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Digestive System Flashcards

DS01-09

1
Q

start of DS01

name 4 abnormalities observed while eating in a horse with dental disease

A
  1. loss of feed or quidding
  2. difficulty chewing or refusing to eat
  3. excessive salivation
  4. packing of feed into cheeks
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2
Q

name 3 changes in ridden performance seen in horses with dental disease

A
  1. resistance and evasion to the bit or bridle
  2. head tilting or tossing, mouth open and/or irregular head carriage
  3. dangerous ridden behaviours (rearing or bolting)
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3
Q

name 4 facial abnormalities seen in horses with dental disease

A
  1. facial swellings and/or discharge
  2. foul odour from mouth or nostrils
  3. nasal discharge (usually unilateral)
  4. enlarged submandibular lymph nodes
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4
Q

how often should regular dental exams be done on horses

A

at least every 12months

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5
Q

name 4 diagnostic procedures that can be performed in a first opinion setting for a horse with suspected dental disease

A
  1. clinical exam
  2. oral exam
  3. upper airway endoscopy
  4. radiography
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6
Q

name the 6 steps of the oral exam in a horse

A
  1. history, clinical exam, watch eat
  2. sedation
  3. external exam and check rostral cavity
  4. place speculum, lavage mouth
  5. assess caudal oral cavity
  6. chart and treatment plan
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7
Q

name 10 pieces of equipment you should have access to in order to perform a thorough oral exam on a horse

A
  1. bright light source
  2. speculum
  3. gloves
  4. dental syringe
  5. dental mirror
  6. periodontal depth probe
  7. occlusal surface explorer
  8. high pressure water irrigation
  9. diastema forceps
  10. dental chart
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8
Q

name the piece of equipment

used to assess depth of periodontal pockets in cases of periodontal disease or depth of infundibular caries

A

periodontal depth probe

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9
Q

name the piece of equipment

used to identify defects in secondary dentine on occlusal surface of teeth

A

occlusal surface explorer

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10
Q

what is the recommended sedation in order to perform an oral exam?

A

combo of alpha-2 agonist and an opioid

(romifidine or detomidine and butorphanol)

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11
Q

name 4 things the incisors should be assessed for during an oral exam

A
  1. dental calculus or draining tracts around gingival margins
  2. diastemata (food packing between teeth)
  3. tooth mobility
  4. secondary dentine defects
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12
Q

until what age can horses be aged by their teeth?

A

until 5 years

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13
Q

when does the first deciduous incisor (Triadan 01) erupt in horses?

A

at birth

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14
Q

when does the second deciduous incisor (Triadan 02) erupt in horses?

A

within 4-6 weeks of birth

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15
Q

when does the third deciduous incisor (Triadan 03) erupt in horses?

A

within 6-9 months of birth

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16
Q

when does the first permanent incisor (Triadan 01) erupt in horses?

A

2.5 years

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17
Q

when does the second permanent incisor (Triadan 02) erupt in horses?

A

3.5 years

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18
Q

when does the third permanent incisor (Triadan 03) erupt in horses?

A

4.5 years

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19
Q

name 5 benefits of using oral endoscopy for an exam

A
  1. visualise subtle disorders
  2. records pictures and videos for continued monitoring
  3. allows client to observe pathology in real time
  4. useful for specialist procedures
  5. sometimes tolerated better than mirror
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20
Q

what is the main indication for upper airway endoscopy?

A

horses with unilateral nasal discharge

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21
Q

what is the most common cause of sinusitis in horses?

A

dental disease

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22
Q

name 4 indications for oral radiography

A
  1. fractured or loose teeth
  2. diseased incisors
  3. suspected sinusitis
  4. facial swelling and/or drainage tracts from face
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23
Q

name the 3 views that should be taken for oral radiography

A
  1. latero-lateral
  2. dorsoventral
  3. oblique views (dorso30lateral-ventrolateral oblique for maxillary arcades)
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24
Q

in oral radiographs, which side should the label be associated with?

A

side adjacent to plate

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25
Q

what are latero-lateral radiograph views of the oral cavity used to image?

A

paranasal sinuses and conchal bullae

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26
Q

name 3 abnormalities that can be seen with latero-lateral radiographs of the oral cavity

A
  1. fluid lines
  2. intra-sinus soft tissue opacities
  3. fractures
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27
Q

what are oblique radiograph views of the oral cavity used to image?

A

maxillary cheek tooth apices

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28
Q

name 7 abnormalities that can be seen with oblique radiographs of the oral cavity

A
  1. periapical sclerosis
  2. periapical halo formation
  3. peridontal ligament widening
  4. loss of lamina dura
  5. clubbing of tooth apices
  6. hypercementosis
  7. reserve crown fragmentation
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29
Q

what are dorsoventral radiograph views of the oral cavity used to image?

A

nasal cavity and axial compartments of paranasal sinuses

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30
Q

name 2 abnormalities that can be seen with dorsoventral radiographs of the oral cavity

A
  1. ventral conchal sinusitis
  2. space occupying lesions
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31
Q

what is the major disadvantage of oral radiographs

A

difficult to interpret

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32
Q

name 3 advantags of oral CT scans

A
  1. prevents superimpositions of anatomical structures
  2. allows user to look at tissue and bone in multiple orientations
  3. can 3D reconstruct images post-processing
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33
Q

name 4 indications for oral CT

A
  1. radiographs equivocal or normal in face of disease
  2. planning Tx for complex dental or sinus conditions
  3. if previous medical or surgical Tx unsuccessful
  4. evidence of extensive disease or extent of disease unknown

(referral level procedure!)

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34
Q

start of DS02

name the 3 dental hard tissues

A
  1. dentin
  2. enamel
  3. cementum
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35
Q

which dental hard tissue is the most calcified?

