Esophageal Fistula and Hiatal Disorders
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Questions and Answers

What is the most common cause of acquired esophageal fistulas?

  • Chronic respiratory disease
  • Congenital abnormalities
  • Esophageal foreign body (correct)
  • Bacterial infection

    • Which clinical sign is NOT typically associated with esophageal fistulas?

  • Dyspnea
  • Excessive salivation (correct)
  • Coughing
  • Fever

    • What is the most definitive method for diagnosing esophageal fistulas?

  • Ultrasound imaging
  • Blood tests
  • Barium esophagram (correct)
  • Physical examination alone

    • What type of hiatal hernia involves the protrusion of both the esophagus and stomach?

    <p>Sliding hiatal hernia</p> Signup and view all the answers

    What is the relationship between gastroesophageal intussusception and congenital idiopathic megaesophagus?

    <p>Intussusception can occur in cases of megaesophagus</p> Signup and view all the answers

    Which of the following factors does NOT contribute to secondary hiatal hernias?

    <p>Hypotension</p> Signup and view all the answers

    What is the recommended treatment for esophageal fistulas?

    <p>Surgical ligation followed by antibiotic therapy</p> Signup and view all the answers

    What role does early surgical intervention play in esophageal function recovery?

    <p>It improves the prognosis for recovery</p> Signup and view all the answers

    What is the primary treatment for salmonellosis in affected animals?

    <p>Treat with enrofloxacin and fluid correction</p> Signup and view all the answers

    Which clinical sign is typically associated with Campylobacter infection?

    <p>Watery-mucoid diarrhea</p> Signup and view all the answers

    What characterizes the carrier state in Campylobacter infections?

    <p>Long-lasting persistence of bacteria in asymptomatic animals</p> Signup and view all the answers

    Which organism is responsible for causing intestinal protothecosis?

    <p>Algae that can colonize the intestinal tract</p> Signup and view all the answers

    Which treatment approach is recommended for chronic IBD in dogs?

    <p>Lymphocytic-plasmacytic management strategies</p> Signup and view all the answers

    What is a common complication of Clostridium perfringens infection?

    <p>Severe necrotizing or ulcerating enterocolitis</p> Signup and view all the answers

    What method is typically used to diagnose Campylobacter infections?

    <p>Isolation of bacteria from feces</p> Signup and view all the answers

    Which of the following statements about histoplasmosis is true?

    <p>It involves multiple organ systems rather than just the intestines.</p> Signup and view all the answers

    Which of the following clinical signs is associated with acute hemorrhagic gastroenteritis caused by C. perfringens in dogs?

    <p>Watery to soft diarrhea</p> Signup and view all the answers

    What is a common limiting factor for diagnosing problems associated with C. perfringens?

    <p>Fecal cultures are unreliable.</p> Signup and view all the answers

    Which treatment option appears to be inconsistent in managing C. perfringens infections?

    <p>Metronidazole</p> Signup and view all the answers

    What characteristic does NOT rule out Inflammatory Bowel Disease (IBD) in dogs?

    <p>Normal endoscopic appearance</p> Signup and view all the answers

    In chronic or recurrent cases of gastrointestinal disorders, which dietary recommendation is advised?

    <p>Highly digestible diet</p> Signup and view all the answers

    What histopathological feature is indicative of IBD in dogs?

    <p>Infiltration of mature lymphocytes and plasma cells</p> Signup and view all the answers

    Which of the following breeds is NOT associated with genetic susceptibility to acute hemorrhagic gastroenteritis?

    <p>Golden Retriever</p> Signup and view all the answers

    What is the primary treatment recommended for neutrophilic (suppurative) enterocolitis in dogs?

    <p>Enrofloxacin and metronidazole</p> Signup and view all the answers

    Which of the following clinical signs are associated with villous atrophy in dogs?

    <p>Severe, bloody-mucoid diarrhea</p> Signup and view all the answers

    What is a characteristic of idiopathic villous atrophy in German shepherds?

    <p>Histological documentation of villous atrophy</p> Signup and view all the answers

    What dietary changes are recommended for managing gluten-sensitive enteropathy?

    <p>Eliminate gluten-containing grains</p> Signup and view all the answers

    What is the difference between simple and strangulated obstructions in the gastrointestinal tract?

    <p>Simple obstructions occlude the lumen only</p> Signup and view all the answers

    Which organism is NOT listed as causing enteric infections related to malabsorption?

    <p>Salmonella</p> Signup and view all the answers

    When diagnosing villous atrophy, which procedure is crucial?

    <p>Jejunal biopsies</p> Signup and view all the answers

    Which of the following treatments may be beneficial for idiopathic villous atrophy?

    <p>Prednisolone</p> Signup and view all the answers

    In the context of intestinal diseases, what does panhypoproteinemia indicate?

    <p>Deficiency of all plasma proteins</p> Signup and view all the answers

    What is the preferred type of lubricant laxative mentioned?

    <p>Flavored petrolatum</p> Signup and view all the answers

    Which laxative is noted for its effectiveness but may cause damage with long-term use?

    <p>Bisacodyl</p> Signup and view all the answers

    Which condition requires surgical management due to an obstructive lesion?

    <p>Megacolon in cats</p> Signup and view all the answers

    What is the clinical significance of lactulose?

    <p>It is the most clinically useful osmotic laxative.</p> Signup and view all the answers

    What is the primary method to manage simple constipation without systemic signs?

    <p>Combination of oral laxatives, dietary modification, and hydration</p> Signup and view all the answers

    For cases of severe constipation, what initial treatment may be required?

    <p>Evacuation of impacted feces from the colon</p> Signup and view all the answers

    Which of the following is contraindicated in the presence of an obstructive lesion?

    <p>Promotility drugs</p> Signup and view all the answers

    What is a less effective laxative that depends heavily on patient hydration?

    <p>Docusate</p> Signup and view all the answers

    What is a common clinical sign associated with esophageal fistulas?

    <p>Coughing</p> Signup and view all the answers

    Which of the following statements about acquired esophageal fistulas is true?

    <p>Common causes include esophageal foreign body and malignancy.</p> Signup and view all the answers

    What diagnostic method confirms the presence of esophageal fistulas?

    <p>Barium esophagram</p> Signup and view all the answers

    Which factor is NOT a cause of secondary hiatal hernias?

    <p>Congenital defects</p> Signup and view all the answers

    What type of hernia involves a protrusion through the esophageal hiatus?

    <p>Sliding hiatal hernia</p> Signup and view all the answers

    What surgical procedure is indicated for treating esophageal fistulas?

    <p>Surgical resection of the fistula</p> Signup and view all the answers

    Which condition is associated with high positive intraabdominal pressure leading to hiatal disorders?

    <p>Vomiting</p> Signup and view all the answers

    What is the prognosis for recovery of esophageal function if surgery is performed early?

    <p>The prognosis is significantly improved.</p> Signup and view all the answers

    What clinical sign is associated with pharyngeal mucoceles?

    <p>Blood-tinged saliva</p> Signup and view all the answers

    Which statement accurately describes zygomatic sialoadenitis?

    <p>It leads to exophthalmos and mucopurulent discharge.</p> Signup and view all the answers

    In the treatment of tonsillitis in small-breed dogs, which option is generally included?

    <p>Administration of antibiotics</p> Signup and view all the answers

    What distinguishes sialoadenosis from other salivary gland disorders?

    <p>It is usually associated with chronic symptoms.</p> Signup and view all the answers

    Which clinical sign is NOT typically associated with cervical mucoceles?

    <p>Exophthalmos</p> Signup and view all the answers

    What is the primary mechanism of action of proton pump inhibitors like omeprazole?

    <p>They inhibit hydrogen potassium adenosine triphosphatase.</p> Signup and view all the answers

    What is a primary diagnostic tool for identifying underlying causes of salivary gland issues?

    <p>History and physical examination</p> Signup and view all the answers

    Which is a likely clinical manifestation of autoimmune disorders affecting salivary glands?

    <p>Oral bleeding</p> Signup and view all the answers

    Which clinical sign is commonly associated with eosinophilic gastritis?

    <p>Chronic vomiting</p> Signup and view all the answers

    Which condition is primarily indicated by a nonpainful mass in the salivary gland area?

    <p>Neoplasia</p> Signup and view all the answers

    What diagnostic method is considered the most effective for identifying gastric conditions?

    <p>Endoscopy</p> Signup and view all the answers

    Which of the following conditions may require laparotomy for further evaluation?

    <p>Biopsies of mucosal irregularities</p> Signup and view all the answers

    What is a potential underlying cause of gastric outflow obstruction?

    <p>Pyloric stenosis</p> Signup and view all the answers

    Which sign is least likely to be seen in cases of eosinophilic gastritis?

    <p>Weight gain</p> Signup and view all the answers

    What is a common clinical feature seen with gastric dilatation-volvulus?

    <p>Projectile vomiting of undigested food</p> Signup and view all the answers

    What is a characteristic diagnostic finding in eosinophilic gastritis?

    <p>Granulomatous lesions</p> Signup and view all the answers

    What is a common clinical sign of gastric foreign bodies in animals?

    <p>Acute-onset vomiting</p> Signup and view all the answers

    What is typically found in vomitus when associated with gastric disorders?

    <p>Food, mucus, and bile-stained fluid</p> Signup and view all the answers

    Which diagnostic method may confirm the presence of gastric foreign bodies?

    <p>Radiography</p> Signup and view all the answers

    In cases of acute vomiting, what approach should be taken regarding feeding?

    <p>Withhold food for 12 to 24 hours</p> Signup and view all the answers

    What indicates that a foreign body might be obstructing the gastrointestinal tract?

    <p>Projectile vomiting</p> Signup and view all the answers

    Which treatment is preferred for removing gastric foreign bodies?

    <p>Endoscopic removal</p> Signup and view all the answers

    What condition may suggest delayed gastric emptying when vomiting occurs?

    <p>Vomiting of undigested food more than 12 hours after eating</p> Signup and view all the answers

    What should be considered in all animals with acute vomiting?

    <p>Gastric foreign bodies</p> Signup and view all the answers

    Which of the following findings is indicative of gastric perforation?

    <p>Pneumoperitoneum</p> Signup and view all the answers

    What is the primary dietary recommendation for managing hypertrophic gastropathy?

    <p>Frequent, small portions of low-fat, digestible carbohydrates</p> Signup and view all the answers

    Which of the following clinical signs is typically observed in small-breed dogs with hypertrophic gastropathy?

    <p>Intermittent vomiting</p> Signup and view all the answers

    What role does intubation play in the initial management of gastric outflow obstruction?

