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30 Cards in this Set
- Front
- Back
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Vomiting
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Vomiting
#1 Step – Differentiate between Dysphagia v. Regurgitation v. Vomiting • Dysphagia – drooling, ptyalism, exaggerated swallowing movements, multiple attempts at swallowing, head an neck is extended, drops food, may see respiratory signs b/c of aspiration • Regurgitation – same signs as above but food comes back up, may be delayed up to hours, may be tubular form; caused by esophageal disease; may see respiratory signs b/c of aspiration • Vomiting – neural reflex initiated by CTZ, forceful; expulsion of ingesta outward, nausea (prodomal signs), restlessness, hypersalivation, aspiration rarely occurs Dysphagia • drooling, ptyalism, exaggerated swallowing movements, multiple attempts at swallowing, head an neck is extended, drops food, may see respiratory signs b/c of aspiration • Three phases of swallowing: a. Oral – voluntary prehension and bolus of food into the oropharynx b. Pharyngeal – contraction of pharyngeal muscles & movement to the crycopharyngeal sphincter; inhibition of respiration c. Crycopharyngeal – relaxes crycopharyngeal sphincter and moves along bolus d. Esophageal – closes crycopharyngeal sphincter and initiates 1 and 2 peristaltic waves, releaxes esophageal sphincter e. Gastroesophageal phase – relaxes LES as bolus approaches and rapidly closes LES after bolus passes • Nerves involved in swallowing: V (facial, motor), VII (trigeminal, sensory), IX (glossopharyngeal), X (vagus), XII (hypoglossal) Diseases of the pharynx: a. RABIES b. Obstructive disease of brachycephalics c. Pharyngeal mucocele d. Nasopharygneal polyp e. Foreign body f. Neoplasia/granuloma g. Neuromuscular dysphagia - central lesion in the brainstem, peripheral neuropathy (botulism, tetanus, polyradiculoneuritis, tick paralysis), Myasthenia gravis h. Hypothyroidism i. Pharyngitis j. Abscess k. Trauma |
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Regurgitation
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Regurgitation
• same signs as above but food comes back up, may be delayed up to hours, may be tubular form; caused by esophageal disease; may see respiratory signs b/c of aspiration • Usually indicative of esophageal disease • In the dog, striated muscle is throughout the entire length of the esophagus • In the cat, there is striated muscle in the proximal 2/3, and smooth muscle in the distal 1/3 • Innervated by the vagus • During the esophageal phase of swallowing (see above) sensory receptors stimulate nucleus solitarius – a defect here may be responsible for idiopathic megaesophagus Diseases of the esophagus a. Esophagitis b. Spirocirca lupi c. Foreign body d. Vascular ring anomaly – Persistent right aortic arch, double aortic arch, anomalous left subclavian artery, aberrant right subclavian artery e. Stricture (sx, foreign body, trauma, caustic agents, esophagitits f. Extraluminal obstruction – mediastinal mass, thryoid tumors, SqCC, foreign body abscess, fungal granuloma, heart base tumors, thymomas, hialar lymphadenopathy g. Hiatal hernia - h. Diverticulum – pulsion, traction i. Bronchial esophagial fistula j. Megaesophagus – Congenital, acquired, idiopathic - Myasthenia gravis - Hypoadrenocorticism - Hypothyroidism - Systemic lupus or other immune-mediated dz - Toxin – lead, thallium, cholinesterase inhibitors such as Atropine or glycopyrollate - Peripheral neuropathy – botulism, tetanus, polyradiculoneuritis, tick paralysis - Canine distemper - Polymyositis – toxoplasmosis, neosporum - Thymoma - Dysauromia k. Toxins, caustic agents l. Neoplasia – Sarcomas from Spirocirca lupi infection, SqCC, osteosarcoma, fibrosarcoma, carcinoma, leiomyomas Dx 1. PE and history 2. Neuro exam 3. Survey films 4. Esophagram 5. Fluoroscopy 6. Endoscopy 7. Esophageal manometry Tx Metochlopramide (Reglan) stimulates distal esophageal peristalsis Anticholinergics (Atropine) decreases LES pressure Calcium channel blocker (Nifedipine) decreases LES pressure |
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Vomiting
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Vomiting
