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16 Cards in this Set
- Front
- Back
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what diagnostic aids are available for gastrointestinal disease
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endoscopy
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Indications for an enema
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constipation or obstipation
to prepare for colonoscopy or radiographic studies to administer radiographic contrast material or medication (diazepam, lactulose) to irrigate the colon in certain types of poisoning |
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What are the potential complications of an enema and how do you prevent them?
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Rupture of diffusely diseased descending colon and septic abdomen
Vomiting due to gastrocolic reflex; can result in aspiration pneumonia ADMINISTER FLUIDS SLOWLY |
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How would you perform an enema?
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Use 10-20 mL/kg (~60mL per any cat) of anything from warm water to cathardics.
DO NOT USE FLEET ENEMAS - phosphate containing Insert a red rubber catheter 2cm into the anus and SLOWLY infuse Immediately place animal in an area where it can defecate Can give enemas every 4 to 6 hours as needed, but keep volume in mind (they will absorb some of it across the mucosa) |
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what is a 'high colonic' enema?
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Tube inserted into the ascending or transverse colon.
Must measure from anus to just caudal to the last rib (cranial abdomen) LUBRICATION is important |
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Indications for orogastric intubation
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GDV
gastric lavage for overdose or poisoning to administer medication or contrast materials nutritional support to remove fluid or acid from the stomach |
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Possible complications of orogastric intubation
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- placement and administration of fluids into the respiratory tract
- gastric perforation - trauma to pharynx, larynx or esophagus |
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Procedure for placing a nasogastric tube
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- Measure from canine teeth to level of the last rib (mark the tube)
- Lubricate to facilitate passage through oropharynx into esophagus - Use tape for a mouth gag - Gently advance tube through oropharynx, down esophagus and into stomach |
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how do you know your nasogastric tube is in the right place?
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- Feel for two tubes - trachea and esophagus
- Blow on tube and see if you hear gurgling in the stomach - Smells like gastric contents - Observe for cough - hard to get it into the trachea without making the dog cough |
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What are differentials for inability to pass a nasogastric tube?
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1. inserted into the trachea
2. esophageal obstruction 3. 360 degree GDV |
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What are the indications for nasoesophageal intubation?
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- Deliver radiographic contrast material (easier to place, esp in cat)
- Deliver medications to a fractious animal - Short term nutritional support |
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Complications of nasoesophageal intubation
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- dislodgement
- much easier to accidently intubate the respiratory tract without making the animal cough |
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How would you place a nasoesophageal tube?
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- apply proparicaine into nose
- measure from nares to 7th ICS - for cats - go ventral and medial to go through the nasal cavity - for dogs - go dorsal for 2 cm, then ventromedial, when you hit the meatus, steer around it - want to make sure it stays in place - suture, glue or staple it to the head - radiograph it to make sure you've placed it correctly |
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indications for a nasopharyngeal exam
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any patient with upper respiratory, proximal GI or oral disease
- specific indications - dysphagia, upper respiratory stridor, frequent or chronic sneezing, stertor or nasal discharge |
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what equipment do you need fora nasopharyngeal exam?
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dental mirror with a light source and a snook hook
General anesthesia |
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how would you perform a nasopharyngeal exam?
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once the animal is under GA, palpate the pharynx using a gloved finger.
- pull the tongue rostrally - insert dental mirror into the oropharynx, just caudal to the soft palate - use the snook hook to gently retract the soft palate rostrally |
