Equine alimentary diseases and surgery Flashcards
colic
abdominal pain
colic clinical signs
- rolling
- pawing
- flank watching
- lip curling
clinical exam of cardiovascular status
- HR, rhythm
- resp rate, temp
- PCV, total protein, lactate
clinical exam of abdomen
- auscultation (divide into 4 quadrants)
- transabdominal ballottement (foals)
clinical exam of rectum
- distention, impaction, displacement
- can only feel part of abdomen
- risk of tear
colic clinical exams
- cardiovascular status
- abdominal exam
- rectal exam
- stomach tube
- ultrasound
- abdominoparacentesis
- gastroscopy
- faecal exam
stomach tubing for colic
gastric overfilling due to obstruction of SI
mouth exam for dental disease
- watch horse eat
- palpate
- sedate, mouth gag
- wash out
- torch, mirror
oesophageal obstruction/choke causes
- bad luck
- eating too fast
- dry food
- poor dentition
- mass
clinical signs of choke
- neck extended
- food discharge from nose, cough, gag
- over time= dehydrated, acid/base imbalance, weight loss
- aspiration pneumonia
can lead to= rupture, stricture due to scar tissue, diverticulum long term (pouch)
diagnosis of choke
- auscultation
- cardiovascular parameters (TPR)
- bloods
- gastroscopy
- ultrasound/radiography
- stomach tube (naso-oesophageal)
choke treatment
- relieve obstruction without causing damage or aspiration
- sedate so head is low, reducing risk of aspiration
- stomach tube, lavage
- check obstruction cleared with gastroscope
gastroduodenal ulceration
- inflammation, erosion, ulceration
- grades 0-4
gastroduodenal ulceration causes
- imbalance between inciting and protective factors
inciting factors: HCl, bile acids, pepsin
protective factors: mucosal blood flow, prostoglandin E, epidermal growth factor production
gastroduodenal ulceration risk factors
- empty stomach, exercise (splashing of gastric juices), diet, stress, NSAIDs
- ## feed before exercise
gastroduodenal ulceration clinical signs
none -> a lot
- poor appetite, recurrent colic, tooth grinding, dog sitting, poor performance
gastroduodenal ulceration diagnosis
gastroscopy
- difficult in foals (size of nostril)
gastroduodenal ulceration treatment
- depends on cause/adult v foal
- adults= omeprazole
- foals= sucralfate
gastric dilation and rupture causes
- primary, secondary, idiopathic
primary= impaction, grain engorgement
secondary= SI or LI obstruction, ileus (inability to contract)
gastric dilation and rupture clinical signs
- overfilling of stomach
- acute colic
- tachycardia
- fluid from nose (just before rupture)
- dehydration
gastric dilation and rupture diagnosis
- clinical signs
- stomach tube/reflux
- colic work up
- gastroscopy
gastric dilation and rupture treatment
- stomach tube (immediately)
- treat underlying cause
- Iv fluids, nutrition
- electrolyte balance maintenance
anterior enteritis
- inflammatory disease affecting proximal SI
- also called duodentitis-proximal jejunitis
- undetermined cause
risk factor- recent diet change
anterior enteritis clinical signs
- hypersecretion in proximal SI
- inflammation causes function ileus
- no muscular propulsion
- distended SI and stomach
- pyrexia
anterior enteritis diagnosis
- colic investigation
- raised protein levels in peritoneal fluid
- reflux/stomach tube
- culture of reflux
anterior enteritis treatment
- repeated gastric decompression
- antibiotics (penicillin, gentamicin)
- Iv fluids/nutrition
- ex lap= SI decompression
malabsorption and maldigestion of SI
- many types of inflammatory type diseases can cause it
clinical signs: weight loss
SI malabsorption and maldigestion diagnosis
- abdominoparacentisis
- ultrasound
- oral glucose tolerance test (doesn’t absorb so levels stay low)
- laparoscopic biopsy
SI malabsorption and maldigestion treatment
- depends on diagnosis and cause
- possible resection, corticosteroids
SI simple obstruction def and causes
simple= obstruction of lumen without vascular comprimise
- food (ileal hypertrophy)
- tapeworm swells junction between ileum and caecum and causes blockage of food
- ascarid impaction (worms block the lumen)
SI strangulation def and causes
simultaneous occlusion of intestinal lumen and blood supply
- pedunculated lipoma (attached to mesentry)
- epiploic foramen entrapment
- SI volvulus (twist)
- mesenteric rent (hole)
- inguinal/diaphragnatic hernia
- intussusception
SI obstruction leads to…
- gastric overfilling (risks rupture)