A

enamel

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36
Q

which dental hard tissue is the least calcified?

A

cementum

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37
Q

name the dental hard tissue

wears first, leaving dentin with elevated regions of enamel called transverse ridges that help grind forage

A

cementum

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38
Q

there are 2 of these along the buccal surface of each maxillary cheek tooth which act as pillars to strengthen teeth and increase occlusal surface area

A

cingula

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39
Q

where do dental overgrowths occur on the maxillary arcade?

A

buccal aspect

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40
Q

where do dental overgrowths occur on the mandibular arcade?

A

lingual aspect

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41
Q

this is a disparity in width between maxillary and mandibular arcades which contributes to dental overgrowths

A

anisognathia

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42
Q

this is the removal and shaping of tooth crown to decrease interference with another tooth or eliminate soft tissue trauma

A

odontoplasty

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43
Q

name 3 things that are removed during odontoplasty

A
  1. sharp enamel points associated with soft tissue lacerations/ulcerations
  2. overgrowths that create abnormal forces along occlusal surface
  3. overgrowths as consequence of malocclusions that cause soft tissue trauma
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44
Q

what is the max amount of secondary dentine that can be removed at one time during odontoplasty to avoid pulp horn exposure

A

no more than 2-3mm

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45
Q

name the 4 types of rasps needed for odontoplasty

A
  1. up-angled
  2. medium open angled
  3. long straight
  4. short offset
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46
Q

name 2 motorised instruments commonly used for odontoplasty

A
  1. rotary burr
  2. rotary discs
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47
Q

this is a malocclusion in which maxillary incisors and canine teeth project over mandibular teeth excessively;
aka ‘parrot mouth’

A

brachygnathism

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48
Q

name the 2 types of brachygnathism

A
  1. overjet
  2. overbite
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49
Q

name the type of brachygnathism

upper incisors protrude rostrally in relation to lower incisors;
often protrude at an outward angle;
horizontal misalignment of teeth

A

overjet

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50
Q

name the type of brachygnathism

occlusal surfaces of maxillary incisors lie in front of occlusal surfaces of mandibular incisors ;
vertical misalignment of incisors

A

overbite

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51
Q

how to treat brachygnathism in foals?

A

surgically brace upper incisors to cheek teeth

(prior to 6mo of age)

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52
Q

how to treat brachygnathism in adult horses?

A

reduce overgrowths on 06s, 11s, and central incisors bi-anually

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53
Q

name the type of malocclusion

aka ‘sow mouth’
uncommon in horses, more common in donkies, mini horses, and ponies;
clinically insignificant but may develop overgrowths

A

underbite

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54
Q

these are permanent incisors in addition to the normal 6 on each arcade;
have long reserve crowns when compared to retained deciduous incisors;
extraction difficult and risks damaging normal teeth

A

supernumerary incisors

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55
Q

name 3 treatments that should be given for incisor fractures in acute stages

A
  1. tetanus prophylaxis
  2. antibiotics (7-10d, TMPS)
  3. NSAIDs
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56
Q

this is resorption of reserve crown, apical region and adjacent alveolar bone with proliferation of irregular cementum in lytic regions;
prominent clinical feature;
primarily involves incisors and canine teeth

A

EOTRH
(Equine Odontoclastic Tooth Resorption and Hypercementosis)

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57
Q

name 5 clinical signs of EOTRH
(Equine Odontoclastic Tooth Resorption and Hypercementosis)

A
  1. reduced ability of grasping apples and carrots
  2. sensitivity to placing a bit in mouth
  3. head shaking
  4. hypersalivation
  5. head shyness
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58
Q

what age of horses are mostly affected by EOTRH
(Equine Odontoclastic Tooth Resorption and Hypercementosis)

A

older horses (15+ years)

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59
Q

name 4 abnormalities on oral exam seen in horses with EOTRH
(Equine Odontoclastic Tooth Resorption and Hypercementosis)

A
  1. hyperaemia
  2. drainage tracts within gums
  3. calculus and feed accumulation around teeth
  4. gingival recession
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60
Q

name 3 abnormalities seen on radiographs in a horse with EOTRH
(Equine Odontoclastic Tooth Resorption and Hypercementosis)

A
  1. bulbous enlargement of apices of involved teeth
  2. resorptive lesions of reserve crowns
  3. widening of periodontal space
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61
Q

how to treat EOTRH
(Equine Odontoclastic Tooth Resorption and Hypercementosis)?

A

surgical extraction of clinically affected teeth

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62
Q

in what sex of horses are canine teeth absent or rudimentary

A

females

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63
Q

these are the small, vestigial first premolars (Triadan 05)

A

wolf teeth

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64
Q

name 5 indications for wolf teeth removal

A
  1. displaced
  2. large
  3. blind
  4. fractured
  5. mandibular
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65
Q

which artery could be lacerated during wolf teeth extraction

A

greater palatine artery

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66
Q

start of DS05

name 7 suggested indications for surgery/euthanasia of colics

A
  1. severe, continuous pain showing no improvement w analgesia
  2. pulse >60 (progressively rising and weakening)
  3. progressive CV collapse
  4. rectal findings positive for acute abdominal disease
  5. progressive reduction in intestinal motility
  6. increasing abd distension
  7. serosanguineous peritoneal fluid w incr protein & WBCs
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67
Q

name 7 steps of tasks prior to referring/transferring colics to a referral centre

A
  1. refer early
  2. decompress stomach (just prior to departure)
  3. analgesia for travel
  4. stabilise prior to referral
  5. put rug on horse and apply leg bandages
  6. provide referral centre w detailed Hx and Tx given
  7. provide owner with good directions to referral centre
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68
Q

name 4 steps of general management of simple colics (when no indications for Sx have been thoroughly evaluated)

