Difference between revisions of "Gastric Motility Disorders"

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{{unfinished}}
 
 
{{dog}}
 
{{cat}}
 
 
 
==Signalment==
 
==Signalment==
 
Can affect both dogs and cats.
 
Can affect both dogs and cats.
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*electrolyte or acid-base imbalances
 
*electrolyte or acid-base imbalances
 
*uraemia
 
*uraemia
*hypothyroidism
+
*[[Hypothyroidism|hypothyroidism]]
*hepatic encephalopathy
+
*[[Hepatic Encephalopathy|hepatic encephalopathy]]
*pancreatitis
+
*[[Pancreatitis|pancreatitis]]
*inflammation or ulceration of the stomach
+
*[[Gastric Ulceration - Dog|gastric ulceration]] and inflammation
 
*anticholinergic drugs and narcotic analgesics used to treat vomiting and diarrhoea
 
*anticholinergic drugs and narcotic analgesics used to treat vomiting and diarrhoea
 
*idiopathic
 
*idiopathic
 +
 
==Diagnosis==
 
==Diagnosis==
+
Diagnosis of gastric motility disorders is usually made once other causes of vomiting have been ruled out. The normal gastric emptying time of a dog is 10-12 hours. Therefore, a dog that vomits an undigested meal more than twelve hours after feeding should be strongly suspected of having a gastric motility disorder if an outflow obstruction and inflammatory disease have been excluded.
 +
 
 
===Clinical Signs===
 
===Clinical Signs===
===Laboratory Tests===
+
*chronic belching and vomiting
 +
*anorexia
 +
*weight loss
 +
*poor body condition
 +
 
 
===Radiography===
 
===Radiography===
===Biopsy===
+
*Contrast radiography may support a diagnosis of a gastric motility disorder:
===Endoscopy===
+
**Half of the animal's daily caloric requirement should be fed as canned food mixed with 5% by weight of barium sulphate. Radiographs are taken every hour until the stomach is empty. This amount of food is normally emptied by the stomach in 5-8 hours. If food is still present after this time, a motility problem is suggested.
 +
*Fluoroscopy studies may be used to assess gastric motility.
 +
 
 +
===Special Diagnostic Techniques===
 +
A definitive diagnosis of gastric motility disorders requires special diagnostic techniques that are not often available. These include measurement of gastric electrical and contractile activity as well as radio-isotope studies.
 +
 
 
==Treatment==
 
==Treatment==
 +
Underlying causes of vomiting should be addressed first.
 +
Drugs that promote gastric peristalsis/motility may be administered once a diagnosis of a gastric motility disorder has been reached. Several drugs have been proposed and may include:
 +
*Cisapride (30 minutes before each meal)
 +
**reduces tachygastria
 +
**increases tone and amplitude of gastric contractions
 +
**relaxes the pyloric canal
 +
**increases contraction in the proximal small intestine
 +
*[[Macrolides and Lincosamides|Erythromycin]]
 +
**acts on smooth muscle motilin receptors to increase gastric contractility
 +
*Metoclopramide
 +
**increases gastric peristalsis
 +
 
==Prognosis==
 
==Prognosis==
 +
Animals that respond well to medical management have a good prognosis. Those who respond poorly to medical treatment have a poor prognosis.
  
 
==References==
 
==References==
 +
 +
*Hall, E.J, Simpson, J.W. and Thomas, D. (2005) '''BSAVA Manual of Canine and Feline Gastroenterology (1st Edition)''' ''BSAVA'' Page 109
 +
 +
*Nelson, R.W. and Couto, C.G. (2009) '''Small Animal Internal Medicine (Fourth Edition)''' ''Mosby Elsevier'' Page 427
 +
 +
 +
 +
[[Category:Stomach_and_Abomasum_-_Pathology]][[Category:To_Do_-_Alimentary]][[Category:Gastric Diseases - Dog]]
 +
[[Category:Gastric Diseases - Cat]][[Category:To Do - Medium]]

Latest revision as of 13:38, 3 May 2011

Signalment

Can affect both dogs and cats.

Description

Abnormal gastric motility has been cited as a contributing factor of conditions such as gastric dilatation-volvulus and gastric outflow obstruction that has resulted from pylorospasm. Many potential causes of gastric stasis have been proposed:

Diagnosis

Diagnosis of gastric motility disorders is usually made once other causes of vomiting have been ruled out. The normal gastric emptying time of a dog is 10-12 hours. Therefore, a dog that vomits an undigested meal more than twelve hours after feeding should be strongly suspected of having a gastric motility disorder if an outflow obstruction and inflammatory disease have been excluded.

Clinical Signs

  • chronic belching and vomiting
  • anorexia
  • weight loss
  • poor body condition

Radiography

  • Contrast radiography may support a diagnosis of a gastric motility disorder:
    • Half of the animal's daily caloric requirement should be fed as canned food mixed with 5% by weight of barium sulphate. Radiographs are taken every hour until the stomach is empty. This amount of food is normally emptied by the stomach in 5-8 hours. If food is still present after this time, a motility problem is suggested.
  • Fluoroscopy studies may be used to assess gastric motility.

Special Diagnostic Techniques

A definitive diagnosis of gastric motility disorders requires special diagnostic techniques that are not often available. These include measurement of gastric electrical and contractile activity as well as radio-isotope studies.

Treatment

Underlying causes of vomiting should be addressed first. Drugs that promote gastric peristalsis/motility may be administered once a diagnosis of a gastric motility disorder has been reached. Several drugs have been proposed and may include:

  • Cisapride (30 minutes before each meal)
    • reduces tachygastria
    • increases tone and amplitude of gastric contractions
    • relaxes the pyloric canal
    • increases contraction in the proximal small intestine
  • Erythromycin
    • acts on smooth muscle motilin receptors to increase gastric contractility
  • Metoclopramide
    • increases gastric peristalsis

Prognosis

Animals that respond well to medical management have a good prognosis. Those who respond poorly to medical treatment have a poor prognosis.

References

  • Hall, E.J, Simpson, J.W. and Thomas, D. (2005) BSAVA Manual of Canine and Feline Gastroenterology (1st Edition) BSAVA Page 109
  • Nelson, R.W. and Couto, C.G. (2009) Small Animal Internal Medicine (Fourth Edition) Mosby Elsevier Page 427