GI emergencies

Indicates an esophageal disorder

The active expulsion of GI contents, preceded by signs of nausea

Watery, blood clots, blood mixed with feces

Black digested blood

Usually associated with large intestine, as is straining and the presence of mucus

Indicates colitis

Blood in the stool coming from the distal jejunum or ileum

Client calls stating that their dog is experiencing nonproductive retching and appears to have abdominal distention, what is this consistent with

If the owner declines to bring in a vomiting pet on an emergency basis, he or she should remove food for at least

A client calls and states that the pet has severe watery diarrhea, or diarrhea with blood, but declines to have the animal examined, what should they do

If the pet has ingested foreign material or a potential toxin, it may be appropriate to have the owner induce vomiting at home and then either bring in the pet for examination and treatment or monitor the pet at home. Vomiting should be induced even if the pet has an altered level of consciousness or is having breathing difficulties.

Diagnostic tests are needed to determine the extent of the disease and help to confirm the diagnosis. The choice of tests may vary, depending on the presenting complaint. Which of the following are part of an immediate database

A loss of serosal detail on abdominal radiographs are consistent with

The usefulness of ultrasound in patients with significant amounts of air in the GI tract can be limited

Four-quadrant abdominocentesis or preferably ultrasound-guided abdominocentesis is indicated if _____________ is a concern

Elevations in levels of abdominal fluid amylase, lipase, or alkaline phosphatase relative to serum indicate _______________

A blood glucose level that is 20 mg/dl (1.1 mmol/L) higher than the abdominal fluid glucose level is consistent with _________, as is a blood-to-fluid lactate concentration difference of greater than 2 mmol/L (Bonczynski et al., 2003 )

Fluid therapy is essential in the management of patients with GI disease. IV fluid therapy is usually indicated; however, in patients that are not vomiting, enteral fluid therapy may be appropriate.

Generally buffered, balanced electrolyte solutions are infused; however, normal saline should be infused in patients with ______________ if the patient is hypochloremic.

The decision to use a colloid is controversial. Patients with an acutely low colloid osmotic pressure (COP) (low albumin) are hypovolemic and are often not perfusing the gut adequately.

Synthetic colloids are significantly more ineffective at raising the COP than plasma

Another indication for a colloid is anticipated significant ongoing losses into the intestinal tract such as often occurs with parvovirus.

Broad-spectrum antibiotics covering both aerobic and anaerobic bacteria are indicated if systemic infection is a concern and should be considered in patients with ________________

Can be used for both decompression of the stomach and delivery of enteral nutrition

NG tubes should be aspirated every ______ initially, then every _______ as needed based on gastric residuals

Gastric distention does not impede diaphragm motion, therefore it does not have a significant negative impact on ventilation.

Which of the following is an acute abdominal condition that warrants emergency surgery

One of the most common reasons for the young dog or cat to present with a vomiting problem

Animal shows signs of salivation, excessive swallowing motions, dysphagia, and apparent vomiting that on closer questioning will be determined to be regurgitation

Is more accurate for diagnosing esophageal tears

If the foreign body cannot be removed orally, then it may be possible to manipulate it into the stomach, where the foreign body is removed via a gastrotomy.

Early signs include nausea, vomiting and inappetence

The GI foreign body will never be palpable on physical examination.

Abdominal ultrasound is very useful at locating foreign material and has been shown to be more accurate than radiographs

Many patients with intestinal foreign bodies cannot be stabilized completely until surgery is performed.

GDV is only seen in large deep-chested dogs

In GDV the gastric distention causes compression of the vena cava, resulting in a decrease in venous return that negatively affects cardiac output.

Patients commonly have a history of attempting to vomit or having nonproductive retching, although occasionally all the owner reports is the dog is more quiet than normal.

Ventricular tachycardia or premature complexes should be treated if

Other intestinal disorders requiring emergent surgical intervention include

If seen early in the disease process, these patients may only show signs of restlessness and nausea, late in the disease they may have a history of vomiting, diarrhea (Which may or may not be hemorrhagic), abdominal distention, abdominal pain, collapse and decompensatory shock

Intussusception, colonic, and mesenteric volvuli are all palpable

Unmistakable presence of blood (frank or digested) in vomitus or diarrhea

Acute hemorrhagic diarrhea syndrome (AHDS) is characterized by

In the patient with AHDS, boluses of crystalloids to restore a normal hematocrit and normal rheology are usually indicated with the goal of

In pancreatitis, most cases are ultimately diagnosed as idiopathic

Patients with this ailment have signs similar to those of other GI emergencies. Anorexia and intermittent vomiting may be the only signs in cats

Usually associated with infection but it can be sterile depending on the source of the inflammation

Typical clinical signs include restlessness, anorexia, vomiting, and abdominal pain.

Is diagnosed by identifying inflammation on microscopic evaluation of fluid obtained via abdominocentesis (or diagnostic peritoneal lavage).

Fluid resuscitation, antibiotics, and analgesics are indicated. Antibiotic therapy is best guided by culture and sensitivity results; broad-spectrum antibiotics should be used pending results. Exploratory surgery is indicated as soon as possible after diagnosis and initial resuscitation.

Animals with GI disease can deteriorate very quickly, especially when vomiting, diarrhea, or both are present. Almost all calls from owners involving an animal with some form of GI distress should be considered emergencies.