A
  1. house on deep inedible bedding
  2. remove all feed for several hours (until several piles of normal faeces have been passed)
  3. provide free access to water
  4. hand walk horse 10-15min every 2-3h (owner)
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69
Q

name 3 reasons you must think carefully before administering drugs to horses with colic

A
  1. potentially contraindicated due to mode of action (reduced GI motility?)
  2. may mask important indicators of requirements for Sx
  3. may alter subsequent clinical exam findings
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70
Q

name a common 1st line analgesic used for treatment of colic;
do not depress gut motility;
excessive usage can lead to side effects: GI ulceration, renal papillary necrosis

A

NSAIDs

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71
Q

name the commonly used analgesic in colic cases

less likely to mask the CV signs of endotoxaemia;
not licensed for use in colic

A

Phenylbutazone

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72
Q

name the analgesic commonly used in colic cases

esp effective in reducing effects of endotoxins on CV parameters;
use only after a thourough evaluation

A

Flunixin meglumine

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73
Q

name the analgesic commonly used in colic cases

very potent analgesics;
temporarily prolong gut transit time;
do not mask the clinical signs of endotoxaemia

A

opioids

(butorphanol and morphine)

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74
Q

name the sedative commonly used in colic cases

sedation and good visceral analgesia;
side effects: reduced gut motility and bradycardia - influence on clinical parameters

A

alpha-2 agonist

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75
Q

name the alpha-2 agonist

potent visceral analgesia;
short duration of action (20-30min) - transient masking of important clinical findings

A

xylazine

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76
Q

name the alpha-2 agonist

30-40min duration;
least amount of ataxia

A

romifidine

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77
Q

name the alpha-2 agonist

longest duration of action (60+ min);
may result in greatest degree of ataxia

A

detomidine

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78
Q

name the spasmolytic drug commonly used in colic cases

metamizole (NSAID) + Butylscopolamine bromide (spasmolytic);
commonly used first line of treatment

A

buscopan compositum

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79
Q

name the spasmolytic drug commonly used in colic cases

hyoscine butylbromide;
no NSAID;
useful to facilitate per rectum exam

A

buscopan vials

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80
Q

name 4 laxatives that can be used for treatment of simple large intestinal impactions

A
  1. isotonic fluid
  2. oral magnesium sulphate
  3. liquid paraffin
  4. dioctyl sodium sulfosuccinate (Dioctyl)
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81
Q

name the IV fluid used for treating colic

correction of dehydration;
hyperinfusion for impactions;
most commonly used

A

polyionic fluid (Hartmann’s)

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82
Q

name the IV fluid used for treating colic

rapid restoration of vascular fluid volume (stabilisation of shock patient);
at expense of intracellular and interstitial fluid volume;
deficit must be corrected by immediate IV infusion of large volumes isotonic fluid

A

hypertonic (7.2%) saline

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83
Q

name the IV fluid used for treating colic

restoration of vascular fluid volume;
good retention in vascular space

A

colloids

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84
Q

name the specific colic

usually secondary to distal (SI) obstruction - fluid accumulation;
occasionally primary (highly fermentable feeds - gas accumulation);
Dx: nasogastric intubation - reflux, gastroscopy following feed witholding, U/S gastric margin, rectal - caudal displacement of spleen

A

gastric dilation

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85
Q

name the specific colic

rare in UK;
caused by C. perfringens?;
often febrile, incr gastric reflux of ‘tomato soup’ fluid, decr gut sounds

A

anterior enteritis

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86
Q

name 3 medical treatments of anterior enteritis

A
  1. gastric decompression
  2. fluid therapy
  3. abx/anti-endotoxic therapy
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87
Q

name the surgical treatment of anterior enteritis

A

small intestinal decompression

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88
Q

name the specific colic

most commonly reported type of colic;
rapid onset;
intermittent mild to moderate pain;
incr gut sounds;
no classical rectal findings;
often resolve spontaneously;
usually complete response to analgesic +/- spasmolytic

A

spasmodic colic

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89
Q

name the specific colic

abdominal distension;
Dx by rectal exam;
Tx: analgesia, exercise

A

tympanic colic

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90
Q

what is the most common site for large colon impaction

A

pelvic flexure

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91
Q

name 3 predisposing factors for large colon impaction

A
  1. reduced water intake
  2. poor quality roughage
  3. poor dentitions
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92
Q

name 3 clinical signs of large colon impaction

A
  1. slow onset over several days
  2. low-grade pain
  3. reduced gut sounds on LHS (normal on R)

(HR and RR usually normal)

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93
Q

name 4 treatments for large colon impaction

A
  1. feed restriction
  2. analgesics
  3. intra-gastric laxatives
  4. intravenous fluids (isotonic)
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94
Q

name the type of colic

more common in small ponies and Arabs;
mild colic initially - gas accumulation proximally - incr severity of pain ;
Dx: reduction in faecal output and rectal exam

A

small colon impaction

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95
Q

name 4 treatments for small colon impaction

A
  1. IV fluids
  2. enteral fluids/liquid paraffin
  3. enemas (risk of bowel perforation)
  4. Sx may be required
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96
Q

what is the most common site for small intestinal intraluminal obstruction in horses

A

ileum

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97
Q

name 2 predispositions to ileal impaction

A
  1. Anaplocephala perforliata (tapeworm)
  2. heavy ascarid burdens in foals (post-worming)
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98
Q

what is the treatment for ileal impaction?

A

surgery!

