Approach to equine weight loss

Question 1

List 4 mechanisms of weight loss in horses

Answer 1

1. Reduced intake
2. Reduced digestion, absorption or assimilation of nutrients
3. Increased losses
4. Increased requirements

Question 2

List 5 things can lead to reduced intake in horses leading to weight loss

Answer 2

Diet (Inappropriate feeding)
Competition for feed
Dental disease
Dysphagia
Pain

Question 3

List 3 things that can lead to reduced digestion, absorption or assimilation leading to weight loss

Answer 3

Dental disorders
Malabsorption syndromes - e.g. damaged villi,
Liver disease

Question 4

List 2 things that can cause increased losses leading to weight loss

Answer 4

Protein losing enteropathy (or nephropathy RARE)
Sequestration to body cavity (peritonitis or pleuritis)

Question 5

List 5 things that can cause increased requirements which leads to weight loss in horses

Answer 5

Pregnancy
Lactating horses
Sepsis
Neoplasia
Other systemic disease

Question 6

List 2 causes of anorexia in horses

Answer 6

Pain
Dysphagia

Question 7

What do you need to think of if food/water is coming out of a horses nostrils

Answer 7

pharyngeal dysphagia

Question 8

Aside from weight loss, what other sign can malabsorption and protein losing enteropathies cause

Answer 8

chronic diarrhoea

Question 9

Describe how to approach weight loss (clinical exam)

Answer 9

History - feeding, worming, stabling, other horses etc
General clinical exam - BCS, temperature, gut sounds, HR, RR, hydration status
Focused exam - dental exam, rectal exam

Question 10

What lab testing can you do to investigate weight loss

Answer 10

Liver, renal, inflammation (acute phase proteins)
Abdominocentesis
FEC - tapeworm

Question 11

When would you do lab testing for weight loss

Answer 11

If you don’t find anything specific on the clinical exam e.g. if you juts found pyrexia with no explanation

Question 12

Name 2 acute inflammatory markers

Answer 12

Serum amyloid A
Fibrinogen

Question 13

when can eosinophilia be seen

Answer 13

Sometimes seen in parasite infestation
Generalised inflammation

Question 14

When do you get hypoglobulinaemia

Answer 14

GI loss

Question 15

When do you get hyperglobulinaemia

Answer 15

Chronic inflammatory disease
Neoplasia

Question 16

When do you get hyperfibrinogenaemia

Answer 16

Infection
Inflammation
Neoplasia

Question 17

How do you perform an oral glucose absorption test

Answer 17

Withhold food overnight (just hay?)
give 1g/kg in a 10-20% dextrose solution via nasogastric tube
Will see a glucose peak
Allows you to detect malabsorption

Question 18

What would prompt you to carry out an oral glucose absorption test

Answer 18

Signs of intestinal thickening on ultrasound - you want to see if that is causing malabsorption

Question 19

What options do you have for locations/techniques of GI biopsies

Answer 19

Duodenal biopsy (transendoscopic)
Rectal mucosal biopsy
Surgical - full thickness

Question 20

Which biopsies would you take If you suspect IBD

Answer 20

Duodenal - SI involvement
Rectal - colon involvement

Question 21

What location do you take rectal biopsies from

Answer 21

10 or 2 on the clock
Don’t take at 12 due to risk of perforation

Question 22

When would you take a full thickness biopsy

Answer 22

If the cause is small intestinal and you can’t get to the bottom of the problem

Question 23

List a problem with oral glucose absorption test

Answer 23

does not only assess small intestine function - as small amount of glucose absorbed in large intestine

Question 24

what is the first thing to rule out in a horse loosing weight

Answer 24

diet issue or parasites

Question 25

what does oedema with weight loss suggest

Answer 25

protein loss

Question 26

what does fever with weight loss suggest

Answer 26

infection or inflammation

Question 27

why does anorexia cause jaundice in horses

Answer 27

they don’t have a bile duct or anywhere to store bile, so it will move into the blood stream