Approach to Medical Diseases of Equine Small Intestine Flashcards
what is anteritor enteritis?
inflammatory/infectious disease of duodenum and proximal jejunum
what is another name for anterior enteritis?
duodenitis-proximal jejunitis/DPJ
what is DPJ characterized by?
voluminous SI secretion
functional ileus
copious gastric reflux
what is the pathophysiology of anterior enteritis?
Clostridium difficile spores ingested and enter the stomach > spores then pass through pylorus to reach the duodenum > proximal SI rich in bile acids secreted via major duodenal papilla > spores interact with bile and germinate into vegetative cells > cells multiply, colonize, and produce toxins > epithelial damage and inflammation > ileus and colic signs
what is the heart rate and gastric reflux of a colic horse?
HR - greater than 60
Gastric Reflux - greater than 8L
what is the primary differential diagnosis for anterior enteritis?
strangulating SI lesion
what are the therapeutic goals for AE?
what causes equine proliferative enteropathy?
Lawsonia intracellularis
what type of horse is primarily affected by equine proliferative enteropathy?
weanlings
how do you treat equine proliferative enteropathy?
long term antibiotics
what are the clinical signs of equine proliferative enteropathy?
weight loss, unthriftiness, edema, depression, fever, hypoproteinemia
what are the therapeutic goals for equine proliferative enteropathy?
what are the types of IBD reported in horses?
eosinophilic enterocolitis
Idiopathic focal eosinophilic enteritis
Multi-systemic eosinophilic epitheliotropic disease (MEED)
Grandulomatous enteritis
Lymphocytic-plasmacytic enterocolitis
what is the presentation of IBD?
weight loss, +/- colic, +/- diarrhea
what do you do when you get to a colic call and the HR is above 60?
pass a nasogastric tube
how do you treat IBD?
corticosteroids, surgical excision, parasite control, diet
what would you expect to feel on a rectal for anterior enteritis/DJP?
loops of distended, fluid-filled SI
Do anterior enteritis patients typically have a fever?
yes
Before transferring a DJP horse for referral what do you do?
give flunixin meglumine
leave in nasogastric tube
what can high fibrinogen indicated on a CBC in a colic horse?
signs of system inflammation
what can a high total protein indicate on BW in a colic horse?
dehydration, hemoconcentration
what does low electrolytes indicate on BW in a colic horse?
loosing fluid into GI tract
what does high creatine indicate on BW in a colic horse?
dehydration, hemoconcentration
what does high bilirubin indicate on BW in a colic horse?
anorexic horse
bilirubin rises
secondary problem
what does high GGT indicate on BW in a colic horse?
inflammation in biliary tracts
secondary problem
what does a high lactate value on BW indicate for a colic horse?
hypovolemic, not perfusing properly
what does a high protein on abdominocentesis indicate for a colic horse?
inflammation so losing protein into abdomen
what are some indicators of anterior enteritis?
HR dec after reflux removed
fever present
pain controlled early on with low dosing of analgesics
What value should potassium NOT exceed when added to fluids?
0.5 mEq/kg/hr
what is the maintenance IV fluid rate for an adult horse?
maintenance = 2-3 mL/kg/hr
Calculate the IV fluid rate for a horse weighing 450kg
3mL x 450kg = 1.3L/hr
how is anterior enteritis treated?
antibiotics, prokinetics, anti-inflammatories, laminitis prevention, parenteral nutrition, fluids (with electrolytes), colloids
what are your differentials?
parasitism
Equine proliferative enteropathy
IBD - granulomatous enteritis
Given these results what do you think the foal with colic has?
Equine proliferative enteropathy
