacytic pharyngitis. How do you treat?
|
Corticosteroids
Megesterol acetate - USE CAUTION Gold salts |
|
|
Passive retrograde movement of esophageal contents is AKA:
|
Regurgitation
|
|
|
What is the hallmark sign of esophageal disease?
|
Regurgitation
|
|
|
You are presented with a dog that the owner says is vomiting. The dog (thankfully) has an episode in the clinic but you notice no abdominal contractions, the movement appears passive. Is this vomiting or regurgitation?
|
Regurgitation
|
|
|
What in the history might point you towards an regurgitation?
|
Weight loss and failure to thrive
Variable relationship to time of eating Consistency varies with the time food is retained Frequency varies greatly Odynophagia |
|
|
What is odynophagia?
|
Pain associated with swallowing
|
|
|
True/false: Dogs with megaesophagus will have a poor appetite.
|
False - they will have an excellent appetite
|
|
|
What are some causes of megaesophagus?
|
Idiopathic
Vascular ring anomaly |
|
|
You suck at reading radiographs but see that a dog you are working on has megaesophagus. Weird thing is this dog also has a cough, fever, is tachypneic and has mucopurulent nasal discharge. What did you miss on the radiographs?
|
Aspiration pneumonia
|
|
|
You are presented with a dog who has weight loss, crackles in his lungs, a painful cervical esophageal region and fever. He was recently diagnosed with idiopathic megaesophagus. What do you think is going on?
|
Aspiration pneumonia
|
|
|
You are presented with a dog who you suspect may have megaesophagus. What is your first diagnostic step
|
Survey radiographs
|
|
|
The pathophysiology of megaesophagus is based on retention of ingesta. What are the two main reasons this would occur?
|
Obstruction
Impaired motility |
|
|
Describe some physical characteristics of regurgitus.
|
Depends on diet and time retained
Cylindrical shaped Mucus covered Food like appearance Abscence of bile Neutral/basic pH |
|
|
You are presented with a dog that the owner says is 'vomiting.' Name some differential diagnoses to account for this.
|
Vomiting
Regurgitation Megaesophagus Oropharyngeal dysphagia Vascular ring anomaly Foreign body Esophagitis Stricture Neoplasia |
|
|
What is oropharyngeal dysphagia?
|
Difficulty swallowing
|
|
|
What are the three phases of swallowing?
|
Oropharyngeal
Esophageal Gastroesophageal |
|
|
Dilation of the esophagus with reduced/absent peristalsis is AKA:
|
Megaesophagus
|
|
|
True/false: Myesthenia gravis can be a secondary cause of megaesophagus in dogs.
|
True
|
|
|
You diagnose a dog with megaesophagus. How do you treat?
|
Elevated feedings
Gruel consistency |
|
|
True/false: the prognosis for megaesophagus is poor unless the primary condition can be identified and treated.
|
True
|
|
|
What are three common locations for foreign body obstructions?
|
Thoracic inlet
Base of the heart Diaphragmatic hiatus |
|
|
True/false: obstructive foreign bodies are not medical emeregencies. They can wait until the morning.
|
False
|
|
|
You are presented with a Lab that ate a sock a few days ago and is now not eating and in general just feeling like crap. Suspecting the sock is somewhere in the GIT, what do you do?
|
Survey radiographs
If that doesn't reveal it, barium series |
|
|
You are presented with a dog who swallowed a chunk of meat (no bone). Based on survey radiographs and a barium esophagram, this is stuck at the gastroesophageal junction. What do you do?
|
Endoscopically go in and try to push it into the stomach
|
|
|
What are some etiologies of esophagitis?
|
Vomiting
General anesthesia Foreign body Post stricture dilation Idiopathic GES incompetance Caustic or thermal ingestion |
|
|
True/false: Doxycycline and Clindamycin can cause esophagitis if the pill gets stuck in the esophagus.
|
True
|
|
|
You put a dog on Doxycycline a few days ago for Lyme disease. The owner brought him back in today because he is unwilling to eat. You notice his cervical esophageal area is painful upon palpation. Suspecting esophagitis, how do you confirm your diagnosis?
