Transcript ALWAYS LOOK FOR THE POSTIVE

ALWAYS LOOK FOR THE
POSITIVE
“When it is dark enough, you can see
the stars.”
-Persian proverb
Diseases of Digestive System
Chapter 2
ORAL DISEASES
Oral Diseases: Periodontal Disease
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Gingivitis: earliest sign of Periodontal Disease
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Reversible inflammation of the soft tissues of the gums
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Cause: accumulation of tartar on teeth
 Tartar is conducive to bacterial growth
 Enzymes produced by bacteria damage tooth attachment
and cause inflammation

Gingival hyperplasia could develop secondary to gingivits
Oral Diseases: Periodontal Disease

Periodontal means “around the tooth”

Periodontal Disease is plaque-induced inflammation of
gums
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Food particles & bacteria collect around gum line and form
plaque (tartar)

Minerals in saliva collect in plaque and harden to form
calculus which adheres to teeth
 3-5 days to harden
 Causes bad breath
 Protects the bacterial environment
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Progressive, results in eventual tooth loss
Oral Diseases: Periodontal Disease

Periodontitis: irreversible condition resulting from
untreated gingivitis
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Receding gums
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Alveolar bone resorption
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Loss of teeth
alveolar bone
Oral Diseases: Periodontal Disease
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Periodontitis
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Separation of teeth from gums to form pockets
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Bacteria and inflammation destroy the periodontal ligament
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Pockets are abnormal if the depth exceeds:
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3mm in the dog
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1mm in the cat
Other consequences

Bacteria enter blood stream

Can cause micro-abscesses in liver, kidneys
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Cause endocarditis on heart valves
Periodontal Pockets
Oral Diseases: Periodontal Disease
Mild tartar
more tartar
severe tartar
>50% bone loss
Mild gingivitis
more gingivitis
gum receding
tooth is loose
No bone loss min bone loss
moderate bone loss
should be pulle
Oral Diseases: Periodontal Disease
Iatrogenic mandibular fracture resulting from
excessive force extraction of a lower molar tooth
Oral Diseases: Periodontal Disease
 Signs of periodontal disease
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Halitosis
Reluctance to chew hard food
Pawing at mouth
personality changes
Sneezing, nasal discharge
Increased salivation
Facial swelling, tooth loss
Dx

