Equine dentistry/GI Flashcards

Question

Prevention of colitis in equine

Answer 1

Avoid oral antibiotics PHF: avoid wetlands with snails +vaccination available (questionable efficacy) Usually unavoidable

Answer 2

Colic = abdominal pain Causes Gastrointestinal- gas, impaction, obstruction (displacement, torsion) Urinary- stones Liver- inflammation Reproductive tract: labour

Answer 3

Dehydration coarse feed sudden decrease in exercise Feeding meals high in Non structural carbohydrates (NSC) Normal anatomy- common sites of impaction: cecum, pelvic flexure, transition between large- small colon Horses can't vomit/erucate

Answer 4

Pleuropneumonia Laminitis Fracture

Answer 5

Reluctance to move Flank watching Lying down Pawing Teeth grinding

Answer 6

Kicking Stretching Roling Refusal to stand Sweating Depressed

Answer 7

Avoid giving meds Don't want to mask symptoms with analgesics Avoid oral drenching especially with mineral oil With hold food but not water Prevent horse from excessive rolling/hurting itself If resting quietly horse can lie down Walkin in an environment free from hazards Stay safe themselves An otherwise very well-trained horse may suddenly go down on top of you

Answer 8

More severe rapidly progressive clinical signs Reflux, endotoxemia Usually surgical Rapid referral Px– poor to good with prompt treatment

Answer 9

Mild, slowly progressive clinical signs May continue to eat Usually medical Px – good to excellent with appropriate treatment

Answer 10

Gas Motility issue: spasmodic vs ileus Displacement, entrapment- E.g. Left dorsal displacement, nephrosplenic entrapment (LI), epiploic foramen entrapment (SI) Volvulus/torsion- e.g. mesenteric volvulus Strangulation- e.g. strangulating lipoma Obstruction - E.g. trichophytobezoars (hairballs), parasites Impaction – poor quality feed+dehydration, sand Infection- E.g.salmonella

Answer 11

Medical vs surgical Making the decision to go to surgery quickly is key to success Looking in the abdomen may be diagnostic as well as provide treatment **Warn owners not all conditions can be treated even with surgery: not all the gut is visible or accessible even when the abdomen is open Any situation which compromises blood supply to intestine results in rapid devitalization/death of intestine and the potential for rupture, endotoxemia etc

Answer 12

Hx and PE Diet, water access, deworming schedule HR: 50-80 bpm moderate pain vs >100 Gut sounds- listen in all 4 quadrants Blood gas Electrolytes, systemic lactate PCV, total protein Dehydration Sedation/Analgesics Rectal exam Palpable abnormalities? Nasogastric intubation Check for reflux Tx. oral fluids/meds (DSS, mineral oil) Jugular IV cath Sometimes in both jugs Abdominocentesis Strangulating vs obstructive Lactae, Culture and sensitivity IV fluids Hypertonic Isotonic (LRS)

Answer 13

Shave and sterile prep a 10cm square at the most ventral point of abdomen at midline or a little to right of midline (to avoid hitting spleen which sits to left of midline) Or ventral midline more cranially where pectorals form a “V” caudal to sternum +/- local anesthetic bleb and scalpel cut down to abdominal wall 18g ½” needle or teat canula Let the blood drip into a purple top tube

Answer 14

Rapid onset massive systemic dehydration Sequestered fluid in intestine Acidosis Compromised bowel Goals Replace volume deficit+maintenance(~50ml/kg/day)+ongoing losses Support systemic blood pressure

Answer 15

Intravenous -Dehydration >5% -Suspected obstruction -Signs of shock Oral -Dehydration <5% -Functional GIT -No signs of shock

Answer 16

7.2% hypertonic saline Rapidly restores systemic volume by drawing interstitial reserve into the vessels by hyperosmotic draw Greater than 5% dehydrated or systemic lactate greater than 4 mmol/L 1 L hypertonic saline = 10 L of normotonic fluids MUST BE FOLLOWED BY AT LEAST 10 L OF NORMOTONIC FLUIDS! Intravenous-Lactated Ringers Solution (LRS) Most horses with colic are acidotic from dehydration and/or compromised bowel LRS is metabolized by the liver to produce a buffer to increase the systemic lactate Oral – Balanced electrolyte solution Horses with no obstructions Ideal for large colon impaction

Answer 17

Intravenous Shock bolus = 20 mL per kg over 30-60 minutes Reassess 2 times maintenance until remainder is replaced Maintenance = 2 mL per kg per hour Oral Bolus 20 mL per kg per hour But never sure if the stomach is entirely empty, so bolus 8 L every one to two hours to be safe CRI 8–20 mL per kg per hour (4–10 L per hour) Most horses tolerate 4 L/ hr very well