|
Barium esophagram
Will see persistent barium coating, irregular mucosa and decreased motility |
|
|
You have diagnosed a dog with esophagitis due to Clindamycin. What might you expect to see with an endoscope?
|
Hyperemia
Erosions Friability Ulcers |
|
|
You have diagnosed a dog with esophagitis. How do you treat?
|
Rest esophagus - NPO, PEG tube
Metaclopramide H2 receptor antagonist or proton pump inhibitor Sucralfate |
|
|
Why is metaclopramide used for treatment of esophagitis?
|
Increases GES tone
Promotes gastric emptying and decreases risk of gastric reflux |
|
|
Why do you have to be careful with analgesics to treat esophagitis?
|
You want to avoid NSAIDS and drugs that can induce vomiting
|
|
|
Stricture is the end result of:
|
Esophagitis
|
|
|
Describe how an esophageal stricture occurs.
|
Injury --> scar tissue --> contraction --> stricture
|
|
|
What are some causes of esophageal stricture?
|
General anesthesia due to gastric reflux
Esophagitis - any cause Post foreign body removal Drugs: Doxy, Clindamycin (cats) |
|
|
You suspect a dog you are working with has an esophageal stricture. How might you diagnose this?
|
Barium esophagram
Endoscopy |
|
|
You have diagnosed a dog with an esophageal stricture. How do you treat it?
|
Balloon catheter dilation via endoscope
PEG tube Steroids to prevent scar formation |
|
|
You've done a balloon catheter dilation of a stricture in a dog. How soon do you want to follow up and what will you do at this follow up?
|
Endoscopy in 7-10 days
|
|
|
Two most common esophageal neoplasms:
|
Squamous cell carcinoma
Leiomyoma |
|
|
Which has a better prognosis in the esophagus, squamous cell carcinoma or leiomyoma?
|
Leiomyoma
|
|
|
How would you diagnose neoplasia in the esophagus?
|
Barium esophagram
Endoscopy/biopsy |
|
|
A forceful reflex ejection of gastric and small bowel contents through mouth is AKA:
|
Vomiting
|
|
|
What is acute vomiting?
|
Abrupt onset of clinical signs for a duration of less than 7 days
|
|
|
Describe the characteristics of vomit.
|
Mucus
Fluid, bile tinged Food - undigested/digested Blood (hematemesis) Foreign material Parasites |
|
|
When you see projectile vomiting, what does this mean?
|
Pyloric disease
|
|
|
True/false: With pyloric disease you will always see projectile vomiting.
|
False, if you see projectile vomiting though it always means pyloric disease
|
|
|
The number one cause of vomiting:
|
Dietary indiscretion
|
|
|
Which of these is not associated with dehydration:
a. pale mucus membranes b. warm extremities c. tachycardia d. decreased skin turgor e. delayed CRT f. enophthalmos |
b. warm extremities - extremities will be cold
|
|
|
What are the four areas that can stimulate the vomiting center in the medulla?
|
Vestibular system
Abdominal receptors (duodenum richly supplied) CRTZ Cerebral centers (not really applicable in animals) |
|
|
True/false: Uremia or drugs (digoxin) can trigger the CRTZ and thus vomiting.
|
True
|
|
|
Where is the CRTZ located?
|
Floor of 4th ventricle
|
|
|
What are the signs that a dog has nausea?
|
Salivating
Frequent swallowing Depression Vocalizing (cats) |
|
|
What are the steps to vomiting?
|
Nausea
Retching Vomiting |
|
|
What is retching?
|
Contraction of the abdominal muscles and diaphragm
|
|
|
True/false: You don't die from vomiting, you die from the cause or the consequences.
|
True
|
|
|
What are the deficits that occur when you vomit?
|
Water
Na Cl K (more due to lack of intake) H Bicarb |
|
|
What are the 4 reasons for hypokalemia associated with vomiting?
|
Decreased intake
Increased loss in vomitus/diarrhea Renal loss Alkalosis (intracellular shift) |
|
|
What are the two reasons for acid-base changes when we vomit?
