GI Disorders

• Vomiting


  active

  behavioural changes before - salivating, pacing etc

  abdominal effort

  food, bile etc

  protective mechanism

  can lead to fluid and electrolyte loss
• Vomiting causes


  GIT (primary) - diet, infectious disease e.g., salmonella, ulceration

  systemic disease (secondary) - renal, hepatic, pancreatitis

  metabolic - addisions disease

  drugs and toxins - NSAIDs, chemotherapy
• Vomiting treatment 


  acute - starve for 24hrs or until vomiting stops, fluid and electrolyte replacement, anti-emetics

  chronic - treat underlying cause, supportive therapy e.g., IVFT, analgesia, anti-emetics
• Vomiting nursing care 


  isolation and barrier nursing - infectious disease

  pain scoring

  administration of medication - parenteral (not oral)

  nutrition and fluid therapy

  good hygiene, grooming

  monitoring parameters and vomiting - colour, quantity, change
• Regurgitation


  passive

  no behavioural changes

  no abdominal effort

  undigested food - no bile
• Regurgitation causes


  megaoesophagus

  oesophagitis

  oesophageal foreign body

  oesophageal stricture

  persistent right aortic arch

  hiatal hernia

  neuromuscular disease
• Megaoesophagus


  dilated oesophagus
• Oesophagitis


  inflammation of the oesophagus
• Oesophageal stricture


  narrowing of oesophagus
• Persistent right aortic arch (PRAA)

  a vessel that should break down in a foetus, it goes around the oesophagus, if this does not break down it will constrict the oesophagus, congenital in German shepherds
• Hiatal hernia


  part of the stomach herniates into the thoracic cavity
• Regurgitation diagnostics


  radiography - plain, barium

  oesophagoscopy

  blood tests
• Regurgitation treatment


  megaoesophagus - medical management, relates to feeding

  oesophagitis - analgesia and gastroprotectants

  foreign body - removal

  stricture - surgery, ballooning

  PRAA - surgical ligation
• Regurgitation nursing care


  monitor breathing - risk of aspiration pneumonia

  pain scoring

  administration of medication

  IVFT

  hygiene, grooming

  nutrition - feed from a height and keep patient upright 10-15mins
• Diarrhoea - dogs and cats

  GIT (primary) - dietary, viral e.g., parvovirus, salmonella, inflammation

  systemic disease (secondary) - hepatic, renal, hyperthyroidism
• Small intestine


  common weight loss and vomiting

  no tenesmus

  increased faecal volume

  no faecal mucous

  haemathochezia

  rare flatulence
• Large intestine


  rare weight loss and vomiting

  common tenesmus

  normal faecal volume

  haemathochezia

  common flatulence
• Haematochezia


  passage of fresh blood through the anus
• Acute diarrhoea


  acute enteritis

  recent research suggests continuing to feed as cells are unable to heal if they do not have the needed nutrients

  food should be bland, easy to digest with a gradual reintroduction of normal diet

  IVFT - replace fluid loss
• Acute enteritis


  the sudden onset of vomiting and diarrhoea
• Chronic diarrhoea 


  inflammatory bowel disease

  neoplasia, helminths, colitis
• Helminths


  worm-like parasites
• Colitis


  digestive disease that cause inflammation of the colon
• Diarrhoea treatment


  depends on underlying cause

  diet trial

  anthelmintic

  antibiotics

  steroids/immunosuppressants

  enzymes supplements

  surgery
• Diarrhoea diagnostics


  blood tests - routine, specific e.g., cobalamin (B12)

  faecal analysis - blood, parasites

  imaging - radiography, ultrasound, endoscopy

  exploratory laparotomy

  biopsy
• Exploratory laparotomy 


  used to diagnose or further investigate problems inside the abdomen that could not be achieved via pre-operative diagnostics
• Diarrhoea nursing care


  isolation and barrier nursing - infectious disease

  pain score

  administration of medication

  hydration - oral vs IVFT

  nutrition

  toileting regularly

  hygiene and grooming

  monitor weight

  reduce stress
• Constipation


  infrequent passage of faeces
• Constipation causes


  diet

  megacolon

  prostatic disease

  perineal hernia

  orthopaedic or neurological disease - can make it painful to toilet

  dehydration

  obstruction
• Megacolon


  dilated colon
• Perineal hernia


  weakening or failure of the muscular diaphragm of the pelvis
• Constipation diagnostics

  clinical exam and history

  rectal exam

  imaging - radiography, ultrasonography, colonoscopy
• Constipation treatment


  enemas

  high fibre diet

  laxatives - lubricants, osmotic, stimulant

  increased exercise

  hydration
• Constipation nursing care

  pain score

  hydration

  nutrition

  administer enemas

  administer medication

  hygiene, grooming
• Megacolon


  lack of motor function of the colon

  colon is impacted but no tenesmus seen

  faeces may occasionally drop from the rectum

  mostly seen in cats
• Pancreatic disease


  self-digestion of the pancreas by digestive enzymes
• Risk factors of pancreatitis

  breed - schnauzers and yorkies

  age - older

  weight - obesity

  diet - high fat

  hypotension
• Pancreatitis clinical signs


  anorexia - they do not want to eat due to pain in abdomen

  vomiting

  lethargy

  abdominal pain

  pyrexia
• Pancreatitis diagnosis


  blood tests - routine haematology and biochem, canine/feline pancreatic lipase is more reliable

  imaging - ultrasound
• Acute pancreatitis treatment


  nutrition

  IVFT

  analgesia

  anti-emetics, anti-oxidants