    <p>It decompresses the stomach by allowing gas and fluid to escape</p> Signup and view all the answers

    What is a potential consequence of metabolic alkalosis in animals with gastric outflow obstruction?

    <p>Increased gastrin concentrations</p> Signup and view all the answers

    What is the purpose of utilizing surgically repositioning in cases of hypertrophic gastropathy?

    <p>To ensure long-term prevention of volvulus</p> Signup and view all the answers

    How does restricting access to water after meals help prevent gastric issues in dogs?

    <p>It reduces the likelihood of bloat</p> Signup and view all the answers

    What underlying factor might be a contributor to hypertrophic gastropathy, particularly in small-breed dogs?

    <p>Chronic irritation from aspirin therapy</p> Signup and view all the answers

    What is the typical composition of vomitus in cases of acute vomiting?

    <p>Food, mucus, and bile-stained fluid with possible blood</p> Signup and view all the answers

    What might be indicated by a left shift in the CBC of a patient with aspiration pneumonia?

    <p>Neutrophilia associated with inflammation</p> Signup and view all the answers

    Which clinical sign could strongly indicate an obstruction in the gastrointestinal tract?

    <p>Projectile vomiting</p> Signup and view all the answers

    Which imaging technique is most effective in detecting esophageal motility disorders?

    <p>Barium swallow fluoroscopy</p> Signup and view all the answers

    What is the recommended management approach for asymptomatic animals with gastric foreign bodies?

    <p>Close monitoring and potential endoscopic removal</p> Signup and view all the answers

    What diagnostic tool is commonly used to identify gastric foreign bodies?

    <p>Radiography</p> Signup and view all the answers

    Which symptom would most likely not be present in the case of cervical esophageal perforation?

    <p>Retching</p> Signup and view all the answers

    What is a common sign of aspiration pneumonia as indicated in the examination?

    <p>Weight loss</p> Signup and view all the answers

    What underlying treatment is recommended for vomiting associated with gastrointestinal disorders?

    <p>Withholding food for 12 to 24 hours and offering a bland diet</p> Signup and view all the answers

    What is a critical consideration when diagnosing gastric foreign bodies in animals?

    <p>Including a thorough history and physical examination</p> Signup and view all the answers

    In esophageal perforation, which complication may arise due to mediastinitis?

    <p>Pneumothorax</p> Signup and view all the answers

    Which of the following findings might be detected by thoracic radiography in cases of esophageal disease?

    <p>Pneumomediastinum</p> Signup and view all the answers

    In raising the suspicion of delayed gastric emptying, which vomiting pattern is significant?

    <p>Vomiting undigested food more than 12 hours after eating</p> Signup and view all the answers

    Which type of laxative is specifically noted for its potential long-term damage to a particular structure in the gastrointestinal tract?

    <p>Stimulant laxatives</p> Signup and view all the answers

    Which statement accurately reflects the prognosis and treatment necessity for gastric foreign bodies?

    <p>The method of removal may depend on the presence of clinical symptoms</p> Signup and view all the answers

    What is the primary safe osmotic laxative recommended for long-term use?

    <p>Lactulose</p> Signup and view all the answers

    Which laboratory test is used to evaluate for acquired myasthenia gravis in cases of swallowing difficulties?

    <p>Acetylcholine receptor antibody titer</p> Signup and view all the answers

    Which condition requires the initial evacuation of impacted feces and addressing dehydration for treatment?

    <p>Severe constipation</p> Signup and view all the answers

    Which clinical manifestation is typically associated with regurgitation in patients with megaesophagus?

    <p>Gagging and retching</p> Signup and view all the answers

    What alternative treatment may be indicated alongside diet modifications for preventing recurrence in cases of constipation?

    <p>Administration of promotility drugs</p> Signup and view all the answers

    Which laxative causes concerns about inhalation lipid pneumonia if administered orally?

    <p>Mineral oil</p> Signup and view all the answers

    What test may be useful to evaluate neuromuscular disorders related to constipation management?

    <p>Electromyography</p> Signup and view all the answers

    Which substance is not advised for treating constipation due to the potential for adverse effects when used long-term?

    <p>Bisacodyl</p> Signup and view all the answers

    Which of the following laxatives relies heavily on the patient’s hydration status for efficacy?

    <p>Emollient laxatives</p> Signup and view all the answers

    What is a common clinical sign of perianal fistulas?

    <p>Severe anal discomfort</p> Signup and view all the answers

    Which diagnostic method is primarily used to identify anorectal foreign bodies?

    <p>Rectal examination</p> Signup and view all the answers

    What condition typically presents with unilateral anal sac distension and marked redness of the overlying skin?

    <p>Anal sac abscess</p> Signup and view all the answers

    What is the primary therapeutic approach for mild cases of anal sac disease?

    <p>Laxative therapy</p> Signup and view all the answers

    Which breed is most commonly associated with perianal fistulas?

    <p>German shepherd</p> Signup and view all the answers

    What clinical sign is indicative of complications from anorectal stricture?

    <p>Dyschezia</p> Signup and view all the answers

    Which treatment may be necessary for recurrent cases of anal sac disease?

    <p>Anal sacculectomy</p> Signup and view all the answers

    What is a common sign observed in animals with anorectal foreign bodies?

    <p>Tenesmus</p> Signup and view all the answers

    What is a significant concern in the treatment of chronic or recurrent C. perfringens infections?

    <p>Long-term treatment may be necessary.</p> Signup and view all the answers

    Which of the following is a common clinical sign associated with protein-losing enteropathy?

    <p>Intermittent weight loss</p> Signup and view all the answers

    What is the primary method for diagnosing inflammatory bowel disease (IBD) in dogs?

    <p>Exclusion of known causes through biopsy</p> Signup and view all the answers

    What histopathological change is typically observed in cases of inflammatory bowel disease (IBD)?

    <p>Diffuse infiltration of the lamina propria with mature lymphocytes</p> Signup and view all the answers

    Which breed is NOT associated with an increased genetic susceptibility to acute hemorrhagic gastroenteritis?

    <p>Beagle</p> Signup and view all the answers

    Which treatment has shown inconsistent results for managing C. perfringens infections?

    <p>Metronidazole</p> Signup and view all the answers

    What abnormality might be observed during an endoscopic examination of the intestine in cases of IBD?

    <p>Mucosal erythema and erosions</p> Signup and view all the answers

    What is the role of fecal assays for C. perfringens enterotoxin in diagnosis?

    <p>It is often unreliable due to the organism being part of normal flora.</p> Signup and view all the answers

    What clinical sign is commonly associated with cervical mucoceles?

    <p>Blood-tinged saliva</p> Signup and view all the answers

    Which diagnosis method may assist in identifying the underlying cause of salivary gland issues?

    <p>Radiographs</p> Signup and view all the answers

    Which symptoms are indicative of tonsillitis in dogs?

    <p>Retching and fever</p> Signup and view all the answers

    What is the underlying cause of zygomatic sialoadenitis?

    <p>Infection leading to exophthalmos and mucopurulent discharge</p> Signup and view all the answers

    What treatment is typically employed for primary tonsillitis in dogs?

    <p>Antibiotics and treating underlying causes</p> Signup and view all the answers

    How may parotid sialoadenitis present clinically in dogs?

    <p>Warm and painful parotid gland with discharge</p> Signup and view all the answers

    Which condition may cause breathing difficulties and is associated with mucoceles?

    <p>Pharyngeal mucocele</p> Signup and view all the answers

    What primarily leads to the diagnosis of salivary gland issues?

    <p>Physical examination and history</p> Signup and view all the answers

    What is a primary complication of large hiatal hernias?

    <p>Pulmonary abscess</p> Signup and view all the answers

    What diagnostic method gives the most definitive confirmation of a hiatal hernia?

    <p>Barium esophagram</p> Signup and view all the answers

    What clinical sign is typically absent in small hiatal hernias?

    <p>Hematochezia</p> Signup and view all the answers

    Which vascular anomaly accounts for the majority of cases in vascular ring abnormalities in dogs?

    <p>Persistent right aortic arch</p> Signup and view all the answers

    What is a common clinical sign associated with anal spasm?

    <p>Anxiety during defecation</p> Signup and view all the answers

    What is the recommended dietary approach for managing reflux esophagitis in small hiatal hernias?

    <p>Frequent feeding of small portions</p> Signup and view all the answers

    Which diagnosis method is used for identifying perianal issues?

    <p>Digital rectal palpation</p> Signup and view all the answers

    Which clinical sign may indicate the presence of extraluminal compression?

    <p>Dyspnea</p> Signup and view all the answers

    What is a potential complication resulting from anal surgery?

    <p>Fecal incontinence</p> Signup and view all the answers

    What is the primary surgical intervention indicated for large hiatal hernias?

    <p>Hernia reduction</p> Signup and view all the answers

    What might indicate the need for surgical intervention in managing anal issues?

    <p>Continuous dyschezia despite treatment</p> Signup and view all the answers

    Which breed is mentioned as being more susceptible to anal sphincter spasms?

    <p>German Shepherd</p> Signup and view all the answers

    What clinical phenomenon is indicative of significant gastroesophageal obstruction?

    <p>Rapid deterioration</p> Signup and view all the answers

    What is a common treatment employed for conditions related to pseudocoprostasis?

    <p>Hair clipping and cleansing</p> Signup and view all the answers

    Which factor is a contributing condition leading to pseudocoprostasis?

    <p>Obesity</p> Signup and view all the answers

    Which conservative treatment method may be successful for managing anal conditions?

    <p>Balloon dilatation</p> Signup and view all the answers

    What treatment is recommended for managing colonic nodular proliferative colitis in cats?

    <p>Fenbendazole</p> Signup and view all the answers

    How can ova containing first-stage larvae be identified in feline feces?

    <p>Direct microscopic examination</p> Signup and view all the answers

    Which intermediate hosts are involved in the transmission of Dipylidium caninum?

    <p>Fleas and lice</p> Signup and view all the answers

    What is the most accurate diagnostic method for detecting entamoeba infections?

    <p>Fecal PCR assay</p> Signup and view all the answers

    Which clinical signs are associated with a typical E. histolytica infection?

    <p>Bloody-mucoid diarrhea</p> Signup and view all the answers

    Which method is commonly utilized for diagnosing Balantidium coli infections?

    <p>Identification of trophozoites in fecal suspensions</p> Signup and view all the answers

    What can contribute to painful defecation in animals?

    <p>Orthopedic disorders limiting positioning</p> Signup and view all the answers

    Which antibiotic is primarily used to treat infections caused by Clostridium difficile?

    <p>Metronidazole</p> Signup and view all the answers

    Which treatment is indicated for managing intestinal neoplasia?

