Gastrointestinal System

 Vomiting is a neural reflex act that

Diseases of the Digestive System results in ejection of food and fluid
from the stomach through the oral
cavity.
 nausea, salivation, or shivering

Gastrointestinal System Gastrointestinal System

 Regurgitation is characterized by  Clinical Findings of GI disease
passive, retrograde reflux of  excessive salivation
previously swallowed material from  diarrhea
the esophagus, stomach, or  constipation or scant feces
rumen.  vomiting
 regurgitation

Gastrointestinal System
 Clinical Findings of Gastrointestinal
Disease continued: Gastroenteritis
 GI tract hemorrhage
 abdominal pain and distention
 shock and dehydration
 suboptimal performance

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Gastritis Diagnosis
 Gastritis may be acute or chronic.  The diagnostic approach to vomiting
 Most are likely secondary to the ingestion of varies depending on whether the
various substances that cause injury to the vomiting is acute or chronic.
gastric mucosa. Continued mucosal damage Acute Gastritis if short duration(<3-4 days)
may initiate an immune-mediated reaction.
 detailed history (including questions related
 Acute gastritis is usually caused by to possible ingestion of garbage or toxins)
dietary indiscretion leading to damage  physical examination (including abdominal
of the gastric mucosa. palpation), examination of the oropharynx,
 Chronic gastritis is caused by a variety and a rectal examination (checking for
evidence of dietary indiscretion).
of diseases.
 If nothing of significance is found,
symptomatic therapy may be administered.

Diagnosis Diagnosis (chronic vomiting)

 Chronic vomiting:  In addition to a detailed history and
 vomiting that occurs more often than physical examination, an initial
once or twice daily, and vomiting database should include a complete
accompanied by hematemesis, blood count, biochemical profile
abdominal pain, depression, (including serum electrolytes),
dehydration, weakness, fever, or urinalysis, and abdominal radiographs
other adverse clinical signs should be (and abdominal ultrasound if
approached more vigorously. available).

Diagnosis (chronic vomiting) Treatment to Gastritis

 Endoscopic evaluation and biopsy of  Control of vomiting should be
the stomach and small intestine may directed to identifying the inciting
be the only test that can determine cause.
the nature of the disease.  Symptomatic therapy for acute
vomiting includes fasting and
withholding water for 24 hr to rest
the GI tract. (Water can be provided
in the form of ice.)

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Treatment to Gastritis Treatment to Gastritis
 If the vomiting has stopped after 24 hr,  Therapy for chronic vomiting is
the animal may be offered small also directed to elimination of the
amounts of water initially. If no further primary cause and, in addition, to
vomiting occurs, small amounts of a
low-fat diet (eg, Canine i/d® [Hill"s])
correction of dehydration,
can be fed 4-6 times the first day or so, electrolyte imbalances, and acid-
after which the animal can be fed its base disorders. The vomiting reflex
standard diet. should be suppressed.

Acute Pancreatitis
 In dogs, acute pancreatitis is most
Pancreatitis common in middle-aged to older
animals; affected dogs are often obese
or female.
 In cats, all age groups can be affected, and there
is no predilection for obesity or sex.
 Etiology: Ingestion of a fatty meal has
always been a suspected trigger of this
disorder.

Acute Pancreatitis Acute Pancreatitis

 Signs vary depending on the  Treatment is challenging because
severity of the disease and the of the multisystemic involvement
extent of systemic involvement. and associated complications. The
Signs are rather nonspecific. goals of therapy are to rest the
 A tentative diagnosis based on pancreas.
clinical signs should be confirmed  Resting the pancreas is best
with various clinical pathology accomplished by restricting all food
tests. and water for a minimum of 4-5
days, or longer if vomiting persists.
 Elevated Amylase
 fluids

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Client Education
Hepatic Disease and Hepatic
 high-fat diets in dogs, should be
avoided Lipidosis

Hepatic Disease Hepatic Lipidosis

 Clinical signs can vary from none  Feline idiopathic hepatic lipidosis is a
to anorexia, vomiting, gastric disease of undetermined etiology that is
ulceration, diarrhea, hepatic associated with a period of anorexia
encephalopathy, fever, coagulation (few days to several weeks), especially
abnormalities, jaundice, ascites, in obese cats.
polyuria and polydipsia,  Factors that may trigger anorexia include a
hepatomegaly or microhepatica, change of diet to initiate weight loss or
other stressful events (eg, moving,
and weight loss. boarding, death of other pets or owners).