|
Dehydration - lactic acidosis
Loss of duodenal bicarb |
|
|
Will you see a change in acid-base balance in an animal that vomits only a couple times?
|
NO
|
|
|
What type of acid-base change will you see in an animal that has been vomiting a lot?
|
Metabolic acidosis
|
|
|
What type of acid base change will you see in an animal with a blocked pylorus?
|
Metabolic alkalosis with paradoxical aciduria
|
|
|
With a pyloric obstruction, an animal with vomit HCl, bicarb, or both?
|
HCl only; bicarb comes from the duodenum
|
|
|
With pre-renal azotemia, what do you expect to be elevated on the bloodwork?
|
BUN
Creat P |
|
|
What happens to TCO2 when you have metabolic acidosis?
|
Decreases
|
|
|
What are your top rule outs for acute vomiting?
|
Acute gastritis (dietary indiscretion is in this category)
Motion sickness Foreign body Parasites Intussusception HGE Ulcers GDV |
|
|
Which parasites can cause vomiting?
|
Hooks
Rounds Giardia |
|
|
Name some systemic diseases that can cause acute vomiting.
|
Acute pancreatitis
Acute renal failure Acute liver failure Addison's Diabetes Mellitus Infectious diseases |
|
|
True/false: Acute vomiting can be either self limiting or life threatening.
|
True
|
|
|
How can you tell if acute vomiting is life threatening?
|
Signs of systemic disease
Severity of dehydration, abdominal pain and depression Frequency of vomiting Hematemesis Diarrhea Signalment |
|
|
True/false: Most cases of acute vomiting are self limiting and require minimal diagnostics.
|
True
|
|
|
You have a dog with acute vomiting. What is your minimum database?
|
PCV
TP Fecal float |
|
|
You are presented with a dog who has been vomiting for 24 hrs. You know its vomit because he did it in the exam room. He is not dehydrated and is still BAR. He is on monthly HW prevention and is not on any meds. How would you treat?
|
NPO for 12 hours w/o vomiting
Correct any dietary indiscretion SQ fluids - although not dehydrated yet, he will be after NPO Antiemetics Dietary management |
|
|
You are treating a dog for acute vomiting. What type of dietary management do you suggest?
|
Ice cubes/small amounts of water
Small frequent meals of soft food Q 4-6 hrs Gradually increase meal size and decrease frequency After resolution for 2-3 days gradually start normal diet over 3-5 days |
|
|
When treating a dog for acute vomiting with dietary management, what type of nutrition do you suggest?
|
Soft food that is:
Highly digestable Low fat Low fiber High carbs |
|
|
When treating a dog for acute self limiting vomiting, how long do you withold food? How long for an animal with life threatening acute vomiting?
|
12 hrs NPO
24 hrs NPO |
|
|
What do prostaglandins and NSAIDS have to do with gastric ulcer formation?
|
NSAIDS decrease PGE which assist with all the cytoprotective activities of the gastric mucosal barrier
|
|
|
Why do we do NPO with an animal who has gastritis?
|
When there is nothing in the stomach there is no acid secretion to perpetuate the cycle of altered cytoprotection of the gastric mucosa
|
|
|
Oral tumors are much more common in dogs or cats?
|
Dogs
|
|
|
What are the typical clinical signs of an oral tumor?
|
Mass in mouth
Salivation Exophthalmos Epistaxis (unilateral) Weight loss Halitosis Bloody oral discharge Dysphagia Cervical lymphadenopathy |
|
|
One of the most common reasons an owner will bring in an animal who has an oral tumor:
|
Bloody discharge from mouth
|
|
|
You need > ___% cortical erosion before tumor invasion is noticed on radiographs.
|
40
|
|
|
When looking for a tumor, do normal rads rule out the possibility?
|
NO
|
|
|
If you suspect an oral tumor, describe your diagnostic workup.
|
Careful palpation
Thoracic radiographs Intraoral radiographs CT scan Large incisional biopsy |
|
|
If you are going to take a biopsy of an oral tumor, how would you go about it?
