Download 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
 Gingivitis: earliest sign of Periodontal Disease
 Reversible inflammation of the soft tissues of the gums
 Cause: accumulation of tartar on teeth
 Tartar is conducive to bacterial growth
 Enzymes produced by bacteria damage tooth
attachment and cause inflammation
Oral Diseases: Periodontal Disease
■ Gingival hyperplasia may occur secondary to
gingivitis in some animals
Oral Diseases: Periodontal Disease
■ Periodontal means “around the tooth”
■ Periodontal Disease is plaque-induced inflammation of
gums
– 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
– Progressive, results in eventual tooth loss
Oral Diseases: Periodontal Disease
 Signs of periodontal disease







Halitosis
Reluctance to chew hard food
Pawing at mouth
personality changes
Sneezing, nasal discharge
Increased salivation
Facial swelling, tooth loss
 Dx
 Complete oral exam
 Presence of tartar (plaque) on teeth
 Complete exam and measurement of periodontal pockets during
dental cleaning
Oral Diseases: Periodontal Disease
Mild tartar
Mild gingivitis
No bone loss
more tartar
more gingivitis
min. bone loss
severe tartar
>50% bone loss
gum receding
tooth is loose
mod. bone loss
should be pulled
Oral Diseases: Periodontal Disease
■ Periodontitis

Separation of teeth from gums to form pockets

Bacteria and inflammation destroy the periodontal ligament

Pockets are abnormal if the depth exceeds:

3mm in the dog

1mm in the cat
 Other consequences

Bacteria enter blood stream

Can cause micro-abscesses in liver, kidneys

Cause endocarditis on heart valves
Oral Diseases: Periodontal Disease
■ Periodontitis: irreversible condition resulting from
untreated gingivitis



Receding gums
Alveolar bone resorption
Loss of teeth
alveolar bone
Periodontal Pockets
Oral Diseases: Periodontal disease
DOXIROBE GEL controls infection and promotes
rebuilding of periodontal structures
*contains Doxycycline, an antibiotic
Oral Diseases: Periodontal Disease
 Treatment: Dental
Prophylaxis
 Dental scaling
 with ultrasonic scaler
 With hand scaler
 Root planning (subgingival
curettage)
 Polishing to smooth the tooth
surface and prevent tartar
buildup
 Flouride treatment
Oral Diseases: Periodontal Disease
Iatrogenic mandibular fracture
resulting from excessive force
extraction of a lower molar tooth
Oral Diseases: Periodontal Disease
Plaque prevention gel
Applied once a week at home
by owner
Oral Diseases: Periodontal Disease
■ Client info
 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
 Extractions are sometimes necessary to clear up
infections beneath the gum line
 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
■ Many Causes:
 Falls, fights, burns, blunt trauma (HBC)
 “High-rise syndrome” in cats
 Fractured hard palate, mandible
 Tongue injury
 Cats playing with needles & thread
 Electrical, chemical burns
 Gunshot wounds, fish hooks
 Bones lodged in teeth
Fx mandible—cat; HBC
Oral Diseases: Trauma
■ Signs





History or signs of head trauma
Increased salivation
Inability to close mouth due to:

Pain

Fracture/dislocation

Foreign body (FB)
Reluctance to eat
Presence of foreign object
■ Dx


PE of oral cavity
X-ray
Oral Diseases: Trauma
 Treatment
 Depends on type of trauma
 Control bleeding
 Provide supportive care
 IV fluids
 pain relief
 Ensure adequate airway
 Repair/extract damaged teeth
 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





Depend on location and size of growth
Abnormal food prehension
Increased salivation
Tooth loss
Oral pain
 Dx



Histology of mass
X-rays to r/o metastasis
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
Oral Diseases: Neoplasia
■ Treatment
 Surgical excision
 Partial removal of mandible/maxilla if bone is
involved
 Radiation therapy
 Chemotherapy
■ 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
■ Accumulation of excessive amounts of saliva in
SQ tissue
■ Most common lesion of salivary glands in dogs;
rarely seen in cats
■ Cause is unknown (tight collar, choke chain?)
■ Signs
– Slowly enlarging, nonpainful, fluidfilled swelling on neck or under
tongue
– Reluctance to eat
– Difficult swallowing
– Blood-tinged saliva
– Respiratory distress
Salivary Mucocele
 Dx
 Clinical signs
 Paracentesis shows thick, bloodtinged fluid
 Treatment
 Aspirate fluid
 Surgical drainage
 Remove salivary gland
 Client info
 Without removal of gland, excess fluid
will continue to accumulate
 Some cases may resolve
spontaneously
Removal of
mandibular
salivary gland
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
– Mucosal irritants
– Gastroesophageal reflux- the most common cause of
esophagitis
■ Reflux of gastric contents into the esophagus leads to
inflammation and abnormal function of the lower esophageal
sphincter
Esophageal Diseases:
Gastroesophageal Reflux
 Clinical Signs




Anorexia
Dysphagia
Excessive salivation
Regurgitation
 Severity of clinical signs depends on:
 The type of material ingested
 The length of contact with the mucosal surface
 The integrity of the esophageal mucosal barrier
Esophageal Diseases:
Gastroesophageal Reflux
Diagnosis: Endoscopy and/or fluoroscopy
Esophageal Diseases:
Gastroesophageal Reflux
 Treatment of Irritating Substances




Do not induce vomiting
Administer activated charcoal
Prevent further ingestion
mucosal protectants
 Sucralfate
 H2 blockers
 Treatment for Gastroesophageal reflux
 Dietary changes –high protein, low fat
 mucosal protectants
 Anti-emetics - Metoclopramide
Esophageal Diseases:
Gastroesophageal Reflux
■ Client Info
 Prevent access to irritating substances
 Avoid excessively hot food
 Always follow oral medications with water to
prevent the tablet or capsule from sticking to
the esophagus causing irritation
Esophageal Disease: Obstruction
■ Esophageal obstruction
 Ingestion of non-digestible objects
 Degree of damage depends on size, shape, time in
esophagus
 Surgical removal is least desirable → stricture
formation
■ Signs
■
■
■
■
■
Exaggerated swallowing movements
Increased salivation restlessness
Retching
Anorexia
Hx of chewing on foreign objects
Esophageal Diseases: Obstruction
Esophageal endoscopy
Esophageal Obstruction
Esophageal Obstruction
■ 7 mo old Pug