    <p>Surgical intervention for biopsy</p> Signup and view all the answers

    What is the primary reason for treating with pyrantel pamoate in cats?

    <p>To expel tapeworms</p> Signup and view all the answers

    What is a common clinical sign associated with intestinal malignancies?

    <p>Vomiting and diarrhea</p> Signup and view all the answers

    Which of the following is a potential cause of rectocolonic obstruction?

    <p>Perineal hernia</p> Signup and view all the answers

    Neuromuscular diseases affecting defecation may result in impairment of which function?

    <p>Coordinated smooth muscle function</p> Signup and view all the answers

    What can dehydration lead to in terms of fecal consistency?

    <p>Drier and harder feces</p> Signup and view all the answers

    Which type of tumors are most commonly described as malignant in the context of intestinal neoplasia?

    <p>Adenocarcinoma and lymphoma</p> Signup and view all the answers

    Which drug classes are known to cause drug-related constipation?

    <p>Anticholinergics and opiates</p> Signup and view all the answers

    What is the common clinical sign associated with thickened loops in the intestines?

    <p>Pain</p> Signup and view all the answers

    Which of the following is a self-limiting treatment option for certain gastrointestinal issues?

    <p>Feeding a restricted diet</p> Signup and view all the answers

    What is the main concern when diagnosing drug- and toxin-induced diarrhea?

    <p>Symptoms can often resolve with discontinuation of the offending agent.</p> Signup and view all the answers

    Which of the following conditions is associated with mesenteric lymphadenopathy?

    <p>Infection</p> Signup and view all the answers

    What is the typical cause of rectal masses found during palpation?

    <p>Neoplasia</p> Signup and view all the answers

    What typically causes a 'sausage loop' appearance in the intestines?

    <p>Intussusception</p> Signup and view all the answers

    What could potentially cause gas and fluid distention in the gastrointestinal tract?

    <p>Obstruction</p> Signup and view all the answers

    Which component is often involved in inflammation that can result in mesenteric lymphadenopathy?

    <p>Neoplasia</p> Signup and view all the answers

    What is a common clinical sign associated with gastroduodenal ulceration?

    <p>Hematemesis</p> Signup and view all the answers

    Which imaging technique is recommended if ulcer perforation is suspected?

    <p>Barium contrast studies</p> Signup and view all the answers

    What laboratory finding may indicate chronic blood loss due to ulceration?

    <p>Microcytic hypochromic anemia</p> Signup and view all the answers

    Which of the following is not a non-GI cause of vomiting that should be evaluated in cases of suspected gastroduodenal ulceration?

    <p>Gastritis</p> Signup and view all the answers

    What chronic condition is listed as a potential cause of gastroduodenal ulcers?

    <p>Chronic gastritis</p> Signup and view all the answers

    Which diagnostic method is most useful for detecting underlying causes of vomiting that are not related to the gastrointestinal tract?

    <p>Abdominal ultrasonography</p> Signup and view all the answers

    What is the primary treatment to manage gastric acid in cases of gastroduodenal ulcers?

    <p>H2 blockers</p> Signup and view all the answers

    What is a common result of abdominal palpation in cases of ulcer perforation?

    <p>Localized pain with rebound tenderness</p> Signup and view all the answers

    Which clinical signs are commonly observed in cases of acute hemorrhagic gastroenteritis in dogs?

    <p>Watery to soft diarrhea and tenesmus</p> Signup and view all the answers

    What is the major challenge in diagnosing C. perfringens infections?

    <p>C. perfringens is part of the normal flora</p> Signup and view all the answers

    Which condition may contribute to painful defecation in animals?

    <p>Anorectal disease</p> Signup and view all the answers

    Which treatment is noted to be less consistent in managing C. perfringens infections?

    <p>Metronidazole</p> Signup and view all the answers

    What types of tumors are most commonly malignant in the intestines?

    <p>Adenocarcinomas and lymphomas</p> Signup and view all the answers

    What is a definitive characteristic of the mucosal histopathology associated with Inflammatory Bowel Disease (IBD) in dogs?

    <p>Diffuse infiltration of mature lymphocytes and plasma cells</p> Signup and view all the answers

    What is a potential external cause of rectocolonic obstruction?

    <p>Prostatic enlargement</p> Signup and view all the answers

    Which diagnostic method is primarily utilized for identifying Inflammatory Bowel Disease (IBD) in dogs?

    <p>Endoscopic examination and biopsy</p> Signup and view all the answers

    Which neuromuscular condition can interfere with colonic smooth muscle function?

    <p>Dysautonomia</p> Signup and view all the answers

    Which of the following breeds is NOT associated with genetic factors linked to acute hemorrhagic gastroenteritis?

    <p>Spitz</p> Signup and view all the answers

    Which of these factors is known to lead to dry and hard feces?

    <p>Dehydration</p> Signup and view all the answers

    For chronic cases of gastrointestinal disorders, what type of diet is recommended?

    <p>Highly digestible diet</p> Signup and view all the answers

    Which abnormal finding on endoscopic examination is associated with Inflammatory Bowel Disease (IBD)?

    <p>Decreased mucosal vascularity</p> Signup and view all the answers

    What definitive method is required to diagnose intestinal neoplasia?

    <p>Biopsy</p> Signup and view all the answers

    What drug-related factor may impair colonic function?

    <p>Anticholinergics</p> Signup and view all the answers

    Which type of benign intestinal tumor is most commonly encountered?

    <p>Adenomatous polyp</p> Signup and view all the answers

    Which viral infection is known for causing acute, severe enteritis in dogs?

    <p>Canine parvovirus</p> Signup and view all the answers

    What is the primary clinical sign associated with Salmonella infections in dogs?

    <p>Acute watery diarrhea</p> Signup and view all the answers

    Which method is typically utilized for diagnosing bacterial enteritis caused by Salmonella?

    <p>Fecal cultures</p> Signup and view all the answers

    Which statement about the presence of C. difficile in animals is true?

    <p>It is part of the normal flora in dogs and cats.</p> Signup and view all the answers

    Which of the following is NOT a common clinical sign associated with intestinal pythiosis?

    <p>Weight gain</p> Signup and view all the answers

    What is the recommended treatment for infections caused by Pythium insidiosum?

    <p>Surgical excision</p> Signup and view all the answers

    Which population is most affected by intestinal pythiosis?

    <p>Young large-breed dogs in southern Gulf States</p> Signup and view all the answers

    What is necessary to confirm a diagnosis of zygomycosis?

    <p>Histologic identification in biopsies</p> Signup and view all the answers

    Which antidiarrheal drug is considered most effective for controlling fluid loss in patients?

    <p>Loperamide</p> Signup and view all the answers

    What potential clinical association is indicated by pallor (anemia) in patients experiencing gastrointestinal issues?

    <p>Gastrointestinal blood loss</p> Signup and view all the answers

    Which of the following conditions is commonly treated with corticosteroids?

    <p>Inflammatory bowel disease (IBD)</p> Signup and view all the answers

    What is a common cause of dietary diarrhea according to the information provided?

    <p>Ingestion of foreign materials</p> Signup and view all the answers

    Which therapy is specifically indicated for treating common intestinal nematodes and Giardia?

    <p>Fenbendazole therapy</p> Signup and view all the answers

    What electrolyte imbalance is commonly associated with severe debilitation in patients with diarrhea?

    <p>Hypokalemia</p> Signup and view all the answers

    Which two conditions might be represented by the signs of emaciation or malnutrition?

    <p>Chronic diarrhea and protein-losing enteropathy</p> Signup and view all the answers

    Which symptom is not typically associated with chronic malabsorption?

    <p>Rapid weight gain</p> Signup and view all the answers

    What condition may result from an overproliferation of microflora in the proximal small intestine?

    <p>Malabsorption and diarrhea</p> Signup and view all the answers

    Which of the following is a common secondary condition leading to small intestinal bacterial overgrowth?

    <p>Hypesecretion of gastric acid</p> Signup and view all the answers

    What diagnostic method is practical for confirming small intestinal bacterial overgrowth?

    <p>Quantitative cultures of duodenal juice</p> Signup and view all the answers

    Which clinical sign is typically absent in small intestinal bacterial overgrowth?

    <p>Blood in the stool</p> Signup and view all the answers

    What is a potential surgical intervention for intestinal obstruction?

    <p>Surgical removal of the obstruction</p> Signup and view all the answers

    What role does immunoglobulin A deficiency play in certain dog breeds?

    <p>It increases susceptibility to overgrowth</p> Signup and view all the answers

    Which diagnostic imaging finding suggests intestinal obstruction?

    <p>Gas or fluid distention of the bowel</p> Signup and view all the answers

    Which symptom could indicate possible gastrointestinal shock?

    <p>Severe abdominal pain</p> Signup and view all the answers

    What is the expected clinical outcome for neonates affected by Salmonellosis?

    <p>High mortality rates are expected</p> Signup and view all the answers

    Which antibiotic is NOT commonly used for treating Campylobacter infections?

    <p>Amoxicillin</p> Signup and view all the answers

    Which clinical sign is most commonly associated with Clostridium perfringens infections?

    <p>Hematochezia</p> Signup and view all the answers

    What is the role of amphotericin B in treating intestinal protothecosis?

    <p>It serves as the primary treatment.</p> Signup and view all the answers

    Which treatment is generally used for chronic inflammatory bowel disease (IBD) in dogs?

    <p>Steroids or immunosuppressive medications</p> Signup and view all the answers

    What is a characteristic of Histoplasmosis in dogs?

    <p>It manifests as a multisystemic infection.</p> Signup and view all the answers

    What diagnostic method is typically used for detecting Campylobacter in dogs?

    <p>Fecal isolation of the organism</p> Signup and view all the answers

    Which of the following is NOT a typical clinical sign of intestinal protothecosis?

    <p>Mild abdominal discomfort</p> Signup and view all the answers

    What is the primary mechanism by which proton pump inhibitors exert their antisecretory effect?

    <p>Inhibiting hydrogen potassium adenosine triphosphatase</p> Signup and view all the answers

    Which clinical sign is most associated with eosinophilic gastritis in dogs?

    <p>Intermittent vomiting</p> Signup and view all the answers

    What diagnostic method is deemed most effective for assessing mucosal abnormalities in the gastrointestinal tract?

    <p>Endoscopy</p> Signup and view all the answers

    In the context of gastric outflow obstruction, which of the following is NOT a recognized cause?

    <p>Acute pancreatitis</p> Signup and view all the answers

    Which of the following clinical signs suggests severe gastric outflow obstruction?

    <p>Projectile vomiting of undigested food</p> Signup and view all the answers

    What long-term management strategy is generally required for conditions like eosinophilic gastritis?

