Equine Alimentary Diseases Flashcards

1
Q

what is colic?

A

abdominal pain in the horse - a sign not a diagnosis

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2
Q

what are the clinical signs of colic?

A
rolling 
pawing
flank watching
lip curling
rolling and throwing themselves around if severe
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3
Q

when may a horse show signs of colic that are not related to abdominal issues?

A

if there is pain elsewhere in the body

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4
Q

what do the signs of colic depend on?

A

severity of case

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5
Q

what is the key question that must be answered when examining colic cases?

A

will this horse require emergency surgery now or not?

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6
Q

how should all colic cases be treated until proven otherwise?

A

that they are surgical unless absolutely certain they are not

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7
Q

what is the most important body system to examine when checking a colic case?

A

cardiovascular system

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8
Q

what parameters (including blood tests) are used to assess cardiovascular function in colic patients?

A
HR and rhythm
RR
temp
PCV
TP
lactate
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9
Q

why must cardiovascular status be carefully monitored in colic patients?

A

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

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10
Q

what can acute conditions of the GI tract lead to?

A

endotoxaemia, dehydration, shock and coagulation disorders

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11
Q

what should be done before administering any analgesia or sedation to a patient?

A

attempt to get HR reading

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12
Q

following cardiovascular exam what is the next area that should be assessed in colic patients?

A

abdomen

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13
Q

is auscultation of the gut useful in colic cases?

A

variable - hugely increased sounds or silence may indicate issue but otherwise not very useful and definitely not in isolation.

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14
Q

what would increased gut sounds in colic patient potentially indicate?

A

spasmodic colic

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15
Q

what would decreased gut sounds in colic patient potentially indicate?

A

stasis

strangulation

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16
Q

how should the abdomen be auscultated?

A

in 4 quadrants (upper and lower on left and right)

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17
Q

what should you look for when examining the abdomen?

A

distention

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18
Q

what does obvious abdominal distention indicate?

A

emergency in horses

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19
Q

what pathology does obvious abdominal distention in horses indicate?

A

large colon torsion

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20
Q

what is the most useful part of an initial exam when diagnosing colic?

A

rectal exam

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21
Q

what can be felt during a rectal exam?

A

only part of the abdomen
can detect displacement, impaction and distension of LI
some SI distension

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22
Q

what is the main risk associated with rectal exam?

A

risk of tear

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23
Q

what equipment is needed for a rectal exam?

A
rectal sleeve
lube
sedation 
LA
buscopan
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24
Q

what is buscopan used for?

A

stops contraction of gut temporarily

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25
Q

what is stomach tubing used for?

A

administration of fluid
medication
relief of gastric overfilling

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26
Q

what is the role of stomach tubing in emergency?

A

empty the stomach to prevent rupture

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27
Q

how may gastric overfilling occur?

A

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

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28
Q

what can be avoided by placing a stomach tube in a horse with gastric overfilling?

A

death and rupture of stomach

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29
Q

what is the main risk associated with stomach tubing?

A

epistaxis - very common

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30
Q

what equipment is needed for stomach tubing?

A
stomach tube
2 buckets (1 with water)
funnel
jug
twitch
sedation
lube
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31
Q

what are the methods of ultrasound that may be used to diagnose colic?

A
rectal 
transabdominal (more common)
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32
Q

what equipment is needed for ultrasound?

A

machine
clippers
spirit
gel

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33
Q

what is abdominoparacentesis?

A

belly tap

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34
Q

what can be shown by abdominoparacentesis?

A
intestinal damage
haemoperitoneum
rupture of stomach (food content)
inflammation
neoplastic cells
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35
Q

what is the risk associated with abdominoparacentesis?

A

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

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36
Q

what signs would you expect to see with gastric rupture?

A

tachycardia
groaning
sweating profusely

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37
Q

what are the 2 techniques that can be used for abdominoparacentesis?

A

using 23G 2 inch needle or teat cannula and 15 blade

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38
Q

is abdominoparacentesis useful for every case?

A

no

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39
Q

how can abdominoparacentesis show intestinal damage?

A

blood
WBC
protein

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40
Q

when may abdominoparacentesis be useful?

A

can show presence of obstruction before stomach fills and evidence is seen on stomach tubing

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41
Q

what equipment is needed fro abdominoparacentesis?

