Difference between revisions of "Gastric Motility Disorders"

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

@@ Line 1: / Line 1: @@
-{{unfinished}}
-{{dog}}
-{{cat}}
 ==Signalment==
 Can affect both dogs and cats.
@@ Line 11: / Line 6: @@
 *electrolyte or acid-base imbalances
 *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
 *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===
-===Laboratory Tests===
+*chronic belching and vomiting
+*anorexia
+*weight loss
+*poor body condition
 ===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==
+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==
+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
+[[Category:Stomach_and_Abomasum_-_Pathology]][[Category:To_Do_-_Alimentary]][[Category:Gastric Diseases - Dog]]
+[[Category:Gastric Diseases - Cat]][[Category:To Do - Medium]]