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Equine Med and Surgery > Abnormal Conditions of the Equine Small Intestine > Flashcards

Abnormal Conditions of the Equine Small Intestine Flashcards

1
Q

what is the difference between a simple/non-strangulating and strangulating obstruction?

A

simple - blood supply normal to intestine involved in obstruction
strangulating - blood supply is constricted/blocked >mucosal ischemic injury > endotoxemia

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2
Q

what color is the peritoneal fluid of simple and strangulating obstructions?

A

simple - normal, yellow
strangulating - serosanguineous, red

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3
Q

what is the difference between a function and mechanical obstruction?

A

function - lumen of SI still moving but motility is altered
mechanical - lumen of SI blocked

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4
Q

what are the non-strangulating/simple obstructions of the SI?

A

ileal impaction
ascarid impaction
enteritis

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5
Q

where are most of the cases of ileal impaction?

A

southeast US

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6
Q

what type of hay is related to ileal impactions?

A

coastal bermuda grass

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7
Q

what causes the early pain attributed to with ileal impaction?

A

spasmodic bowel contraction around impaction

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8
Q

what is a good diagnostic for small intestine issues?

A

gastric reflux

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9
Q

Does ileal impaction always have gastric reflux?

A

depends on duration of obstruction
if long backs up into stomach

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10
Q

what can severe small intestinal distention cause and what can this in turn lead to?

A

severe small intestinal distension > severe pain > ileus

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11
Q

what can you give a horse that has an ileal impaction?

A

IV fluids
flunixin meglumine
mineral oil via NGT if no reflex

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12
Q

what are the complications of a ileal impaction if it is delayed?

A

gastric rupture, laminitis, mucosal necrosis, and ileal perforation

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13
Q

what is the prognosis for an ileal impaction?

A

favorable if treated early
Re-impactions rare

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14
Q

Matty said Ascarid impaction and parasites will be covered by Dr.B so skipped

A

hehe hi

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15
Q

Is duodenitis-proximal jejunitis (DPJ) a functional or mechanical obstruction?

A

functional

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16
Q

what is DPJ pathogenesis?

A

inflammation of proximal SI > endotoxemia and ileus > fluid accumulation in SI & stomach

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17
Q

What is a typical differentiator of DPJ?

A

large volume of fluid passed in nasogastric tube - Horse feels better for a while after

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18
Q

How do you differentiate between DPJ and a strangulating lesion?

A

belly tap
DPJ - rarely serosanguineous
cell count and total protein inc to a lesser extent compared to a strangulating obstruction

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19
Q

which has a greater SI distension - DPJ or mechanical obstruction(strangulating)?

A

mechanical obstruction

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20
Q

How do you treat DPJ?

A

frequent gastric decompression
correct dehydration & electrolyte imbalances
restoration of normal intestinal function

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21
Q

With a horse with DPJ when do you let them have food?

A

once ileus resolved and no more reflux
very slow food introduction

22
Q

Do you give a DPJ horse antibiotics?

A

no - gut bacteria already messed up

23
Q

what is the benefit for surgery on a DPJ suspected horse?

A

diagnostic procedure to rule out mechanical obstruction

24
Q

what is the prognosis for DPJ?

A

surgery performed in few cases
25-94% survival rate - recurrence rare

25
Q

what are examples of strangulating obstructions?

A

SI volvulus
epiploic foramen entrapment
pendunculated lipoma
intussusception
mesenteric rents
inguinal/scrotal hernia

26
Q

what is a small intestinal volvulus?

A

rotation in a segment of jejunum +/- ileum around mesentery so that SI is twisted

27
Q

what age group has a higher prevalence for SI volvulus?

A

foals - 2-4 months age

28
Q

How do you diagnose SI volvulus?

A

abdominal ultrasound
severe pain alternated with periods of depression
abdominal distension
SI distended on rectal

29
Q

what is a differentiator between a small intestinal volvulus and enteritis in a foal?

A

SI volvulus - afebrile
enteritis - febrile

30
Q

what is the treatment of a SI volvulus?

A

surgery

31
Q

what is the prognosis of a SI volvulus?

A

good for survival to hospital surgery discharge

32
Q

what is an epiploic foramen entrapment?

A

SI gets traped in epiploic foramen

33
Q

what happens to the tissue that gets trapped within the epiploic foramen?

A

everything inside foramen becomes dead

34
Q

what are the risk factors for epiploic foramen entrapment?

A

cribbing, history of colic, increased time in a stall, tall horses

35
Q

Do changes in peritoneal fluid represent the extent of intestinal damage in an epiploic foramen entrapment?

A

no b/c the blood collects where the strangulating region is which is in the epiploic foramen

36
Q

what is the treatment of an epiploic foramen entrapment?

A

surgery

37
Q

what is the prognosis of an epiploic foramen entrapment?

A

18-95% short term survival
35-70% long term survival
4 times more likely for a re-laparotomy than horses with other types of colic

38
Q

what is a pedunculated lipoma?

A

benign, smooth-walled fat tumor suspended by a thin mesenteric pedicle of variable length

39
Q

when does a pedunculated lipoma cause a strangulating obstruction?

A

pedicle wraps around intestine and its mesentery

40
Q

what age group is pedunculated lipomas often seen in?

A

older horses

41
Q

what breeds of horses are at higher risk of a pedunculated lipoma?

A

ponies, arabians, and saddlebreds

42
Q

what are the four types of intussusception and which is most common?

A

jejunojejunal, jejunoileal, ileoileal, and ileocecal

ileocecal most common

43
Q

what are the predisposing factors of intussusception?

A

segmental motility differences from enteritis
heavy ascarid burden
abrupt diet changes
tapeworm infection

44
Q

what can cause a mesenteric rent?

A

congenital, secondary to mesodiverticular bands, primary lesion of unknown cayuse, trauma or mesenteric stretching from another lesion or foal

45
Q

what is a mesenteric rent strangulating obstruction?

A

SI gets strangled in hole in mesentery

46
Q

which has a better prognosis mesenteric rent strangulation or intussusception?

A

intusccusception
mesenteric rent worst prognosis (can’t always close hole)

47
Q

what is the difference between an indirect and direct inguinal/scrotal hernia?

A

indirect - acquired and non reducible
direct - congenital and reducible

48
Q

how do foals and adults get diaphragmatic hernias?

A

foals - congenital
adults - trauma

49
Q

what are some post operative complications?

A

anastomotic obstruction, postoperative pain, endotoxemia, ileus, adhesions, short bowel syndrome

50
Q

What do strangulating lesions require to correct?

A

SURGERY

51
Q

How long can you wait on a strangulating lesion?

A

trick question you dont want to wait on a strangulating lesion get that horse to surgery

Equine Med and Surgery (18 decks)

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