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99
Q

name 4 predisposing causes of caecal impaction

A
  1. as with colon impactions
  2. hospitalisation
  3. general anaesthesia
  4. NSAIDs
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100
Q

name the type of caecal impaction

impactions of dry ingesta filling the caecum

A

type 1

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101
Q

name the type of caecal impaction

impaired caecal outflow due to motility dysfunction - prone to spontaneous rupture

A

type 2

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102
Q

what is the treatment for sand impactions

A

psyllium mucilloid administered via nasogastric tube

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103
Q

name 5 predisposing factors of colon displacement

A
  1. age (>7y)
  2. breed (warmbloods)
  3. recent foaling
  4. abrupt change in feeding
  5. previous displacements
    .
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104
Q

name the type of colic

migration of colon between spleen and body wall - entrapment over nephrosplenic ligament

A

left dorsal displacement of the colon (LDDC)

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105
Q

name the type of colic

pelvic flexure moves between caecum and body wall in craniocaudad direction ;
+/- partial or complete torsion;
degree of colic depends of degree of obstruction/torsion

A

right dorsal displacement of the colon (RDDC)

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106
Q

name 5 causes of secondary functional obstructive colic

A
  1. bowel ischaemia
  2. post-op
  3. drug admin
  4. peritonitis
  5. metabolic disorders
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107
Q

name 3 common abdominal neoplasms that may result in recurrent or chronic colic of varying severities

A
  1. gastric squamous cell carcinoma
  2. intestinal lymphosarcoma
  3. pedunculated lipoma
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108
Q

start of DS03

this is the name for retained deciduous cheek teeth

A

caps

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109
Q

these are abnormal spaces between adjacent teeth which allow entrapment of feed material and subsequent periodontal disease

A

diastema

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110
Q

name the two types of diastema

A
  1. valve diastema
  2. open diastema
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111
Q

name the type of diastema

space between adjacent teeth wider near gum than occlusal surface;
created one-way valve, where food becomes trapped between teeth but cannot escape

A

valve diastema

112
Q

name the type of diastema

space between adjacent teeth equal width from occlusal surface to gum;
food less likely to become trapped

A

open diastema

113
Q

which teeth are most commonly affected by diastema

A

caudal mandibular cheek teeth

114
Q

this is thought to be the most painful oral disease - due to gingivitis and periodontal disease;
most common clinical sign of oral pain from thos disease is quidding

115
Q

what plays the greatest role in development of periodontal disease due to a diastema

A

impacted food

116
Q

name the two parts of treatment for oral diastema

A
  1. odontoplasty
  2. food removal
117
Q

this is typically performed 3-4wks after initial treatment of diastema if initial treatment is ineffective at treating periodontal disease

A

diastema widening

(using diastema burr)

118
Q

what type of packing can be used in a diastema to prevent further food packing while allowing gingiva to heal

A

polyvinyl soloxane

119
Q

if diastema are the result of severe cheek tooth displacement, what may be required?

A

extraction of displaced tooth

120
Q

what dietary managment should be done for a horse with dental diastema

A

eliminate/reduce consumption of food containing long fibres (hay)

(more likely to become trapped in diastema)

121
Q

if left untreated, name 3 diseases that could result from diastema/periodontal disease

A
  1. periapical infection
  2. osteomyelitis
  3. orosinus fistulas
122
Q

where do supernumerary cheek teeth most commonly develop at?

(more than 6 cheek teeth in a row)

A

caudal aspect of maxillary cheek teeth rows

123
Q

name the cheek teeth disorder

inflammation and progressive destruction of periodontal tissues;
if left untreated, tissues surrounding and supporting tooth are destroyed until eventually tooth itself may be lost

A

periodontal disease

124
Q

what induces periodontal disease in brachydont teeth
(dogs and cats)

A

plaque-induced

125
Q

how is periodontal disease initiated in hypsodont teeth (horses)

A

by entrapment of feed in anatomical defects (such as diastema)

126
Q

name the 6 parts of the cycle of periodontal disease

A
  1. initial insult to periodontum
  2. inflammation of periodontal tissue
  3. degradation of periodontal tissue
  4. loss of periodontal support
  5. periodontal pockets create anaerobic environment
  6. invasion and proliferation of bacteria
127
Q

why is periodontal disease able to be reversed in horses?

A

prolonged eruption and continuous development of periodontal fibres

128
Q

name the cheek teeth disorder

demineralisation of calcified (inorganic) dental tissues and eventual destruction of the organic component of teeth

A

dental caries

129
Q

name the two types of dental caries

A
  1. infundibular caries (IC)
  2. peripheral caries
130
Q

name the dental caries type

developmental disorder where there is incomplete filling of infundibula with cementum;
food material packs into defects and bacterial fermentation ensues, resulting in progressive IC;
extremely common with almost all horses having some degree present in the maxillary cheek teeth

A

infundibular caries (IC)

131
Q

if left untreated, name 3 conditions infundibular caries (IC) can lead to

A
  1. sagittal fractures
  2. pulp involvement
  3. secondary apical infection
132
Q

name the infundibular carry (IC) grade

normal tooth

133
Q

name the infundibular carry (IC) grade

cementum only

134
Q

name the infundibular carry (IC) grade

cementum and underlying enamel affected

135
Q

name the infundibular carry (IC) grade

cementum, enamel, and dentine affected

136
Q

name the infundibular carry (IC) grade

secondary dental fracture

137
Q

name the dental caries type

contributing factors: feeding hay and grain high in water soluble carbohydrates, feeding haylage and water low in pH;
severe cases can lead to periodontal disease or dental fracture

A

peripheral caries

138
Q

name the peripheral caries grade

normal tooth

139
Q

name the peripheral caries grade

cementum only affected, superficial pitting lesions

140
Q

name the peripheral caries grade

cementum only affected, but complete loss in some areas exposing enamel

141
Q

name the peripheral caries grade

cementum and underlying enamel affected

142
Q

name the peripheral caries grade

cementum, enamel and dentine affected

143
Q

name the peripheral caries grade

secondary dental fracture

144
Q

which teeth are most commonly affected by cheek tooth fractures

A

maxillary cheek teeth
(Triadan 09s)