• Controlled by CTZ of the medulla • If comes from the pylorus, then H+ are loss and induces a metabolic alkalosis • If comes form the proximal duodenum, then water and electrolytes are lost • If comes from the distal small intestine, then loss of bicarb, and acidosis can occur DDx 1. Enteritis – Non-specific acute gastritis 2. Gastritis 3. Diet 4. Parasites – young animals 5. Gastric or intestinal obstruction 6. Pancreatitis – trypsinogen (along with phospholipase A, elastase, lipase and colipase) is activated causing autodigestion of pancreas 7. Liver dz – nitrogenous waste productes causes GI ulceration 8. Hypoadrenocorotism – Addisons; glucocorticoid deficiency V+ 9. Hypercalcemia 10. Uremia 11. DKA a. diabetic ketoacidosis; insulin resistance b/c in diabetogenic hormones (epinephrin, glucagon, cortisol, growth hormone, FFAs, AA, metabolic aciodsis b. This stimulates lipolysis which induces a ketogenesis and gluconeogenesis causing a hyperglycemia 12. Hyperthyroidism 13. Feline heart worm dz – chronic V+ in the cat 14. Colitis 15. Gastrinoma – Zollinger-Ellison syndrome 16. Gastric/duodenal ulcers 17. Neoplasia – gastric, intestinal, liver, pancreas 18. Chronic renal failure – uremic toxins serum gastrin which irritates the stomach 19. Parvo – Ondansetron is a good choice Tx • Fluids (Ringers for acidosis, Saline for alkalosis) • NPO, then water and bland diet • Remove offending agent • Antiemetics (BAD MOP) a. Chlorpromazine (thorazine) b. Prochlorpromazine c. Metochlopramide (Regland) d. Butorphanol e. Ondansetron – good for Parvo • Antacids a. H2 blockers (Cimetidien, Ranitindin, Famotidien b. Proton pump inhibitor – Omeprazole • Atropine – don’t use b/c paralyzes the gut and creates an ileus • Antibiotics – melena or hematemesis (proof of breakdown of mucosa integrity) • Cytoprotecitve agents – ulcer tx a. Sucralfate b. Misoprostel – PGE analog, good for NSAID –induced ulcers |
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Otitis externa/media
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Otitis externa/media
• Otitis media often occurs as an extension of otitis externa through a ruptured tympanic membrane • Can cause damage to vestibulocochlear nerve (CN 8) • Cerumen (aprocrine) glands in external ear canal produces wax • Often secondary to underlying dz a. excessive moisture (swimming) b. improper cleaning solutions c. parasites – otodectes cynotis, Demodex, Sarcoptes and Notoedres, Otobius megini d. allergies e. Foreign bodies – grass awns f. obstruction – neoplasia, polyps, cerumen gland hyperplasia, accumulationof hair g. Keratinization disorders – seobrrhea, increased cerumen produciton • Signs: a. Ear pain b. Redness, swelling c. Scaling and exudation d. Malodor e. Head tilt – vestibular signs f. If media/interna is affected: - nerve damage facial nerve (CN 7) to ophthalmic branch causing lack of tear production and parasympathetic branch causing gastrointestinal signs via ipislateral rostral 2/3 of tongue - V+ and nausea - Horners syndrome and anisocoria and/or protrusion of third eyelid - Tympanic membrane is gray, dull, opaque and bulging indicating middle ear exudate - Pain on opening mouth - Corneal ulcer b/c can’t blink eye • Tx by dx underlying dz |
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What is the relationship between large dogs and small dogs with hydration
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What is the relationship between large dogs and small dogs with hydration
Not a linear relationship The larger the animal, the less proportionally they need in calories and water |
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What is maintenance fluids for small animals
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What is maintenance fluids for small animals
66 ml/kg However, as the previous question states, may be too much for large dogs |
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What is surgical hydration infusion for small animals
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What is surgical hydration infusion for small animals
11-22 ml/kg/hr |
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What is BER
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What is BER
Basal (resting) Energy requirement – usually 12 hours after feeding, following sleep and a thermoneurtral condition BER = 30 x Kgbw + 70 BER = 70 x Kgbw0.75 Second one is much more accurate |
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What is MER
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What is MER
Maintenance (daily) energy requirement Adds needs for moderate activity of gathering food MER (dog) = 1.8 x BER MER (cat) = 1.4 x BER |
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What is TER
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What is TER
Total Energy Requirement Includes ‘life factors’ TER (hospitalized) = BER x Illness factor TER (at home) = MER x Illness factor |
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What is the illness factor for sepsis
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What is the illness factor for sepsis
1.2 |
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Why try to feed the least calories
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Why try to feed the least calories
Cost |
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Which life factor is the highest
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Which life factor is the highest
Sledding Peak lactation |
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What is important to remember when feeding a kitten
