Digestion & Metabolism 2: Non-Equine LI Dz Flashcards
colic is usually specific to either the _____ ____ or ____ ____
SMALL INTESTINE or LARGE INTESTINE
signs of colic are not always present in WHAT kinds of lesions?
LI INFLAMMATORY LESIONS or COLITIS/D+
why is US particularly helpful for diagnosing LI intestinal lesions in CAMELIDS & SMALL RUMINANTS?
bc we CANNOT PALPATE THESE ANIMALS PER RECTUM
BASIC diagnostics for LI lesions… (6)
- HISTORY
- PE
- BASELINE LABS
- US
- FECAL EGG COUNT
- PCR or ELISA for INFECTIOUS PATHOGENS on FECES
3 most common CLINICAL SIGNS for CATTLE WITH LI DISEASE… (one is an or)
- SLOWER DROP IN MILK PRODUCTION/FEED CONSUMPTION
- CONSISTENT D+ or LACK OF MANURE
- COLIC
4 most common CLINICAL SIGNS for CAMELIDS WITH LI DISEASE…
- D+ or ABSENT OUTPUT
- TENESMUS
- INCREASED ABDOMINAL DISTENTION
- SEVERE COLIC
why does COLIC tend to be MORE SEVERE for LI OBSTRUCTION in CAMELIDS vs. CATTLE?
LESS SPACE/NOT AS LARGE OF AN LI IN CAMELIDS
3 distinct anatomical regions of LI that can be affected by INTESTINAL DZ?
- CECUM
- SPIRAL COLON
- DESCENDING COLON
a RIGHT-SIDED PING indicates a problem with WHAT part of LI?
what 2 problems?
CECUM
cecal DISTENTION or VOLVULUS
INFLAMMATORY lesions in the LI tend to show ____ signs when compared to ____ Dz
CHRONIC signs (takes a long time to show up) when compared to SI Dz
examination should be aimed at distinguishing ____ vs. ____ if we suspect LI dz in NON-EQUINE LA
what can make this differentiation MORE DIFFICULT?
OBSTRUCTION vs. INFLAMMATION
NO D+ CAN MAKE THIS MORE DIFFICULT!
why should we start observing animals FROM A DISTANCE during PE?
because LOOKING FOR SIGNS OF COLIC or D+ and CAMELIDS/SMALL RUMINANTS TEND TO BE NON-DEMONSTRATIVE
5 common PE findings for CAMELIDS/SMALL RUMINANTS for LI DZ?
- signs of SYSTEMIC INFLAMMATION/PAIN
- TACHYCARDIA
- ABDOMINAL DISTENTION
- DEHYDRATION/CARDIOVASCULAR COMPROMISE
- R-sided PING
- SUCCUSSION (fluid/gas)
3 common PALPATION PER RECTUM findings for LI DZ…
- DISTENDED CECUM = “BREAD BOX”
- DISTENDED SPIRAL COLON
- D+
if we find D+ on palpation per rectum, this localizes disease to the….
LI
camelids are more likely to show WHAT 2 clinical signs more than cattle in LI DZ?
- SIGNS OF SEVERE INFLAMMATION/SIRS
- ABDOMINAL DISTENTION due to anatomy
would we expect to see HYPOCHLOREMIC METABOLIC ALKALOSIS in LI dz? why or why not?
NO, because that’s only in SI lesions because HCl NOT NORMALLY ABSORBED IN SI
if we see DISTENDED LOOPS OF BOWEL ON US (shown), what 2 possible lesions can it be?
- DISTENDED SPIRAL COLON
- DISTENDED SI
DDxs for D+ in CATTLE… (6)
- SALMONELLA
- CORONAVIRUS
- BVDV
- JOHNE’S DZ
- CALF D+
- ENTEROTOXEMIA caused by C. PERFRINGENS
what is WINTER DYSENTERY?
CORONAVIRUS
what is the MOST COMMON CAUSE OF D+ in CAMELIDS?
give 3 examples?
4 other DISEASES?
ENDOPARASITISM
3 examples?
1. HOT complex (Haemonchus, Ostertagia, Teladorsagia)
2. EIMERIA
3. TRICHURIS (whipworms)
4 other diseases?
