frieda, an 8-yr-old f/s black dsh, weighs 14# and was diagnosed with diabetes mellitus 1 year ago when she weighed 18#. she still has episodes of hyperglycemia (during which time she is pu/pd) because her owner has difficulty administering her medication and feeding her at the same time every day. her veterinarian recommended that her owner feed frieda a special diet that is high in fiber to help her lose weight.

1. what is diabetes mellitus? (you may want to refer to chapter 11.)
a chronic metabolic disorder characterized by high blood sugar levels (hyperglycemia)

2. what part of her history correlates to the diagnosis of diabetes mellitus?

in addition to her uncontrolled diabetes, frieda has had spasmodic episodes of diarrhea and flatulence for the past year. during these episodes her stool is black and tarry. based on the duration of illness, her veterinarian recommended passing an endoscope to look at her intestinal mucosa.

3. list all of frieda’s signs of disease.

4. define diarrhea and flatulence.

5. because her stool is black and tarry, what word is used to describe it?

6. what part of the gastrointestinal tract is affected when stool is black and tarry?

7. based on the black and tarry stool, what type of lesion would the veterinarian look for with the endoscope?

8. do you think the endoscope would be passed rectally or orally?

9. define spasmodic.

10. what additional information would you like to ask the client about her cat?

Question

frieda, an 8-yr-old f/s black dsh, weighs 14# and was diagnosed with diabetes mellitus 1 year ago when she weighed 18#. she still has episodes of hyperglycemia (during which time she is pu/pd) because her owner has difficulty administering her medication and feeding her at the same time every day. her veterinarian recommended that her owner feed frieda a special diet that is high in fiber to help her lose weight.

1. what is diabetes mellitus? (you may want to refer to chapter 11.)
   a chronic metabolic disorder characterized by high blood sugar levels (hyperglycemia)

2. what part of her history correlates to the diagnosis of diabetes mellitus?

in addition to her uncontrolled diabetes, frieda has had spasmodic episodes of diarrhea and flatulence for the past year. during these episodes her stool is black and tarry. based on the duration of illness, her veterinarian recommended passing an endoscope to look at her intestinal mucosa.

3. list all of frieda’s signs of disease.

4. define diarrhea and flatulence.

5. because her stool is black and tarry, what word is used to describe it?

6. what part of the gastrointestinal tract is affected when stool is black and tarry?

7. based on the black and tarry stool, what type of lesion would the veterinarian look for with the endoscope?

8. do you think the endoscope would be passed rectally or orally?

9. define spasmodic.

10. what additional information would you like to ask the client about her cat?

Accepted Answer

### Question 2
# Brief Explanations:
Frieda's episodes of hyperglycemia (with PU/PD - polyuria/polydipsia) and weight change (from 18# to 14#) correlate. Hyperglycemia is a key sign of diabetes, and weight loss can occur in uncontrolled diabetes. Also, the difficulty in consistent medication/feeding may affect diabetes control.
# Answer:
Her episodes of hyperglycemia (with PU/PD), weight loss from 18# to 14#, and difficulty with consistent medication/feeding (affecting diabetes management) correlate with diabetes mellitus.

### Question 3
# Brief Explanations:
From the text, identify signs: diabetes - hyperglycemia, PU/PD, weight loss; gastrointestinal - spasmodic diarrhea, flatulence, black/tarry stool.
# Answer:
- Diabetes - related: Hyperglycemia, polyuria/polydipsia (PU/PD), weight loss (from 18# to 14#)
- Gastrointestinal - related: Spasmodic episodes of diarrhea, flatulence, black and tarry stool

### Question 4
# Brief Explanations:
Diarrhea: abnormal frequency/looseness of stools. Flatulence: excessive gas in the digestive tract, leading to passing gas.
# Answer:
- Diarrhea: The abnormal passage of loose, watery, or frequent stools, often due to disrupted intestinal function.
- Flatulence: The presence of excessive gas in the gastrointestinal tract, resulting in the passing of gas (flatus) or abdominal discomfort from gas buildup.

### Question 5
# Brief Explanations:
Black and tarry stool is called melena, which indicates upper gastrointestinal bleeding (digested blood).
# Answer:
Melena

### Question 6
# Brief Explanations:
Melena (black/tarry stool) comes from upper GI tract (stomach, small intestine) because blood is digested there, turning stool black/tarry. Lower GI bleeding (colon/rectum) is usually red or maroon.
# Answer:
Upper gastrointestinal tract (stomach or small intestine)

### Question 7
# Brief Explanations:
Melena suggests bleeding, so the veterinarian would look for a bleeding lesion (ulcer, erosion, vascular abnormality) in the upper GI mucosa (stomach/small intestine).
# Answer:
A bleeding lesion (such as an ulcer, erosion, or vascular abnormality) that is causing blood loss into the gastrointestinal tract.

### Question 8
# Brief Explanations:
To examine upper GI (stomach/small intestine) where melena originates, endoscope is passed orally (through mouth, down esophagus to stomach/small intestine). Rectal endoscopy (proctoscopy/colonoscopy) is for lower GI.
# Answer:
Orally (to examine the upper gastrointestinal tract - stomach and small intestine, where the bleeding causing melena likely occurs)

### Question 9
# Brief Explanations:
Spasmodic means involving involuntary, sudden, and intermittent muscle contractions (in this case, intestinal spasms causing diarrhea/flatulence episodes).
# Answer:
Relating to or characterized by spasms (involuntary, sudden, and intermittent muscle contractions), often causing sudden, brief episodes of discomfort or abnormal function (like intestinal spasms in Frieda's case).

### Question 10
# Brief Explanations:
Ask about diet (current food, treats), water intake (beyond PU/PD), activity level, stressors (could affect GI/diabetes), any other medications/supplements, and details of diarrhea/flatulence episodes (frequency, triggers, consistency besides black/tarry).
# Answer:
- Diet details: What specific food (including treats) is Frieda fed? Any recent diet changes?
- Water intake: How much water does she drink (beyond the PU/PD episodes)?
- Activity level: Has her activity level changed?
- Stress factors: Any recent stressors (e.g., new pets, environment changes) that could affect her GI or diabetes?
- Medication compliance: More details on how often medication is missed and why?
- Diarrhea/flatulence triggers: Are there any triggers (e.g., certain foods, times of day) for the spasmodic GI episodes?
- Stool details: Any other stool characteristics (e.g., mucus, blood besides black/tarry) or changes?

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