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Equine Med Final (Old Material) > Diarrhea (key points only) > Flashcards

Diarrhea (key points only) Flashcards

1
Q

What should you think of causing diarrhea with prior drug use in the history (NSAIDs)?

A
  • Right dorsal colitis
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2
Q

What is a major component of the normal horse microbiome?

A
  • Firmicutes
  • Actinobacteria
  • Spirochetes
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3
Q

What bacteria tend to be in greater abundance in horses with diarrhea?

A
  • Fusobacteria

- VERY variable

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4
Q

Clinical signs associated with diarrhea

A
  • Anorexia, obtundation, fever
  • Diarrhea of variable severity
  • Colic, abdominal distention
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5
Q

Do horses with enteritis have diarrhea?

A
  • NO
  • Often fever, colic, low WBC count
  • NO DIARRHEA
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6
Q

What part of the horse GIT is dysfunctional in an adult horse with diarrhea?

A
  • Colon dysfunction
  • Colon, cecum or both
  • Failure to absorb excess water or increased fluid secretion
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7
Q

Clinical pathologic changes in a horse with diarrhea

A
  • Hemoconcentration
  • pre-renal azotemia
  • Neutropenia, left shift, toxic changes
  • Hypoproteinemia, hypoalbuminemia
  • Metabolic acidosis
  • Hyponatremia, hypochloremia, hypokalemia
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8
Q

Abdominocentesis of a horse with diarrhea

A
  • Generally normal
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9
Q

Infectious etiologies of horses with acute diarrhea

A
  • Salmonella
  • Clostridia
  • Potomac horse fever
  • 70% are unknown
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10
Q

Salmonella diarrhea

A
  • Invasive in the cecum and colon
  • +/- enterotoxic
  • Endotoxin
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11
Q

Clinical signs of horses with Salmonella

A
  • May show no clinical signs (carriers are quite common)
  • Mild clinical disease
  • Acute colitis (VERY sick)
  • Small colon impaction
  • Proximal enteritis
  • Chronic diarrhea
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12
Q

How can a horse contract Salmonella?

A
  • Contaminated feed or water
  • Contaminated hands
  • Ingestion of dead insects
  • Contact with a contaminated surface
  • Lots of ways basically
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13
Q

Risk factors for Salmonella

A
  • younger
  • Stress or transport
  • Hospitalization
  • NG tubing
  • Antimicrobial treatment
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14
Q

Diagnosis of Salmonella

A
  • Fecal culture (DIFFICULT)
  • Fecal PCR (doesn’t let you know if it’s alive or not)
  • Negative culture doesn’t rule it out (Take serial cultures)
  • Necropsy (bowel, LN)
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15
Q

Treatment for Salmonella

A
  • SUpportive
  • MAYBE antibiotics?
  • Prolonged shedding
  • Zoonotic potential
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16
Q

What cell type is Potomac horse fever often invading?

A
  • Monocytes and macrophages

- Colonic epithelium, mast cells

17
Q

Season for Potomac horse fever

A
  • May-Nov
18
Q

Transmission of Potomac horse fever

A
  • # 1 is ingestion of the aquatic insect that has picked up the metacercaria
  • Could be ingestion of the egg
  • Not the ingestion of a snail
  • Ingestion of cercaria possible too
  • Ingestion of the metacercaria in an aquatic insect larva/nymph or adult
19
Q

Diagnosis of Potomac horse fever

A
  • Paired samples (IFA, ELISA)

- PCR in blood or feces considered most definitive

20
Q

Treatment of Potomac Horse Fever

A
  • Oxytetracycline
  • Typically rapid response
  • Suppotive care
21
Q

Vaccination with Potomac Horse Fever

A
  • Different strains!
22
Q

Clostridial diarrhea

A

C. perfringens
C. dificile
C. sordelli
Can have co-infections

23
Q

What toxins do Clostridium spp produce?

A
  • Enterotoxins
  • Beta toxin - type C
  • Toxin A is an enterotoxin
  • Toxin B is a cytotoxin
24
Q

Risk factors for Clostridial diarrhea

A
  • Antibiotics

Stress

25
Q

Antibiotics to never use in horses?****

A
  • Lincomycin
  • Clindamycin
  • Florfenicol
  • Tilmicosin
  • Erythromycin
  • Tylosin
  • Tiamulin
26
Q

Diagnosis of Clostridium

A
  • C. perfringens is in 12-22% of normal horses
  • High percentage of foals
  • Culture probably not super helpful
  • Toxin identification (cellular cytotoxicity, PCR for toxin genes, enzyme immunoassays)
27
Q

Treatment for Clostridial diarrhea

A
  • Anti-inflammatory meds
  • Metronidazole (anaerobic), PPG
  • Limit feed intake
  • Biosponge
  • Sacchromyces boulardii
28
Q

Prevention of Clostridial diarrhea

A
  • Probiotics??? (Lactobacillus not super helpful!)
  • Vaccination of pregnant mares
  • Can start mares on antitoxin when they foal
29
Q

Coronavirus

A
  • Anorexia, lethargy fever
  • Diagnose with fecal PCR
  • Usually self-limiting
  • VERY thickened mucosa on ultrasound
30
Q

Lawsonia Intracellularis age of affected horse

A
  • Primarily weanlings
  • Proliferative enteropathy
  • Characterized by weight loss, obtundation, edema
  • Hypoproteinemia and hypoalbuminemia
  • Diagnose with PCR and serology
31
Q

Chronic diarrhea causes

A
  • Diet, parasitism, sand
  • Abscesses
  • Salmonella
  • Right dorsal colitis
  • IBD
32
Q

Diagnosis for chronic diarrhea

A
  • xray for sand
  • 5 fecal cultures for Salmonella
  • Fecal PCR
  • Fecal flotation for parasites
  • Fecal cytology for protozoa
33
Q

IBD diagnosis

A
  • Have to rule everything else out
  • Treatment is steroids
  • Can be diffuse
  • Submucosal layer is thickened
34
Q

Diagnostic approach to diarrhea in general

A
  • Symptomatic treatment and hope?
  • Fecal diagnostics (culture is the standard; fecal flotation, fecal cytology, fecal PCR!)
  • Ultrasound
  • Absorption tests with glucose
  • GI neoplasia (LSA is most common)
35
Q

Treatment for diarrhea first question?

A

1 Do they need treatment?

  • Often they have a large volume fluid loss and thus need a large volume fluid replacement
  • Often need colloids due to low albumin
36
Q

Other treatment for diarrhea

A
  • Anti-inflammatory meds (Flunixin, pentoxyfylline)
  • Intestinal protectants
  • Smectite clay
  • Sacchromyces boulardii
37
Q

What treatment if too many bacteria or protozoa?

A
  • metronidazole or some other one
38
Q

What treatment if too few protozoa?

A
  • fecal transfaunation
  • 2-3x a day
  • Done most often for chronic diarrhea patients
  • Pretty unclear how much volume
  • Added to a gallon of water?
39
Q

3 most common causes of weight loss in horses

A
  1. Teeth
  2. parasites
  3. Nutrition

Equine Med Final (Old Material) (11 decks)

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