what is prognosis for HGE patient? recurrence? what are poor prognostic indicators?
good prognosis for most patients if treated early/aggressively
recurrence is possible
poor indicator if hypoproteinemic or septic
what is the most common etiology for chronic gastritis? second most common?
(both defined as immune mediated, although specific cause rarely determined-occult parasite, food allergy, immune rx to unknown pathogen)
How do you diagnose chronic gastritis?
when other causes of chronic vomiting ruled out AND *biopsy confirms inflammation*
what may be the ONLY clinical sign with chronic gastritis patient? what percent are asymptomatic?
In addition to MDB, what other routine tests should be run when trying to rule out other causes of chronic gastritis (esp. in cats)?
what do you expect to see when scoping a chronic gastritis patient?
hemorrhages on mucosa
Before definitive diagnosis, you can try to treat suspected chronic gastritis with dewormers and dietary therapy. Once histopath results confirm your suspicion, what is your treatment plan? what is your goal?
steroids or other immunosuppressants
goal to manage, not cure (good prognosis w/lymphocytic/plasmocytic and eosinophilic in dogs)
What percentage of clinically healthy cats/dogs test positive for Helicobacter organisms? Why is this significant?
~40-100% of healthy dogs/cats are positive
~60-100% of vomiting dogs/cats are positive
*presence of organism does not equate with disease*
cause and effect uncertain
what is the most common clinical feature associated with Helicobacter disease?
most are asymptomatic
(can see nausea, vomiting, anorexia)
what is treatment suggested for helicobacter associated disease?
*multiple combinations suggested*
Physaloptera rara, nematode that attaches to stomach wall, causes vomiting in dogs. What is worm burden required to see these signs? is this a happy or sad vomiter?
only *one worm* can cause clinical signs so even if don't see the worm, *treat* with fenbendazole (emperical deworming)
-pt is otherwise BAR/happy
Is Chronic hypertrophic pyloric gastropathy (aka pyloric stenosis) more commonly a congenital or acquired problem? more common in dogs or cats?
acquired (cause unknown)
what are the three types of acquired chronic hypertrophic pyloric gastropathies?
1-circular muscle hypertrophy
2-muscle hypertrophy + mucosal hyperplasia
3-primarily mucosal hyperplasia
which breeds are more commonly associated with acquired pyloric stenosis? what age?
lhasa apsa, pekingese, shihtzu, poodle
Is patient with chronic hypertrophic pyloric gastropathy a "happy" or "sick" vomiter? Will patient have metabolic acidosis or alkalosis?
happy- vomit shortly after eating but otherwise BAR
metabolic alkalosis (vomiting HCl- and kidney retains bicarb)
how is pyloric stenosis definitively diagnosed? what is treatment when its confirmed?
histopath to confirm - complex surgery
(can see stenosis on scope/ultrasound but need biopsy to confirm there is no inflammation/infiltrates associated)
what are findings with MDB if patient has high/pyloric obstruction?
Will most foreign bodies pass on their own or need to be removed?
most need to be removed
When the stomach dilates excessively and rotates, what is usually the direction of rotation?
pylorus rotates from right, passes underneath the stomach and ends up dorsal to gastric cardia on left side
Does being offspring of parents who had GDV put the dog at higher risk? does being older or younger increase risk?
yes, offspring incr. risk
older incr. risk
what will be MDB findings on GDV patient? What about coagulation tests?