A
clippers
scrub
sterile gloves
plain tube
EDTA tube
either: 23G 2 inch needle or teat cannula, 15 blade and 2ml of LA
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42
Q

is an oral exam required for colic patients?

A

no

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43
Q

what equipment is needed for oral exams?

A
sedation
gag
torch
head stand
flush mouth
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44
Q

what can gastroscopy be used for?

A

diagnosis of ulceration, outflow obstruction and impaction
assessment of choke before and after treatment
biopsy

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45
Q

how long should patients be starved before planned gastroscopy?

A

at least 12 hours

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46
Q

what equipment is needed for gastroscopy?

A
sedation
gag / short stomach tube
gastroscope (long endoscope)
air
water
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47
Q

when is radiography useful in abdominal assessment of horses?

A

foals

adults to see if there is sand build up

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48
Q

why can sand cause GI issues?

A

taken in if grazing on sandy soil or having hay in arena turnout. Irritates LI wall

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49
Q

what tests can be performed on blood samples to diagnose GI issues?

A
PCV
TP
lactate
haematology
biochemistry
fibrinogen
serum amyloid A
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50
Q

what tests can be performed on peritoneal fluid samples to diagnose GI issues?

A

gross appearance
cytology
protein

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51
Q

what should peritoneal fluid look like?

A

yellow
straw coloured
clear

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52
Q

what tests can be performed on faecal samples to diagnose GI issues?

A

egg count

culture

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53
Q

why may a glucose absorption test be performed in horses?

A

suspected SI malabsorption

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54
Q

what techniques may be used for invasive investigations or biopsies?

A

laparoscopy

laparotomy

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55
Q

what dental diseases can horses suffer from?

A
eruption disorders
dental decay
periodontal disease
fractured tooth
diastema
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56
Q

what can be done with teeth that are causing issues?

A

filling
widening of diastema to prevent impaction of food
removal

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57
Q

what are the issues with the removal of horses teeth?

A

hypsodont - if removed the opposite one will have nothing to grind against and will overgrow

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58
Q

how often do horses teeth need to be rasped?

A

at least once a year

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59
Q

why do horses need to have regular teeth rasping?

A

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

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60
Q

what is the risk associated with not regularly rasping horses teeth?

A

dysphagia

impaction in LI from not chewing properl

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61
Q

describe how to examine a horses mouth for dental disease?

A
watch horse eat
palpate mouth
sedate and place mouth gag
wash out mouth
use torch and mirror to look at all surfaces of teeth
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62
Q

what is an emergency condition seen in the oesophagus?

A

oesophageal obstruction / choke

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63
Q

what are the usual primary causes of choke?

A

bad luck
eating too fast
dry concentrate
poor dentition

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64
Q

what are the more rare secondary causes of choke?

A
oesophageal damage (usually from previous choke)
mass
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65
Q

what are the immediate clinical signs of choke?

A

neck extended
food/discharge from nose
cough
gagging

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66
Q

what are the signs of chronic choke?

A

dehydration
acid-base imbalance (due to saliva loss)
weightloss

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67
Q

what are the risks associated with choke?

A

aspiration pneumonia
rupture

stricture or diverticulum long term

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68
Q

how is choke diagnosed?

A
auscultation
cardiovascular parameters
gastroscopy
stomach tube
(bloods, ultrasound, plain and contrast radiography more rare)
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69
Q

what is the goal of choke treatment?

A

relieve obstruction without causing damage or aspiration

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70
Q

how can a stomach tube diagnose choke?

A

will stop at blockage before it enters stomach

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71
Q

how is choke treated?

A

sedate to lower head
place stomach tube and lavage obstruction through tube
tube is not used to push blockage

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72
Q

why is a lowered head during choke treatment desirable?

A

reduce aspiration risk

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73
Q

what can be done in desperation if choke won’t shift?

A

GA and use cuffed ET tube

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74
Q

what drugs may be given to hep with choke?

A

buscopan / oxytocin to relax smooth muscle

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75
Q

what can be done if horse is becoming fed up with tubing during treatment for choke?

A

leave sedated and muzzled on IVFT and try again in an hour

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76
Q

what should be done once choke is cleared?

A

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

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77
Q

what drugs may be needed following choke?

