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 |
| − | * | + | *hepatic encephalopathy |
| − | * | + | *pancreatitis |
| − | * | + | *inflammation or ulceration of the stomach |
*anticholinergic drugs and narcotic analgesics used to treat vomiting and diarrhoea | *anticholinergic drugs and narcotic analgesics used to treat vomiting and diarrhoea | ||
*idiopathic | *idiopathic | ||
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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. | 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 | *chronic belching and vomiting | ||
*anorexia | *anorexia | ||
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===Special Diagnostic Techniques=== | ===Special Diagnostic Techniques=== | ||
| − | A definitive diagnosis of gastric motility disorders requires special diagnostic techniques that are not often available. These include measurement of gastric | + | A definitive diagnosis of gastric motility disorders requires special diagnostic techniques that are not often available. These include measurement of gastric eradio-isotope studies and |
==Treatment== | ==Treatment== | ||
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**relaxes the pyloric canal | **relaxes the pyloric canal | ||
**increases contraction in the proximal small intestine | **increases contraction in the proximal small intestine | ||
| − | * | + | *Erythromycin |
**acts on smooth muscle motilin receptors to increase gastric contractility | **acts on smooth muscle motilin receptors to increase gastric contractility | ||
*Metoclopramide | *Metoclopramide | ||
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==Prognosis== | ==Prognosis== | ||
Animals that respond well to medical management have a good prognosis. Those who respond poorly to medical treatment have a poor prognosis. | Animals that respond well to medical management have a good prognosis. Those who respond poorly to medical treatment have a poor prognosis. | ||
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==References== | ==References== | ||
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*Nelson, R.W. and Couto, C.G. (2009) '''Small Animal Internal Medicine (Fourth Edition)''' ''Mosby Elsevier'' Page 427 | *Nelson, R.W. and Couto, C.G. (2009) '''Small Animal Internal Medicine (Fourth Edition)''' ''Mosby Elsevier'' Page 427 | ||
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Revision as of 15:15, 24 August 2009
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This article is still under construction. |
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
- inflammation or ulceration of the stomach
- 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 eradio-isotope studies and
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