|
Do an incisional biopsy if the tumor is very big from the middle of the tumor - send for histopathology (cytology not useful for oral tumors due to inflammation and necrosis)
|
|
|
You have a dog with an oral squamous cell carcinoma. What are your treatment options?
|
Surgical excision
Cryosurgery Radiation |
|
|
What are the most common oral cancers in dogs?
|
Fibrosarcoma
SCC Melanoma |
|
|
If you decide to surgically excise an oral tumor from a dog, what type of margins do you want?
|
At least 2 cm
|
|
|
Describe cryosurgery for the treatment of oral tumors.
|
Minimally invasive - nonsurgical
For small masses only Often only palliative |
|
|
True/false: Acanthomatous epulis and SCC do well with radiation therapy.
|
True
|
|
|
How if effective is radiation therapy for oral melanoma?
|
Palliative only
|
|
|
What are our mandiblectomy options?
|
Unilateral rostral
Bilateral rostral Vertical ramus Complete unilateral Segmental |
|
|
When doing a rostral mandiblectomy, how far caudal do you make the cut?
|
To PM1, can go to PM4 if need be
|
|
|
What are our maxillectomy options?
|
Unilateral rostral
Bilateral rostral Lateral Bilateral palatine |
|
|
When doing a bilateral rostral maxillectomy, how far caudal can you make your incision?
|
Can extend to PM2
|
|
|
What is the important difference between a mandiblectomy and a maxillectomy?
|
Maxilla - need buccal mucosa on nasal and oral sides
|
|
|
When doing a bilateral maxillectomy, what type of facial deformity results?
|
Roman nose appearance
|
|
|
Which type of maxillectomy can result in an oronasal fistula if tissue transfer is not done?
|
Bilateral palatine
|
|
|
When doing a mandiblectomy, what nerve block do you use?
|
Inferior alveolar nerve block (at mental foramen)
|
|
|
When doing a maxillectomy, what nerve block do you use?
|
Infraorbital nerve block (at infraorbital foramen)
|
|
|
What large breed dog commonly gets oral fibrosarcomas?
|
Goldens
|
|
|
How does an oral fibrosarcoma look histologically?
|
Looks benign but acts aggressively
|
|
|
Why not treat an oral fibrosarcoma with radiation therapy?
|
Fibrosarcoma is unresponsive to radiation because it doesn't have much blood supply (and is thus oxygen deprived)
|
|
|
What is considered a successful survival time with treatment of an oral fibrosarcoma?
|
A year
|
|
|
Is fibrosarcoma locally invasive or metastatic?
|
Locally invasive; metastatic less than 20% of the time
|
|
|
True/false: Fibrosarcoma often comes back even if removed.
|
True - hard to get all the tendrils that the tumor sends out
|
|
|
True/false: Oral melanoma behaves very different from cutaneous melanoma.
|
True
|
|
|
If an oral melanoma is >2 cm, what does this mean for survival?
|
Survival of only 164 days; if < 2 cm, survival of 511 days
|
|
|
Most common feline oral tumor:
|
SCC
|
|
|
In cats, is oral SCC locally invasive or metastatic?
|
Locally invasive
|
|
|
Describe the metastatic potential of SCC in dogs.
|
Rostral oral cavity = low potential
Tongue and tonsil = high potential |
|
|
What kind of prognosis does an oral SCC of the tongue/tonsil carry in the dog?
|
Very poor
|
|
|
What are the three most common types of epulides in dogs?
|
Fibrous
Ossifying Acanthomatous |
|
|
What is the most common type of epulis?
|
Acanthomatous
|
|
|
Do epulides invade into bone?
|
YES, the rostral mandible is the most common site
|
|
|
Best way to diagnose oral tumors:
|
BIOPSY
|
|
|
Which has a high metastatic rate, mandibular or maxillary osteosarcoma?
|
Maxillary
|
|
|
Are tonsillar tumors commonly unilateral or bilateral?
|
Bilateral
|
|
|
You are presented with a dog who has tonsilar tumors. What do you tell the owner?