1. SALMONELLA
2. C PERFRINGENS
3. NEOPLASIA
4. JOHNE’S DZ
JOHNE’S DZ…
what is the name of the organism?
chronicity?
it’s an infection of the ___ ____
6 species it appears in?
incubation period?
95% of infected cattle….
2 transmissions?
MYCOBACTERIUM AVIUM subs. PARATUBERCULOSIS (MAP)
CHRONIC
infection of the GI TRACT
6 species?
1. CAMELIDS
2. CATTLE
3. SHEEP
4. GOATS
5. BISON
6. DEER
incubation period = 2-10 YEARS, so HARD TO MANAGE
95% of infected cattle NEVER SHOW CLINICAL SIGNS EVER
2 transmissions?
1. FECAL-ORAL, often in maternity pen
2. IN-UTERO
clinical signs in JOHNE’S DZ tend to appear… (2)
- AFTER incubation
- or at least AFTER 2 YEARS
4 common CLINICAL SIGNS of JOHNE’S DZ?
for the third clinical sign, what is the LIKELIHOOD in small ruminants, cattle, camelids?
- WEIGHT LOSS –> SEVERE EMACIATION
- DECREASED MILK PRODUCTION from D+
- DIARRHEA
CATTLE > CAMELIDS»_space; SMALL RUMINANTS - DISTAL LIMB & SUBMANDIBULAR EDEMA due to HYPOPROTEINEMIA
4 stages of JOHNE’S DZ INFECTION
STAGE 1 = INVASION PHASE
–> patient ingests mycobacterium & INVADES INTESTINAL CELLS
STAGE 2 = ECLIPSE PHASE
–> shedding but NOT DETECTABLE ON TESTS & NO CLINICAL SIGNS
–> lasts 2-10 years
STAGE 3 = ASYMPTOMATIC PHASE
–> occurs AFTER INCUBATION PERIOD, so still SHEDDING but FECAL & SERUM POSITIVE
STAGE 4 = CLINICAL SIGNS PHASE
–> HEAVY SHEDDING
–> BAD CLINICAL SIGNS w/ EMACIATION & D+ (if cow or camelid)
JOHNE’S DZ can occur in _____ age cows but ____ are most susceptible
ANY age cows but CALVES are most susceptible
how long does JOHNE’S DZ cause infection?
what 2 big problems does it cause for herds?
JOHNE’S DZ IS A LIFELONG INFECTION WITH NO TX
2 problems?
1. DECREASED MILK PRODUCTION
2. TRANSMISSION TO OTHER HERD MEMBERS VERY POSSIBLE
TESTING for JOHNE’S DZ….
when should we perform INDIVIDUAL testing? what 3 tests can we run & what’s the GOLD STANDARD?
what’s the goal of HERD testing?
what KINDS of samples should we use for HERDS?
if a test is POSITIVE, what does that mean?
perform INDIVIDUAL testing for PATIENTS WITH CLINICAL SIGNS
3 tests for INDIVIDUALS?
1. FECAL CULTURE IS THE GOLD STANDARD, fecal PCR can also be done
2. SEROLOGY (should be +)
3. MILK ELISA (should be +)
goal of HERD testing = TO DETECT & CULL POSITIVE INDIVIDUALS
we should use POOLED samples for herds
if a test is POSITIVE = animal is SHEDDING
CATTLE LI OBSTRUCTIONS tend to present as ___ ____
CAMELID LI OBSTRUCTIONS tend to be ___ ____ ____, but can also be what other 2 things?
in ALL OF THESE, what TYPE of lesions are these?
