Don’t be your own enemy “If there is no enemy within, the enemy outside can do us no harm.” -Les Brown

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 GastritisAcute Gastritis

◦ Commonly seen in dogs Spoiled food Change in diet Food allergy Infections (bacterial, viral, parasitic) Toxins (chemicals, plants, drugs, organ failure) Foreign objects

◦ Signs Anorexia Vomiting (maybe dehydration) Painful abdomen Hx of diet change, toxin ingestion, infection, parasites

Acute Gastritis Dx

◦ Hx and PE

◦ CBC, Chem Panel to assess dehydration, metabolic imbalance, organ failure

Rx

◦ NPO until vomiting stops

4-6 sips of water q1h

Fluid therapy (SQ or IV)

◦ Gradually start feeding

Bland food (Hill’s I/D, boiled chicken/rice)

◦ Antiemetics

Maropitant (Cerenia)

Metoclopramide (Reglan)

◦ Coating agents

Sucralfate

◦ H2-blockers (famotidine, ranitidine, cimetidine)

◦ Antibiotics—often prescribed, rarely needed

Acute Gastritis

Client info

Avoid abrupt changes in dietGradually mix new food in with old (1 wk)

If pet vomit 2-3 times, NPO x 24 h; if it continues see vet

Dogs and cats do not need variety

Immune-Mediated Inflammatory Bowel Disease (Chronic gastritis, Enteritis, Colitis)

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

Clinical Signs Chronic vomiting, wt loss Diarrhea, straining to defecate, mucus in stool

Immune-Mediated Inflammatory Bowel Disease (Chronic gastritis, Enteritis, Colitis)

Diagnosis Fecal to r/o parasites CBC, Chemistry panel, urinalysis to r/o metabolic

disorder FeLV, FIV to r/o those diseases Endoscopy of stomach, SI, and colon, and

biopsy for definitive diagnosis

Treatment Azathioprine—immunosupressant Cyclophosphamide—inhibits immune system response Sulfasalazine—a sulfa drug with

anti-inflammatory/antibacterial effects Most effective against colitis

Metronidazole Prednisone Hypoallergenic diet

Free from preservative, additives

Highly digestible protein (rabbit, lamb, duck, chicken)

Homemade diets with rice base

Some commercial diets are available

Immune-Mediated Inflammatory Bowel Disease (Chronic Gastritis, Enteritis, Colitis)

Inflammatory Bowel Disease

Client infoDefinitive diagnosis is through biopsyLife-long conditionImmunosuppressive drugs have side-

effects (PU/PD/PP, wt gain, skin/urinary infections)

Use lowest dose that provides effect

Stomach Diseases:Gastric UlcerationUsually a result of long-term NSAIDs (aspirin, ibuprofen,

phenylbutazone) Signs

Vary from asymptomatic to vomiting

blood Anemia, edema Melena Anorexia Abdominal pain Septicemia if perforation occurs

Gastric Ulceration

Dx

X-ray using contrast medium (Barium) to show ulceration in stomach lining (caution if perforation is suspected)

Endoscopy

Gastric Ulceration

Rx

◦ Fluid therapy for dehydration

◦ NPO (as before)

◦ Coating agents/antacids

◦ Cimetidine—H2 antagonist (↓ HCl production)

◦ Omeprazole—↓ HCl production (proton-pump inhibitor)

Client info

◦ Do not use NSAIDs without veterinary supervision

◦ Give NSAIDs with meal/antacids

Stomach Diseases: Gastric Dilatation/Volvulus

Primarily a disease of large, deep-chested dogs (2-10 yrs)

Dilation—gas filled; Volvulus—twisted along longitudinal axis Cause: Food/exercise? Etiology unclear

Signs

◦ Abdominal pain/distension

◦ Weakness, collapse, depression, nausea, salivation

◦ Increased HR, RR – may lead to arrhythmias

Gastric Dilatation/Volvulus


Stomach Diseases: GDV

Diagnosis◦ PE shows depressed, weak animal with dpoor

perfusion (↑CRT)

◦ X-rays show air filled stomach- “double-bubble”

◦ ECG may show vent arrhythmia or sinus tachycardia

◦ CBC and Chem panel necessary to assess electrolyte levels and pH imbalances

Gastric Dilatation/Volvulus Treatment

◦ Goals

Decompress stomach◦ Pass stomach tube◦ 18 gauge needle

Stabilize patient (fluids, electrolytes, ECG)◦Rx for shock

IV fluids

Corticosteroids

◦Antibiotics Prepare for Sx

◦ Surgery ASAP



Post-OpECGBlood pressurePain managementMonitor urine outputAntibioticsMaintain fluids (oral, IV)

Client info

Avoid large mealsLimit exercise after mealsFeed high-quality protein dietTack-down procedure not 100%

preventative


Gastric Neoplasia

Most common malignant neoplasia in dogs is adenocarcinoma; in cats lymphoma

Signs

Wt loss Vomiting w/ or w/o blood Obstruction Usually seen in older animals

Dx

Endoscopy and biopsy for diagnosis X-ray with Barium contrast

Treatment

Surgery is treatment of choiceMany tumors are too far advanced (inoperable)

Chemotherapy Radiation less successful for gastric tumors

Client info

Prognosis is poor; gastric neoplasia is a fatal disease

Supportive care, control of vomiting, good nutrition are needed for these animals

Gastric Neoplasia

Documents

Don’t be your own enemy “If there is no enemy within, the enemy outside can do us no harm.” -Les Brown