Difference between revisions of "Gastric Motility Disorders"
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==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 | + | *[[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- | + | 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. |
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===Clinical Signs=== | ===Clinical Signs=== | ||
*chronic belching and vomiting | *chronic belching and vomiting | ||
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*poor body condition | *poor body condition | ||
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===Radiography=== | ===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. | ||
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| + | ===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. | ||
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==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 | ||
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| + | *Nelson, R.W. and Couto, C.G. (2009) '''Small Animal Internal Medicine (Fourth Edition)''' ''Mosby Elsevier'' Page 427 | ||
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| + | [[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:
- nervous inhibition due to pain or trauma
- electrolyte or acid-base imbalances
- uraemia
- hypothyroidism
- hepatic encephalopathy
- pancreatitis
- gastric ulceration and inflammation
- anticholinergic drugs and narcotic analgesics used to treat vomiting and diarrhoea
- idiopathic
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