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Equine (Poppy) > Diarrhoea > Flashcards

Diarrhoea Flashcards

1
Q

Is diarrhoea in the neonate indicative of SI or LI disease?

A

LI

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2
Q

Is diarrhoea in the juvenile/adult indicative of SI or LI disease?

A

LI

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3
Q

What age are foals commonly weaned?

A

6 months

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4
Q

What age do foals begin eating roughage?

A

Towards 6 weeks (end of neonatal period)

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5
Q

Infectious causes of diarrhoea in the neonatal foal between 0 and 10 days of age

A

Viral: Rotavirus, Coronavirus (usually immunocompromised)
Gram +ve: Clostridium spp.
Gram -ve: E. coli, Salmonella spp., Actinobacillus spp.
Fungal (immunocompromised): Candida, Mucor
Protozoal: Cryptosporidium

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6
Q

Additional infectious causes of diarrhoea in neonatal foals 10 days to 6 weeks (majority same as 0-10 days)

A

Gram +ve: Rhodococcus equi (uncommon)
Parasites: Strongyloides westerii, Parascaris equorum, Strongylus vulgaris

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7
Q

How are neonates infected with Strongyloides westerii?

A

Through mares milk

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8
Q

Non-infectious causes of diarrhoea from 0-10 days

A

Foal heat diarrhoea
Secondary to meconium impaction
Errors in feeding (concentration/volume, particularly if orphaned)
Gastroduodenal ulceration
Sand enterocolitis
Systemic disease (sepsis, perinatal asphyxia syndrome/neonatal maladjustment syndrome)
Congenital lactose intolerance

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9
Q

Non-infectious causes of diarrhoea in foals 10 days to 6 weeks

A

Foal heat diarrhoea (<2w)
Secondary to meconium impaction
Errors in feeding (concentration/volume, post enteritis lactose intolerance)
Gastric ulceration
Sand enterocolitis
Antibiotic induced diarrhoea (oral)

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10
Q

Treatment of diarrhoea in the neonate

A

Underlying cause?
Consequences (fluid/electrolyte loss, bacterial translocation, albumin loss, nutrition)

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11
Q

Problem with providing nutrition in neonatal diarrhoea

A

Decreased absorption of nutrients = enteral rest/starving required
Must provide nutrition another way

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12
Q

Risk factors for developing GI disease in the neonate

A

Failure of passive transfer
Pre-existing disease
Poor hygiene in peripartum period
High stocking density
Antimicrobial administration
Milk replacer therapy

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13
Q

Clinical signs of acute diarrhoea in the juvenile/adult horse

A

Cow pat to high volume/hosepipe D+++
Quiet/depressed
Colic
Fever
Hypovolaemia
SIRS
Laminitis
Secondary infection

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14
Q

Infectious causes of acute diarrhoea in the young horse

A

Salmonella spp.
C. difficile
C. perfringens
Coronavirus
Cyathostomiasis
Lawsonia intracellularis
(Rhodococcus equi)

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15
Q

What pathogen causes equine proliferative enteropathy (thickened small intestine on ultrasound scan)?

A

Lawsonia intracellularis bacteria

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16
Q

What signs are seen with equine proliferative enteropathy?

A

Severe hypoalbuminaemia
Weight loss +++

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17
Q

Causes of chronic diarrhoea in the juvenile horse

A

Salmonella spp.
Cyathostomiasis
Right dorsal colitis
Sand enteropathy
Inflammatory bowel disease
Dietary
Lawsonia intracellularis
Rhodococcus equi

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18
Q

Which two causes of diarrhoea in the juvenile horse have increased risk geographically and on farms with history of disease/annual reoccurrence?

A

Lawsonia
R. equi

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19
Q

Diarrhoea is an incommon manifestation of Rhodococcus equi; what does it usually cause?

A

Respiratory disease

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20
Q

Risk factors for developing diarrhoea in the juvenile/adult horse

A

Gastrointestinal disease
Immunosuppression
Antimicrobials
General anaesthesia
Recent abdominal surgery
Hospitalisation
Other horses
Dietary change

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21
Q

Key consideration with diarrhoea cases

A

Isolation is necessary as it is difficult to rule infectious cause in/out

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22
Q

Clinical signs of chronic diarrhoea in the adult horse (compared with acute)

A

Cow pat to D+++ (not hosepipe)
Bright to depressed
Colic
Fever
Ventral oedema (albumin loss causes decrease in oncotic pressure)
Weight loss
Electrolyte imbalances
Often normovolaemic

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23
Q

Do horses have a risk of deteriorating rapidly with acute or chronic diarrhoea?

A

Acute

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24
Q

Causes of acute diarrhoea in the adult horse

A

Salmonella spp.
Clostridiosis
Coronavirus
Cyathostomiasis
Antimicrobial
Right dorsal colitis
Grain (carbohydrate) overload
Dietary

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25
Q

Nosocomial bacteria which causes large volume watery diarrhoea and is intermittently shed. Can also cause bacteraemia

A

Salmonella

26
Q

What bacterial infection in the adult horse develops following antimicrobials?

A

Clostridiosis

27
Q

Nosocomial

A

Comes from a hospital

28
Q

Is C. difficile or C. perfringens a more common cause of diarrhoea?