A

antibiotics and antiinflammatories

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78
Q

what equipment is needed for treating choke?

A
endoscope / gastroscope
sedation
twitch
stomach tube
2 buckets (1 with water)
funnel and jug
overalls
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79
Q

what are the 2 areas of the horses stomach?

A

glandular and non-glandular

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80
Q

where may stomach ulcers form?

A

in either glandular or non-glandular area

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81
Q

what can stomach ulcers cause?

A

inflammation
erosion
ulceration
perforation

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82
Q

how may ulcers be graded?

A

0 (none) to 4 (actively bleeding)

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83
Q

how prevalent are ulcers in horses?

A

10-100% depending on literature and whether grade I is considered relevant

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84
Q

in how many foals is gastroduodenal ulceration seen?

A

25-57%

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85
Q

what causes ulcers?

A

imbalance between inciting and protective factors

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86
Q

why may foals show higher prevalence of glandular ulcers?

A

reduced mucosal blood flow anyway
when sick this further reduces
NSAIDs will increase problem

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87
Q

what are the inciting factors of gastroduodenal ulcers?

A

HCl
bile acids
pepsin

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88
Q

what are the protective factors that will prevent gastroduodenal ulcers?

A
mucus bi-carbonate layer
mucosal blood flow
mucosal prostaglandin E
epidermal growth factor production
gastroduodenal motility
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89
Q

what are the risk factors for gastroduodenal ulcers?

A
empty stomach
exercise
diet (high concentrates)
NSAIDs
hospitalisation
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90
Q

what increases the risk of squamous ulcers?

A

exercise on an empty stomach

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91
Q

what increases the risk of glandular ulcers?

A

NSAIDs

92
Q

what are the clinical signs of gastroduodenal ulceration?

A

varies from nothing to poor appetite, recurrent colic, tooth grinding, dog sitting, diarrhoea, poor performance

93
Q

what is the aim of dog sitting in gastroduodenal ulcer patients?

A

movement of acid away from sore, sensitive non glandular area

94
Q

how is gastroduodenal ulceration diagnosed?

A

gastroscopy

assumption

95
Q

is the presence of GD ulcers always significant?

A

no - they may be incidental and not the cause of presenting issue

96
Q

what does treatment of GD ulcers depend on?

A

cause

age of horse (adult or foal)

97
Q

how are adult horses treated for GD ulceration?

A

omeprazole

misoprostal - increases blood flow to gastric wall

98
Q

what are the issues with misoprostal?

A

off licence

is abortive in humans

99
Q

how are foals with GD ulcers treated?

A

sucralfate

100
Q

why are foals not given any NSAIDs in hospital?

A

contraindicated due to reduction in blood flow to stomach already seen in foals

101
Q

what are the risks of giving omeprazole (any drug that raises pH) to foals?

A

may make the sick which increases likelihood of GI ulcers

102
Q

what are the main causes of gastric dilation and rupture?

A

primary
secondary
idopathic

103
Q

what are the primary causes of gastric dilation and rupture?

A

gastric impaction
grain engorgement
other

104
Q

what happens during gastric impaction?

A

stomach stops contracting and amptying

105
Q

what are the signs of gastric impaction?

A

acute or chronic colic

106
Q

what is the cause of gastric impaction?

A

unknown

107
Q

when is gastric impaction often discovered?

A

PM

108
Q

why does gastric dilation lead to rupture?

A

horses are unable to vomit

109
Q

what are the secondary causes of gastric dilation and rupture?

A

small and large intestinal obstruction

ileus (secondary to EGS)

110
Q

what is the most common cause of gastric dilation and rupture?

A

small or large intestinal obstruction

111
Q

what are the signs of gastric dilation and rupture?

A
overfilling of stomach (loads of fluid when tube passed)
acute colic
tachycardia
fluid from nose
dehydration
112
Q

why does gastric dilation and rupture lead to dehydration?

A

fluid produced in stomach is not being absorbed from LI

113
Q

what is a sign that a horses stomach is about to rupture?

A

fluid from nose - pass stomach tube immediately!!

114
Q

how is gastric dilation and rupture diagnosed?

A

clinical signs and history
reflux (lots of fluid in stomach tube)
colic work up
gastroscopy

115
Q

how is gastric dilation and rupture treated?

