EQ Weight loss and chronic colic Flashcards
Define colic
Behavioural manifestation of visceral pain.
What causes intestinal colic
Intestinal pain (stretch, inflammation, ischemia) and altered contractility (muscle spasm, ileus)
What are the physiological mechanisms of weight loss?
Reduced intake, Reduced digestion/ absorption/ assimilation of food, Increased nutrient loss, Increased nutritional requirement
When is colic classed as chronic?
Been happening for 48hrs plus
When is colic classed as recurrent?
Shorter bouts than with chronic but keep happening
What treatment should a horse who has had a rectal/ duodenal biopsy receive after the procedure?
Tetanus prophylaxis should be up to date, antibiotic therapy
What are the most common causes of wt loss?
Dental disorders (reduced intake), parasitism, inadequate diet
What history should be assessed when presented with a case of recurrent colic?
Diet (changes), colic history, faecal output/ consistency, otehr medical conditions, worming, dental problems, steriotypies, sand pastures?
What methodologies are used for investigation of acute colic?
Rectal exam, clinical signs, NG intubation
What preliminary clinical pathology tests should be considered and why when assessing colic cases?
- Enzymes/ bile acids - visceral disease
- WCC, fibrinogen, globulins - inflammatory process
- Albumin - protein loss
- Hypercalcaemia - malignancy? FEC
Verminous arteritis
Strongylus vulgaris
How can dehydration alter interpretation of TP?
Decreases in TP may be masked by concurrent dehydration
In what clinical situations may hypoalbuminaemia occur?
PLE (GI loss), liver disease, effusions
Hyperfibrinogenaemia may occur in which clinical situations?
Infection, inflammation, neoplasia
Serum amyloid A is an example of what?
Acute phase protein
If a horse with colic signs is intermittently febrile what aetiology may be suspected?
Neoplasia, abscess
How do you perform an oral glucose absorption test
- The horse to be tested should be fasted for 18-24 hours.
- 1 g glucose per kg body weight is administered by stomach tube.
- Blood samples are collected into fluoride anticoagulant at times 0, 30, 60, 90, 120, 150, 180, 210 and 240 mins.
- Glucose levels should peak at double resting (0 mins) levels at 60-120 mins and return to resting levels by 240 mins.
What is suggested by normal, partial and complete with an oral glucose absoprtion test?
Normal - 85% increase in blood glucose at 2 hours, decreases
Partial - 15-85% rise in 2 hours. Small intestinal disease, large intestinal disease, normal intestine
Complete - 15% rise in 2 hours. Small intestinal disease
Transabdominal ultrasound in colic cases should be used to assess what?
Wall thickness
Luminal diameter
Motility
Anatomy
What structures are visible on the right side of the horse with transabdominal US?
Liver cranially
Caecal base and body (body caudally)
What structures are visible on the left side of the horse on transabdominal US?
Stomach - rib space 8-13, medial to spleen
Spleen
Small intestine - ventrally, loops
What differentials should be expected for protein loosing enteropathies?
- Cyathostominosis
- Mixed strongyle
- Idiopathic
- Infiltrative bowel disease
- Neoplasia
- Lawsonia (3-11 mo)
What is infiltrative bowel disease?
Presence of inflammatory cells in the intestinal wall leading to malabsorption and protein-loss.
- Granulomatous - macrophages
- Lymphoplasmacytic - Lymphocytes, plasma cells
- Eosinophilic - Eosinophils
What pharaceuticals are used in treatment on infiltrative bowel disease?
Steroids - dexamethasone, prednisolone (monitor for infection and lami)
Anthelmintic
Multisystemic eosinophilic epitheliotropic disease (MEED)
Unknow aetiology
Eosinophilic granulomas, vasculitis, and fibrinoid necrosis of intramural vessels
May also involve skin, coronary band, pancreas, liver etc
What clinical signs may be indicative of lymphoma/ disseminated neoplasia?
- Fever
- Wt loss
- Peritonitis
- Pleural effusion
- Abdominal distension
- Palpable mass per rectum
- Hypercalcaemia
- Haemolysis
- Cachexia