Hepatic Lipidosis Hepatic Lipidosis

 Clinical signs are variable but can  Treatment is primarily supportive,
include dramatic weight loss (30-40%, unless an underlying cause can be
experimentally) due to anorexia, found.
vomiting, lethargy, and diarrhea.  Fluid therapy
 Icterus or pale mucous membranes,  Feeding as soon as possible is
ptyalism, hepatomegaly, and decreased essential.
body condition with retention of  Occasionally, appetite stimulants (eg,
abdominal fat are commonly seen diazepam or cyproheptidine) may be
helpful.

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 GDV
Gastric Dilatation and Volvulus
 GDV tends to primarily affect
(GDV) large, deep-chested dogs.
 Doberman Pinschers, German
Shepherd Dogs, Standard Poodles,
Great Danes, Saint Bernards, Irish
Setters, and Gordon Setters are
affected most commonly.

Gastric Dilatation and Volvulus Gastric Dilatation and Volvulus

(GDV) (GDV)
 Dilatation likely precedes volvulus.  If the volvulus is >180°, the distal
Dilatation occurs secondary to the esophagus becomes occluded.
accumulation of gas or fluid (or
both) within the stomach, the  Clinical signs may include an acute
outflow from which is obstructed. onset of restlessness, apparent
discomfort, abdominal pain, repeated
 The stomach rotates 90-360° in a
unproductive retching, excessive
clockwise fashion about the distal
salivation, and abdominal distention.
esophagus.

Gastric Dilatation and Volvulus

(GDV) GDV Diagnosis
 Progression to volvulus predisposes to  A history of ingestion of a large meal
hypovolemic shock. followed by exercise and repeated
 Abnormalities on physical examination attempts to vomit is common.
include:  Dogs not in a state of shock may
tachypnea or dyspnea
appear anxious.


 Rapid and weak pulses, pale mucous

membranes and prolonged capillary refill  Hypersalivation and abdominal
time indicative of hypovolemic shock. distention with gas are noted on
 An irregular heart rate and associated pulse physical examination.
deficits indicate cardiac arrhythmias.

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 Gastric Dilatation and Volvulus Gastric Dilatation and Volvulus
(GDV) (GDV)
 Abdominal Radiographs  Because endotoxemia may
 The principal goals of initial treatment complicate the disease process,
antibiotics (eg, ampicillin) are often
Abdominal radiographs
are to stabilize the animal and given.
decompress the stomach.
 Gastric decompression should be
accomplished as soon as possible.
 Initial management for shock should  Initially, an attempt should be made to
include the administration of IV fluids pass a well-lubricated orogastric (or
stomach) tube.

Gastric Dilatation and Volvulus

(GDV) Client Education of GDV
 If a tube cannot be readily passed  Dogs with a tendency to develop
dilatation and volvulus should be fed
into the stomach, excess gas may smaller meals more frequently over the
be relieved by inserting a large- course of the day.
bore (16-18 gauge) "over the  Excessive exercise should be avoided to
needle" catheter into the stomach decrease the likelihood of volvulus, and
percutaneously. consumption of large volumes of water
after exercise should be avoided to limit
 surgical techniques gastric distention.
 Gastropexy, others

Periodontal Disease
 Bacterial infection of the tissue
Periodontal Disease surrounding the teeth causes
inflammation of the:
 Gingivae, periodontal ligament, cementum,
and alveolar bone

 Ultimately, teeth are lost due to the loss

of their supporting tissues. This is the
major reason for tooth loss in dogs.

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Periodontal Disease Periodontal Disease
 Periodontal disease is caused by gross  In periodontitis, the destructive
accumulation of many different bacteria inflammatory process of the
at the gingival margin due in part to a periodontium is induced and driven by
lack of proper oral hygiene. bacterial plaque that contains specific
bacteria that destroy the gingiva,
periodontal ligament, alveolar bone,
 In gingivitis, the inflammation of the and root cementum.
marginal gingival tissues is induced by  It usually occurs after years of plaque,
calculus, and gingivitis.
bacterial plaque and does not affect the
peridontal ligament or alveolar bone.  It is irreversible and results in
permanent loss of tooth support.

Periodontal Disease Periodontal Disease

 Gingivitis usually can be treated  Periodontitis needs to be treated with
by thorough cleaning of the teeth, thorough cleaning above and below the
including below the gingival gum line. In areas of increased
subgingival depth (>4 mm), surgical
margin. means (usually gingivectomy) should
be used to gain access to the root
surface for cleaning.

Periodontal Disease
 Teeth can generally be salvaged
until they have lost 75% of their Any Questions?
bone support from one or more
roots.
 Otherwise, tooth needs to be extracted

 This can be evaluated by

radiography of the jaws.