A
stomach tube ASAP
treat underlying cause
IV fluids
IV nutrition (if gut stasis - only short term)
electrolytes
NPO
116
Q

when can gastric dilation and rupture patients be fed?

A

when stomach tube is not producing fluid

117
Q

is anterior enteritis common in the UK?

A

no

118
Q

what is anterior enteritis also known as?

A

duodenitits-proximal jejunitis

119
Q

what is anterior enteritis?

A

inflammatory condition affecting proximal small intestine

120
Q

what is the cause of anterior enteritis?

A

in most cases unknown

may be bacterial involvement in some (can be cultured from reflux)

121
Q

what bacteria may be involved with anterior enteritis?

A

Salmonella

Clostridia

122
Q

where can bacteria causing anterior enteritis be sampled from?

A

gastric reflux

123
Q

what is a high risk factor for anterior enteritis?

A

recent diet change to high concentrate

124
Q

what are the main clinical signs of anterior enteritis?

A

distended SI and stomach
signs relating to gastric dilation
pyrexia

125
Q

why does anterior enteritis cause distention of the SI and stomach?

A

hypersecretion in the proximal SI and functional ileus due to inflammation leads to build up of fluid as it is no longer propelled into LI

126
Q

how is anterior enteritis diagnosed?

A

may be suspected SI obstruction and only surgery will determine difference
colic investigation
reflux

127
Q

what are the findings in peritoneal fluid of a patient with anterior enteritis?

A

raised protein but not serosanguinous

128
Q

what will be performed on the reflux of a patient with suspected anterior enteritis?

A

culture

129
Q

what is usually needed to diagnose anterior enteritis?

A

ex lap as is hard to differentiate from SI

130
Q

how is anterior enteritis treated?

A
repeated gastric decompression (q2h)
antibiotics
IVFT
electrolytes
nutritional support NPO
analgesia
ex lap with decompression of SI
131
Q

what antibiotics are often used for anterior enteritis?

A

penicillin
gentamicin
metronidazole

132
Q

what is the prognosis of anterior enteritis?

A

25-94% depending on the case

133
Q

is malabsorption and maldigestion often seen in horses?

A

no - fairly rare

134
Q

what happens during malabsorption and maldigestion?

A

animal is unable to absorb nutrients from food

135
Q

what can cause malabsorption and maldigestion?

A

inflammatory type diseases

lymphosarcoma

136
Q

what are the clinical signs of malabsorption and maldigestion?

A

weight loss

137
Q

how is malabsorption and maldigestion diagnosed?

A

abdominoparacentesis
ultrasound
oral glucose tolerance test
laparoscopic / laparotomy biopsy

138
Q

what can been seen on the ultrasound of a patient with malabsorption and maldigestion?

A

thickened SI wall

inflammation

139
Q

what is the role of a glucose tolerance test in the diagnosis of malabsorption and maldigestion?

A

confirms lack of absorption

140
Q

how is malabsorption and maldigestion treated?

A

method depends on diagnosis
resection
corticosteroids
no treatment

141
Q

what is the prognosis of malabsorption and maldigestion?

A

depends on diagnosis and response to treatment

142
Q

what are the main types of SI obstruction?

A

simple

strangulating

143
Q

describe a simple SI obstruction

A

obstruction of the lumen without direct obstruction of vascular flow

144
Q

what can simple SI obstruction be caused by?

A

course food material
ileal hypertrophy
ascarid impaction
adhesions

145
Q

what is ileal hypertrophy?

A

thickening of the area between the ileum and the caecum leading to eventual blockage by food

146
Q

what can ileal hypertrophy be caused by?

A

secondary to tapeworm and muscular hypertrophy associated with increased gut effort due to worms

147
Q

why does ascarid impaction cause simple SI obstruction?

A

worms physically block lumen

148
Q

describe a strangulating SI obstruction

A

simultaneous occlusion of intestinal lumen and its blood supply

149
Q

what are the main causes of strangulating SI obstruction?

A
pedunculated lipoma
epiploic foramen entrapment
SI volvulus
mesenteric rent
inguinal or diaphragmatic hernia
intussusception
150
Q

what is a pedunculated lipoma?

A

benign fatty lump attached to the mysentery by a long stalk that can wrap around and strangulate SI

151
Q

what does SI obstruction result in?