    <p>Identifying and addressing the underlying cause</p> Signup and view all the answers

    Which of the following statements about endoscopic findings in eosinophilic gastritis is accurate?

    <p>Mucosal abnormalities may include irregularity and firmness.</p> Signup and view all the answers

    In cases of profuse vomiting, which laboratory finding is likely to be observed?

    <p>Hypokalemia</p> Signup and view all the answers

    What can be an indication of associated systemic disease during a physical examination for gastrointestinal issues?

    <p>Acute weight loss</p> Signup and view all the answers

    Which of the following factors does NOT contribute to the risk of gastric dilatation-volvulus (GDV)?

    <p>High protein diet</p> Signup and view all the answers

    What is a key clinical sign associated with a complete obstruction caused by gastric dilatation-volvulus (GDV)?

    <p>Nonproductive retching</p> Signup and view all the answers

    Which laboratory test is specifically used to assess potential malabsorption issues related to the intestinal condition?

    <p>Serum folate and cobalamin assays</p> Signup and view all the answers

    What abnormal finding might be observed during abdominal percussion in cases of GDV?

    <p>Tympani</p> Signup and view all the answers

    What should be prioritized in the treatment of an animal presenting with dehydration and electrolyte abnormalities due to gastrointestinal distress?

    <p>Fluid therapy</p> Signup and view all the answers

    Which statement about the prognosis for intestinal tumors is correct?

    <p>Benign tumors have a good prognosis while adenocarcinomas have a poor prognosis.</p> Signup and view all the answers

    What is a typical correlation noted in gastrointestinal conditions that can be assessed through patient history?

    <p>Correlation between diet and fecal characteristics</p> Signup and view all the answers

    What is the purpose of feeding animals frequent small meals in an upright position?

    <p>To reduce the likelihood of aspiration pneumonia</p> Signup and view all the answers

    Which condition is typically treated with symptomatic and supportive care instead of surgery?

    <p>Idiopathic megaesophagus</p> Signup and view all the answers

    Which of the following is a common cause of esophagitis?

    <p>Chronic vomiting due to dietary indiscretion</p> Signup and view all the answers

    In what scenario might surgical repair be necessary for esophageal issues?

    <p>If the perforation is large or leads to complications</p> Signup and view all the answers

    What significant findings might be observed during esophagoscopy in severe esophagitis?

    <p>Mucosal erythema and ulcerations</p> Signup and view all the answers

    What is the role of parenteral antibiotics in managing esophageal conditions?

    <p>To prevent secondary infections like aspiration pneumonia</p> Signup and view all the answers

    Which treatment is typically indicated for small esophageal tears?

    <p>Medical management only</p> Signup and view all the answers

    When should esophagoscopy be performed in suspected cases?

    <p>For any suspected reflux esophagitis or obstructive disease</p> Signup and view all the answers

    What is the most common type of neoplasia observed in dogs concerning esophageal issues?

    <p>Leiomyoma</p> Signup and view all the answers

    Which clinical sign is NOT typically associated with esophageal neoplasia?

    <p>Hematuria</p> Signup and view all the answers

    What condition can potentially arise from the malignant transformation of a granuloma caused by Spirocerca lupi?

    <p>Esophageal carcinoma</p> Signup and view all the answers

    What diagnostic procedure is essential for confirming esophageal neoplasia?

    <p>Endoscopy and biopsy</p> Signup and view all the answers

    Which of the following is a common clinical sign of esophageal neoplasia?

    <p>Ptyalism</p> Signup and view all the answers

    Which imaging technique is likely to reveal an intrathoracic mass related to esophageal conditions?

    <p>X-ray</p> Signup and view all the answers

    What type of neoplasia is most commonly found in cats concerning esophageal issues?

    <p>Squamous cell carcinoma</p> Signup and view all the answers

    What is the recommended approach for managing an underlying cause of esophageal issues?

    <p>Treating the underlying cause</p> Signup and view all the answers

    Which of the following conditions is NOT a potential cause of gastroduodenal ulceration?

    <p>Pneumonia</p> Signup and view all the answers

    What laboratory finding may indicate chronic blood loss in patients with gastroduodenal ulcers?

    <p>Microcytic hypochromic anemia</p> Signup and view all the answers

    Which imaging technique is utilized to evaluate the presence of foreign bodies in the gastrointestinal tract?

    <p>Barium contrast study</p> Signup and view all the answers

    Which clinical sign is NOT typically associated with gastroduodenal ulceration?

    <p>Hyperactivity</p> Signup and view all the answers

    What is the recommended treatment approach to control gastric acid in gastroduodenal ulcers?

    <p>H2 blockers</p> Signup and view all the answers

    Which diagnostic method may be necessary if perforation of a gastroduodenal ulcer is suspected?

    <p>Abdominocentesis</p> Signup and view all the answers

    Which of the following is an indication that perforation and septic shock might be occurring due to a gastroduodenal ulcer?

    <p>Acute onset abdominal pain</p> Signup and view all the answers

    Which clinical sign might suggest the presence of a gastric neoplasia related to gastric conditions?

    <p>Weight loss</p> Signup and view all the answers

    What is a potential cause of chronic inflammation in dogs?

    <p>Pain from obstruction</p> Signup and view all the answers

    Which of the following factors is commonly associated with drug-induced diarrhea in dogs?

    <p>Discontinuation of the medication</p> Signup and view all the answers

    What type of intestinal mass may be palpated during a rectal examination?

    <p>Polyps</p> Signup and view all the answers

    Which condition is indicated by 'sausage loop' in dogs?

    <p>Intussusception</p> Signup and view all the answers

    What condition could be indicated by thickened intestinal loops upon examination?

    <p>Inflammation or lymphoma</p> Signup and view all the answers

    Which type of intestinal foreign body might cause aggregated loops in dogs?

    <p>Linear foreign body</p> Signup and view all the answers

    What type of lesion may be indicated by circumferential narrowing during an examination?

    <p>Spasm</p> Signup and view all the answers

    What is a common self-limiting treatment approach for gastrointestinal conditions in dogs?

    <p>Feeding of a restricted diet</p> Signup and view all the answers

    What is the primary treatment strategy for managing severe constipation?

    <p>Evacuation of impacted feces</p> Signup and view all the answers

    Which type of laxative is preferred for patients needing mild relief without risk of causing lipid pneumonia?

    <p>Flavored petrolatum</p> Signup and view all the answers

    What is a critical consideration when using stimulant laxatives for constipation management?

    <p>They may cause damage to the myenteric plexus with prolonged use</p> Signup and view all the answers

    What dietary approach can help prevent the recurrence of constipation?

    <p>Increased intake of fluids and dietary fiber</p> Signup and view all the answers

    Which laxative is noted for being clinically useful and safe for long-term use?

    <p>Lactulose</p> Signup and view all the answers

    In the context of managing constipation, what is the role of promotility drugs?

    <p>They should be avoided in obstructive conditions</p> Signup and view all the answers

    What is a significant risk associated with the use of mineral oil as a laxative?

    <p>Potential for inhalation lipid pneumonia</p> Signup and view all the answers

    Which characteristic is associated with high-fiber bulk-forming laxatives?

    <p>They are available as commercial high-fiber diets</p> Signup and view all the answers

    What is a possible reason for intestinal pain in dogs?

    <p>Obstruction</p> Signup and view all the answers

    Which condition is associated with thickened loops in a dog's intestine?

    <p>Inflammation</p> Signup and view all the answers

    What could cause mesenteric lymphadenopathy in dogs?

    <p>Infection</p> Signup and view all the answers

    What is a potential complications of dexamethasone administration in dogs?

    <p>Hemorrhagic gastroenterocolitis</p> Signup and view all the answers

    Which clinical sign may indicate intussusception in dogs?

    <p>Sausage loop appearance</p> Signup and view all the answers

    What is a common misconception regarding the resolution of drug-induced diarrhea?

    <p>It can persist despite medication discontinuation</p> Signup and view all the answers

    What diagnosis method is primarily used for identifying drug- and toxin-induced diarrhea?

    <p>Review of the medical history</p> Signup and view all the answers

    Which condition is correctly associated with linear intestinal foreign bodies in dogs?

    <p>Aggregated loops of intestine</p> Signup and view all the answers

    Which condition is associated with the potential development of gastroduodenal ulcers?

    <p>Nonsteroidal antiinflammatory drugs (NSAIDs)</p> Signup and view all the answers

    What is a common clinical sign that may indicate gastroduodenal ulceration?

    <p>Hematemesis</p> Signup and view all the answers

    Which laboratory finding is most likely to be seen with chronic blood loss due to ulceration?

    <p>Regenerative anemia</p> Signup and view all the answers

    Which imaging technique is used primarily to detect non-GI causes of vomiting in the context of gastroduodenal ulcers?

    <p>Abdominal ultrasonography</p> Signup and view all the answers

    What is the significance of performing abdominocentesis in the diagnosis of gastroduodenal ulcers?

    <p>To evaluate for potential perforation</p> Signup and view all the answers

    Which treatment is commonly used to manage gastric acid levels in patients with gastroduodenal ulcers?

    <p>H2 blockers</p> Signup and view all the answers

    Which of the following conditions is least likely to be a direct cause of ulceration in the gastrointestinal tract?

    <p>Celiac disease</p> Signup and view all the answers

    What should be included in the drug history review when diagnosing potential gastroduodenal ulcers?

    <p>Administration of ulcerogenic drugs</p> Signup and view all the answers

    Which clinical sign is associated with eosinophilic inflammation in intestinal diseases?

    <p>Chronic vomiting</p> Signup and view all the answers

    What is a common laboratory finding associated with intestinal lymphangiectasia?

    <p>Hypoalbuminemia</p> Signup and view all the answers

    Which treatment approach is considered the most effective for inflammatory bowel disease?

    <p>Oral prednisolone administration</p> Signup and view all the answers

    In the diagnosis of regional granulomatous enterocolitis, what is necessary to confirm the condition?

    <p>Identification of characteristic lymphatic lesions in biopsies</p> Signup and view all the answers

    What clinical sign often accompanies large bowel diarrhea in granulomatous enterocolitis?

    <p>Tenesmus</p> Signup and view all the answers

    Which dietary recommendation is advised for managing certain forms of IBD?

    <p>Exclude and restrict dietary fats</p> Signup and view all the answers

    What is a secondary method to diagnose intestinal disorders related to hormonal imbalances?

    <p>Urine protein determination</p> Signup and view all the answers

    What common clinical finding may indicate the presence of granulomatous enterocolitis?

    <p>Abdominal effusion</p> Signup and view all the answers

    What is a common treatment option for large bowel diarrhea associated with mucosal damage?