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Complete oral exam
Presence of tartar (plaque) on teeth
Measurement of periodontal pockets
Oral Diseases: Periodontal Disease
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Treatment: Dental Prophylaxis
◦
Dental scaling
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with ultrasonic scaler
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With hand scaler
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Root planning
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Gingival curettage
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Lavage
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Polishing to smooth the tooth
surface and prevent tartar buildup
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Flouride treatment
Oral Diseases: Periodontal disease
DOXIROBE GEL controls infection and promotes
rebuilding of periodontal structures
*contains Doxycycline, an antibiotic
Oral Diseases: Periodontal Disease
Plaque prevention gel
Applied once a week at home
by owner
Oral Diseases: Periodontal Disease
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Client info
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Good oral hygiene is necessary for all pets
 Brush teeth daily
 Schedule routine dental cleanings at veterinary office
 Treat gingivitis early before irreversible
lesions occur
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Extractions are sometimes necessary to clear up
infections beneath the gum line
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Hard, crunchy food may promote better dental health by
removing tartar before it calcifies
 Once it calcifies, tartar must be removed professionally
http://www.youtube.com/watch?v=qnbJZWycdg&feature=PlayList&p=480B67A7E8907594&p
laynext_from=PL&playnext=1&index=5
Oral Diseases: Trauma
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Many Causes:
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Falls, fights, burns, blunt trauma (HBC)
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“High-rise syndrome” in cats
 Fractured hard palate, mandible
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Tongue injury
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Cats playing with needles & thread
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Electrical, chemical burns
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Gunshot wounds, fish hooks
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Bones lodged in teeth
Fx mandible—cat; HBC
Oral Diseases: Trauma
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Signs
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History or signs of head trauma
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Increased salivation
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Inability to close mouth due to:
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Pain
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Fracture/dislocation
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Foreign body (FB)
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Reluctance to eat
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Presence of foreign object
Dx
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PE of oral cavity
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X-ray to r/o embedded FB
Oral Diseases: Trauma
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Treatment
 Depends on type of trauma
 Control bleeding
 Provide supportive care
 IV fluids
 pain relief
Ensure adequate airway
 Repair/extract damaged teeth
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Client info
 Discourage chewing on electric cords
 Don’t leave caustic/toxic chemicals out
 Keep pets in fenced yard or on leash when outside
 Animals still eat well without entire tongue
Oral Diseases: Neoplasia
Relatively common in cats and dogs - malignant melanoma
and squamous cell carcinoma most common
 Signs
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Depend on location and size of growth
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Abnormal food prehension
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Increased salivation
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Tooth loss
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Oral pain
Dx
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Histology of mass
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X-rays to r/o metastasis
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Biopsy of regional lymph node to r/o metastasis
Oral Diseases: Neoplasia
Squamous cell
carcinoma (Upper R 3rd
incisor)
Bone loss around lesion
Rostral maxillectomy
was curative
Oral Diseases: Oral Neoplasia
A gingival (buccal mucosa)
melanoma involving a dog's
caudal mandible
and temporomandibular joint
region.
Above: An invasive feline
oral squamous cell
carcinoma (courtesy of
Jon Slattery)
Oral Diseases: Neoplasia
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Treatment
 Surgical excision
 Partial removal of mandible/maxilla if bone is involved
 Radiation therapy
 Chemotherapy
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Client info
 Prognosis for malignant tumors is guarded to poor even
with aggressive therapy
 Benign lesions have good Prognosis
 Animals (esp.cats) with bone removed may need
nutritional support (feeding tube)
Oral Diseases: Salivary Mucocele
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Accumulation of excessive amounts of saliva in SQ
tissue
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Most common lesion of salivary glands in dogs;
rarely seen in cats
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Cause is unknown (tight collar, choke chain?)
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Signs
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Slowly enlarging, nonpainful, fluid-filled
swelling on neck or under tongue
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Reluctance to eat
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Difficult swallowing
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Blood-tinged saliva
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Respiratory distress
Salivary Mucocele
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Dx
◦ Clinical signs
◦ Paracentesis shows thick, blood-tinged fluid
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Treatment
◦ Aspirate fluid
◦ Surgical drainage
◦ Remove salivary gland; insert Penrose drain
x7d
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Client info
◦ Without removal of gland, excess fluid will
continue to accumulate
◦ Some cases may resolve spontaneously
Removal of
mandibular
salivary gland
Lip-Fold Dermatitis
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Often seen in breed with pendulous upper lips
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Constant moisture in the folds from saliva causes bacterial growth
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Food, hair, moisture cause irritation, erythema, and fetid odor
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Signs/Diagnosis
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Halitosis
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Collection of debris in lower lip fold
Lip-Fold Dermatitis
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Treatment
◦ Dental cleaning
◦ Clip hair
◦ Clean out folds
◦ Diaper rash cream applied topically
◦ Surgery is permanent treatment
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Client info
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Keep lip folds dry
Flush/clean lip folds
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with 2.5% benzoyl peroxide shampoo
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chlorhexidine
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malaseb pledgets (chlorhexidine + miconazole)
Drying agents like corn starch several times a day
Good dental hygiene will help prevent it
WHAT SETS YOU APART?
“I am not afraid to die on a treadmill. I will not be
outworked. If we get on a treadmill together, one of two
things will happen; You’re going to get off first or I’m going
to DIE. It’s really that simple.”
-Will Smith
ESOPHAGEAL
DISEASES
Esophageal Diseases: Gastroesophageal Reflux

Esophagitis is an inflammation of the esophageal wall
caused by
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Mucosal irritants
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Gastroesophageal reflux- the most common cause of esophagitis
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Reflux of gastric contents into the esophagus leads to inflammation and
abnormal function of the lower esophageal sphincter
Esophageal Diseases: Gastroesophageal Reflux
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Clinical Signs
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Anorexia
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Dysphagia
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Excessive salivation
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Regurgitation
Severity of clinical signs depends on:
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The type of material ingested
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The length of contact with the mucosal surface
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The integrity of the esophageal mucosal barrier
Esophageal Diseases: Gastroesophageal Reflux
Diagnosis: Endoscopy and/or fluoroscopy
Esophageal Diseases: Gastroesophageal Reflux
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Treatment of Irritating Substances
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Do not induce vomiting
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Administer activated charcoal
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Prevent further ingestion
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mucosal protectants - sucralfate
Treatment for Gastroesophageal reflux
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Dietary changes –high protein, low fat
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mucosal protectants – sucralfate, H2 blockers
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Anti-emetics - Metoclopramide
Esophageal Diseases: Gastroesophageal Reflux
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Client Info
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Prevent access to irritating substances
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Avoid excessively hot food
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Always follow oral medications with water to prevent the tablet or
capsule from sticking to the esophagus causing irritation
Esophageal Disease: Obstruction
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Esophageal obstruction
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Ingestion of nondigestible objects
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Degree of damage depends on size, shape, time in esophagus
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Surgical removal is least desirable → stricture formation
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Signs
 Exaggerated swallowing movements
 Increased salivation restlessness
 Retching
 Anorexia
 Hx of chewing on foreign objects
Esophageal Diseases: Obstruction
Esophageal endoscopy
Esophageal Obstruction
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Diagnosis
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Endoscopy
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Radiography
6 month old St. Bernard
Esophageal Obstruction
Esophageal Obstruction
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8 yr male cat
Esophageal Obstruction
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7 mo old Pug