145
Q

name the 3 most common cheek teeth fracture configurations

A
  1. maxillary buccal slab fracture (1st and 2nd pulp chambers)
  2. mandibular buccal slab fracture (4th and 5th pulp chambers)
  3. midline saggital fracture (infundibula)
146
Q

what type of cheek teeth fractures MUST be treated with dental extraction

A

midline sagittal fractures

147
Q

name the most common soft tissue neoplasm of the quine oral cavity

A

squamous cell carcinoma

148
Q

name the 3 types of dental tumours

A
  1. epithelial tumours (ameloblastomas)
  2. calcified tumours from dentinal tissues (odontoma)
  3. combos of all 3 dental components (compound odontoma)
149
Q

this is the most common route of infection for cheek tooth apical infection;
blood or lymphatic borne bacterial infection of a possibly compromised apical pulp

A

anachoresis

150
Q

what is the treatment of cheek tooth apical infection in early stages if infection is confined to apex of affected tooth and pulp cavities remain vital

A

antibiotics

151
Q

what is the treatment for cheek tooth apical infection if infection progresses

A

extraction of affected tooth

152
Q

what kind of sedation should be given for a tooth extraction?

A
  1. bolus of an alpha-2 agonist + opioid
  2. CRI of an alpha-2 agonist for duration of procedure
153
Q

name 4 nerve blocks of the head to assist with patient comfort during dental extractions

A
  1. maxillary
  2. infraorbital
  3. mandibular
  4. mental
154
Q

name 3 methods of teeth extraction

A
  1. extraction per os (removal of tooth orally)
  2. minimally invasive transbuccal technique (MTE)
  3. repulsion with a dental punch or Steinmann pin
155
Q

name the tooth extraction technique

systematic stretching and break down of periodontal ligament followed by intra-oral extraction along eruption pathway of tooth ;
technique of choice;
should always be attempted first

A

extraction per os

156
Q

how long is packing left in place following a per os tooth extraction before re-evaluation

157
Q

name the tooth extraction technique

used if clinical crown fractures to a point that forceps cannot be applied to the tooth to attempt oral extraction;
a threaded bar is seated into the tooth to be extracted through a buccotomy incision and ventral force is applied to the bar until the tooth is removed

A

minimally invasive transbuccal technique (MTE)

158
Q

name the tooth extraction technique

performed using a Steinmann pin or dental punch;
technique of choice if clinical crown fractures to a point that the extraction equipment cannot be applies to the tooth and the minimally invasive transbuccal technique fails or is not possible

A

extraction through repulsion

159
Q

start of DS04

this is a clinical sign, NOT a dagnosis;
clinical signs consistent with abdominal (usually GI) pain

160
Q

name 3 ‘fasle colics’
origin of pain fron non-GI structures

A
  1. peritonitis
  2. cholangiohepatitis
  3. pleuritis
161
Q

name 5 signs associated with colic

A
  1. flank watching
  2. pawing
  3. rolling
  4. signs of bed disturbance
  5. abnormal position - lying on back
162
Q

name the order of the 6 parts of the wquine GI tract

A
  1. stomach
  2. small intestine
  3. caecum
  4. large colon
  5. small colon
  6. rectum
163
Q

name 4 causes of colic

A
  1. distension
  2. inflammation
  3. ischaemia
  4. stretching of mesentery
164
Q

what will be the outcome if there is obstruction of ingesta/gas flow within the bowel

A

distension of bowel in front of the obstruction

165
Q

what is the main objective of a clinical exam of a colic patient

A

determine whether condition can be treated medically or requires surgery

166
Q

what is the most common cause of colic in young horses

A

intussusceptions

167
Q

what is the most common cause of colic in old horses

A

pedunculated lipomas

168
Q

what is the most common cause of colic in neonate horses

A

meconium impactions

169
Q

what is the most common cause of colic in large breeds of horses

A

large colon displacements

170
Q

what is the most common cause of colic in recently foaled mares

A

colonic torsions

171
Q

what is the most common cause of colic in stallions

A

inguinal herniation

172
Q

name 3 common causes of tachycardia in horses

A
  1. haemoconcentration
  2. reduced venous return
  3. endotoxaemia

(rarely due to pain)

173
Q

name 3 common causes of increased RR in horses

A
  1. pain
  2. acidosis
  3. severe gastric distension / hind gut tympany
174
Q

name 4 things to check the consistency of faeces for?

A
  1. blood
  2. worms
  3. sand
  4. mucous (prolonged transit time)
175
Q

name the abnormal rectal finding

very common;
doughy mass;
when severe - often palpable within the pelvis;
can be secondary in some conditions with colonic stasis (eg subacute grass sickness)

A

impaction of pelvic flexure (PFI)

176
Q

name the abnormal rectal finding

may be palpable in ileus (acute grass sickness), enteritis, strangulating SI obstructions, non-strangulating SI obstructions, non-strangulating infarctions;
immediate referral should be considered

A

small intestinal distension

177
Q

name the abnormal rectal finding

invagination of the caecal apex;
may be palpated as a mass within the caecum

A

caecocaecal intussusception

178
Q

name the abnormal rectal finding

painful, oedematous mass within the caecal base;
also results in small intestinal distension

A

caecal intussusception

179
Q

name the abnormal rectal finding

primary flatulent colic;
transverse or small colon obstruction;
large colon displacements;
large colon torsions

A

large intestinal gaseous distension

180
Q

name the abnormal rectal finding

left large colon migrates dorsally between spleen and body wall;
ultimately hooks over nephrosplenic ligament;
colon palpated in left/dorsal abdominal quandrant running in a dorsoventral direction

A

nephrosplenic entrapment of large colon (LDDLC)

181
Q

name the abnormal rectal finding

may be palpable per rectum if situated in a suitable position;
can range in size from golf ball-sized to football-sized;
may be one or more;
may be discernible increases in the lymphoid tissue

A

intra-abdominal abscess(es) or neoplasia

182
Q

name 3 indications for nasogastric intubation

A
  1. diagnosis of gastric distension with gas or liquid
  2. relief of gastric distension
  3. admin of therapeutic agents directly into the stomach
183
Q

name 6 conditions that result in gastric dilation/reflux and may benefit from nasogastric intubation

A
  1. ileus
  2. enteritis
  3. strangulating SI obstructions
  4. non-strangulating SI obstructions
  5. non-strangulating infarctions
  6. some cases of LI obstruction
184
Q

what is the normal total protein of peritoneal fluid?

