Chronic colic and weight loss

Question 1

what are the four mechanisms of weight loss?

Answer 1

reduced intake
reduced digestion/absorption/assimilation
increased losses
increased requirements

Question 2

what are the main three causes of weight loss?

Answer 2

dental disease
parasitism
inadequate diet

Question 3

what percentage bodyweight fibre should a horse be eating?

Answer 3

2.5%

Question 4

what is chronic colic?

Answer 4

colic lasting more than 48 hours

Question 5

what is recurrent colic?

Answer 5

short periods of colic that recur at variable intervals

Question 6

what are the four types of causes of intestinal pain (colic)?

Answer 6

stretch
ischaemia
inflammation
muscle spasm

Question 7

how localised is visceral pain?

Answer 7

not very (it is diffusely located)

Question 8

what is the systematic approach to weight loss cases?

Answer 8

history/clinical examination
rectal exam
diet/competition
teeth
worming
faecal sand

Question 9

what can be measured to assess presence of inflammatory processes?

Answer 9

white cell count
fibrinogen
globulins

Question 10

what is assessed on clinical pathology to determine protein loss?

Answer 10

albumin

Question 11

what causes verminous arteritis?

Answer 11

Strongylus vulgaris

Question 12

where does Strongylus vulgaris migrate to?

Answer 12

mesenteric artery

Question 13

what can mask decreased total protein?

Answer 13

concurrent dehydration

Question 14

is hypoalbuminaemia more common from protein losing enteropathy or nephropathy?

Answer 14

protein losing enteropathy more common

Question 15

why aren’t globulins lost as easily across the GI tract compared to albumin?

Answer 15

globulin are much bigger

Question 16

how does chronic inflammatory disease effect globulin?

Answer 16

causes hyperglobulinaemia

Question 17

what type of acute phase protein is albumin?

Answer 17

negative (goes down in response to inflammation) - production by liver is downregulated

Question 18

what are the two main positive acute phase proteins?

Answer 18

fibrinogen
serum amyloid A

Question 19

what does a massive increase in monoclonal serum protein suggest? (a skyrocket)

Answer 19

tumours

Question 20

what should the appearance of peritoneal fluid be?

Answer 20

clear and light yellow

Question 21

what is diaphodesis?

Answer 21

migration of red blood cells from vessels into the peritoneal cavity

Question 22

what can neutrophils in peritoneal taps tell us about the peritonitis?

Answer 22

whether the peritonitis is septic or not

Question 23

how do neutrophils appear when there is a septic peritonitis?

Answer 23

large nucleus and possible intercytoplasmic bacteria
degenerate toxic neutrophils

Question 24

what is assessed when ultra sounding intestines?

Answer 24

wall thickness
lumen diameter
motility
anatomy

Question 25

what structures are visible on a right transabdominal ultrasound?

Answer 25

large intestine (caecum, right dorsal colon, right ventral colon) liver duodenum right kidney

Question 26

which part of the colon does the caecum empty into first?

Answer 26

right ventral colon

Question 27

what structures are visible on a left transabdominal ultrasound?

Answer 27

spleen left kidney left ventral colon stomach small intestine

Question 28

how many intercostal spaces should the stomach take up?

Answer 28

no more than 5 (8th-13th)

Question 29

how thick is the wall of the stomach?

Answer 29

7-8mm

Question 30

why is the ventral abdomen a point of interest on ultrasound?

Answer 30

fluid will accumulate here

Question 31

what can be done to assess the function of the small intestine in regards to weight loss?

Answer 31

glucose absorption test

Question 32

what is normal for an oral glucose absorption test?

Answer 32

>85% increase in blood glucose over 2 hours

Question 33

what is partial uptake for an oral glucose absorption test?

Answer 33

15-85% increase in blood glucose over 2 hours

Question 34

where are rectal biopsies of the mucosa taken from?

Answer 34

20-30cm within then a small mucosal sample taken around 4 or 8 o'clock

Question 35

do horses having a rectal biopsy need pain management?

Answer 35

no (no alpha fibres in rectum for local isn't needed)

Question 36

what are the three categories of inflammatory/infiltrative bowel disease?

Answer 36

granulomatous enteritis lymphocytic-plasmocytic enteritis eosinophilic enteritis

Question 37

what does inflammatory/infiltrative bowel disease cause?

Answer 37

malabsorption and protein losing enteropathy

Question 38

what are some differentials for inflammatory bowel disease?

Answer 38

cyanthostominosis mixed strongyle infection idiopathic neoplasia lawsonia (3-11 month foals)

Question 39

how is multisystemic eosinophilic epitheliotrophic disease treated?

Answer 39

dexamethasone

Question 40

what is the most common neoplasia of the GI tract of horses?

Answer 40

lymphoma

Question 41

what paraneoplastic syndromes are associated with equine lymphoma?

Answer 41

hypercalcaemia haemolytic anaemia cachexia

Question 42

how is inflammatory bowel disease treated?

Answer 42

prednisolone dexamethasone (anthelmintics)

Question 43

what are the two categories of inflammatory bowel disease?

Answer 43

steroid responsive non-steroid responsive