|
Not much we can do here; survival is < 1 yr
|
|
|
Tonsilar tumors are typically which neoplasms?
|
SCC
Lymphoma Metastatic melanoma |
|
|
Majority of tongue tumors are what type of neoplasm?
|
SCC
|
|
|
70% of all oral tumors in cats are:
|
SCC
|
|
|
Describe a primary cleft palate.
|
Involves structures rostral to the incisive foramina (affects the lip)
|
|
|
Describe secondary cleft palate.
|
Caudal to the incisive foramina
Affects hard and/or soft palate |
|
|
When is secondary cleft palate detected?
|
At birth
|
|
|
At what age is secondary cleft palate surgery done?
|
6-8 wks of age - tube feed until then
|
|
|
Is dehiscence a problem with secondary cleft palate surgery?
|
Yes, so you may have to do multiple surgeries
|
|
|
What is a salivary mucocele?
|
Saliva collects in the cervical region (sublingual or pharyngeal area)
|
|
|
2 breeds commonly affected by salivary mucoceles:
|
Poodles
German Shepherds |
|
|
When you are dealing with a salivary mucocele, why is it important to ask owners which side they first noticed swelling on?
|
Because by the time we see it, the swelling is all over
|
|
|
True/false: A salivary mucocele is a non-secretory cystic structure
|
True
|
|
|
What is the etiology of salivary mucoceles?
|
Unknown
|
|
|
True/false: The parotid is a common gland to cause a salivary mucocele.
|
False - we will never see a salivary mucocele caused by the parotid
|
|
|
Describe how you would surgically remove a mandibular or sublingual salivary mucocele.
|
Pass gland under the digastricus muscle
Remove to the level of the lingual nerve Penrose drain for 48 hrs |
|
|
What is a rannula?
|
Accumulation of saliva
Beneath the mucosa along the tongue |
|
|
True/false: A rannula is alomst an incidental finding unless it is so big the animal has difficulty breathing.
|
True
|
|
|
Where do pharyngeal mucoceles occur?
|
In the oropharynx
|
|
|
What is the chief complaint associated with an animal with a pharyngeal mucocele?
|
Airway obstruction
|
|
|
How do you treat a pharyngeal mucocele?
|
Remove and submit to pathologist
Remove sublingual and mandibular salivary glands |
|
|
Where do feline inflammatory polyps usually occur?
|
Tympanic cavity (within the bulla)
Mucosa of nasopharynx or middle ear |
|
|
Are feline inflammatory polyps a unilateral or bilateral disease?
|
Unilateral
|
|
|
Who typically gets feline inflammatory polyps, young cats or old cats?
|
Young
|
|
|
Describe the clinical signs associated with feline inflammatory polyps.
|
Sterterous respiration
Bilateral nasal discharge Sneezing Changes in phonation Dysphagia Scratching at ear |
|
|
What is the exact cause of feline inflammatory polyps?
|
Unknown
|
|
|
What are the two compartments to the feline bulla?
|
Ventromedial
Dorsolateral |
|
|
Which compartment of the feline bulla do polyps arise from?
|
Ventromedial
|
|
|
How do you diagnose feline inflammatory polyps?
|
Pharyngeal exam
Rads (open mouth view usually/ lateral) Otoscopic exam |
|
|
What is the common side effect of traction avulsion of a feline inflammatory polyp?
|
Horner's syndrome - lasts about 4 wks and cat goes back to normal
|
|
|
You have just removed a polyp from a cat via retraction avulsion. What can you do to decrease the reoccurence rate?
|
Put it on steroids
|
|
|
What is the surgical approach to removing a feline inflammatory polyp?
|
Ventral bulla osteotomy
|
|
|
Vascular ring anomalies primarily affect what organ?
|
Esophagus
Does not affect CV function |
|
|
What is the most common vascular ring anomaly?
|
Persistent right aortic arch
|
|
|
Most common dog breed to be affected by a vascular ring anomaly:
|
German Shephard
|
|
|
What are the clinical signs that a vascular ring anomaly is present?