- deterioration of intestinal mucosa
- intestine dies
- sepsis
- endotoxaemia
SI obstruction clinical signs
- colic (severe as gut dies, eases when gut dead)
- reflux
- tachycardia
- hypovolaemia
- distended SI on rectal exam
- peritoneal fluid= serosanguinous, protein, lactate
SI obstruction treatment
- surgery or euthanasia
- rarely, ileal impaction can clear
caecum simple obstruction
- caecal impaction
primary or secondary: - primary= underlying motility disorder
- secondary= young horses after painful orthopaedic procedures
caecal impaction clinical signs
- colic
- can just rupture
- lower faecal output
- looks sad
caecal impaction diagnosis
- clinical signs/history
- rectal exam
- abdominoparacentesis
caecal impaction treatment
- medically if possible
- oral/Iv fluids
- surgery (typhlotomy or caecal bypass)
caecal intussusception
- inflammation secondary to tapeworm
- clinical signs: colic
caecal intussusception diagnosis
- rectal
- ultrasound (potential donut)
- peritoneal fluid (could be normal)
LI obstruction examples
simple- impaction, displacement
strangulating- torsion
LI impaction def and causes
- usually at pelvic flexure
- blockage of food material
causes: poor teeth, long fibre, motility disorder, box rest, sand
LI impaction clinical signs
- mild colic (can be chronic)
- reduced faecal output
LI impaction diagnosis
- clinical signs
- rectal
LI impaction treatment
- oral fluids and cathartics (pull more water into gut)
- analgesia
- eventually surgery
LI displacement
- gases up and travels to the wrong place
- can correct itself, remain displaced or torse
LI displacement diagnosis
- rectal
- ultrasound
- abdominoparacentesis
LI displacement treatment
- fluids
- analgesia
- for nephrosplenic entrapment= phenylepherine then lunge (shrinks spleen)
- surgery
LI torsion clinical signs
- strangulation
- extreme pain
- distended abdomen
- respiratory compromise
LI torsion treatment
immediate surgery
acute inflammatory LI diarrhoea causes
- salmonellosis
- colitis
- parasites
- neoplasia
acute non-inflammatory LI diarrhoea causes
- excitement
- food hypersensitivity
- toxicity
LI diarrhoea diagnosis
- cardiovascular parameters
- rectal
- ultrasound
- abdominoparacentesis
LI diarrhoea treatment
- hydration
- electrolytes
- anti-endotoxic
- treat underlying cause
- plasma
- TAKE CARE OF THEM (spend time with them, clean up)
small colon impaction
- foreign body (plastic bag)
- difficult to diagnose (diarrhoea and colic)
peritonitis
- inflammation of peritoneal cavity
colic clinical signs that indicate surgery
- severe behavioural signs despite analgesia
- absence of faeces
- HR >60
- poor MM colour
- reduced/no gut sounds on auscultation
- rectal= distention, displacement
- increased PCV, protein, lactate
- positive reflux (>2L)
- ultrasound= distended intestines
- discoloured, turbid peritoneal fluid
prep of horse for colic surgery
- jugular catheter placement
- decompress stomach with nasogastric tube
- admin of analgesia
- iv fluids to support circulation
- clip abdomen
- remove shoes/tape feet
- rinse mouth
SI strangulation obstruction
- maroon -> purple -> black
- mucosa becomes permeable to endotoxin which leaks into peritoneal cavity and circulation
- can cause ileus
post op care of colic patient
- colic check/exam every 2-4 hours
- analgesia
- antimicrobials
- IV fluids
- belly bandage
- monitor for complications
- nasogastric intubation to check for reflux
potential post op complications of colic
- pain
- pyrexia
- laminitis (secondary to endotoxaemia)
post op feeding of colic patient
- significant reflux= nil by mouth, Iv fluids
- when reflux has ceased, begin with small vol of water (5cm depth bucket)
- grass is good first solid food, then gradually introduce hay
- return to normal vol over 3 days
post op exercise for colic patient
- box rest for 6 weeks with short hand walks
- ensure no incisional problems
- turn out in small paddock at 6 weeks
- ridden exercise can take place after 3 months
endotoxaemia as post op complication
- tachycardia/pnoea
- pyrexia -> hypothermia
- hyperaemic MM -> dark purple
- colic signs, dullness
ileus as post op complication
- nasogastric intubation, gastric decompression
- IV fluids, supplement with electrolytes if needed
jugular thrombophelbitis as post op complication
- remove catheter
- anti-flamm treatment
- thrombolytics (aspirin)
- antibiotics?
long term complications of post op colic patient
adhesions