    <p>Antibiotics and anti-inflammatory agents</p> Signup and view all the answers

    Which condition is characterized by chronic, noninflammatory, mucoid large bowel diarrhea?

    <p>Fiber-responsive diarrhea</p> Signup and view all the answers

    What agents may be indicated in the medical therapy for gastrointestinal disorders?

    <p>Cobalamin and azathioprine</p> Signup and view all the answers

    In diagnosing gastrointestinal issues, what is the key factor considered for exclusion?

    <p>Normal colonoscopic biopsy results</p> Signup and view all the answers

    Which symptom is indicative of eosinophilic gastroenteritis?

    <p>Mature eosinophils in blood</p> Signup and view all the answers

    When treating eosinophilic gastroenteritis, which is commonly involved in the treatment protocol?

    <p>Immunosuppressive agents</p> Signup and view all the answers

    In protein-losing enteropathy, which isn't typically a cause?

    <p>Bacterial overgrowth</p> Signup and view all the answers

    What dietary management is recommended for patients with fiber-responsive diarrhea?

    <p>Enhance fiber content in the diet</p> Signup and view all the answers

    What is a potential cause of rectocolonic obstruction?

    <p>Intraluminal foreign body</p> Signup and view all the answers

    Which of the following conditions can interfere with colonic innervation?

    <p>Hypothyroidism</p> Signup and view all the answers

    Which benign tumor type is most commonly associated with intestinal neoplasia?

    <p>Adenomatous polyp</p> Signup and view all the answers

    What diagnostic method is essential for definitive confirmation of intestinal neoplasia?

    <p>Biopsy</p> Signup and view all the answers

    Which of the following clinical signs is typically associated with the advanced stages of intestinal neoplasia?

    <p>Vomiting and diarrhea</p> Signup and view all the answers

    What role does hypokalemia play in colonic function?

    <p>Inhibits colonic smooth muscle contraction</p> Signup and view all the answers

    Which drug class is most likely to cause slowed defecation as a side effect?

    <p>Antihistamines</p> Signup and view all the answers

    What physiological state can lead to fecal matter becoming unusually dry and hard?

    <p>Fluid and electrolyte disorders</p> Signup and view all the answers

    Study Notes

    Esophageal Fistula

    • Fistulas are abnormal communications between the esophagus and airways, primarily the bronchi.
    • Acquired fistulas are more common than congenital ones.
    • Causes include esophageal foreign bodies, trauma, malignancy, or infection.
    • Bronchoesophageal fistulas are frequently associated with esophageal diverticula.
    • Clinical signs include contamination of the airways with fluid and food.
    • Common signs include coughing, fever, and dyspnea.
    • Diagnosis involves physical examination findings, thoracic radiography, and confirmation with a barium esophagram.
    • Treatment includes surgical resection of the fistula.

    Hiatal Disorders

    • Hiatal hernias occur when there is protrusion of the distal esophagus and stomach through an enlarged esophageal hiatus into the thorax.
    • A sliding hiatal hernia is a common type.
    • A congenital form has been described in Shar-Peis.
    • Hiatal hernias can be secondary to increased intra-abdominal pressure, chronic upper airway obstruction like brachycephalic syndrome, or tetanus.
    • Gastroesophageal intussusception, an invagination of the stomach into the distal esophagus, is seen with congenital idiopathic megaesophagus.
    • Treatment involves radical surgical excision of the affected segments.

    Intestinal Protothecosis

    • Caused by algae that may colonize the intestinal tract of dogs and cause severe necrotizing or ulcerating enterocolitis.
    • Clinical signs include large bowel diarrhea with hematochezia.
    • Additional signs are related to invasion of other organs, such as visceral organs, eyes, and the central nervous system.
    • Organisms can be identified in feces, cytology preparations, and biopsies.
    • Treatment involves a combination of amphotericin B and itraconazole.

    Chronic Inflammatory Bowel Disease (IBD)

    • Lymphocytic-plasmacytic IBD is the most common form of IBD in dogs and cats.
    • Factors that may play a role include mucosal hypersensitivity to antigens and genetic factors.
    • Clinical signs include vomiting, diarrhea, and weight loss.
    • Protein-losing enteropathy may also be present.
    • IBD is a diagnosis of exclusion.
    • Endoscopic abnormalities may include mucosal erythema, petechiae, erosions, ulcers, increased mucus, friability, or granularity.
    • Mucosal histopathology shows diffuse infiltration of the lamina propria with mature lymphocytes and plasma cells.
    • Treatment involves a combination of amphotericin B and itraconazole.

    Histocytic Ulcerative Colitis

    • Chronic idiopathic IBD of young boxer dogs characterized by infiltration of the colon by distinctive periodic acid-Schiff (PAS)-positive histiocytes.
    • Clinical signs include severe, bloody-mucoid large bowel diarrhea in young boxers.
    • Diagnosis is based on breed and the presence of PAS-positive histiocytes in a biopsy.
    • Treatment includes enrofloxacin with metronidazole and feeding a highly digestible diet.

    Neutrophilic (Suppurative) Enterocolitis

    • Cause is unknown.
    • Villous atrophy is associated with intestinal malabsorption and chronic diarrhea.

    Villous Atrophy

    • Primary causes include gluten-sensitive enteropathy of Irish setters and idiopathic canine villous atrophy in German shepherds.
    • Secondary causes include diffuse infiltrative intestinal diseases and enteric infections.
    • Clinical signs include small bowel diarrhea and weight loss.
    • Diagnosis is by histologic documentation of villous atrophy in jejunal biopsies.
    • Treatment for gluten-sensitive enteropathy involves eliminating gluten-containing cereal grains from the diet for life.
    • Treatment for idiopathic villous atrophy involves dietary management, folate, cobalamin, antibiotics, or prednisolone.

    Salivary Gland Disorders

    • Neoplasia of the salivary glands is rare.
    • Clinical signs can include hypersalivation, halitosis, oral bleeding, dysphagia, anorexia, and weight loss.
    • Diagnosis is primarily based on history and physical examination.
    • Treatment involves treating the underlying cause and symptomatic treatment, including dental prophylaxis and systemic antibiotics.

    Mucoceles

    • Mucoceles are fluid-filled sacs that form due to obstruction of the salivary gland duct.
    • Clinical signs depend on the affected gland.
    • Cervical mucoceles present as soft, non-painful masses.
    • Ranulas cause dysphagia and blood-tinged saliva.
    • Pharyngeal mucoceles can cause breathing or swallowing difficulty.
    • Zygomatic mucoceles can cause exophthalmos (protruding eyeballs).
    • Fistulas present as small skin openings draining serous fluid.
    • Zygomatic sialoadenitis (inflammation of the zygomatic salivary gland) causes exophthalmos, pain on opening the mouth, and mucopurulent discharge from the duct.
    • Parotid sialoadenitis (inflammation of the parotid salivary gland) presents as a painful, warm parotid gland and discharge.
    • Sialoadenosis (enlargement of the salivary glands) is usually associated with chronic signs, including hypersalivation, retching, regurgitation, and vomiting.
    • Neoplasia of the salivary glands typically presents as a non-painful mass in the region of the salivary gland.
    • Treatment involves surgical ligation and antibiotic therapy if indicated.
    • Prognosis for recovery of esophageal function is better if surgery is performed early.

    Tonsillitis

    • Primary tonsillitis can occur in young, small-breed dogs.
    • Tonsillitis can also be secondary to chronic infections of the nasopharynx, vomiting, chronic regurgitation, or coughing.
    • Clinical signs include retching, cough, fever, and anorexia.
    • Diagnosis is based on physical examination and history.
    • Treatment involves antibiotics and addressing the underlying cause.

    Esophageal Fistula

    • Esophageal fistulas are communications between the esophagus and airways, most commonly the bronchi.
    • Acquired fistulas are more common than congenital fistulas.
    • Causes of acquired fistulas include esophageal foreign body, trauma, malignancy, or infection.
    • Bronchoesophageal fistulas are frequently associated with esophageal diverticula.
    • Clinical signs are related to contamination of the airways with fluid and food.
    • Common signs include coughing, fever, and dyspnea.
    • Diagnosis is based on physical examination findings, thoracic radiography, and confirmation with a barium esophagram.
    • Treatment involves surgical resection of the fistula.

    Hiatal Disorders

    • Hiatal hernias are a protrusion of the distal esophagus and stomach through an enlarged esophageal hiatus into the thorax.
    • A sliding hiatal hernia is the most common type.
    • Congenital hiatal hernias have been described in Shar-Peis.
    • Hiatal hernias can also occur secondary to high positive intraabdominal pressure (e.g., abdominal trauma, vomiting), chronic upper airway obstruction (e.g., brachycephalic syndrome), or tetanus.
    • Gastroesophageal intussusception is an invagination of the stomach into the distal esophagus.
    • Gastroesophageal intussusception is seen with congenital idiopathic megaesophagus.

    Stomach Disorders

    Vomiting

    • Vomiting is a common clinical sign associated with gastrointestinal (GI) and non-GI disorders.
    • Nausea (hypersalivation, repeated licking and swallowing), retching, and abdominal contractions often precede vomiting.
    • Vomitus consists of stomach and duodenal contents (food, mucus, and foamy or bile-stained fluid with a neutral or acidic pH) and may contain blood (hematemesis).
    • Projectile vomiting usually indicates gastric outlet or upper small bowel obstruction.
    • Vomiting of undigested food more than 12 hours after eating suggests delayed gastric emptying.
    • Diagnosis involves careful review of history and physical examination, including oral and rectal palpation.
    • Endoscopy and laparotomy may be indicated for biopsies.

    Eosinophilic Gastritis and Granuloma

    • Eosinophilic infiltration is usually diffuse but may present as a granulomatous lesion in dogs.
    • An allergic or immunologic hypersensitivity has been suggested.
    • Eosinophilic gastritis is rarely associated with hypereosinophilic syndrome in cats.
    • Clinical signs include chronic vomiting, hematemesis, melena, anorexia, and weight loss.
    • Endoscopy is the diagnostic method of choice.

    Gastric Outflow Obstruction

    • Gastric outflow obstruction can be caused by foreign bodies, chronic hypertrophic pyloric gastropathy, congenital pyloric stenosis, pyloric mass, gastric dilatation-volvulus, or extrinsic compression.
    • Clinical signs include projectile vomiting of undigested food, abdominal distention, belching, and weight loss.
    • Abdominal radiograph may suggest delayed gastric emptying.
    • The gastric outflow region appears normal on radiographs.
    • Treatment involves addressing the underlying cause.
    • A diet low in fat and high in digestible carbohydrate is recommended.
    • Small frequent meals and a liquid diet may be better tolerated.
    • Promotility drugs may be used as needed.

