Transcript DISEASES OF THE STOMACH

Don’t be your own enemy
“If there is no enemy within, the
enemy outside can do us no harm.”
-Les Brown
DISEASES OF THE
STOMACH
Stomach Diseases: Acute Gastritis
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Acute Gastritis
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Commonly seen in dogs
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Spoiled food
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Change in diet
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Food allergy
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Infections (bacterial, viral, parasitic)
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Toxins (chemicals, plants, drugs, organ failure)
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Foreign objects
Signs
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Anorexia
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Vomiting (maybe dehydration)
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Painful abdomen
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Hx of diet change, toxin ingestion, infection, parasites
Acute Gastritis
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Dx
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Hx and PE
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CBC, Chem Panel to assess dehydration, metabolic imbalance, organ failure
Rx
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NPO until vomiting stops
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4-6 sips of water q1h
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Fluid therapy (SQ or IV)
Gradually start feeding
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Bland food (Hill’s I/D, boiled chicken/rice)
Antiemetics
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Maropitant (Cerenia)
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Metoclopramide (Reglan)
Coating agents
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Sucralfate
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H2-blockers (famotidine, ranitidine, cimetidine)
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Antibiotics—often prescribed, rarely needed
Acute Gastritis
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Client info

Avoid abrupt changes in diet
 Gradually
mix new food in with old (1 wk)
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If pet vomit 2-3 times, NPO x 24 h; if it continues
see vet
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Dogs and cats do not need variety
Immune-Mediated Inflammatory Bowel Disease
(Chronic gastritis, Enteritis, Colitis)
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A decreased tolerance to the diet or to the normal flora
results in accumulation of inflammatory cells in lining
of stomach, Small Intestine, or Large Intestine
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Clinical Signs
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Chronic vomiting, wt loss
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Diarrhea, straining to defecate, mucus in stool
Immune-Mediated Inflammatory Bowel Disease
(Chronic gastritis, Enteritis, Colitis)
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Diagnosis
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Fecal to r/o parasites
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CBC, Chemistry panel, urinalysis to r/o metabolic
disorder
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FeLV, FIV to r/o those diseases
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Endoscopy of stomach, SI, and colon, and biopsy for
definitive diagnosis
Immune-Mediated Inflammatory Bowel Disease
(Chronic Gastritis, Enteritis, Colitis)
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Treatment
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Azathioprine—immunosupressant
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Cyclophosphamide—inhibits immune system response
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Sulfasalazine—a sulfa drug with anti-inflammatory/antibacterial
effects
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Most effective against colitis
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Metronidazole
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Prednisone
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Hypoallergenic diet
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Free from preservative, additives
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Highly digestible protein (rabbit, lamb, duck, chicken)
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Homemade diets with rice base
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Some commercial diets are available
Inflammatory Bowel Disease
 Client
info
 Definitive
 Life-long
diagnosis is through biopsy
condition
 Immunosuppressive
drugs have side-effects
(PU/PD/PP, wt gain, skin/urinary infections)
 Use
lowest dose that provides effect
Stomach Diseases:Gastric Ulceration
Usually a result of long-term NSAIDs (aspirin, ibuprofen,
phenylbutazone)
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Signs
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Vary from asymptomatic to vomiting
blood
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Anemia, edema
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Melena
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Anorexia
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Abdominal pain
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Septicemia if perforation occurs
Gastric Ulceration
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Dx
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X-ray using contrast medium (Barium) to show
ulceration in stomach lining (caution if perforation is
suspected)
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Endoscopy
Gastric Ulceration
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Rx
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Fluid therapy for dehydration
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NPO (as before)
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Coating agents/antacids
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Cimetidine—H2 antagonist (↓ HCl production)
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Omeprazole—↓ HCl production (proton-pump inhibitor)
Client info
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Do not use NSAIDs without veterinary supervision
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Give NSAIDs with meal/antacids
Stomach Diseases: Gastric
Dilatation/Volvulus
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Primarily a disease of large, deep-chested dogs (2-10 yrs)
Dilation—gas filled; Volvulus—twisted along longitudinal axis
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Cause: Food/exercise? Etiology unclear
Signs
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Abdominal pain/distension
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Weakness, collapse, depression, nausea, salivation
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Increased HR, RR – may lead to arrhythmias
Gastric Dilatation/Volvulus
Gastric Dilatation/Volvulus
Stomach Diseases: GDV
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Diagnosis
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PE shows depressed, weak animal with dpoor
perfusion (↑CRT)
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X-rays show air filled stomach- “double-bubble”
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ECG may show vent arrhythmia or sinus
tachycardia
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CBC and Chem panel necessary to assess
electrolyte levels and pH imbalances
Gastric Dilatation/Volvulus
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Treatment
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Goals
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Decompress stomach
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Pass stomach tube
18 gauge needle
Stabilize patient (fluids, electrolytes, ECG)
Rx for shock
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IV fluids
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Corticosteroids
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Antibiotics
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Prepare for Sx
Surgery ASAP
Gastric Dilatation/Volvulus
Gastric Dilatation/Volvulus
 Post-Op
 ECG
 Blood
 Pain
pressure
management
 Monitor
urine output
 Antibiotics
 Maintain
fluids (oral, IV)
Gastric Dilatation/Volvulus
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Client info
 Avoid
large meals
 Limit
exercise after meals
 Feed
high-quality protein diet
 Tack-down
procedure not 100% preventative
Gastric Neoplasia
Most common malignant neoplasia in dogs is adenocarcinoma; in cats
lymphoma
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Signs
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Wt loss
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Vomiting w/ or w/o blood
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Obstruction
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Usually seen in older animals
Dx
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Endoscopy and biopsy for diagnosis
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X-ray with Barium contrast
Gastric Neoplasia
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Treatment
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Surgery is treatment of choice
 Many
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tumors are too far advanced (inoperable)
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Chemotherapy
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Radiation less successful for gastric tumors
Client info
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Prognosis is poor; gastric neoplasia is a fatal disease
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Supportive care, control of vomiting, good nutrition
are needed for these animals