Diarrhea-Sanchez

Question 1

Infectious causes acute diarrhea

Answer 1

1. Salmonella
2. Neorickettsia risticii
3. Clostridium difficile
4. Clostridium perfringens
5. Larval cyathostomosis
6. Viral dz
   - rotavirus
   - coronavirus

Question 2

Non-infectious causes acute diarrhea

Answer 2

1. Diet changes
2. Antibiotics (routine, ionophore)
3. Hoary alyssum
4. Heavy metals
5. Cantharidin (blister beetle)
6. NSAIDS (RDC)

Question 3

Signalment and hx

1. Young horses
2. Performance horses
3. Alfalfa hay
4. Recent feed change
5. Number animals
6. Previous antimicrobial tx

Answer 3

1. Young horses-clostridial infection
2. Performance horses-NSAID
3. Alfalfa hay-cantharadin
4. Recent feed change-grain overload
5. Number animals-susp toxic/infectious salm, c. difficile
6. Previous antimicrobial tx-salm, c. difficile

Question 4

Diagnostics

1. Culture feces
2. PCR blood
3. PCR feces
4. Additional fecal tests

Answer 4

1. Culture feces
   - salmonella
2. PCR blood
   - N. risticii (EDTA)
3. PCR feces
   - clostridial toxins (perfringens/difficile)
   - coronavirus
   - lawsonia intracellularis (age-dependent)
   - salmonella
4. Additional fecal tests
   - McMaster’s quantification
   - Sand sedimentation
   - Gram stain (Clostridium)

Question 5

Indications for abx

Answer 5

1. Potomac horse fever
2. Substantial leukopenia (neuts < 1,000)
3. Peritonitis

Question 6

N. risticii (PHF)

Answer 6

1. Biphasic, not chronic
2. DX by blood PCR (EDTA)
3. TX oxytetracycline

Question 7

Clostridial infection

Answer 7

1. Lots of risk factors
2. Fecal toxin test/culture/gram stain
3. Biosponge, Metronidazole

Question 8

Equine coronavirus

Answer 8

1. GI and neuro signs

2. Fatality with hyperammonemia

Question 9

Cantharidin toxicosis

Answer 9

1. Mucosal sloughing
2. DX-toxin detection serum, urine, gastric contents
3. HypoCa, HypoMg

Question 10

Chronic diarrhea Inflammatory

Answer 10

1. Chronic salmonellosis
2. Parasitism
   - cyathostomosis
   - mixed strongyle infection
3. IBD
4. Neoplasia
5. RDC
6. Sand enteropathy
7. Peritonitis

Question 11

Chronic diarrhea Non-inflammatory

Answer 11

1. Dietary indiscretions
2. Sand
3. Alterations of normal flora
4. Liver dz

Question 12

Can have sig protein loss in…. (5)

Answer 12

1. IBD
2. RDC
3. Neoplasia
4. Salmonellosis - variable
5. Cyathostomosis

Question 13

RDC treatment

Answer 13

1. Avoid NSAIDS
2. Complete pelleted diet - small, frequent meals
3. Psyllium mucilloid
4. Sucralfate
5. Metronidazole
6. Misoprostol

Question 14

Cyathostomosis syndromes (6)

Answer 14

1. Acute diarrhea young adults (esp winter)
2. Recurrent diarrhea in adults
3. Rapid weight loss and edema +/- diarrhea
4. Chronic weight loss and ill thrift
5. Non-specific colic
6. Cecocecal and cecocolic intussceptions

Question 15

Larval cyathostomosis
DX
TX

Answer 15

DX
-gross exam feces
-fecal wet prep
-often fecal neg
TX
-anthelmentics (fenbendazole, moxidectin)
-corticosteroids

Question 16

Peritonitis causes (5)

Answer 16

1. GI perf
2. Iatrogenic (rectal tear, castration)
3. Trauma (post-foaling)
4. Post-op
5. Actinobacillus equuli

Question 17

Peritonitis foals (5)

Answer 17

1. Gi Perf
2. Omphalitis
3. Uroperitoneum
4. Abscesses
5. Sepsis

Question 18

Peritonitis DX

Answer 18

Ab tap culture

Ab cell count > 10,000 cells/microL

Question 19

Peritonitis TX

Answer 19

1. Exploratory
2. Antibiotics
3. Lavage

Question 20

Peritonitis Prognosis

1. GI rupture
2. Uterine tear
3. A. equuli
4. Post-op

Answer 20

1. GI rupture-Grave
2. Uterine tear-Fair to Good
3. A. equuli-Good
4. Post-op-Moderate