A

less than 25 g/L

185
Q

start of DS06

name 3 indications for surgical referral of a colic case

A
  1. failure to respond to medical treatment
  2. pain that cannot be controlled
  3. signs of surgical lesion during diagnostic evaluation
186
Q

what is the most common approach to colic surgery

A

ventral midline incision under GA with horse in dorsal recumbency

187
Q

name 2 specific conditions of the stomach that may be treated surgically

A
  1. gastric impaction in adult horses
  2. gastric outflow obstruction in foals
188
Q

name the surgical stomach disorder

idiopathic smooth muscle hypertrophy or stricture due to severe gastric ulceration;
most managed medically but surgical Tx can be pursued as a last resort - bypass procedures or pyloroplasty

A

gastric outflow obstruction

189
Q

name the surgical stomach disorder

excess feed material in stomach;
can be primary or due to underlying cause;
most managed medically through gastric lavage;
surgery may be pursued if impaction fails to resolve - intraoperative infusion of fluids or manual removal by gastrotomy

A

gastric impaction

190
Q

name the strangulating obstruction of the small intestine

fatty tumours most often associated with small intestine mesentery;
benign, slow growing, with mesenteric attachments that elongates to form a stalk;
stalk encircles adjacent sm intestine or small colon, resulting in a strangulating obstruction;
most cases seen in horses >15y of age

A

pedunculated lipoma

191
Q

name the strangulating obstruction of the small intestine

entrapment of sm intestine in epiploic foramen, resulting in strangulating obstruction;
signalment: taller horses and thoroughbred, crib-biting and wind-sucking behaviour, incr incidence in winter, recent episodes of colic

A

epiploic foramen entrapment (EFE)

192
Q

name the anatomical structure

located in R dorsal abdo;
slit-like opening, bordered by caudal vena cava, caudate lobe of liver, hepatoduodenal ligament, portal vein, and pancreas;
small intestine can displace through this opening, resulting in a strangulating obstruction of involved sm intestine

A

epiploic foramen

193
Q

name the strangulating obstruction of the small intestine

rotation of jejunum or ileum greater than 180 degres about its mesentery;
primary or secondary to pre-existing lesions;
esp present in 2-4mo old foals

A

small intestinal volvulus (SIV)

194
Q

name the strangulating obstruction of the small intestine

invagination of one part of the intestine into an aboral intestinal segment that receives the invagination;
believed to be caused by altered motility of intestine

A

intussusception

195
Q

name the strangulating obstruction of the small intestine

small intestine passes through inguinal canal into scrotum

A

inguinal hernia

196
Q

euthanasia is advised due to risk of malabsorption syndrome post-op if more than what percent of small intestine requires resection?

197
Q

name 4 observations used to assess viability of intestine

A
  1. colour of serosa
  2. motility
  3. constriction at site of obstruction
  4. odour
198
Q

name the non-strangulating obstruction of the small intestine

caused by inappropriate feed (coastal bermuda hay), intestinal tapeworm, or Parascaris spp.;
surgical decompression into caecum without enterotomy (except when due to bermuda hay);
prognosis good for longterm survival

A

small intestinal impaction
(ileal impaction most common)

199
Q

name the non-strangulating obstruction of the small intestine

inflammatory condition of duodenum and proximal jejunum causing a functional obstruction;
Tx: gastric decompression via nasogastric tube OR surgery if not responding;
prognosis for survival to hospital discharge 25-94%

A

anterior enteritis

200
Q

name the lesion of the caecum

due to accumulation of dry ingesta or abnormal caecal motility resulting in an impaction of fluid consistency;
motility disorder in hospitalised patients (post GA, repeated sedation, limited movement, painful conditions);
decision for surgery must be made early as caecum can spontaneously rupture

A

caecal impaction

201
Q

name 4 medical treatments for caecal impaction

A
  1. analgesia
  2. enteral fluids
  3. IV fluids
  4. feed restriction
202
Q

name the lesion of the caecum

rare cause of colic;
chronic intermittent pain;
caeco-caecal (within the caecum) or caeco-colic (within the lg intestine);
Tx with typhlectomy or ileocolostomy

A

caecal intussusception

203
Q

name the lesion of the large colon

causes include feed, sand, enteroliths, and foreign bodies;
occur most often at pelvic flexure or R dorsal colon at transition into transverse colon;
majority managed medically (fluids +/- analgesia)

A

large colon impaction

204
Q

name 4 indications for surgery for lg colon impaction

A
  1. uncontrollable pain
  2. CV parameters deteriorate
  3. evidence of intestinal devitalisation
  4. concurrent lg colon displacement
205
Q

what is the surgical treatment for lg colon impaction

A

pelvic flexure enterotomy to decompress colon

206
Q

name the lesion of the large colon

colon rotates around longitudinal axis, usually with ventral colon moving dorsomedially;
onset of abdominal pain sudden and severe;
prompt surgical intervention needed!
post-op complications common;

A

large colon volvulus

207
Q

once the large colon is replaced following lg colon volvulus, what 4 options does the surgeon have

