Equine Alimentary Diseases Flashcards
what are the signs of colic?
rolling pawing flank watching lip curling (occasionally show signs of abdominal pain when the pain is from another area)
what is involved in clinical examination of suspected colic?
cardiovascular status respiratory rate temperature HCT and TP, lactate abdominal exam rectal exam stomach tubing ultrasound abdominoparacentesis oral exam radiography faecal examination
what are you looking for during an abdominal exam?
auscultation of all 4 quadrants of abdomen
transabdominal ballottement in foals
abdominal distension
what can you feel for during a rectal exam?
distension, impaction, displacement
what equipment is required for a rectal examination?
rectal sleeve, lubricant
optional sedation/LA/buscopan
why might you need to use stomach tubing?
for gastric overfill - occurs mostly in small intestinal obstruction
can administer fluid and medication in appropriate cases
what equipment is required for stomach tubing?
stomach tube, 2 buckets (one with water)
funnel, jug
sedation and lube
what are the 2 types of ultrasounds performed with GI upset?
rectal or transabdominal
what is abdominoparacentesis?
belly tap - obtaining peritoneal fluid
what can abdominoparacentesis help to identify?
intestinal damage - blood, WBCs, protein
haemoperitoneum (spleen rupture)
GI rupture
inflammatory/neoplastic cells
what equipment is required for abdominoparacentesis?
clippers, scrub, sterile gloves, plain tube and EDTA tube
23g 2 inch needle
OR
teat cannula, 15 blade, sterile swab, 2ml local anaesthetic
what equipment is required for an oral exam?
sedation gag torch head stand flush mouth
what is gastroscopy?
visualisation of the oesophagus and stomach using endoscopy
what can gastroscopy help to identify?
ulceration, outflow obstruction, impaction
choke
help take biopsy
when might radiography be used?
in foals
in suspected sand ingestion in adults
what can be tested from a blood sample?
HCT and total protein lactate haematology biochemistry fibrinogen and SAA
how can we assess peritoneal fluid?
gross appearance
cytology
protein content (inflammation)
what colour should peritoneal fluid be?
yellow/straw coloured and clear
not cloudy or red
what tests can be done on a faecal sample?
faecal egg count
culture
when might a glucose absorption test be performed?
with suspected small intestinal malabsorption (weight loss, low albumin)
what is the difference between a laparoscopy and a laparotomy?
laparoscopy = small surgical incision laparotomy = large surgical incision
what types of dental disease can horses suffer with?
eruption disorders dental decay periodontal disease fractured teeth diastema (gaps)
why is tooth removal not typically first line treatment for dental disease in horses?
opposite tooth will have nothing to grind against, requires frequent rasping
what are the primary causes of oesophageal obstruction?
random, eating too fast, dry concentrate, poor dentition
what are the secondary causes of oesophageal obstruction?
oesophageal damage, masses
what are the clinical signs of oesophageal obstruction?
extended neck
food/discharge from nose, coughing, gagging
dehydration and weight loss
(risk of aspiration pneumonia)
how is oesophageal obstruction/choke diagnosed?
auscultation cardiovascular parameters gastroscopy attempt to pass stomach tube (bloods, ultrasound, radiography)
what is the treatment for choke?
sedate so head is low to reduce risk of aspiration
stomach tube, lavage obstruction
how do you check that choke has been resolved?
check obstruction cleared with gastroscope
check no damage to mucosa
check trachea with endoscope for aspiration, tracheal wash
check for underlying problems
what causes gastroduodenal ulceration?
imbalance between inciting and protective factors
(inciting factors = HCl, bile acids, pepsin
protective factors = mucus-bicarbonate layer, mucosal blood flow)
what are the risk factors for gastroduodenal ulceration?
empty stomach, exercise, diet, stress, NSAIDs
what are the clinical signs of gastroduodenal ulceration?
usually none
some have poor appetite, recurrent colic, tooth grinding, dog sitting, diarrhoea, poor performance
how do you diagnose gastroduodenal ulceration?
gastroscopy
how do you treat gastroduodenal ulceration?
depends on cause - mostly involves management
adults - omeprazole
foals - sucralfate
what are the primary causes of gastric dilation and rupture?
gastric impaction, grain engorgement - causes acute or chronic colic
what causes secondary gastric dilation and rupture?
small or large intestinal obstruction
ileus (functional obstruction)
what are the clinical signs of gastric dilation and rupture?
overfilling of stomach acute colic tachycardia fluid from nose dehydration
how is gastric dilation and rupture diagnosed?
assessment of clinical signs
reflux (pass a stomach tube)
colic work up
gastroscopy
how is gastric dilation and rupture treated?
stomach tubing immediately!!!
identify and treat underlying cause
IV fluids and nutrition, electrolytes
what is anterior enteritis?
inflammatory condition affecting the proximal small intestine
what causes anterior enteritis?
mostly unknown aetiology
some caused by Salmonella or Clostridia
recent diet change to high concentrate is a risk factor
what is the pathophysiology of anterior enteritis?