|
Esophageal obstruction (regurgitation noticed at weaning)
Weight loss Aspiration pneumonia |
|
|
How do you diagnose a vascular ring anomaly?
|
Barium swallow
|
|
|
How do you surgically treat a vascular ring anomaly?
|
Ligate the ligamentum arteriosis (fetal structure)
|
|
|
True/false: Megaesophagus is secondary to a vascular ring anomaly.
|
True
|
|
|
Is GDV an acute life threatening condition?
|
Yes
|
|
|
Why does hypovolemic shock occur w/ GDV?
|
Bloated stomach puts pressure on the vena cava and blood cannot return to the heart
|
|
|
Why does splenomegaly occur with GDV?
|
Due to pressure from the GDV on the splenic vessels
|
|
|
What are we trying to prevent by treating GDV quickly?
|
Gastric necrosis
Perforation |
|
|
How do you treat GDV?
|
Fluids
Decompression w/ orogastric tube |
|
|
How do you measure an orogastric tube?
|
From incisors to 13th rib
|
|
|
When you pass an orogastric tube, should the head be flexed or extended?
|
Flexed
|
|
|
True/false: GDV is usually not associated with engorgement of food.
|
True
|
|
|
Factors w/ GDV associated with mortality:
|
Gastric necrosis
Gastric resection Splenectomy Preoperative cardiac arrhythmias Depression/coma |
|
|
Name some risk factors associated with GDV:
|
Purebred (deep chested)
Increased breed size Increased weight Increased age German Shephard Males Single meal/day |
|
|
True/false: Fearful or stressed animals have a greater incidence of GDV.
|
True
|
|
|
Why does having a raised food bowl increase the risk of GDV?
|
Because it increases aerophagia
|
|
|
What are two amusing things that owners report as decreasing the risk of GDV?
|
Dog described as being happy
Feeding table scraps |
|
|
True/false: Most cases of pancreatitis in dogs get better.
|
True
|
|
|
True/false: we use radiographs to diagnose pancreatitis.
|
False - we use it to rule out other possibilities (obstructions, etc)
|
|
|
Describe the echogenicity of pancreas with pancreatitis.
|
Decreased echogenicity
|
|
|
True/false: negative ultrasound findings r/o pancreatitis.
|
False
|
|
|
Gold standard in pancreatitis diagnosis:
|
Pancreatis biopsy - the problem is this kills the dog most of the time
|
|
|
Is TLI a good test for pancreatitis in the dog and cat?
|
No; great for exocrine pancreatic insufficiency
|
|
|
What does cPLI look at?
|
Lipase only
|
|
|
cPLI is sensitive or specific?
|
Sensitive
|
|
|
What are the signs in dogs of pancreatitis?
|
Acute vomiting
Abdominal pain Fever |
|
|
What are the signs of pancreatitis in cats?
|
Lethargy
Anorexia |
|
|
True/false: 50% of cats with pancreatitis do not vomit.
|
True
|
|
|
True/false: Surgery of the stomach is one of the most common surgeries we will do.
|
True
|
|
|
What is the most common reason a gastrotomy is performed?
|
Foreign body
|
|
|
Gastric tumors normally occur where in the stomach?
|
By the pylorus
|
|
|
The gastric artery is located where at the stomach?
|
Lesser curvature
|
|
|
Which artery is located at the greater curvature of the stomach?
|
Gastro-epiploics
|
|
|
With GDV, what portion of the stomach is most affected? What does this mean for the vasculature?
|
Fundic portion
Means gastroepiploics and short gastric arteries are affected |
|
|
Gastrotomy is what type of surgical wound?
|
Clean contaminated
|
|
|
How soon after a gastrotomy might you notice esophagitis?
|
About a week later
|
|
|
What is the point of stay sutures when doing a gastrotomy?
|
Decreases contamination
Helps with manipulation Atraumatic tissue handling |
|
|
To do a gastrotomy, where is the incision made in the stomach?
|
In the hypovascular area; midway between curvatures
|
|
|
What suture pattern do you want to use to close the stomach?
|
Cushing
|
|
|
What suture material would you want to use to close the stomach?