A

C. difficile

29
Q

Clostridium that can cause large volume haemorrhagic diarrhoea in the horse (mainly neonates, also adults)

A

C. perfringens (type A and C more common)

30
Q

Most important equine parasitic disease

A

Cyathostomiasis

31
Q

When is cyathostomiasis most commonly seen?

A

Spring

32
Q

Life cycle of cyathostomes

A

PPP 6-14w
Can remain encysted from weeks to 2y
Encysted hypobiotic larvae unaffected by most anthelmintics
IL3 emerge in Spring, many at once (clinical disease)

33
Q

Why do antimicrobials cause colitis?

A

Disrupt GI flora
Lack of competition for nutrients
Pathogenic bacteria proliferate

34
Q

Which antibiotics have a higher likelihood of causing antimicrobial associated colitis?

A

Antibiotics affecting anaerobes because obligate anaerobe population of the flora is most important

35
Q

Cause of right dorsal colitis

A

NSAIDs

36
Q

How does grain overload cause diarrhoea/SIRS/laminitis?

A

SI digestion overwhelmed so soluble carbohydrates (CHO) enter LI
Rapid fermentation by lactic acid producing bacteria lowers pH so gram negative bacteria die and endotoxins released
Lactic acid poorly absorbed = osmotic diarrhoea
Other bacteria overgrow and gut wall becomes compromised so bacteria and toxins enter circulation

37
Q

Causes of chronic diarrhoea

A

Salmonellosis
Cyathostomiasis
Right dorsal colitis
Sand enteropathy
Inflammatory bowel disease
Dietary (dietary imbalance/change in diet/change in flora)

38
Q

Most frequently isolated Salmonella spp.

A

Typhimurium

39
Q

Chronic diarrhoea caused by cyathostomiasis

A

Affects colon wall
Milder than acute disease

40
Q

Sand enteropathy

A

Abnormal accumulation of sand in the large intestine causing diarrhoea (often associated with acute intestinal obstruction)

41
Q

Causes of inflammatory bowel disease (4)

A

Multisystemic eosinophilic epitheliotropic disease/MEED
Granulomatous enteritis
Lymphocytic/plasmocytic enteritis/colitis
Lymphosarcoma

42
Q

Aim of diagnostics in diarrhoea

A

Determine likely cause
Determine need for supportive therapy
Determine need for specific therapy
Determine risk to in-contact horses and personnel

43
Q

Treatment of acute diarrhoea

A

Fluid replacement and electrolytes
Anti-inflammatories
Analgesia
Antimicrobials
Adsorbents
Nutrition
Specific therapy

44
Q

Fluid replacement for mild/moderate diarrhoea

A

Voluntary drinking +/- NGT

45
Q

Fluid replacement for moderate/severe diarrhoea

A

Hartmanns

46
Q

Why must a fluid bolus not be given quickly to a horse with diarrhoea?

A

Loss of albumin = decreased oncotic pressure
Increased risk of oedema if bolus given too quickly

47
Q

Electrolytes advised in horses with diarrhoea

A

Many: KCl
Some: NaHCO3 or Na

48
Q

Analgesia for diarrhoea

A

Flunixin meglumine?
Temporary relief: xylazine/detomidine +/- butorphanol
CRI for severe pain: butorphanol, lidocaine +/- ketamine

49
Q

Antimicrobial choice in horse with diarrhoea that is neutropaenic or showing signs of sepsis (secondary infections)

A

Penicillin IM and Gentamycin IV

50
Q

Antimicrobial for horse with Clostridiosis

A

Metranidazole PO

51
Q

Best probiotics in horses

A

Faecal transfaunation via NGT from horse that hasn’t had antimicrobials/no other infection

52
Q

Adsorbent used in horses with diarrhoea

A

Di-Tri Octahedral Smectitie (Biosponge) given SID/BID via NGT

53
Q

Nutrition for horse with diarrhoea

A

Ideally complete pelleted diet (no grain/hay)
Inappetent: good quality grass/hay/anything
Corn oil for added calories

54
Q

Specific therapy for right dorsal colitis

A

Misoprostol
Psylium

55
Q

Specific therapy for cyathostomiasis

A

Anthelmintics (Moxidectin)
Pre-treatment with steroids as inflammation expected (dexamethasone/prednisolone)

56
Q

Specific therapy for sand enteropathy

A

Psyllium

57
Q

Specific therapy for L. intracellularis

A

Doxycycline

58
Q

Management of sepsis in acute diarrhoea

A

Circulatory support (fluids +/- dobutamine)
Flunixin (block parts of sepsis cascade)
Cryotherapy (reduce laminitis)
Plasma? (Expensive to make a difference to protein levels)
Pentocyfyline? (Suppress pro-inflammatory cytokines?)
Polymixin B? (Prevents initiation of pro-inflammatory cascade?)

59
Q

Treatment of diarrhoea in the neonate

A

IVFT (care with sodium/acid base balance)
Antimicrobials (FPT/sepsis)
GI rest (PPN/TPN)

60
Q

Factors that indicate isolation is needed in diarrhoea

A

2 out of 3
Pyrexia
Neutropaenia
Diarrhoea

Equine (Poppy) (11 decks)

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