Clinical GI (EQ) Flashcards
What is the normal temperature range of the horse?
37.5-38.4oC
Which needle should be used for abdominocentesis in the horse?
18G
1.5”
What colour is normal peritoneal fluid?
Straw coloured
What are the normal values in equine peritoneal fluid for: TP, WBCC, lactate?
TP <20g/L
WBCC <5x10^9
Lactate <2mmol/l
What amount of net reflux after NG intubation is serious?
2L
What are normal systemic values for PCV, TP and lactate?
PCV: 35-45%
TP: 60-70g/L
Lactate <2mmol/L
What are the 3 main causes of foal colic?
Meconium impaction
Ruptured Bladder
Congenital abnormalities
How is equine grass sickness diagnosed?
Intestinal biopsy with C botulinum type C
What is a partial response to the glucose absorption test and what does this indicate?
15-85% inc at 2h
SI/Li Dz or normal
What is a complete response to the glucose absorption test and what does this indicate?
> 15% inc at 2h
SI Dz
What 2 things should be given for a rectal biopsy?
ABs
Tetanus prophylaxis
How many rib spaces (MAX) should the stomach occupy on US?
5
Where is the stomach located for US of the horse?
8-13th ICS
What are the 3 infiltrative bowel Dz of the horse/
Eosinophilic Enteritis
Granulomatous enteritis
Lymphocytic-Plasmacytic enteritis
How are infiltrative bowel Dz treated?
Prednisolone
Dexamethasone
Anthelmintics
Which type of lymphoma is commonly found in juveniles or old horses?
Alimentary
Which type of lymphoma is usually found in old horse, involving the GIT?
Generalised
What are 2 common bacterial causes of persistent GI infection?
S equi
R equi
What is diagnostic of chronic bacterial GI infection?
Neutrophilia
Hyperfibrinogen
Anaemia
What are the 3 haemogram changes associated with chronic parasitism?
Hypoalbuminaemia
Hyperglobulinaemia
Neutrophilia
NOT eosinophilia
What are the 2 divisions of Equine Gastric Ulcer Syndrome?
EGGUS (glandular)
ESGUS (squamous)
What are 3 RFs for EGUS?
Intermittent Feeding
High conc diet
Exercise
How is EGUS treated?
Omeprazole - lower dose and less time needed for ESGUS
What is responsible for acute diarrhoea?
Colitis
Name 5 common infectious causes of Chronic Diarrhoea.
Salmonella Lawsonia Paraistism Abdominal Abscess R equi
Name 3 common non-infectious causes of Chronic Diarrhoea.
Sand
Granulomatous enteritis
Lymphosarcoma
How many faecal samples are needed to diagnose salmonella?
5
What is the larvicidal treatment protocol for a horse?
Fenbendazole 10mg/kg SID 5d
THEN
1w Moxidectin
What is the most common cause of acute colitis in horses >9m old
Idiopathic
What is SIRS caused by?
Compromised intestinal wall allows bacterial endotoxin to enter circulation
What causes the distributive shock seen in SIRS?
Endothelial injury –> oedema –> reduced venous return.
Also reduced contractility due to direct action of toxin.
Apart from the GIT, which 2 organ systems are commonly affected by sirs and how?
Integument - inflammation of lamellae = laminitis
Kidneys - due to haemodynamic effects
How does SIRS cause tissue hypoxia/ischaemia?
Cells unable to undergo oxid phos w/glucose.
What is the most common species causing salmonellosis in the horse?
S. typhimurium
What are the 3 effects of S. Typhi toxins in the horse?
Endotoxin - haemodynamic
Cytotoxin - mucosa
Enterotoxin - inc Na/H2O secretion
What are the haemogram changes associated with salmonellosis?
Neutropenia
Hyponatraemia
Dehydration
What should be done with salmonella + patients?
ISOLATE to prevent spread
Administration of which drug group causes C. difficile overgrowth & subsequent diarrhoea?
Antibiotics
How is antibiotic-induced diarrhoea treated?
Metronidazole
Withdraw other AB
Fluids and support
What are the signs of a 4-7% dehydration? How large is the fluid deficit?
skin tent 2-3s
CRT 2-3s, MM fair
PCV 40-50%
25-35L
What are the signs of a 7-9% dehydration? How large is the fluid deficit?
Sunken Eyes
Skin tent 305s
CRT >2-4s, MM tacky
PCV 50-65%
40-50L
What are the signs of a >9% dehydration? How large is the fluid deficit?
skin tent 5s
CRT >4s, MM dry
PCV >65%
> 50L
When are colloids indicated?
TP <40g/L
PCV > TP
what should be added to Hartmanns in cases of acute eq diarrhoea?
K+ (20/L)
Which NSAID is best to treat SIRS?
Flunixin 0.5-1mg/kg
Which 3 oral protectants can be given in SIRS?
Bismuth subsalicylate
Activated charcoal
Smectite
What can be visualised on RHS abdo U/S?
Liver
Caecum
R Dorsal Colon
What can be visualised on LHS abdo U/S?
Stomach
Spleen
Kidney
SI
Which 3 drugs are useful for the treatment of infiltrative bowel diseases?
Prednisolone
Dexamethasone
Anthelmintics
Which areas are most commonly affected by multisystemic eosinophilic epithelitrophic Dz?
Skin at CBs/nose, pancreas and liver.
Which type of lymphoma are juveniles most predisposed to?
Alimentary
Which type of lymphoma are aged horses most predisposed to?
Generalised
Chronic infection with which parasite may cause verminous arteritis and TE colic?
large strongyles
Chronic infection with which parasite may cause submucosal inflammation?
Small Strongyles
What is the pH of the glandular portion of the stomach?
1.8
What is the pH of the squamous portion of the stomach?
5.4
What are the 4 grades of squamous ulcer?
- mucosa intact but areas of red/thickening
- 1+ small lesions present
- 1+ large lesions present
- extensive lesion with deep ulceration
Crib biting is a risk factor for which 3 types of colic?
EFE (epiploic foramen entrapment)
SCOD (simple colonic obstruction)
Recurrent colic
Which colic is associated with inc housing at winter and straw bedding?
Large colon impaction
Which 3 CV parameters would indicate the need for euthanasia in the colic case?
HR >90bpm
PCV >60%
Purple MMs
On peritoneal tap, you see brown/red ingesta contaminated fluid - what is the prognosis for the patient?
Hopeless - PTS!
O calls to say horse is coughing, shaking its head up/down and has food at nostrils. What is your advice?
CHOKE!
Take all food/water away and monitor for 30m.
No change: Sedate, NGT, lavage.
what is the best Tx for grade I-III rectal prolapse?
Reduce and assess cause.
what is the best Tx for grade IV rectal prolapse? Px?
Surgery - Poor Px
What should your approach be to managing an incisional hernia?
1e: Prolong box rest and apply hernia belt.
2e - surgical Tx 4-6m post initial surgery
What is the 1st step to managing a wound which you suspect to have penetrated the abdomen?
Cling Film over it!!