|
PDS, Maxon
|
|
|
True/false: when doing a gastrotomy you should change gloves halfway through surgery.
|
True, helps decrease contamination
|
|
|
Why can pyloric obstruction occur when doing a gastrotomy?
|
You made your incision too close to the pylorus
|
|
|
Indications for gastrotomy tubes:
|
Nutritional supplementation
Medication Gastric decompression |
|
|
What is the preferred catheter to use for a gastrotomy tube?
|
Mushroom tip catheter (could also use a Foley)
|
|
|
True/false: When using a gastrotomy tube, a permanent adhesion is forms between the stomach and the body wall.
|
True
|
|
|
True/false: When a gastrotomy tube is pulled out prematurely by the patient, this is a medical emergency.
|
False - no big deal. If a PEG tube gets pulled out early you have to go back in
|
|
|
With a gastrotomy, what portion of the stomach is sutured to the body wall? Into which portion of the stomach is the catheter placed?
|
Fundus
|
|
|
When placing a gastrotomy tube, why is it important to make sure you are caudal to the 13th rib?
|
You do not want to puncture the diaphragm
|
|
|
How long is a gastrotomy tube left in place?
|
Weeks to months
|
|
|
Describe the process of removing a gastrotomy tube.
|
Animal sedated
Tube pulled out w/ 4x4 Healing with second intention |
|
|
What type of suture pattern is used to secure the gastrotomy tube to the stomach?
|
Purse string
|
|
|
What is gastroplexy?
|
Procedure used to tack the right side of the stomach to the right body wall to prevent future GDV
|
|
|
If you see a huge stomach during a celiotomy, how can you tell if its GDV or bloat?
|
If its GDV, the omentum is pulled over the stomach as twist occurs
|
|
|
What vessels do we worry about being compressed with GDV?
|
Caudal vena cava
Portal vein |
|
|
Why do we worry about hypovolemia and septic shock with GDV?
|
Because the caudal vena cava and portal veins are compressed
|
|
|
How can you tell if you completely untwisted a GDV?
|
Look at the splenic vasculature
|
|
|
The majority of vascular damage to the stomach with GDV is in which anatomical region?
|
Fundic
|
|
|
Which two organs do you really want to inspect well after untwisting a GDV?
|
Stomach
Spleen |
|
|
True/false: Gastroplexy prevents both GDV and bloat.
|
False, only GDV
|
|
|
Which portion of the stomach is sutured to the right body wall with gastroplexy?
|
Pyloric antrum
|
|
|
What is prophylactic gastroplexy?
|
Doing a gastroplexy prior to an animal having GDV (i.e. you might want to offer it in a large breed deep chested dog at the time of spay/neuter)
|
|
|
Name some breeds that are susceptible for chronic hypertrophic pyloric gastropathy.
|
Boxers
Bostons Shih Tzu Maltese |
|
|
What is the best way to diagnose chronic hypertrophic pyloric gastropathy?
|
Endoscopy
|
|
|
What surgical procedure would you use to correct chronic hypertrophic pyloric gastropathy?
|
Pyloroplasty - a full thickness incision is made and tissue is reoriented to increase the diameter of the outflow tract
|
|
|
Which form of pyloroplasty has the best results?
|
Y-U technique
|
|
|
True/false: When you do a pyloroplasty to correct chronic hypertrophic pyloric gastropathy, you should always go ahead and get a full thickness biopsy.
|
True
|
|
|
An incision into the lumen of the stomach is AKA:
|
Gastrotomy
|
|
|
Creation of an artificial opening into the gastric lumen is AKA:
|
Gastrostomy
|
|
|
Permanent adherence of the stomach to the body wall is AKA:
|
Gastropexy
|
|
|
You should withold food for how many hours prior to performing a gastric surgery?
|
8-12 to be sure the stomach is empty
|
|
|
Why are bacteria scarce in the stomach compared to other parts of the GIT?
|
Due to low pH; so those with healthy immune function rarely require antibiotics following gastrotomy
|
|
|
The esophagus enters the stomach through the:
|
Cardiac ostium
|
