Equine Alimentary Diseases Flashcards
what is colic?
abdominal pain in the horse - a sign not a diagnosis
what are the clinical signs of colic?
rolling pawing flank watching lip curling rolling and throwing themselves around if severe
when may a horse show signs of colic that are not related to abdominal issues?
if there is pain elsewhere in the body
what do the signs of colic depend on?
severity of case
what is the key question that must be answered when examining colic cases?
will this horse require emergency surgery now or not?
how should all colic cases be treated until proven otherwise?
that they are surgical unless absolutely certain they are not
what is the most important body system to examine when checking a colic case?
cardiovascular system
what parameters (including blood tests) are used to assess cardiovascular function in colic patients?
HR and rhythm RR temp PCV TP lactate
why must cardiovascular status be carefully monitored in colic patients?
very important
will have huge influence on decision making
acute conditions of the GI tract can lead to endotoxaemia, dehydration, shock and coagulation disorders - all detected through CVS parameters
what can acute conditions of the GI tract lead to?
endotoxaemia, dehydration, shock and coagulation disorders
what should be done before administering any analgesia or sedation to a patient?
attempt to get HR reading
following cardiovascular exam what is the next area that should be assessed in colic patients?
abdomen
is auscultation of the gut useful in colic cases?
variable - hugely increased sounds or silence may indicate issue but otherwise not very useful and definitely not in isolation.
what would increased gut sounds in colic patient potentially indicate?
spasmodic colic
what would decreased gut sounds in colic patient potentially indicate?
stasis
strangulation
how should the abdomen be auscultated?
in 4 quadrants (upper and lower on left and right)
what should you look for when examining the abdomen?
distention
what does obvious abdominal distention indicate?
emergency in horses
what pathology does obvious abdominal distention in horses indicate?
large colon torsion
what is the most useful part of an initial exam when diagnosing colic?
rectal exam
what can be felt during a rectal exam?
only part of the abdomen
can detect displacement, impaction and distension of LI
some SI distension
what is the main risk associated with rectal exam?
risk of tear
what equipment is needed for a rectal exam?
rectal sleeve lube sedation LA buscopan
what is buscopan used for?
stops contraction of gut temporarily
what is stomach tubing used for?
administration of fluid
medication
relief of gastric overfilling
what is the role of stomach tubing in emergency?
empty the stomach to prevent rupture
how may gastric overfilling occur?
stomach continually secretes fluid
if there is a blockage in the GI tract this fluid will back up into the stomach and fill it
if pressure is not relieved the stomach will rupture as horses cannot vomit
what can be avoided by placing a stomach tube in a horse with gastric overfilling?
death and rupture of stomach
what is the main risk associated with stomach tubing?
epistaxis - very common
what equipment is needed for stomach tubing?
stomach tube 2 buckets (1 with water) funnel jug twitch sedation lube
what are the methods of ultrasound that may be used to diagnose colic?
rectal transabdominal (more common)
what equipment is needed for ultrasound?
machine
clippers
spirit
gel
what is abdominoparacentesis?
belly tap
what can be shown by abdominoparacentesis?
intestinal damage haemoperitoneum rupture of stomach (food content) inflammation neoplastic cells
what is the risk associated with abdominoparacentesis?
low risk
care with diagnosis of gastric rupture (and then euthanasia) due to food matter in sample as this may be due to needle passing into gut
what signs would you expect to see with gastric rupture?
tachycardia
groaning
sweating profusely
what are the 2 techniques that can be used for abdominoparacentesis?
using 23G 2 inch needle or teat cannula and 15 blade
is abdominoparacentesis useful for every case?
no
how can abdominoparacentesis show intestinal damage?
blood
WBC
protein
when may abdominoparacentesis be useful?
can show presence of obstruction before stomach fills and evidence is seen on stomach tubing
what equipment is needed fro abdominoparacentesis?
clippers scrub sterile gloves plain tube EDTA tube either: 23G 2 inch needle or teat cannula, 15 blade and 2ml of LA
is an oral exam required for colic patients?
no
what equipment is needed for oral exams?
sedation gag torch head stand flush mouth
what can gastroscopy be used for?
diagnosis of ulceration, outflow obstruction and impaction
assessment of choke before and after treatment
biopsy
how long should patients be starved before planned gastroscopy?
at least 12 hours
what equipment is needed for gastroscopy?
sedation gag / short stomach tube gastroscope (long endoscope) air water
when is radiography useful in abdominal assessment of horses?
foals
adults to see if there is sand build up
why can sand cause GI issues?
taken in if grazing on sandy soil or having hay in arena turnout. Irritates LI wall
what tests can be performed on blood samples to diagnose GI issues?
