Transcript Diseases of Digestive System - Dr. Brahmbhatt`s Class Handouts

ALWAYS LOOK FOR THE POSTIVE
“When it is dark enough, you
can see the stars.”
-Persian proverb
Diseases of Digestive System
Oral cavity
Esophagus
Stomach
Small Bowel
Large Bowel
Liver
Pancreas
Rectum
Anus
Chapter 2
GI system
 GI tract: mouth -> anus
 Accessory structures
Teeth,
tongue,_____________,
liver, pancreas,
______________
Diseases
Oral cavity
Esophagus
Stomach
Small Bowel
Large Bowel
Liver
Pancreas
Rectum
Anus
Oral Diseases: Periodontal Disease
 Periodontal Disease is plaque-induced inflammation of gums
 Progressive
 gingivitis, gingival hyperplasia, peridontitis with vertical bone destruction, and peridontitis
with horizontal bone destruction
 The end result is _____________________
 Periodontal means “around the tooth”
 Etiology
 Food particles, bacteria collect around gum line and form plaque (tartar)
• Causes gingivits
 Minerals in saliva collect in plaque and harden to form ___________ which adheres
to teeth
• 3-5 d to harden
• Causes bad breath
• Protects the bacterial environment
Oral Diseases: Gingivitis
 Gingivitis—earliest signs of Periodontal Disease
Involves only the ______________ of the gums
_______________ inflammation of gums
Gingival hyperplasia (may also be breed- or drug-related)
Cause—accumulation of tartar on teeth
 Tartar is conducive to bacterial growth
 _____________ produced by bacteria damage tooth attachment and
cause inflammation
Oral Diseases: Periodontal Disease
Without intervention, gingivitis progresses to:
 Periodontitis— _____________ condition:
Loss of gingival root attachment (receding gums)
Alveolar bone _____________
Loss of teeth
alveolar bone
Normal Gingiva
Oral Diseases: Periodontal Disease
 Periodontitis—irreversible condition:
 Alveolar bone resorption
 Gingivitis—reversible; earliest signs of Periodontal Disease
Mild tartar
Mild gingivitis
____________
more tartar
more gingivitis
min bone loss
severe tartar
_____________
moderate bone loss
>50% bone loss
tooth is loose
should be pulled
Oral Diseases: Periodontal Disease
 Calculus builds up under gums
 Separates teeth from gums to form ___________, which encourages
more bacteria to accumulate and grow
 Bacteria secrete toxins/enzymes that cause detachment of tooth from bony
socket
 WBC’s invade area and release their enzymes to destroy bacteria
• These enzymes also cause detachment of tooth from bone
 Pockets get deeper and deeper
• Weakens bone
• Can cause ___________________________
 Other sequellae
 Bacteria enter blood stream
 Can cause micro-abscesses in liver, kidneys
 Cause _______________ on heart valves
Oral Diseases: Periodontal Disease
Iatrogenic mandibular fracture resulting from excessive force extraction of a
lower molar tooth
Oral Diseases: Periodontal Disease
 Signs
Halitosis
Reluctance to chew hard food
Pawing at mouth
Oral pain; personality changes
_________________________________
Increased salivation
Facial swelling; tooth loss
 Dx
Complete oral exam
Presence of tartar (plaque) on teeth
Oral Diseases: Periodontal Disease
 Rx
 Dental scaling
 with ultrasonic scaler
 Root scaling/planing (below gum line)
 with thin ultrasonic tip; ____________________
 Gingival curettage
 with curette against inner surface of gums
(gingival pocket’s diseased soft tissue inner
surface)
 Polishing to smooth the tooth surface and prevent
tartar buildup
 Irrigation to remove diseased tissue and plaque
Oral Diseases: Periodontal disease
DOXIROBE GEL controls ___________ and promotes rebuilding of periodontal
structures
*contains Doxycycline, an antibiotic
Oral Diseases: Periodontal Disease
Plaque prevention gel
Applied once a week
Oral Diseases: Periodontal Disease
 Client info
Good oral hygiene is necessary for all pets
 ______________________________
 Routine dental cleanings performed at veterinarian’s
 Treat gingivitis early before irreversible lesions occur