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What is important to remember when feeding a kitten
Stomach has very small volume so must increase the density of the food |
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What is a neutraceutical
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What is a neutraceutical
Potential, rather than established benefit Ex: Herbs, vitamins, immunomodulators, performance enhancers, chondroprotecive agents |
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What are the special amino acid requirements for dogs and cats
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What are the special amino acid requirements for dogs and cats
Dogs need: Arginine Glutamine – enterocyte health via chyme coating Butyrate – bacterial fermentation for fiber Linoieic and alpha linoleic acid – fats Eicosapentaenoic Cats – Taurine |
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What are the energy comparisons of protein, fat and CHO
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What are the energy comparisons of protein, fat and CHO
Protein – 4 Kcal/gm Fat – 9 Kcal/g CHO – 4 Kcal/g |
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What are the protein requirements for dogs and cats
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What are the protein requirements for dogs and cats
Dogs = 4g/kg/day Cats = 6 g/kg/day |
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What is the ideal BCS for small animals
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What is the ideal BCS for small animals
3/5 |
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True tapeworms & Pseudotapeworms (Cestodes)
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True tapeworms & Pseudotapeworms (Cestodes)
• Eucestoda – true tapeworms • Coyloda – pseudotapeworms • Hermaphroditic • Always endoparasites • Adults always in GI tract • Lack alimentary tract –take food via absorption through body wall • Great variety in size |
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Tapeworm Body
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Tapeworm Body
1. Scolex – head • 4 suckers called acetabula • Armed – if has hooks or rostellum (retractable nose which may be covered with backward facing hooklets • Unarmed – if scolex used to anchor the adult tapeworm in place of small intestine 2. Neck – germinal region from which rest of body will develop 3. Strobila – segments called proglottids, each contain both femail and male repro organs as they grow futher from scolex, the more mature and developed the scolex gets. • Immatrue proglottids – most proximal, contain immature, non-functioning repro organs • Mature proglottids – middle in chain, contain mature, fully functioning repro organs ‘teenagers’ • Gravid proglotids – most distal, farthest away from neck, contain degenerated, non-functioning (atrophied) repro organs. Only organ left is uterus distended with eggs. Some become detached as it is passed out of the feces. Internal organ system 1. Tegument – outer covering, feeding or absorptive structure, lacks a digestive tract 2. Muscular system 3. Excretory system 4. Nervous system 5. Repro system – hermaphroditic |
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Life cycle
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Life cycle
1. Adult - within intestine of definitive host 2. Eggs – proglottids containing eggs are voided in feces of definitive host 3. Metacestode – when ingested by suitable intermediate host, LARVAL TAPEWORM; egg hatches, metacestode migrates to extraintestinal site within intermediate host. 4. Definitive host igests intermediate host containing metacestode stage. Scolex excyst or evaginates and attaches to mucosa of the small intestine. Scolex grows a neck, neck grows the strobila containing proglottids = Adult tapeworm. |
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Developmental stages in the life cycle of tapeworms
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Developmental stages in the life cycle of tapeworms
1. Egg – oncasphere, growth ball fuly embryonated; 3 pr. Of hooklets; embryophore (covering); igested by immediate host; penetrates intestinal wall & migrates to extraintestin 2. Metacestode – immediate host; many types! • Cystecercoid – single scolex; NOT invaginated into itself in a tiny fluid-filled cavity; ‘right side out’ scolex; usually invertebrates such as mites or fleas • Cystecercus – single scolex; invaginated into itself in a large, fluid-filled cavity; ‘Inside out’ scolex; vertebrates such as ruminants, rabbits & mice • Coenurus – Large, fluid-filled cavity with many invaginated scolices; multi-headed cystecercus • Hydated cyst – Large, fluid-filled cavity; develops other cysts called ‘brood capsules’, brood capsules contain protoscolices • Misc metacestode stages (explained later) |