PCV TP lactate haematology biochemistry fibrinogen serum amyloid A
what tests can be performed on peritoneal fluid samples to diagnose GI issues?
gross appearance
cytology
protein
what should peritoneal fluid look like?
yellow
straw coloured
clear
what tests can be performed on faecal samples to diagnose GI issues?
egg count
culture
why may a glucose absorption test be performed in horses?
suspected SI malabsorption
what techniques may be used for invasive investigations or biopsies?
laparoscopy
laparotomy
what dental diseases can horses suffer from?
eruption disorders dental decay periodontal disease fractured tooth diastema
what can be done with teeth that are causing issues?
filling
widening of diastema to prevent impaction of food
removal
what are the issues with the removal of horses teeth?
hypsodont - if removed the opposite one will have nothing to grind against and will overgrow
how often do horses teeth need to be rasped?
at least once a year
why do horses need to have regular teeth rasping?
teeth continuously erupt and if natural grinding on other teeth isn’t even hooks can develop at the front and back as well as sharp edges
what is the risk associated with not regularly rasping horses teeth?
dysphagia
impaction in LI from not chewing properl
describe how to examine a horses mouth for dental disease?
watch horse eat palpate mouth sedate and place mouth gag wash out mouth use torch and mirror to look at all surfaces of teeth
what is an emergency condition seen in the oesophagus?
oesophageal obstruction / choke
what are the usual primary causes of choke?
bad luck
eating too fast
dry concentrate
poor dentition
what are the more rare secondary causes of choke?
oesophageal damage (usually from previous choke) mass
what are the immediate clinical signs of choke?
neck extended
food/discharge from nose
cough
gagging
what are the signs of chronic choke?
dehydration
acid-base imbalance (due to saliva loss)
weightloss
what are the risks associated with choke?
aspiration pneumonia
rupture
stricture or diverticulum long term
how is choke diagnosed?
auscultation cardiovascular parameters gastroscopy stomach tube (bloods, ultrasound, plain and contrast radiography more rare)
what is the goal of choke treatment?
relieve obstruction without causing damage or aspiration
how can a stomach tube diagnose choke?
will stop at blockage before it enters stomach
how is choke treated?
sedate to lower head
place stomach tube and lavage obstruction through tube
tube is not used to push blockage
why is a lowered head during choke treatment desirable?
reduce aspiration risk
what can be done in desperation if choke won’t shift?
GA and use cuffed ET tube
what drugs may be given to hep with choke?
buscopan / oxytocin to relax smooth muscle
what can be done if horse is becoming fed up with tubing during treatment for choke?
leave sedated and muzzled on IVFT and try again in an hour
what should be done once choke is cleared?
use gastroscope to check definite clearance, mucosa isn’t damaged
check trachea with endoscope for aspiration (TW if choke has been ongoing)
check for underlying issues
rest from feeding
what drugs may be needed following choke?
antibiotics and antiinflammatories
what equipment is needed for treating choke?
endoscope / gastroscope sedation twitch stomach tube 2 buckets (1 with water) funnel and jug overalls
what are the 2 areas of the horses stomach?
glandular and non-glandular
where may stomach ulcers form?
in either glandular or non-glandular area
what can stomach ulcers cause?
inflammation
erosion
ulceration
perforation
how may ulcers be graded?
0 (none) to 4 (actively bleeding)
how prevalent are ulcers in horses?
10-100% depending on literature and whether grade I is considered relevant
in how many foals is gastroduodenal ulceration seen?
25-57%
what causes ulcers?
imbalance between inciting and protective factors
why may foals show higher prevalence of glandular ulcers?
reduced mucosal blood flow anyway
when sick this further reduces
NSAIDs will increase problem
what are the inciting factors of gastroduodenal ulcers?
HCl
bile acids
pepsin
what are the protective factors that will prevent gastroduodenal ulcers?
mucus bi-carbonate layer mucosal blood flow mucosal prostaglandin E epidermal growth factor production gastroduodenal motility
what are the risk factors for gastroduodenal ulcers?
empty stomach exercise diet (high concentrates) NSAIDs hospitalisation
what increases the risk of squamous ulcers?
exercise on an empty stomach