This mini series aims to help you diagnose and manage the gastrointestinal diseases seen in first opinion practice. A problem-based approach is useful when learning about gastrointestinal disease, as the clinical signs of medical and surgical diseases are often similar and vague. In addition, diseases of other body systems, e.g. renal disease, pyometra, may present with the same problems e.g. vomiting, lethargy, inappetance.

• Join Alison Moores BVSc(Hons) CertSAS DipECVS MRCVS for three 2-hour online sessions
• Comprehensive notes to downloaded
• Self-assessment quizzes to ‘release’ your 8 hours CPD certification (don’t worry, you can take them more than once if you don’t quite hit the mark first time)
• A whole year’s access to recorded sessions for reviewing key points
• Superb value for money – learn without travelling
• Watch the recordings on your iPad!
• This Mini Series was originally broadcast in May 2018

Programme

Gastrointestinal disease: Diagnostic tools; Medical stabilization; Surgical principles

The first session will consider typical presenting complaints, differential diagnoses and decision-making in choosing diagnostic tests. Diagnostic imaging is the most useful method for diagnosing gastrointestinal disease, especially ultrasonography.
Animals with gastrointestinal disease may be weak, cachexic, dehydrated and have electrolyte disturbances. Hypovolaemic shock may be present, especially if gastrointestinal tract rupture has occurred and septic peritonitis has developed. Recognition of fluid and electrolyte disturbances is important to allow them to be corrected prior to surgery.
Basic surgical principles (Halstead’s principles) are important for all surgical procedures. Specific principles of gastrointestinal surgery will reduce risks of contamination and infection, and reduce risks of healing complications. Careful choices must be made for antibiotic selection, analgesia and suture materials.

What you’ll learn:

• A problem orientated approach to gastrointestinal disease – how to approach the vomiting patient
• Diagnostic imaging tools for the gastrointestinal tract
• Stabilising the gastrointestinal patient
• Principles of gastrointestinal surgery

Exploratory Laparotomy and Stomach

A thorough exploratory laparotomy must be performed in any patient with gastrointestinal disease. Decisions must be made as to whether gastrointestinal tract biopsies or biopsies of other organs are needed. Hints and tips will be provided to help perform laparotomy.
Surgical gastric diseases are uncommon; the most common are gastric dilatation-volvulus and gastric foreign bodies. There will be hints and tips for gastric surgery, and gastrotomy for removal of foreign bodies will be explained using video.

What you’ll learn:

• Exploratory laparotomy
• Gastric diseases
• Gastrotomy

Small Intestine

Common surgical diseases of the small intestine include foreign bodies and neoplasia. Small intestinal biopsy is a useful tool for distinguishing inflammatory from neoplastic disease, when endoscopy is unavailable or has not proved useful. It is particularly important in diagnosis of feline intestinal lymphoma. Enterotomy is typically performed for removing intestinal foreign bodies whereas enterectomy is indicated for removal of compromised intestine due to various causes, including foreign body, neoplasia and intestinal rupture. Hints and tips to improve success with intestinal surgery will be given, including video of intestinal surgery.
Many patients will have an uncomplicated recovery from intestinal surgery. Others have ongoing fluid and electrolyte disturbances and require more medical and fluid therapies. Enteral nutrition is important to encourage gastrointestinal healing.
The most common complication of intestinal surgery is dehiscence and septic peritonitis. Vomiting is an early sign but other more subtle signs may be recognized early on. Prompt diagnosis is necessary, and can be achieved with ultrasound to look for development of peritoneal fluid, and abdominocentesis for cytology to recognize intra-cellular bacteria. Medical stabilsation is required prior to laparotomy to treat septic peritonitis. Ileus may also present with inappetance and vomiting, and can be differentiated from septic peritonitis with ultrasound.

What you’ll learn:

• Small intestinal diseases
• Small intestinal surgery – biopsy, enterotomy, enterectomy
• Post-operative care and nutrition
• Recognising post-operative complications