    Hypertrophic Gastropathy

    • Hypertrophic gastropathy is a heterogeneous group of disorders.
    • The cause is unknown in most cases.
    • Possible causes include stress in excitable small-breed dogs, chronic irritation from aspirin therapy, or hypergastrinemia.
    • Clinical signs include chronic intermittent vomiting, anorexia, weight loss, abdominal distension, hematemesis, and concurrent diarrhea in Basenjis.
    • Typically occurs in small-breed dogs with chronic intermittent vomiting.
    • Metabolic alkalosis may occur with profuse vomiting and gastric outflow obstruction.
    • Gastrin concentrations may be elevated.

    Gastric Dilatation-Volvulus (GDV)

    • GDV is a life-threatening condition in which the stomach dilates and twists on itself.
    • Contributing factors include breed predisposition, rapid eating, stress, and exercise after eating.
    • Clinical signs include acute onset of restlessness, retching, hypersalivation, and abdominal distension.
    • Diagnosis is confirmed with radiographs.
    • Treatment involves surgical correction with gastropexy.

    Gastric Foreign Bodies

    • Most common in dogs.
    • Linear foreign bodies are more likely in cats.
    • Acute-onset vomiting is the most common sign.
    • Some may present with chronic vomiting.
    • Radiography can be used to identify the object and reveal a distended stomach.
    • Endoscopic removal is preferred.
    • Gastrostomy may be performed if the object cannot be removed via endoscopy.

    Proton Pump Inhibitors (PPIs)

    • PPIs have broad-spectrum antisecretory activity.
    • They interrupt the final common pathway of acid secretion by inhibiting hydrogen potassium adenosine triphosphatase.
    • Antacids neutralize luminal gastric acid.

    Esophageal Disorders

    • Megaesophagus is characterized by dilation and decreased motility of the esophagus.
    • Causes: congenital, acquired (myasthenia gravis, hypothyroidism, botulism, polymyositis, idiopathic)
    • Clinical Signs: regurgitation (especially after eating), weight loss, aspiration pneumonia (repeated unsuccessful attempts to swallow with gagging, retching, and spitting of food)
    • Diagnosis: radiography (suggests megaesophagus and aspiration pneumonia), barium swallow fluoroscopy (detects motility disorders)
    • Treatment: surgical correction in some cases, medical management (elevate food bowl, thicken food with water)
    • Prognosis: variable

    Esophageal Perforation

    • The most common cause is foreign bodies.
    • Clinical Signs: anorexia, depression, odynophagia, cervical swelling, cellulitis, draining fistula, cough, dyspnea, fever
    • Diagnosis: thoracic radiography (pneumomediastinum, pneumothorax, mediastinal or pleural effusion)
    • Treatment: Surgical excision is required.
    • Prognosis: variable

    Stomach Disorders

    • Vomiting is a common sign associated with gastrointestinal (GI) and non-GI disorders.

    Stomach Disorders: Vomiting

    • Clinical Signs: nausea (hypersalivation, licking and swallowing), retching, abdominal contractions. Vomitus contains stomach and duodenal contents (food, mucus, bile-stained fluid) and may contain blood (hematemesis). Projectile vomiting suggests gastric outlet or upper small bowel obstruction. Undigested food more than 12 hours after eating suggests delayed gastric emptying.
    • Diagnosis: careful history and physical examination (oral and rectal)
    • Treatment: treatment of the underlying cause, antiemetic and acid control therapy

    Stomach Disorders: Gastric Foreign Bodies

    • More common in dogs than cats. Linear foreign bodies are more common in cats.
    • Clinical Signs: acute-onset vomiting, chronic vomiting, signs of toxicity due to type of foreign body ingested.
    • Diagnosis: radiography (identifies object and distended stomach).
    • Treatment: endoscopic removal (preferred). Asymptomatic animals can be managed conservatively. Gastrostomy if object cannot be removed via endoscopy.

    Small Intestine Disorders

    • Small intestinal disease: a significant cause of vomiting, diarrhea, and maldigestion/malabsorption.

    Small Intestine Disorders: Tyzzer's Disease

    • An acute, enterotoxemia-producing, necrotizing disease caused by Clostridium perfringens type C.
    • Clinical Signs: watery to soft diarrhea, hematochezia, tenesmus
    • Diagnosis: fecal cultures (not useful), fecal assays for C.perfringens
    • Treatment: antibiotics (ampicillin, amoxicillin-clavulanate, tylosin, clindamycin)
    • Prognosis: variable

    Small Intestine Disorders: Inflammatory Bowel Disease (IBD)

    • A chronic inflammatory condition of the small intestine, most commonly a lymphocytic-plasmacytic enterocolitis.
    • Causes: exact cause unknown, suspected causes: environmental factors.
    • Clinical Signs: chronic vomiting, chronic diarrhea (may be intermittent and last for months to years), weight loss.
    • Diagnosis: diagnosis of exclusion
    • Treatment: control predisposing factors, dietary management, immunosuppressive drugs (azathioprine, chlorambucil), anti-inflammatory drugs (corticosteroids)

    Small Intestine Disorders: Chronic Enteritis

    • Cause unknown.
    • Clinical Signs: diarrhea, maldigestion, malabsorption.
    • Treatment: antibiotics, dietary management (highly digestible diet)

    Large Intestine Disorders

    • Large intestinal disorders can be difficult to diagnose and are often secondary to small intestinal disease.
    • Large intestinal disorders can also be caused by: parasites, infectious agents, foreign bodies, neoplasia.
    • These disorders can cause: diarrhea, constipation or obstipation, hematochezia, mucus production, and abdominal pain.

    Large Intestine Disorders: Antibiotic-Associated Diarrhea (AAD)

    • Associated with Clostridium difficile overgrowth in the presence of antibiotic therapy (usually broad-spectrum antibiotics).
    • Clinical Signs: diarrhea, tenesmus, abdominal pain, fever, leukocytosis.
    • Diagnosis: fecal culture and toxin testing (confirms the diagnosis).
    • Treatment: Discontinue the antibiotic, supportive care, metronidazole, vancomycin (for severe cases)

    Large Intestine Disorders: Lymphocytic-Plasmacytic Colitis

    • Clinical Signs: watery diarrhea, increased mucus production, tenesmus, weight loss.
    • Diagnosis: fecal smear, colonoscopy with biopsy.
    • Treatment: dietary management (low-residue diet), anti-inflammatory drugs (corticosteroids), anti-diarrheal medications.

    Large Intestine Disorders: Megacolon

    • Cause: idiopathic, most common in cats.
    • Clinical Signs: constipation, straining to defecate, abdominal distension.
    • Diagnosis: radiography, abdominal ultrasound, physical examination.
    • Treatment: laxatives (lactulose, miralax), dietary management (high-fiber diet), surgical intervention in severe cases.

    Colonic Disorders

    • Colonic disorders can cause a variety of clinical signs, including diarrhea, constipation, abdominal pain, and weight loss.

    Colonic Disorders: Colitis

    • Causes: infectious agents, parasites, dietary indiscretion, stress, inflammatory bowel disease (IBD), neoplasia.
    • Clinical Signs: diarrhea, tenesmus, hematochezia, mucus production, abdominal pain.
    • Diagnosis: fecal examination, colonoscopy, biopsy.
    • Treatment: identifying and treating the underlying cause, supportive care, anti-diarrheal medications, anti-inflammatory drugs (corticosteroids).

    Colonic Disorders: Constipation

    • Causes: lack of exercise, low water intake, poor diet, megacolon, anorectal stricture (stenosis).
    • Clinical Signs: straining to defecate, difficulty passing stool, hard dry stools, abdominal pain.
    • Diagnosis: physical examination, radiography, abdominal ultrasound.
    • Treatment: increasing water intake, increasing fiber in the diet, laxatives (lactulose, miralax), promotility agents (cisapride).

    Colonic Disorders : Hemorrhagic Gastroenteritis

    • Cause: Clostridium perfringens type A, other factors (viral, bacterial, dietary changes, stress, immune deficiency)
    • Clinical Signs: acute onset of vomiting and/or diarrhea, blood in the stool (hematochezia or melena), abdominal pain, dehydration.
    • Diagnosis: fecal examination, CBC, blood chemistry.
    • Treatment: fluid therapy, supportive care, antibiotics (metronidazole).

    Anorectal Disorders: Anorectal Foreign Bodies and Fecaliths

    • Causes Ingested bones, sticks, needles, can become lodged in the rectum or anal sphincter.
    • Clinical Signs: dyschezia (difficulty defecating), tenesmus (straining associated with defecation).
    • Diagnosis: rectal examination.
    • Treatment: removal via palpation.

    Anorectal Disorders: Anorectal Stricture (Stenosis)

    • Cause: trauma caused by foreign bodies, surgery, inflammation.
    • Clinical Signs: dyschezia, constipation, rectal bleeding.
    • Diagnosis: rectal examination, radiography.
    • Treatment: dilation, surgical correction (colostomy or anorectal reconstruction).

    Anorectal Disorders: Perineal Hernia

    • A condition most common in male dogs.
    • Clinical Signs: perineal swelling.
    • Diagnosis: physical examination.
    • Treatment: surgical repair, castration (in male dogs)

    Anorectal Disorders: Anal Sac Abscesses

    • Causes: blocked anal sacs, inflammation.
    • Clinical Signs: perineal swelling, pain, discharge.
    • Diagnosis: physical examination.
    • Treatment: manual evacuation, irrigation, antibiotics.

    Anorectal Disorders: Perianal Fistula

    • Causes: unknown. Most common in German Shepherd dogs and Irish Setters.
    • Clinical Signs: dyschezia, tenesmus, severe anal discomfort.
    • Diagnosis: physical examination.
    • Treatment: surgical correction, medical management (antibiotics, topical medications).

