Day 6 - Gastrointestinal diseases Flashcards
Gastric ulcers in newborn foals
Glandular mucosa and greater curvature affected
Tx: H2 antagonists (ranitidine), sucralfate
Sucklings and weanlings
Lesions along the lesser curvature on the squamous mucosa
Gastroduodenal ulcer disease in foals
Diffuse inflammation to severe ulceration and thickening of duodenal wall
- Delayed gastric emptying
- Gastric or duodenal rupture
Yearlings and adult horses
On the squamous mucosa along the margo plicatus
General treatment of gastric ulcers
- Proton pump inhibitors: omeprazol
- H2 antagonists: Rantidine
- Sucralfat
Acute gastric dilation and impaction - pathogen (7)
– Fermentation: gas, volatile fatty acids, lactate
– Fluid influx
– Gastric dilation, colic
– Pressure on diaphragm, compromised respiration
– Decreased venous return
– Hypovolaemic shock
– Gastric rupture
Acute gastric dilation and impaction - CS
- Sudden onset, fast progression
- Severe, continuous colic
- Decreased GI motility
- Negative rectal findings
- Diagnostic nasogastric tubing
- Haemoconcentration, Hyperlactataemia
- Enlarged stomach on ultrasound
Acute gastric dilation and impaction - Dx
- Nasogastric tubing
- Ultrasonography
Acute gastric dilation and impaction - Tx (3)
- Spasmolytics, analgesics
- Stomach tubing and lavage
- IV fluid therapy
Gastric parasites
Gasterophilosis
Draschia megastoma
Ivemectrin
Spasmodic colic - Aetiology
- Nutritional deficiencies
- Cold water
- Weather
- Parasites
- Steneous excercise
Spasmodic colic - Pathogenesis
- Smooth muscle spasms
- Hypermotility
- Vagotonia (parasymp.)
Spasmodic colic - CS
Mild colic signs, borgormi, gas, loose faeces
Spasmodic colic - DD (7)
- Tympany (primary, secondary)
- Impaction
- Ileus
- Acute gastric dilation
- Acute enteritis
- Pregnancy colic
- Urinary colic (kidney, ureter, urethra)
Spasmodic colic - Tx
- Spasmolytics (butylscopolamine)
- NSAIDs
- Hand walking
- Activated charcoal or other absorbents via NG tube
- IV fluids
Proximal enteritis - aeti
- unknown
- clostridium, fusobact, salmonella
- sudden diet change
Proximal enteritis - Pathogen
Increased secretion
* cAMP, cGMP system, Calcium system
* Na+ and Cl- to gut lumen: Water follows ions
* Bacterial toxins
* Protein rich fluid secreted to intestinal lumen
Initially hyperperistalsis, then functional ileus
* Serositis, peritonitis
* Activation and migration of inflammatory cells
* Intestinal distention, Endotoxins
Decreased absorption
* Marked fluid and electrolyte loss
* Haemoconcentration, hypovolaemia, decreased tissue perfusion, oliguria, haemorrhages, Yellowish bands
* From stomach to large intestine
* Degeneration, necrosis, sloughing
* Neutrophilic infiltration (propria, submucosa, mucosa) * Haemorrhages on serosa and in muscularis
* Haemorrhagic, fibrinonecrotic DPJ
Hepatic changes
Peritoneal fluid
* Higher total protein (TP), than in mechanical ileus
* increase of TP relative to nucleated cell count
* Leakage of blood or plasma into abdominal cavity
* No significant leukocyte chemotaxis
Proximal enteritis - CS
- colic signs, reflux
- Fever
- Decr peristaltic sounds
- Rectal: distended SI loops
Proximal enteritis - Clinical pathology
- PCV, TPP, lactate: ↑
- CBC – WBC count ↑↓↔
- Hypo; Na, Cl, K
- Prerenal azotaemia
- Increased AST, AP, GGT → liver damage
- Metabolic acidosis
- Abdominocentesis; yellow tube
Proximal enteritis - Tx (8)
- Supportive
- Nasogastric tubing
- Fluid therapy: Crystalloids, Ringers and colloids (HES)
- Antibiotics → Dysbacteriosis in large intent Penicillin, metronidazole, – Gentamicin, enrofloxacin (Gr-)
- Anti-inflammatory and analgesic therapy
– Flunixin meglumine, Butorphanol - Prokinetic drugs: Lidocaine (best), Metoclopramide
- Parenteral feeding
– Dextrose, amino acids, lipid, isotonic solution
– Blood glucose checks, insulin
Direct causes of diarrhoea
- Increased faecal water and electrolyte content
- Hypersecretion and malabsorption
Indirect causes of diarrhoea (5)
- Acute colonic inflammation causes increased prostaglandin release –> hypersecretion
- Some enterotoxins bind to secretory receptors
- VFA and sodium malabsorption causes increased permeability in the large colon
- Abnormal microflora produces a large amount of dissolved metabolites
- Altered intestinal motility forward content faster
Sequale of diarea
- Significant and fast loss of Na+, K+, Cl- and HCO3-
- Loss of plasma to intestinal lumen in severe cases
- Dehydration, metabolic acidosis, shock, renal insufficiency, death
Acute colitis - aeti
- Bacterial: Salmonellosis, Clostridiosis, Neorickettsiosis
- Parasitic: Strongylosis, Cyathostominosis, Anoplocephalosis
- Toxic: Antibiotic-associated diarrhoea, Cantharidin toxicosis
- Miscellaneous: Intestinal anaphylaxia, Carbohydrate overload, Sand enteropathy