CATTLE LI OBSTRUCTIONS = CECAL DILATATION
CAMELID OBSTRUCTIONS tend to be SPIRAL COLON FECALITHS, but can also be…
1. CECAL IMPACTIONS
2. SPIRAL COLON IMPACTIONS
all are NON-STRANGULATING LESIONS
if a NON-EQUINE LA has a LI OBSTRUCITON, then it REQUIRES…
SURGERY
FAT NECROSIS around the DESCENDING COLON…
causes WHAT kind of obstruction?
common in WHAT 2 kinds of animals?
causes WHAT clinical sign?
causes DESCENDING COLON/RECTUM OBSTRUCTION
common in…
1. HIGH BCS CATTLE
2. BEEF CATTLE
causes REDUCED MANURE PRODUCTION
NEOPLASIA/LYMPHOMA…
causes WHAT kind of obstruction?
causes WHAT clinical sign?
causes DESCENDING COLON/RECTUM OBSTRUCTION
causes REDUCED MANURE PRODUCTION
RECTAL PROLAPSE…
causes WHAT kind of obstruction?
usually associated with what 3 clinical signs?
in PIGS, can be related to…. (1)
3 tx options?
causes DESCENDING COLON/RECTUM OBSTRUCTIONS
usually associated with…
1. TENESMUS
2. hx of D+
3. TAIL DOCKING
can be related to HORMONES in pigs
3 tx?
1. EPIDURAL
2. REPLACEMENT
3. +/- RESECTION
for INFLAMMATORY/INFILTRATIVE DZ, we usually see WHAT clinical sign?
D+
CECAL TORSION…
what KIND of lesion is this?
what SPECIES is most likely to get it?
STRANGULATING LI LESION
common in CATTLE
SPIRAL COLON VOLVULUS…
what KIND of lesion is this?
what SPECIES is most likely to get it?
in CATTLE, causes what sign?
STRANGULATING LI LESION
most common in CAMELIDS
in CATTLE, causes ACUTE SEVERE PAIN
INTUSSUSCEPTION in LI…
what KIND of lesion is this?
what are the 2 types? (name & description)
common in WHAT 3 species?
overall commonality?
STRANGULATING LI LESION
2 types?
1. CECOCECAL = cecal APEX going into BODY
2. CECOCOLIC = cecum going into ASCENDING COLON
3 species?
1. CALVES
2. ALPACAS
3. LLAMAS
overall RARE
CECAL DILATATION…
what KIND of lesion is this?
= what is it?
what SPECIES can we see this in?
NON-STRANGULATING OBSTRUCTION
= DILATATION with GAS/DIGESTA prevents ANYTHING FROM GETTING THROUGH ILEUM
can see in CATTLE
CECAL RETROFLEXION…
what KIND of lesion is it?
= what happens?
what SPECIES can we see this in?
NON-STRANGULATING LESION
= ILEOCECAL-COLIC JUNCTION flips either DORSALLY or VENTRALLY, causing the cecum to point CRANIALLY when it should be pointing CAUDALLY
can see in CATTLE
if you see these clinical signs in A COW…
1. R-SIDED DISTENTION
2. R-SIDED PING
3. CECAL DISTENTION on PALPATION PER RECTUM
then WHAT 3 disorders would you suspect?
OVERALL, WHAT ARE THESE?
- CECAL DILATATION
- CECAL RETROFLEXION
- CECAL TORSION
OVERALL = CECAL DISORDERS
MEDICAL or Sx management for CECAL DISORDERS depends on… (2)
if in doubt, what should you do?
- DIAGNOSIS = is it INFLAMMATORY or OBSTRUCTIVE
(IF OBSTRUCTIVE –> SX) - RESPONSE TO MEDICAL STABILIZATION
if in doubt, SURGICAL EXPLORATION!
5 medical managements for LI DZ in NON-EQUINES… (small ruminants & camelids)
hints: nutrition, transplant, inflammation, sepsis parasites
- NUTRITIONAL SUPPORT = remove GRAIN/SILAGE or any LONGSTEM ROUGHAGE
- GI SUPPORT via TRANSFAUNATION, THIAMINE or PANTOPRAZOLE
- NSAIDs (flunixin meglumine) for INFLAMMATION
- +/- BROAD-SPECTRUM ANTIMICROBIALS if worried about TRANSLOCATION ACROSS VERY INFLAMED COLON OR GI MUCOSA
- PARASITE DEWORMERS or COCCIDIOSTATS for EIMERIA
for OBSTRUCTIVE lesions in the LI, what 3 different procedures can we perform?
for all 3, what APPROACH do we use?
usually ____ are STANDING, while ___ ____ ____ are ______
3 procedures?