A
  1. resection
  2. coloplexy for prevention of recurrence
  3. recovery with no further intervention
  4. euthanasia
208
Q

name 6 possible complications following large colon resection

A
  1. septic peritonitis
  2. haemoabdomen
  3. pain
  4. adhesion formation
  5. weight loss
  6. diarrhoea
209
Q

name the large colon surgical procedure

taking out part of the lg colon to prevent lg colon displacement and torsion;
extensive and expensive as an elective procedure

A

large colon resection

210
Q

name the large colon surgical procedure

create a surgical adhesion from ventral colon to body wall to prevent recurrence of lg colon volvulus or displcement;
can be incorporated into closure of linea alba during a ventral midline coeliotomy

A

large colon colopexy

211
Q

name 4 possible complications of large colon colopexy

A
  1. recurrent colic
  2. incisional hernia
  3. catastrophic rupture of colon
  4. enterocutaneous fistula
212
Q

name the small colon/rectum lesion

faecal impaction, enteroliths, bezoars (concretions of magnesium ammonium phosphate crystal, plant material and/or hair), foreign bodies, intramural haematomas, retained meconium;
medical management: improve hydration, soften impaction by admin of osmotic laxatives and analgesia;
surgical management: manual decompression/enterotomy

A

small colon impaction

213
Q

name the small colon/rectum lesion

uncommon cause of colic in foals;
heritable congenital condition;
diagnose with contrast radiography or colonoscopy;
treat with surgical correction if segment missing is not too long

A

atresia coli/atresia ani

214
Q

name the small colon/rectum lesion

often secondary to conditions causing tenesmus;
mild cases treated by replacement under epidural anaesthesia and a purse-string suture placed in anal sphincter;
severe cases may require surgical amputation

A

rectal prolapse

215
Q

name the small colon/rectum lesion

occur during rectal palpation, usually at attachment of mesocolon in the 10-2 o’clock position;
diagnosis: blood on rectal sleeve

A

rectal tears

216
Q

name the 4 most important steps for management of rectal tears

A
  1. realise and identify the lesion early
  2. report it to the owner
  3. first sid
  4. refer if necessary
217
Q

name the 7 steps of first aid for rectal tears

A
  1. sedate
  2. epidural or lidocaine topically per rectum
  3. evacuate rectum with care
  4. pack rectum with damp cotton wool
  5. broad spectrum abx
  6. NSAIDs
  7. referral/surgery
218
Q

start of DS07

how long will the ventral midline incision be for colic surgery

219
Q

what type of suture material is used to close the linea alba and what pattern

A

large gauge absorbable suture (vicryl or PDS) in continuous pattern

220
Q

name the time period following colic surgery based on recommendation

box rest with hand-grazing for 10-15min, 2-4 times per day

221
Q

name the time period following colic surgery based on recommendation

small paddock turnout (3-4 times the size of a normal stable)

A

weeks 9-16

222
Q

name the time period following colic surgery based on recommendation

normal turnout

A

weeks 17-24

223
Q

name the time period following colic surgery based on recommendation

ridden exercise gradually introduced

224
Q

this can be added to rations to increase calorie count, improve palatability or increase moisture;
high, particularly soluble fibre feed which is readily digested and yields slow-release energy;
low in sugar and does not contain starch;
must be given soaked to avoid oesophageal choke!

A

sugar beet (beet pulp)

225
Q

how often should horses be checked following colic surgery?

A

2-3 times per day (at least)

226
Q

what percent of colic patients will have a further episode of colic following hospital discharge

227
Q

name 3 specific types of colic that have been shown to be associated with incr risk of postop colic

A
  1. large colon volvulus
  2. R or L dorsal displacements of the lg colon
  3. sm intestinal resection and anastomosis
228
Q

name 3 prophylactic surgeries that can be performed to prevent postoperative colic

A
  1. nephrosplenic ablation
  2. large colon colopexy
  3. large colon resection
229
Q

start of DS08

name the 2 diseases that are part of Equine Gastric Ulcer Syndrome (EGUS)

A
  1. Equine Squamous Gastric Disease (ESGD)
  2. Equine Glandular Gastric Disease (EGGD)
230
Q

name 3 risk factors for ESGD

A
  1. high concentrate diet
  2. no access to adlib forage
  3. limited access to water
231
Q

name 5 risk factors for EGGD

A
  1. exercise
  2. transport
  3. stabling
  4. multiple handlers
  5. concurrent disease
232
Q

what is the only way to diagnose EGUS

A

gastroscopy

233
Q

name 5 non-specific clinical signs for EGUS

A
  1. changes to temperament
  2. poor performance
  3. adverse behaviour
  4. dull coat
  5. weight loss/reduced appetite
234
Q

how long to starve horses prior to gastroscopy to diagnose EGUS

A

overnight (from 6pm)

235
Q

how long to remove water for prior to a gastroscopy to diagnose EGUS

236
Q

what sedation should be used for gastroscopy

A

standard - Alpha 2 and opioid

237
Q

name the ESGD grade based on the squamous mucosa description

epithelium is intact, no appearance of hyperkeratosis

238
Q

name the ESGD grade based on the squamous mucosa description

mucosa is intact, but there are areas of hyperkeratosis or gastritis

239
Q

name the ESGD grade based on the squamous mucosa description

small, single or multi-focal lesions

240
Q

name the ESGD grade based on the squamous mucosa description

large single or extensive superficial lesions

241
Q

name the ESGD grade based on the squamous mucosa description

extensive lesions with areas of apparent deep ulceration

242
Q

name the ESGD treatment

licensed first line treatment;
70-80% healing within 28d treatment;
lower bioavailability in presence of food

A

oral omeprazole
(Gastroguard and Peptizole - paste)
(Equizole - granules)