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Horse tapeworms have the following in common
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Horse tapeworms have the following in common
1. Scolex don’t have rostellum or hooks so unarmed 2. Squatty body 3. Oncosphere has 3 coverings; Innermost membrane called Pyriform Apparatus 4. Large animal GI tract is definitive host Exception: Dipylidium caninum – double pored tapeworm does not possess 1-4 above |
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Taeniid-Type Tapeworms
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Taeniid-Type Tapeworms
• Usually large • Usually have proglottids thant are ‘slim-jim’ • Usually armed • Single-pored-only one pore per proglottid • Typical taenid type egg- embryophore is brown with striated appearance, on inside of egg are SIX tiny hooklets • Metacestode stages; 1. Cysticercus 2. Strobilocercus 3. Coenurus 4. Hydatid Cyst • MOST LARVAL METACESTODES WILL BE MORE PATHOGENIC TO INTERMEDIATE HOST THAN ADULT TAPEWORMS ARE TO DEFINITIVE HOST !!!!! |
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Pseudotapeworms (Cotylodans)
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Pseudotapeworms (Cotylodans)
• Bothria - narrow grooves on scolex • One set of male and female repro organs per proglottid, usually in center • Produce operculated eggs – release ciliated hexacanth embryo • 2 intermediate hosts • First intermediate host is Crustacean for metacestode stage Procercoid Second intermediate host is fish or frog for the metacestode |
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Dipylidium caninum
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Dipylidium caninum
• ‘double pored tapeworm’ or ‘cucumber seed tapeworm’ • Small intestine of dogs, cats, humans • Armed, 4 scolexes, 3-4 rows of hooks, 2 sets of male & female repro organs, an individual gravid proglottid resembles seed of cucumber, ea filled with 100s – 1000s of egg packets Each egg packet is filled with 20-30 hexacanth embryos. • Larval fleas • Adult in host; gravid proglottids break from the chain and voided in feces; Proglo rupture, release egg packets, which rupture & disseminating the eggs. Eggs igested by larval fleas; eggs develop to infective cysicercoid stage. Host is infected by igesting cyticercoid . Cysticercoid release the scolex, scolex attaches. • Not very harmful; constipation, D+, Pot-bellied, unthrifty; cause host to ‘scoot’, Gravids can crawl all over the place before releasing eggs. • Visual • YES - zoonotic • Children can ingest fleas or lice containing cysticercoids! |
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Mesocestoides tetrathyridum
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Mesocestoides tetrathyridum tapeworm of dog and other canids
ODD BALL Small intestine of dog or cat, can also be intermediate host;, 2 metacestode stages; Cysticercoid in grain mites, Tetrathyridium in amphibians, birds, rats, dogs and cats Adult: 4 suckers and Unarmed Egg: Lack striated embryo Tretrathyridia look like snow or grits Rats Dogs, cats, rats, humans Adult found in sm intest of def host. Eggs passed on to environment and are ingested by the 1st imm host, coprophagous (feces-eating) mites. Cystercercoids develop. 2nd imm host ingests & tretrathyridum form and multiply asexually by longitudinal splitting. D+ in humans FF Prevent dogs and cats from roaming |
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Diphyllobothrium latum
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Diphyllobothrium latum
“broad fish tapeworm’ Small intestine of dogs, cats, polar bears in N. Europe or Great Lakes Longest tapeworm. ‘Rosette Effect’ – on gravid proglottids, Operculated eggs Crustacean Fish Adult has wide host range in small intestine, eggs contact water and hatch. Produced cilia-coated hexacanth “Coracidium’ 1st host eats and it develops into Procercoid stage. 2nd host ingests & it becomes a Plercercoid stage. Def host eats This tapeworm absormbs a large amt of B-12 from the gut. Lack of this vit produces pernicious anemia. Operculated egg on FF Yes Freeze or cook fish properly |
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Spirometra mansonoides
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Spirometra mansonoides
‘zipper tapeworm’ Small intestine of dogs and cats Body looks like a zipper Eggs are operculated Cyclops species Crustacean Frog, rat or water snake Same as above, only another name for Plercercoid is Sparganum If humans drink water containing the cyclops w/ procercoid, the sparganum will develop in musculature of human, If human eats the musculature of 2nd host contianing sparganum, it will migrate to musculature of human When flesh of frogs, rats or water snakes are used for poultice, can develop sparganum in SQ. Spargana in humans can migrate SQ. FF, can be mistaken for fluke eg Yes (see signs) |