hypersecretion and functional ileus of proximal SI
leading to distended stomach and SI
what are the clinical signs of anterior enteritis?
overfilling of stomach acute colic tachycardia fluid from nose dehydration often pyrexic
how is anterior enteritis diagnosed?
belly tap shows raised protein but not serosangiunous
reflux and culture
often need ex-lap
what is the differential diagnosis for anterior enteritis?
physical SI obstruction
how is anterior enteritis treated?
repeated gastric decompression (every 2 hours)
antibiotics (penicillin, metronidazole)
IV fluid, electrolytes, nutritional support
analgesia
what are the clinical signs of malabsorption/maldigestion?
weight loss
what can cause malabsorption/maldigestion?
a number of inflammatory type diseases
lymphosarcoma
how is malabsorption/maldigestion diagnosed?
abdominoparacentesis
ultrasound
oral glucose tolerance test
laparoscopic biopsy
what is the treatment for malabsorption/maldigestion?
depends on diagnosis
resection, corticosteroids?
may be no treatment
what is a simple SI obstruction?
obstruction of intestinal lumen without direct obstruction of vascular flow
what causes simple SI obstruction?
coarse food material
ileal hypertrophy (usually secondary to tapeworm)
ascarid impaction (worms)
adhesions
what is strangulation of the SI?
simultaneous occlusion of the intestinal lumen and its blood supply
what are the possible causes of SI strangulation?
pedunculated lipoma
epiploic foramen entrapment
SI volvulus
mesenteric rent
inguinal/diaphragmatic hernia
intussusception
what can SI obstruction lead to?
results in gastric overfilling - risk rupture deterioration of intestinal mucosa intestine dies sepsis endotoxaemia
what are the clinical signs of SI obstruction?
colic reflux tachycardia hypovolaemia rectal - distended small intestine serosanguinous peritoneal fluid
how is SI obstruction treated?
surgery or euthanasia - must act fast if surgery
will rarely clear by self
what is the long-term prognosis for colic surgery?
60-70%
what causes primary caecal obstruction?
underlying motility disorder
what causes secondary caecal obstruction?
usually in young horses after painful orthopaedic procedures
what are the clinical signs of caecal impaction?
colic
can just rupture - signs of severe shock, death
how is caecal impaction diagnosed?
assume caecal impaction unless proven otherwise
clinical signs and history
rectal exam
abdominoparacentesis
how is caecal impaction treated?
oral and IV fluids
surgery - typhlotomy or caecal bypass (only if don’t respond to medical management)
what is the prognosis for caecal impaction?
90% success - most respond to medical management if caught early
what is caecal intussusception?
telescoping of the ileum into the caecum/caecum into itself
what are the clinical signs of caecal intussusception?
colic - varying severity, can be chronic
how is caecal intussusception diagnosed?
rectal exam
ultrasound
how is caecal intussusception treated?
surgery
then treat tapeworm (likely cause)
what are the 2 types of large intestinal obstruction?
simple - impaction, displacement
strangulating - torsion
at what part of the LI does impaction usually occur?
pelvic flexure
what are the risk factors for LI impaction?
poor teeth long fibre motility disorders recent box rest sand ingestion
what are the clinical signs of LI impaction?
usually mild colic, can be chronic
reduced faecal output
how is LI impaction diagnosed?
rectal examination
how is LI impaction treated?
oral fluids and cathartics
analgesia
paraffin and IV fluids (preference)
eventually surgery if does not resolve
are pro-motlity drugs helpful in treatment of LI impaction?
no - avoid, can burst gut
what types of LI displacement can occur?
right dorsal
left dorsal
nephrosplenic surgery
how is LI displacement diagnosed?
rectal exam
ultrasound
abdominoparacentesis
how is LI displacement treated?
medically if not too painful and no evidence of gut damage - oral and IV fluids, analgesia, phenylephrine and lunging
surgery if gut damage/painful/persistent
what is LI torsion?
strangulating lesion of the LI
what are the the clinical signs of LI torsion?
extreme pain
distended abdomen
respiratory compromise
how is LI torsion diagnosed?
rectal exam - will be able to insert very little due to gas
how is LI torsion treated?
immediate surgery - emergency
what is the prognosis for LI torsion?
depends on damage to the LI
risks recurrence
what are the inflammatory causes of acute diarrhoea?
usually infection (salmonellosis, clostridiosis, colitis, parasites) neoplasia
what are the non-inflammatory causes of acute diarrhoea?
excitement management change food hypersensitivity toxicity iatrogenic purges
how is the cause of diarrhoea assessed?
cardiovascular parameters rectal exam ultrasound abdominoparacentesis rectal biopsy faecal egg count and culture
how is diarrhoea treated?
hydration, electrolytes
anti-endotoxins, antibiotics (if required)
laminitis prevention
treat underlying cause
nursing care important!! clean them, hand feed treats, brush hair
how can peritonitis be diagnosed and treated?
presents with pyrexia and mild colic
diagnosed with abdominoparacentesis
treated with antibiotics or surgery if persistent/recurrent