Extractions are sometimes necessary to clear up infections
_______________ food may promote better dental health by
removing tartar before it calcifies
 Once it calcifies, tartar must be removed professionally
http://www.youtube.com/watch?v=qnbJZWycdg&feature=PlayList&p=480B67A7E8907594&playnext
_from=PL&playnext=1&index=5
Oral Trauma
 Causes (many)
Falls, fights (bites), burns, blunt trauma (HBC)
______________________ in cats
 Fractured: hard palate, mandibular symphysis
Tongue injury from biting own tongue, dog fight, eat
from tin can in garbage, FB
Cats playing with needles, thread; strangulate tongue
Electrical, chemical burns
Gunshot wounds, fish hooks
Bones lodged in teeth
(Foreign body)
Fx mandible—cat; HBC
Oral Trauma
 Signs
 History or signs of head trauma
 Increased salivation
 Inability to close mouth; due to:
 Pain
 Fracture/dislocation
 FB
 Reluctance to eat (same reasons)
 Presence of foreign object
 Dx
 PE of oral cavity
 X-ray to r/o embedded FB
Oral Trauma
 Rx
Depends on type of trauma
Control bleeding
Provide _______________________
 IV fluids
 pain relief
Insure adequate airway
Repair/extract damaged teeth, fracture
 Client info
Like kids, if animals can get into trouble, they will
 Discourage chewing on electric cords
 Don’t leave caustic/toxic chemicals out
 Keep pets in fenced yard or on leash when outside
 Animals still eat well without entire tongue
Oral Neoplasia
Relatively common in cats and dogs; __________________ and squamous
cell carcinoma most common
 Signs
Depend on location and size of growth
Squamous cell
More common in males
carcinoma
(Upper R 3rd
Abnormal food prehension
incisor)
Increased salivation
Bone loss
Tooth loss
around lesion
Oral pain
 Dx
Histology of mass
X-rays to r/o metastasis
Biopsy of LN to r/o metastasis
Rostral
maxillectomy
was curative
Oral Diseases: Oral Neoplasia
Benign neoplasia
Papillomas
______________
Oral Diseases: Oral Neoplasia
A gingival (buccal mucosa) melanoma
involving a dog's caudal mandible
and temporomandibular joint region.
Above: An invasive feline oral
squamous cell carcinoma
(courtesy of Jon Slattery)
Oral Neoplasia
 Rx
Surgical excision
Partial removal of mandible/maxilla if bone is involved
Radiation therapy
Chemotherapy
 Client info
Px for malignant tumors is ________________ even with
aggressive therapy
Benign lesions have good Px
Animals (esp cats) with bone removed may need nutritional
support (feeding tube)
Oral Diseases
http://veterinarydentistry.posterous.com/
Salivary Mucocele
Accumulation of excessive amounts of______________________
Most common lesion of salivary glands in dogs; rarely seen in cats (following
trauma)
Cause is unknown (tight collar, choke chain??)
 Signs
Slowly enlarging,_______________, fluid-filled swelling on
neck or under tongue
Reluctance to eat
Difficult swallowing
Blood-tinged saliva
Respiratory distress
Salivary Mucocele
 Dx
Clinical signs
Paracentesis shows thick, _________________
 Rx
Aspirate fluid
Surgical drainage
Remove salivary gland; insert Penrose drain x 7 d
 Client info
Cause is unknown; trauma may be involved
Without removal of gland, excess fluid will continue to
accumulate
Some cases may resolve spontaneously
Removal of
mandibular
salivary gl
Lip-Fold Dermatitis
Often seen in breed with _________________(spaniels, setters, St. Bernard,
bulldogs, bassets)
Constant moisture in the folds from saliva causes bacterial growth
Food, hair, moisture cause irritation, erythema, and fetid odor
 Signs
 Halitosis
 Collection of debris in lower lip fold
 Dx
 Clinical signs
 Rx
 Dental cleaning
 Clip hair
 Clean out folds (food)
 Medicated wipes
 Sx is ________________
Lip-Fold Dermatitis
 Client info
Keep lip folds ______________ (for the rest of animal’s
life!!)
Flush/clean lip folds
 with 2.5% benzoyl peroxide shampoo
 chlorhexidine
 malaseb pledgets (chlorhexidine + miconazole)
Drying agents like corn starch several times a day
Good dental hygiene will help prevent it