1. ENTEROTOMY
2. REDUCTION
3. ANASTOMOSIS
for all 3, use a RIGHT PARALUMBAR APPROACH
usually CATTLE standing, while CAMELIDS, SMALL RUMINANTS, CALVES are ANESTHETIZED
2 indications for ENTEROTOMY?
- CECAL DISORDERS
- SINGLE SPIRAL COLON CECOLITHS/IMPACTIONS
2 indications for REDUCTION?
- CECAL TORSION
- SPIRAL COLON VOLVULUS
1 indication for ANASTOMOSIS?
ATRESIA COLI
TYPHLOTOMY is used for ____ diseases in _____, which include… (3)
use WHAT kind of approach under _____ _____
used for CECAL diseases in CATTLE, including…
1. CECAL DILATATION
2. CECAL RETROVERSION
3. CECAL TORSION
use RIGHT PARALUMBAR approach under LOCAL ANESTHESIA
ATRESIA COLI…
what AGE/ANIMAL most susceptible?
usually 2 historical findings?
tends to occur in WHAT 2 regions?
common in WHAT BREED?
associated with WHAT veterinary procedure?
usually NEWBORN CALVES
2 hx…
1. ABDOMINAL DISTENTION & PAIN
2. LACK OF MECONIUM or FECAL PRODUCTION
tends to occur in…
1. SPIRAL COLON (mid)
2. ASCENDING LOOP
common in HOLSTEINS (DAIRY CATTLE)
associated with PALPATION OF EMBRYONIC VESICLE AT 42 DAYS PREGNANCY
once ATRESIA COLI is suspected, what should we do? why?
we should do PROMPT SURGICAL INTERVENTION
CALVES CAN BE COME VERY SEPTIC/SEPTIC PERITONITIS QUICKLY
PRIOR to sx for ATRESIA COLI, what should we do for the patient?
3 treatments?
what KIND of anastomosis should be performed at the end?
we should STABILIZE THE PATIENT prior to sx
3 treatments?
1. IV FLUIDS
2. BROAD SPECTRUM ANTIBIOTICS
3. +/- PLASMA TRANSFUSION
should perform a SIDE-TO-SIDE ANASTOMOSIS to try and EQUALIZE LUMEN SIZE BETWEEN BOWELS
ATRESIA ANI..
how is it diagnosed?
what SPECIES is it more common in?
usually associated with OTHER ___ ___, such as… (4)
common CLINICAL SIGN?
treatment?
diagnosis = LIFT UP TAIL & NO ANUS THERE
more common in BEEF»_space; DAIRY breeds
usually associated with OTHER CONGENITAL DEFECTS, such as…
1. POLYDACTYLY
2. CLEFT PALATE
3. CONGENITAL HEART PROBLEMS
4. ABSENT/CROOKED TAIL
clinical sign = LACK OF MECONIUM PRODUCTION
treatment = SURGICALLY CREATE AN ANUS
RECTAL PROLAPSE…
occurs more commonly in WHAT 3 species?
grade 1-4?
occurs more commonly in…
1. CATTLE
2. SHEEP
3. PIGS
GRADE 1 = MUCOSA ONLY
–> VERY UNCOMMON
GRADE 2 = COMPLETE PROLAPSE OF ALL LAYERS
GRADE 3 = VARIABLE AMOUNT OF DESCENDING COLON INTUSSCEPTS into the RECTUM + GRADE 2
GRADE 4 = RECTUM + DESCENDING COLON PROLAPSE
if we have a GRADE 4 RECTAL PROLAPSE, it’s usually…
usually NOT FIXABLE bc LOSS OF VASCULAR SUPPLY
tx for GRADE 1 vs GRADE 2 RECTAL PROLAPSE?
GRADE 1 = REPLACEMENT + PURSE STRING SUTURES
GRADE 2 = SUBMUCOSAL RESECTION & SUTURE ENDS TOGETHER
tx for GRADE 3 RECTAL PROLAPSE?
why can this be difficult?
FULL THICKNESS RESECTION & ANASTOMOSIS
difficult bc often HEMORRHAGE and HARD TO DO
