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| | |'''Neoplastic''' | | |'''Neoplastic''' |
| − | |Adenocarcinoma, lymphosarcoma, leiomyoma, [[Gastrinoma|gastrinoma]] (Zollinger-Ellison syndrome), | + | |Adenocarcinoma, lymphosarcoma, leiomyoma, [[Gastrinoma|gastrinoma]], (Zollinger-Ellison syndrome), Mast cell Tumours. |
| | |- | | |- |
| | |'''Metabolic/endocrine''' | | |'''Metabolic/endocrine''' |
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| | ===Endoscopy and Biopsy=== | | ===Endoscopy and Biopsy=== |
| | Diagnostic test of choice and allows biopsies to be taken. [[NSAIDs|NSAID]] related ulcers are reguarly located in the antrum and there is limited mucosal thickening or irregularity whereas ulcerated [[Gastric Neoplasia|gastric tumours]] will have thickened mucosa and edges. Any biopsies should be taken at the edge of normal and diseased tissue to avoid further deepening or perforation. | | Diagnostic test of choice and allows biopsies to be taken. [[NSAIDs|NSAID]] related ulcers are reguarly located in the antrum and there is limited mucosal thickening or irregularity whereas ulcerated [[Gastric Neoplasia|gastric tumours]] will have thickened mucosa and edges. Any biopsies should be taken at the edge of normal and diseased tissue to avoid further deepening or perforation. |
| | + | |
| | + | |
| | + | ==Pathology== |
| | | | |
| | ==Treatment== | | ==Treatment== |
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| | Omeprazole is the drug of choice to treat ulceration associated with mass cell tumours and gastrinomas. It inhibits the hydrogen-potassium ATPase which prevents hydrogen ion prouction by the parietal cells. | | Omeprazole is the drug of choice to treat ulceration associated with mass cell tumours and gastrinomas. It inhibits the hydrogen-potassium ATPase which prevents hydrogen ion prouction by the parietal cells. |
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| − | | + | |
| | ===Mucosal protectants=== | | ===Mucosal protectants=== |
| | Such as misoprostol can be given alongside NSAIDs to decrease the risk of ulceration. '''[[Gastroprotective Drugs#Binding Agents|Sucralfate]]''' which is polyaluminium sucrose sulphate, binds to damaged mucosa and assists in the treatment of gastric ulceration. It is best given 2 hours after acid inhibitors to prevent interference. | | Such as misoprostol can be given alongside NSAIDs to decrease the risk of ulceration. '''[[Gastroprotective Drugs#Binding Agents|Sucralfate]]''' which is polyaluminium sucrose sulphate, binds to damaged mucosa and assists in the treatment of gastric ulceration. It is best given 2 hours after acid inhibitors to prevent interference. |
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| | Hall, J.E., Simpson, J.W. and Williams, D.A., (2005) '''BSAVA Manual of Canine and Feline Gastroenterology (2nd Edition)''' ''BSAVA'' | | Hall, J.E., Simpson, J.W. and Williams, D.A., (2005) '''BSAVA Manual of Canine and Feline Gastroenterology (2nd Edition)''' ''BSAVA'' |
| | + | Ettinger, S.J, Feldman, E.C. (2005)'''Textbook of Veterinary Internal Medicine''' (6th edition, volume 2)W.B. Saunders Company |
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| − | Merck & Co (2008) '''The Merck Veterinary Manual'''
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| | | | |
| − | ==From Pathology Section==
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| | [[Gastric Ulceration - all species]] | | [[Gastric Ulceration - all species]] |
| − | * Although ulcers are often secondary to other diseases, primary idiopathic peptic ulcers do occur, due to
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| − | ** Hyperacidity
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| − | ** Gastric carcinoma in older dog
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| − |
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| − | * Secondary ulcers are often associated with systemic diseases particularly '''uraemia''' and '''mast cell tumours'''. Gastric ulcer may be the cause of death but is not the primary disease.
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| − | *# '''Mast cell tumours'''
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| − | *#*Boxers and Labradors are predisposed to these.
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| − | *#* Vomit continually together with abdominal pain.
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| − | *#* Ulcers are usually near the duodenum.
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| − | *#** Frequently secondarily infected.
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| − | *#** Often penetrate deeply.
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| − | *#* Actively secreting mast cell tumours produce histame, leasing to gastric hyperacidity and therefore secondary peptic ulcers.
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| − | *# '''Uraemia'''
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| − | *#* Gastric lesions usually occur with chronic renal disease.
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| − | *#** Gastrin is produced by the G cells of the gastric antrum during the gastric phase of digestion .
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| − | *#*** Acts on H2 receptors on parietal cells to increase production of HCl.
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| − | *#*** Increases release of histamine from gastric mucosal mast cells to increase HCl release.
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| − | *#** Serum levels of gastrin are increased in chronic renal disease in dogs and cats.
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| − | *#* In acute renal failure death ensues before gastric ulceration develops.
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| − | *#* '''Pathogenesis'''
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| − | *#** Loss of nephron and medullary concentration gradient in chronic interstitial nephritis mean collecting ducts cannot resorb fluid.
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| − | *#*** A common cause of interstitial nephritis in the dog was leptospirosis.
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| − | *#** Consequently, the animal drinks and urinates in enormous quantities, and urea is washed out with large quantities of fluid ("compensated renal failure").
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| − | *#** If fluid is restricted, urea cannot be washed out and the animal becomes uraemic.
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| − | *#*** Urea is excreted into [[Forestomach - Anatomy & Physiology|stomach]], giving it a horrible ammoniacal smell and filling it with brown smelly liquid.
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| − | *#*** Urea is also excreted into the [[Colon - Anatomy & Physiology|colon]].
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| − | *#** Urea in the stomach breaks down to ammonia, irritating the mucosa and contributing to gastric ulcer.
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| − | *#** Uraemia also causes arteriolar degeneration in the submucosa, leading to hypoxic damage to the mucosa. This is another contributing factor to gastric ulcer.
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| − | *#** [[Control of Feeding - Anatomy & Physiology#The Vomit Reflex|Vomiting]] causes dehydration and further raises blood urea.
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| − | *#*** A vicious circle is produced- ends in death by [[Control of Feeding - Anatomy & Physiology#The Vomit Reflex|vomiting]], dehydration and shock.
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| − | *#** '''Note:''' If an animal in compensated renal failure is given anaesthetic, it will not drink much. It then may start to [[Control of Feeding - Anatomy & Physiology#The Vomit Reflex|vomit]] and die due to uraemia.
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| − | * NSAIDs, Zollinger-Ellison syndrome (due to pancreatic gastrin-secreting tumour), cirrhosis and bile reflux can all also cause gastric ulcers in the dog.
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| | [[Category:Gastric_Ulceration]][[Category:Dog]] | | [[Category:Gastric_Ulceration]][[Category:Dog]] |
| | [[Category:To_Do_-_Caz]] | | [[Category:To_Do_-_Caz]] |