    Gastroduodenal Ulceration and Bleeding

    • Causes include: NSAIDs, glucocorticoids, chronic gastritis, hepatic disease, renal failure, neurologic disease, hypoadrenocorticism, gastric neoplasia, mast cell tumors, gastrinoma, or stress
    • Clinical signs: anorexia, vomiting, hematemesis, melena, abdominal pain, and weight loss
    • Acute onset abdominal pain, depression, and collapse suggest ulcer perforation and septic shock
    • Diagnosis involves reviewing drug history for ulcerogenic drugs
    • Laboratory evaluation may show regenerative anemia or microcytic hypochromic anemia with chronic blood loss.
    • Treat with H2 blockers to control gastric acid
    • Consider endoscopy or exploratory laparotomy if indicated

    Intestinal Palpation

    • Masses: Foreign body, neoplasia, granuloma
    • Thickened loops: Infiltration (inflammation, lymphoma)
    • “Sausage loop”: Intussusception
    • Aggregated loops: Linear intestinal foreign body, peritoneal adhesions
    • Pain: Inflammation, obstruction, ischemia, peritonitis
    • Gas of fluid distention: Obstruction, ileus, diarrhea
    • Mesenteric lymphadenopathy: Inflammation, infection, neoplasia

    Rectal Palpation

    • Masses: Polyp, granuloma, neoplasia
    • Circumferential narrowing: Stricture, spasm, neoplasia
    • Coarse mucosal elevations: Colitis, neoplasia

    Intestinal Masses and Diseases

    • Benign tumors: adenomatous polyps, adenomas, and leiomyomas
    • Malignant tumors: adenocarcinoma and lymphoma most commonly.
    • Lesions can include carcinoid tumors, leiomyosarcoma, fibrosarcoma, mastocytoma, hemangiosarcoma, and anaplastic sarcoma
    • Clinical signs are initially vague and progress to vomiting and diarrhea. Signs may vary with location of neoplasia
    • Definitive diagnosis requires biopsy. Abdominal radiography or ultrasonography may detect intestinal masses

    Viral Enteritis

    • Canine parvovirus, coronavirus, and rotavirus cause viral enteritis and diarrhea in dogs. Canine parvovirus is acute, severe, highly contagious enteritis
    • Coronavirus and rotavirus cause mild clinical signs except in neonates
    • Canine distemper virus also causes diarrhea.

    Bacterial Infections

    • Salmonella - Transmitted by the fecal-oral route
    • Clinical signs: watery or mucoid diarrhea containing blood, vomiting, tenesmus, and fever. Some animals may have chronic or intermittent diarrhea, and many are asymptomatic carriers
    • Diagnoses by isolation of the bacteria from fecal or blood samples
    • C. perfringens: Treat with ampicillin, amoxicillin-clavulonate, tylosin, or clindamycin. Metronidazole seems to work less consistently.

    Intestinal Parasites: Helminths

    • Ascarids can be present in normal dogs and cats and also in animals with mild diarrhea or acute hemorrhagic diarrhea
    • Fecal assays for toxins A and B are available for diagnosis of C. difficile
    • Treat with metronidazole if C. difficile is suspected.

    Fungal Infections

    • Intestinal pythiosis and zygomycosis: Pythium insidiosum and Zygomycetes can invade the digestive tract, causing granulomatous tissue reactions.
    • Pythiosis is most common in young large-breed dogs in the southern Gulf States. It is rare in cats.
    • Clinical signs: chronic intractable diarrhea (may be bloody) and vomiting, depression, and progressive weight loss
    • Confirmation of diagnosis requires histologic identification in biopsies

    Inflammatory Bowel Disease (IBD)

    • Predisposed breeds: basenji, German shepherd dog, soft-coated wheaten terrier, and shar-pei
    • Clinical signs: vomiting, diarrhea, and weight loss. Protein-losing enteropathy may be present. Signs may be intermittent and last for months to years.
    • IBD is a diagnosis of exclusion of all known causes of lymphocytic-plasmacytic inflammation of the intestinal tract
    • Diagnoses by endoscopy or biopsy

    Other causes of diarrhea

    • Eosinophilic gastroenteritis: Diagnosed by breed and presence of PAS-positive histiocytes in a biopsy
    • Treat with enrofloxacin with metronidazole. Feed a highly digestible diet.
    • Mucosal hypersensitivity to antigens and genetic factors can contribute to IBD
    • Neutrophilic (suppurative) enterocolitis: Cause is unknown
    • Painful defecation: May be caused by anorectal disease (e.g., anal sacculitis) or orthopedic disorders that limit positioning
    • Rectocolonic obstruction: Caused by intraluminal causes (e.g., foreign body, perineal hernia) or external compression (e.g., prostatic enlargement, pelvic fractures)
    • Neuromuscular disease: May interfere with colonic innervations or smooth muscle function or with positioning for defecation.
    • Fluid and electrolyte disorders: Dehydration causes feces to become dry and hard; hypokalemia and hypercalcemia can impair colonic smooth muscle function
    • Drug-related: Anticholinergics, opiates, loperamide, antihistamines, barium sulfate

    Antidiarrheal Drugs

    • Antidiarrheal drugs are used to control fluid loss in short-term cases
    • Loperamide or diphenoxylate are most effective

    Corticosteroids

    • Corticosteroids are indicated for inflammatory bowel disease (IBD).

    NSAIDs

    • NSAIDs may be used in chronic colitis.

    Antibiotics

    • Antibiotics should only be used to treat specific bacterial enteropathogens.

    Fenbendazole Therapy

    • Fenbendazole is used to treat common intestinal nematodes and Giardia spp.

    Cobalamin Therapy

    • Cobalamin therapy is used in chronic small intestinal disease or exocrine pancreatic insufficiency.

    Dietary Diarrhea

    • Dietary indiscretions include overeating, ingestion of spoiled garbage, and ingestion of abrasive or indigestible foreign material that can traumatize the gastrointestinal mucosa.

    Proton Pump Inhibitors

    • Proton pump inhibitors such as omeprazole and pantoprazole have broad-spectrum antisecretory activity because they interrupt the final common pathway of acid secretion by inhibiting hydrogen potassium adenosine triphosphatase.
    • Antacids neutralize luminal gastric acid.

    Gastritis

    • Clinical signs of gastritis include intermittent vomiting (weeks to months), and are not consistently associated with eating.

    Endoscopy

    • Endoscopy is the diagnostic method of choice for gastritis
    • Mucosal abnormalities include irregularity, firmness, or ulceration.
    • Laparotomy may be indicated for biopsies.

    Eosinophilic Gastritis and Granuloma

    • Eosinophilic infiltration is usually diffuse but may present as a granulomatous lesion in dogs.
    • Allergic or immunologic hypersensitivity has been suggested.
    • Eosinophilic gastritis is rarely associated with hypereosinophilic syndrome in cats.
    • Clinical signs include chronic vomiting, hematemesis, melena, anorexia, and weight loss.
    • Endoscopy is the diagnostic method of choice.
    • Prognosis is good for benign tumors but poor for adenocarcinoma

    Gastric Dilatation-Volvulus (GDV)

    • GDV causes complete obstruction of gastric outflow, which impairs venous return through the vena cava causing hypovolemic and endotoxic shock.
    • The cause is unknown.
    • Older large-breed, deep-chested dogs are predisposed.
    • Risk factors include:
      • having a first-degree relative affected by GDV
      • a lean body conformation
      • rapid eating
      • eating from a raised bowl
      • eating one meal daily
      • exercise or stress after a meal
      • a fearful temperament
    • Clinical signs include acute onset of abdominal distension, nonproductive retching, salivating, and respiratory distress.
    • Physical examination usually reveals tympani on abdominal percussion and findings indicative of hypovolemia or shock.
    • Hypokalemia

    Gastric Outflow Obstruction

    • Foreign bodies, chronic hypertrophic pyloric gastropathy, congenital pyloric stenosis, pyloric mass, gastric dilatation-volvulus, or extrinsic compression can cause gastric outflow obstruction.
    • Clinical signs include projectile vomiting of undigested food, abdominal distention, belching, and weight loss.

    Diagnosis of Gastric Outflow Obstruction

    • Laboratory findings are unremarkable unless profuse vomiting occurs and results in hypokalemia.
    • Physical examination: Perform rectal examination and palpate abdomen. Look for signs of systemic disease.
    • Routine laboratory tests (CBC, biochemistry profile) and thyroid profile in cats to exclude hyperthyroidism.

    Small Intestinal Bacterial Overgrowth

    • Caused by an overproliferation of microflora within the proximal small intestine that results in malabsorption and diarrhea.
    • May develop secondary to other disorders (e.g., intestinal obstruction, dysfunction of the ileocolic junction, motility disorders, hyposecretion of gastric acid, exocrine pancreatic insufficiency).
    • Immunoglobulin A deficiency may explain the breed predilection in German shepherds, basenjis, and shar-peis.
    • Clinical signs consist of chronic watery diarrhea and steatorrhea.
    • Diagnosis requires quantitative aerobic and anaerobic cultures of duodenal juice taken by endoscopy, intestinal intubation, or laparotomy after an 18-hour fast.

    Intestinal Obstruction

    • Clinical signs:
      • Vomiting, often projectile
      • Anorexia
      • Depression
      • Abdominal distension or pain
      • Diarrhea, melena, hematochezia, and shock may occur
      • May occur due to foreign bodies, intussusceptions, or distended bowel loops

    Intestinal Obstruction Diagnosis

    • Abdominal palpation may identify foreign bodies, intussusceptions ("sausage loop"), or distended bowel loops.
    • Radiographic findings include gas or fluid distention of the bowel, retention of contrast material, and luminal filling defects.

    Intestinal Obstruction Treatment

    • Surgical removal of the obstruction
    • Management of complications
    • Supportive medical treatment

    Salmonellosis

    • Most infected dogs are clinically normal carriers.
    • Exposure is high with overcrowding and poor sanitation.
    • Clinically, dogs may present with watery-mucoid diarrhea, hematochezia, vomiting, tenesmus.
    • Fever is usually mild or absent.
    • Some animals may have chronic or intermittent diarrhea.
    • Diagnosis is by isolation of Salmonella from feces.
    • Treat with enrofloxacin or trimethoprim-sulfa, and correct fluid deficits.
    • Mortality is high in neonates.
    • Salmonellosis is a zoonotic disease.

    Campylobacter

    • Most infected dogs are clinically normal carriers.
    • Exposure is high with overcrowding and poor sanitation.
    • Clinical signs include watery-mucoid diarrhea.
    • Hematochezia, vomiting, and tenesmus may occur.
    • Fever is usually mild or absent.
    • Some animals may have chronic or intermittent diarrhea.
    • Diagnosis is by isolation of Campylobacter from feces.
    • Treat with erythromycin, enrofloxacin, or azithromycin.
    • Carrier state may persist.

    Clostridium perfringens

    • These bacteria normally reside in the bowel in the vegetative form but can release their toxin (CPE) during sporulation endogenously within the bowel or exogenously in contaminated food.
    • Prognosis is guarded. Clinical signs often persist despite treatment.

    Histoplasmosis

    • Histoplasmosis is a multisystemic infection with intestinal involvement caused by Histoplasma capsulatum.
    • Clinical signs include:
      • Large bowel diarrhea with hematochezia.
      • Signs related to invasion of other organs (visceral organs, eye, central nervous system [CNS]).
    • Diagnosis is by identifying organisms in:
      • Feces
      • Cytology preparations
      • Biopsies
    • Treat with a combination of amphotericin B and itraconazole.