A

gastric overfilling as nothing can pass into LI through SI
deterioration of intestinal mucosa
intestine will die (increased length and severity with time)
sepsis
endotoxaemia

152
Q

with what type of SI obstruction does deterioration of gastric mucosa happen faster?

A

strangulating lesion

153
Q

what are the clinical signs of SI obstruction?

A
colic
reflux
tachycardia
hypovolaemia
distended SI on rectal exam
serosanguinous peritoneal fluid with high protein and lactate
154
Q

what will colic be like in a patient with an SI obstruction?

A

severe as the gut dies, will ease when the gut is dead

155
Q

what can be detected by peritoneal fluid?

A

early strangulation

156
Q

how is SI obstruction treated?

A

surgery
euthanasia
ileal impaction will very rarely clear alone (and this is by chance)

157
Q

what is the prognosis for short term survival following SI obstruction surgery?

A

80%

158
Q

what is the prognosis for long term survival following SI obstruction surgery?

A

60-70%

159
Q

how much rest is needed following SI obstruction surgery?

A

3-4 months

160
Q

what is involved in a simple cecal obstruction?

A

impaction, becomes blocked with food

161
Q

what are the 2 main types of simple obstruction of the caecum?

A

primary

secodary

162
Q

what is the reason for primary caecal impaction?

A

underlying motility disorder

163
Q

what is the reason for secondary caecal impaction?

A

usually young horses following painful (e.g. orthopedic) procedures but not well understood

164
Q

what are the clinical signs of caecal impaction?

A
colic (although not always)
depressed
not eating
reduced faecal output
may just rupture leading to severe shock and death
165
Q

what must be monitored after any surgery to protect against caecal impaction?

A

faecal output
appetite
pain

166
Q

what should be assumed if horse is inappetant, depressed and has low faecal output?

A

may be caecal impaction until proven otherwise

167
Q

how is caecal impaction diagnosed?

A

clinical signs and history
rectal exam as can often palpate
abdominoparacentesis

168
Q

how is caecal impaction treated preferably?

A

medically

169
Q

when may surgical treatment of caecal impaction be needed?

A

if there is intestinal damage / endotoxaemia

170
Q

what is involved in medial treatment of caecal impaction?

A

oral and IV fluids

171
Q

what is involved in the surgical treatment of caecal impaction?

A

typhlotomy - open ceacum

caecal bypass if necessary

172
Q

what is the prognosis of caecal impaction?

A

90% success due to close monitoring and prevalence in hospital

173
Q

what are the 2 main types of caecal intussusception?

A

ileo-caecal

caeco-caecal

174
Q

when is caecal intussusception often seen?

A

young horses

those with a high tapeworm burden

175
Q

what are the clinical signs of caecal intussusception?

A

colic of varying severity

chronic colic if happening repeatedly and then correcting on it’s own

176
Q

how is caecal intussusception diagnosed?

A

rectal
ultrasound
peritoneal fluid (although care as may suggest more extensive damage than is actually present)

177
Q

how is caecal intussusception treated?

A

surgery

treatment for tapeworm

178
Q

what is the prognosis for caecal intussusception?

A

as for colic surgery

179
Q

what are the 2 main types of LI obstruction?

A

simple

strangulating

180
Q

what is simple LI obstruction due to?

A

impaction

displacement

181
Q

what is strangulating LI obstruction due to?

A

torsion

182
Q

where is impaction LI obstruction usually located?

A

pelvic flexure

183
Q

why is impaction LI obstruction usually seen at the pelvic flexure?

A

narrows and there is a change in innervation

184
Q

what can cause impaction LI obstruction?

A
food material
poor teeth
long fibre
motility disorder so reduced movement
recent box rest
sand
185
Q

what are the clinical signs of LI obstruction due to impaction?

A
mild colic (may be chronic)
reduced faecal output or none
186
Q

how is LI impaction diagnosed?

A
rectal exam (key)
abdominoparacentesis
187
Q

how is LI impaction treated?

A
oral fluids (repeated through stomach tube)
cathartics
analgesia (care with type)
paraffin may help to move obstruction
IVFT
eventual surgery
188
Q

what are cathartic drugs?

A

draw water into the gut

189
Q

why should horses not be given pro-motility drugs?

A

can cause gastric / intestinal rupture

190
Q

what is the prognosis for LI impaction?

