Diagnostics for weight loss

Question 1

What clinical history details do you need to collect when investigating intestinal causes of weight loss?

Answer 1

◦ Age and activity
◦ Perceived length of weight loss
◦ Diet: amount and frequency is important!
◦ Worming history
◦ Dental care
◦ Episodes of diarrhoea, soft manure, inappetence, colic…

Question 2

What environmental management details do you need to collect when investigating intestinal causes of weight loss?

Answer 2

◦ Type of pasture: size, grass coverage and species, weeds, trees..
◦ Sharing pasture with other horses (how many)
◦ Living with other animal species

Question 3

What should you include in your physical exam when investigating intestinal causes of weight loss?

Answer 3

◦ Body score
◦ Muscle waste: pay attention to head muscles, cervical and epaxial
◦ Presence of oedema: ventral, distal limbs
◦ Faecal staining on hindquarters
◦ HR, abnormal lung sounds, GI motility
◦ Dental exam
◦ Type and quality of faeces, presence of parasites, sand, gravel, long-stem fibre

Question 4

What information can abdominal ultrasound provide when investigating intestinal causes of weight loss?

Answer 4

◦ SI wall thickness: inguinal area, cranioventral abdomen, next to R-Kidney
‣ Abnormal >4mm
◦ LI wall thickness: right dorsal colon (11-13th ICS), left ventral abdomen
‣ Abnormal >6mm
◦ Thicker walls associated with reduced absoprtion
◦ Can only obtain images of 50% LI and 30% of SI
◦ Liver: right and left lobules: sharpness of edges, echogenicity, masses, gas shadowing structures
◦ Peritoneal fluid: anechoic viscous
‣ between abdominal wall and organ
◦ Masses: round, lobulated, variable echogenicity

Question 5

What further investigations can you do in intestinal causes of weight loss?

Answer 5

• intestinal function test
• intestinal biopsies
• faecal analysis

Question 6

What diagnostic results do you expect with inflammatory bowel disease?

Answer 6

Question 7

What are clinical signs associated with liver disease?

Answer 7

◦ Depression
◦ Anorexia
◦ Weight loss
◦ Abdominal discomfort (colic)
◦ Icterus
◦ Fever
◦ Photosensitization
◦ Hepatic encephalopathy: circling, walking compulsively, head pressing

Question 8

What parameters are important in liver disease?

Answer 8

Question 9

What further diagnostics can you undertake when investigating hepatic causes of weight loss?

Answer 9

• ultrasound
• biopsy