    Intestinal Protothecosis

    • Caused by algae that may rarely colonize the intestinal tract of dogs and cause severe necrotizing or ulcerating enterocolitis.
    • Clinical signs include:
      • Large bowel diarrhea with hematochezia.
      • Signs related to invasion of other organs (visceral organs, eye, central nervous system [CNS]).
    • Identify organisms in feces, cytology preparations, and biopsies.
    • Treat with a combination of amphotericin B and itraconazole.

    Chronic IBD (Lymphocytic-Plasmacytic IBD)

    • The most common form of IBD in dogs and cats.
    • Factors that may play a role include:
      • Genetics
      • Immune-mediated disease
      • Environmental factors
      • Dietary factors
    • Clinical signs:
      • Vomiting
      • Anorexia
      • Depression
      • Abdominal distension or pain
      • Diarrhea
      • Melena
      • Hematochezia
      • Shock

    Chronic IBD Diagnosis

    • Abdominal palpation may identify foreign bodies, intussusceptions ("sausage loop"), or distended bowel loops
    • Radiographic findings include gas or fluid distention of the bowel, retention of contrast material, and luminal filling defects.

    Chronic IBD Treatment

    • Surgical removal of the obstruction
    • Management of complications
    • Supportive medical treatment
    • Treatment involves radical surgical excision of the affected segments. A combination of amphotericin B, itraconazole, and terbinafine may be successful. Prognosis is guarded to poor.

    Constipation

    • Causes include ingestion of foreign material (e.g., hair in cats, bones in dogs), environmental conditions (e.g., unfamiliar surroundings) that may cause inhibition of defecation.

    Anorectal Diseases

    • May be caused by:
      • Impacted anal sacs
      • Rectal prolapse
      • Perianal fistulas
      • Anal gland adenocarcinomas

    Anorectal Disease Treatment

    • Treatment involves expressing anal sacs, surgical repair, or medical management.
    • Poor prognosis for certain anorectal diseases (e.g., anal gland adenocarcinomas).

    Esophageal Foreign Body

    • Common in dogs
      • Bones and vomited hairballs in cats typically lodge at the thoracic inlet, base of the heart, or hiatus of the diaphragm

    Esophageal Perforation

    • Ancillary tests are used to evaluate underlying causes of esophagitis
    • Medical management is sufficient for small tears.
    • Surgical repair is needed if the perforation is large, or mediastinitis or pleuritis occur
    • Give parenteral antibiotics, fluid therapy, and nothing per os for 5 to 7 days.
    • Consider feeding by gastrostomy tube or parenteral nutritional support

    Esophagitis

    • Causes of esophagitis include foreign bodies, oral medications (doxycycline), thermal injury, caustic injury, Pythium insidiosum infection, and gastroesophageal reflux
    • Chronic vomiting, hiatal hernia, general anesthesia, or indwelling nasogastric (NG) tube can all contribute to gastroesophageal reflux

    Esophageal Neoplasia

    • Primary neoplasia is rare
    • Leiomyoma is most common in dogs
    • Squamous cell carcinoma is most common in cats
    • Osteosarcoma and fibrosarcoma in dogs may develop with malignant transformation of a granuloma caused by Spirocerca lupi
    • Other tumors occasionally metastasize to the esophagus
    • Clinical signs include regurgitation, dysphagia, and ptyalism

    Gastroduodenal Ulceration and Bleeding

    • Causes include nonsteroidal anti-inflammatory drugs (NSAIDs), glucocorticoids, chronic gastritis, hepatic disease, renal failure, neurologic disease, hypoadrenocorticism, gastric neoplasia, mast cell tumors, gastrinoma, or stress
    • Clinical signs include anorexia, vomiting, hematemesis, melena, abdominal pain, and weight loss.
    • Acute onset abdominal pain, depression, and collapse suggest ulcer perforation and septic shock
    • Diagnosis is based on drug history, reviewing for ulcerogenic drugs
    • Laboratory evaluation may show regenerative anemia or microcytic hypochromic anemia with chronic blood loss

    Chronic Diarrhea

    • Caused by inflammation
    • Diagnosis is by review of history only
    • Self-limiting with feeding of a restricted diet and prevention of indiscriminant eating

    Drug- and Toxin-Induced Diarrhea

    • Many medications may cause diarrhea (e.g. NSAIDs, digitalis, lactulose, antihelmintics, antibiotics, many antineoplastic drugs).
    • Many exogenous toxins cause diarrhea (e.g., bacterial enterotoxins causing food poisoning, heavy metals, insecticides).
    • Diagnosis is based on a review of the history
    • Diarrhea usually resolves with discontinuation of the medication or dose reduction, and with elimination of the toxin from the body.
    • Give supportive treatment as indicated

    Intestinal Parasites: Helminths

    • Ascarids:
      • High-fiber bulk-forming laxatives are available as commercial high-fiber diets or fiber supplements (e.g., wheat bran, psyllium)
      • Lubricant laxatives: Flavored petrolatum is preferred, while mineral oil may lead to inhalation lipid pneumonia and should not be given orally
      • Emollient laxatives: Docusate is a mild laxative, and its efficacy depends on patient hydration
      • Osmotic laxatives: Lactulose is the most clinically useful and effective, and it is safe for long-term use
      • Stimulant laxatives: Bisacodyl is the most effective, but long-term use may damage the myenteric plexus and contraindicated in the presence of an obstructive lesion
      • Promotility drugs are contraindicated in the presence of an obstructive lesion. Cisapride is the most effective

    Megacolon in Cats

    • Most cases are idiopathic.

    Gastroduodenal Ulceration and Bleeding

    • Causes: NSAIDs, glucocorticoids, chronic gastritis, hepatic disease, renal failure, neurologic disease, hypoadrenocorticism, gastric neoplasia, mast cell tumors, gastrinoma, or stress
    • Clinical Signs: anorexia, vomiting, hematemesis, melena, abdominal pain, and weight loss
    • Acute onset abdominal pain, depression, and collapse suggest ulcer perforation and septic shock
    • Diagnosis: Review drug history for ulcerogenic drugs. Laboratory evaluation may show regenerative anemia or microcytic hypochromic anemia with chronic blood loss. Evaluate for underlying disorders.
    • Treatment: H2 blockers to control gastric acid

    Intestinal Palpation

    • Masses: Foreign body, neoplasia, granuloma
    • Thickened loops: Infiltration (inflammation, lymphoma)
    • “Sausage loop”: Intussusception
    • Aggregated loops: Linear intestinal foreign body, peritoneal adhesions
    • Pain: Inflammation, obstruction, ischemia, peritonitis
    • Gas of fluid distention: Obstruction, ileus, diarrhea
    • Mesenteric lymphadenopathy: Inflammation, infection, neoplasia
    • Rectal Palpation:
      • Masses: Polyp, granuloma, neoplasia
      • Circumferential narrowing: Stricture, spasm, neoplasia
      • Coarse mucosal association: Colitis, neoplasia

    Diarrhea

    • Inflammatory Bowel Disease (IBD)
      • Chronic inflammatory condition of the gastrointestinal tract
      • Clinical signs: Chronic vomiting and diarrhea, often with blood and mucus.
      • Diagnosis: Based on clinical signs, history, and biopsy.
      • Treatment: Dietary therapy with a novel protein source or fiber supplementation, oral prednisolone, metronidazole, cobalamin, azathioprine, chlorambucil, cyclosporine, or motility-modifying antidiarrheal drugs.
    • Eosinophilic Gastroenteritis
      • Uncommon form of IBD characterized by infiltration of the GI tract with mature eosinophils.
      • Clinical signs: Chronic vomiting, small or large bowel diarrhea, protein-losing enteropathy, granulomas.
      • Diagnosis: Demonstration of eosinophilic inflammation in intestinal biopsies.
      • Treatment: Fenbendazole to exclude parasites, feeding trial to exclude food allergy, oral prednisolone.
    • Regional Granulomatous Enterocolitis
      • Uncommon form of IBD characterized by transmural granulomatous inflammation.
      • Clinical signs: Chronic large bowel diarrhea containing mucus and fresh blood, tenesmus, and abdominal pain.
      • Diagnosis: Biopsy to detect fungi and acid-fast organisms.
      • Treatment: Tetracycline, tylosin, and metronidazole for 10 to 14 days.
    • Fiber-responsive Diarrhea
      • Chronic, non-inflammatory, mucoid large bowel diarrhea
      • Clinical signs: Intermittent mucoid diarrhea (without hematochezia). Working dogs and excitable dogs are predisposed.
      • Diagnosis: Based on exclusion of other causes of colonic disease (e.g., dietary, infectious, parasitic, IBD).
      • Treatment: Digestible diet with fiber supplementation (psyllium), motility-modifying antidiarrheal drugs.
    • Protein-losing Enteropathy
      • A variety of intestinal diseases associated with accelerated loss of plasma proteins into the gut.
      • Clinical signs: Severe hypoalbuminemia (subcutaneous edema, ascites, hydrothorax), chronic intermittent or persistent diarrhea.
      • Diagnosis: Typical laboratory findings include hypoalbuminemia, hypoglobulinemia, lymphopenia, hypocholesterolemia, and hypocalcemia.
      • Treatment: Similar to lymphocytic-plasmacytic IBD. Dietary fat restriction is warranted.
    • Painful Defecation:
      • Can result from anorectal disease (e.g., anal sacculitis) or orthopedic disorders.
      • May lead to inhibition of defecation.
    • Rectocolonic Obstruction
      • Can be caused by intraluminal causes (e.g., foreign body, perineal hernia) or external compression.
    • Neuromuscular disease
      • May interfere with colonic innervations or smooth muscle function.
      • Examples: Intervertebral disc disease at the lumbosacral region, dysautonomia, hypothyroidism.
    • Fluid and electrolyte disorders:
      • Dehydration causes feces to become dry and hard.
      • Hypokalemia and hypercalcemia can impair colonic smooth muscle function.
    • Drug-related: Anticholinergics, opiates, loperamide, antihistamines, barium sulfate.

    Intestinal Neoplasia

    • Benign tumors: Adenomatous polyps, adenomas, leiomyomas
    • Malignant tumors: Adenocarcinoma and lymphoma most commonly, carcinoid tumors, leiomyosarcoma, fibrosarcoma, mastocytoma, hemangiosarcoma, and anaplastic sarcoma.
    • Clinical signs: Initially vague, progress to vomiting and diarrhea. Signs may vary with location of neoplasia.
    • Diagnosis: Biopsy. Abdominal radiography or ultrasonography may detect intestinal masses.

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