A

excellent

fair if surgery required

191
Q

what are the main types of LI displacement?

A

right dorsal
left dorsal
nephroplenic entrapment

192
Q

what is nephrosplenic entrapment?

A

large intestine becomes trapped on the left side between the kidney and the spleen over the nephrosplenic ligament

193
Q

what can happen with LI displacement?

A

may correct itself or with medical treatment
may remain displaced until gut becomes compromised and surgery is required
torsion - emergancy surgery

194
Q

how is LI displacement diagnosed?

A

rectal exam
ultrasound
abdominoparacentesis to decide if surgical

195
Q

what type of LI displacement is shown on ultrasound

A

nephrosplenic entrapment (NSE)

196
Q

how is LI displacement treated if no evidence of gut damage and not too painful?

A

medically - fluids (oral and IV), analgesia

197
Q

when will surgery be required to treat LI displacement?

A

if painful
evidence of gut damage
if persistant

198
Q

how can NSE LI displacement be treated?

A

phenylepherine and lunging (shake it around!!)

199
Q

what does Phenylepherine do?

A

shrinks spleen

200
Q

when does LI torsion occur?

A

follows displacement

spontaneous

201
Q

what is LI torsion?

A

strangulating lesion of LI

202
Q

what are the clinical signs of LI torsion?

A

extreme, violent pain
distended abdomen
respiratory compromise

203
Q

how is LI torsion diagnosed?

A

rectal exam - very difficult due to gas and LI

204
Q

how is LI torsion treated?

A

immediate surgery with potential LI resection (although difficult)

205
Q

what is the prognosis of LI torsion?

A

depends on damage to LI

risk of recurrance

206
Q

what are the 4 types of diarrhoea?

A

acute
chronic
infectious
non-infectious

207
Q

should diarrhoea cases be isolated?

A

if fever or until proven non-infectious

208
Q

what are the 2 types of acute diarrhoea?

A

inflammatory

non-inflammatory

209
Q

what are the causes of acute inflammatory diarrhoea?

A
Salmonellosis
Clostridiosis
Colitis (NSAIDs)
Ehrlichia risticii
parasites
neoplasia
210
Q

what are the causes of acute non-inflammatory diarrhoea?

A
excitement
management change
food hypersensitivity
toxicity
iatrogenic purges
211
Q

what are the 2 types of chronic diarrhoea?

A

disruption of normal physiology

inflammatory / infiltrative disease

212
Q

what causes chronic diarrhoea due to disruption of normal physiology?

A

dietary sensitivity
dental disease
antibiotic induced

213
Q

what causes chronic diarrhoea due to inflammatory / infiltrative disease?

A

parasites
IBDs
neoplasia

214
Q

how is diarrhoea assessed and cause diagnosed?

A
CVS parameters
rectal exam
ultrasound
abdominoparacentesis
rectal biopsy
FEC
faecal cultures
215
Q

why are CVS parameters assessed in the diarrhoea patient?

A

assess how sick they are

216
Q

what cardiovascular parameters will be assessed in the diarrhoea patient?

A
sepsis
endotoxaemia
dehydration
WBC
electrolytes
217
Q

how is diarrhoea treated?

A
hydration 
electrolytes
anti-endotoxic
laminitis prevention (e.g. ice boots)
treat underlying cause
antibiotics
plasma
feeding through
218
Q

what is the most crucial element of care for the diarrhoea patient?

A

nursing!

hand feed, clean and grooming

219
Q

is small colon impaction common?

A

no

220
Q

what is small colon impaction caused by?

A
foreign body (plastic bag)
Salmonella
221
Q

how is small colon impaction diagnosed?

A

difficult

guessed from history of intermittent diarrhoea and colic

222
Q

how is small colon impaction treated?

A

medical treatment

many require surgery

223
Q

what is peritonitis?

A

infection / inflammation of the peritoneum or peritoneal fluid

224
Q

what is the difference between primary and secondary peritonitis?

A

primary is idiopathic

secondary follows surgery

225
Q

what are the signs of peritonitis?

A

pyrexia

mild colic

226
Q

how is peritonitis diagnosed?

A

abdominoparacentesis

227
Q

how is peritonitis treated?

A

antibiotics

persistent or recurrent may need laparoscopy or laparotomy