243
Q

name 3 options for treating EGGD

A
  1. oral omeprazole and sucralfate
  2. misoprostol
  3. long-acting injectable omeprazole
244
Q

name 4 ‘Pros’ of oral omeprazole and sucralfate for the treatment of EGGD

A
  1. licensed product + human prep
  2. good for needle shy horses
  3. no human health concerns
  4. treats both ESGD and EGGD
245
Q

name 3 ‘Cons’ of oral omeprazole and sucralfate for the treatment of EGGD

A
  1. compliance
  2. horses not tolerant of syringing
  3. ideally give on empty stomach
246
Q

name 3 ‘Pros’ of misoprostol for the treatment of EGGD

A
  1. oral tablet can be given in feed
  2. good for needle shy or difficult to syringe horses
  3. no requirement for empty stomach
247
Q

name 3 ‘Cons’ of Misoprostol for the treatment of EGGD

A
  1. not licensed
  2. human health implications
  3. only suitable for EGGD
248
Q

name 5 ‘Pros’ of long-acting injectable omeprazole for the treatment of EGGD

A
  1. good for horses unable to syringe
  2. no starving requirements
  3. no human health concerns
  4. treats both ESGD and EGGD
  5. no compliance issues
249
Q

name 3 ‘Cons’ of long-acting injectable omeprazole for the treatment of EGGD

A
  1. not licensed
  2. injection site reactions/abscesses
  3. not suitable for needle shiy horses
250
Q

this is an obstruction of the lumen of the oesophagus;
most frequently associated with hard feed

251
Q

name 4 broad causes of choke

A
  1. dietary indescretion
  2. dental
  3. behavioural
  4. oesophageal abnormalities
252
Q

name 5 clinical signs of choke

A
  1. distress
  2. coughing/stretching out neck
  3. bilateral nasal discharge
  4. salivation
  5. firm oesophagus may be palpable
253
Q

name 7 treatments for choke

A
  1. sedation
  2. spasmolytics
  3. smooth muscle relaxants
  4. NSAIDs
  5. pass NGT
  6. oesophageal lavage
  7. broad spectrum abx
254
Q

name 4 reasons to refer a horse with choke

A
  1. poor response to standing lavage
  2. choke >24h duration
  3. systemic concerns
  4. recurrent choke episodes
255
Q

name 2 possible complications choke can cause

A
  1. aspiration pneumonia
  2. oesophageal stricture
256
Q

name 6 clinical signs of equine grass sickness (EGS) attributable to ANS (autonomic nervous system) derangement

A
  1. tachycardia
  2. dysphagia
  3. salivation (acute)
  4. bilateral ptosis
  5. sweating
  6. rhinitis sicca (chronic)
257
Q

name 2 clinical signs of equine grass sickness (EGS) attributable to ENS (enteric nervous system) derangement

A
  1. gastric reflux (acute)
  2. faecal alterations (sub-acute)
258
Q

name 2 faecal alterations seen with sub-acute equine grass sickness (EGS)

A
  1. firm
  2. mucus coating
259
Q

name 4 general clinical signs of equine grass sickness (EGS)

A
  1. dull demeanour (acute)
  2. tucked up abdo sillhouette (sub-acute & chronic)
  3. penile prolapse (chronic)
  4. muscle fasiculations
260
Q

name 5 diagnostics for equine grass sickness (EGS)

A
  1. trans-rectal exam
  2. nasogastric intubation
  3. U/S
  4. phenylephrine eye drops
  5. exploratory laparotomy
    .
261
Q

start of DS09

diarrhoea in adult horses is almost exclusively due to this

A

disorders of the large intestine

262
Q

name 4 infectious causes of acute diarrhoea

A
  1. Salmonella typhimurium
  2. Clostridium difficile
  3. Clostridium perfringens
  4. Coronavirus
263
Q

name a parasitic cause of acute diarrhoea

A

Cyathostomiasis

264
Q

name a toxic cause of acute diarrhoea

265
Q

name 5 chronic inflammatory conditions causing chronic diarrhoea

A
  1. chronic salmonellosis
  2. chronic cyathostomiasis
  3. Lawsonia intracellularis
  4. sand
  5. NSAID toxicity
    .
266
Q

name 3 infiltrative disorders/inflammatory bowel disease (IBD) that cause chronic diarrhoea

A
  1. granulomas
  2. lymphocytic-plasmacytic
  3. multisystemic eosinophilic epitheliotropic disease (MEED)
267
Q

name 3 non-GI causes of chronic diarrhoea

A
  1. liver disease
  2. congestive heart failure
  3. renal disease
268
Q

name 4 signs of dehydration/hypovolaemia

A
  1. prolonged CRT
  2. tachycardia
  3. skin turgor
  4. gum moisture
269
Q

name 2 signs of endotoxaemia

A
  1. injected mucous membranes
  2. tachycardia
270
Q

name 3 electrolyte abnormalities that may be seen with acute diarrhoea

A
  1. hyponatraemia
  2. hypochloraemia
  3. hypokalaemia
271
Q

name 4 signs of chronic inflammation

A
  1. decreased PCV
  2. decr erythrocyte count
  3. elevated WBCC
  4. elevated fibrinogen
272
Q

where does glucose/xylose absorption occur?

A

in small intestine

273
Q

name the 3 part treatment approach to acute diarrhoea

A
  1. replacement of fluid losses
  2. replacement of electrolyte losses
  3. replacement of protein losses
274
Q

name the type of IV fluid

limited retention in vascular space;
more suited to correction of dehydration

A

lactated ringers

275
Q

name the type of IV fluid

‘quick fix’
always follow with isotonic solutions

A

hypertonic NaCl

276
Q

name the type of IV fluid

better retention in vascular space;
preferable if associated protein loss (oncotic pressure)

277
Q

what is the specific treatment for Clostridiosis

A

metronidazole

Equine (11 decks)

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