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Equine > Equine diarrhoea > Flashcards

Equine diarrhoea Flashcards

1
Q

Define equine diarrhoea

A

Increased frequency and change in consistency - some use interchangably with colitis
Isolation important as difficult to differentiate

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2
Q

Causes of acute diarrhoea in the horse

A

Salmonella spp.
Clostridium difficile
Clostridium perfringens
Coronavirus
Cyathostominosis
Antimicrobial associated
Right dorsal colitis
Grain overload
Dietary

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3
Q

Clinical signs of equine diarrhoea

Clinical signs of chronic equine diarrhoea

A

Cow pat to high volume hosepipe D+++
Quiet to depressed
Colic
Fever
Hypovolaemia
SIRS
Laminits
Secondary infections
Significant risk of rapid deterioration

Chronic
- Ventral oedema
- Weight loss
- Electrolyte imbalances

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4
Q

Salmonella D+

Risk factors

A

Some are zoonotic
Nosocomial (from hospital)
Common large volume, watery D+
Bacteriaemia
Intermittent shedding

Risk factors
- Recent abdominal surgery
- GI disease (small colon impaction)
- immunosuppression
- Antimicrobials
- GA
- High ambient temperatures
- Prolonged hospital stay
- Horses actively shedding or carriers

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5
Q

Clostridiosis D+

Risk factors

A

Commonly - antimicrobial associated and nosocomial
Normal flora in all ages - low numbers do not produce toxins
Toxins produced - disease
Difficile and perfringens

Risk factors
- Dietary changes
- Hospitalisation
- Antimicrobials
- GI disease
- Not fully understood

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6
Q

Coronavirus D+

A

Enteric pathogen
Outbreaks
Risk factors not fully understood

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7
Q

Cyathostominosis D+

Risk factors

Treatment

A

Equine parasitic disease - high prevalence
Can have severe clinical signs
Pre-patent disease
Most commonly seen in spring - sudden mass emergence - clinical disease

Can remain encysted from weeks to 2 years
Encysted, hypobiotic larvae unaffected by most anthelmintics
Mass emergence in spring
- Mucosal injury
- Ulceration
- Inflammation

Risk factors
- Age
- Season
- Period since last anthelmintic
- Altered host immunity
- Stress
- Dietary changes
- Unknown factors

Moxidectin
Pre - treatment with steroids - dexamethasone or prednisolone

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8
Q

Antimicrobial colitis

A

Disruption of GI flora, no competition for nutrients, pathogenic bacteria proliferate, obligate anaerobe most important and antbiotics affecting these will cause D+

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9
Q

Right dorsal colitis

A

NSAID toxicity - often higher than licenced dose
Not always and not always long term use
Can occur in normovolamic

Misoprostal may be helpful
Psyllium may be helpful

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10
Q

Grain overload D+

A

Large quanity of hard feed
SI digestion overwhelmed and soluble CHO enters LI
Rapid fermentation by lactic acid producing bacteria lowers pH - gram negative bacteria die - endotoxin released
Other bacteria overgrow and gut wall compromised - bacteria and toxins enter circulation

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11
Q

Risk factors for D+

A
  • gastrointestinal disease
  • Immunosuppression
  • Antimicrobials
  • General anaesthesia
  • Recent abdominal surgery
  • Hospitalisation
  • Other horses – could be acutely infected with shedding or silent carriers intermittent shed
  • Dietary changes
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12
Q

Chronic diarrhoea causes

A

Chronic diarrhoea
Salmonella spp.
Cyathostomiasis
Right dorsal colitis
Sand enteropathy - often intestinal obstruction - treat with psyllium
Inflammatory bowel disease
Dietary

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13
Q

Young horse D+ causes

A
  • Equine Proliferative Enteropathy
  • Rhodococcus equi
  • Salmonella spp.
  • Clostridium difficile
  • Clostridium perfringens
  • Coronavirus
  • Cyathostomiasis
  • Antimicrobial Associated
  • Right Dorsal Colitis
  • Grain overload
  • Dietary
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14
Q

Young horse D+ clinical signs

A
  • Cow pat to high volume hosepipe D+++
  • Quiet to depressed
  • Colic
  • Fever
  • Hypovolaemia
  • SIRS
  • Laminitis
  • Secondary infections
  • Have a significant risk of deteriorating rapidly!
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15
Q

Equine proliferative enteropathy
Cause
Age

A

Lawsonia intracellularis
2-8months of age usually
Proliferative enteropathy of small intestine
Geographical
Severe hypoalbuminaemia
Weight loss +++

    Farms with a history of disease and often annual reoccurrence in this age group

Treat - doxycycline

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16
Q

Rhodococcus equi

A

Usually get respiratory disease
Uncommon manifestation is D+
Common cause of pneumonia

    Farms with a history of disease and often annual reoccurrence in this age group
17
Q

Neonate diarrhoea causes - Foal 0-10 days
Infectious
Viral
Bacterial
Fungal
Protozoal

A

Virus
- Rotavirus
- Coronavirus

Bacterial
- Gram positive enterocolitis - clostridium
- Gram negative infections - E.coli, Salmonella, Actinobaccilus

Fungal - immunocompromised foals
- Cadida/mucor

Protozoal
- Cryptosporidium

18
Q

Foal 0-10 days causes of diarrhoea
Non-infectious

A

Foal heat diarrhoea
Secondary to meconium infection
Errors in feeding - concentration or volume - orphaned foals
Gastroduodenal ulceration
Sand enterocolitis
Systemic disease - perinatal asphaxia, neonatal adjustment, sepsis
Congenital lactose intolerance

19
Q

Foal diarrhoea 10 days - 6 weeks
Infectious

A

Virus
- Rotavirus
- Coronavirus - immunocompromised

Bacterial
- Gram positive enterocolitis - clostridium, rhodococcus equi (uncommon <6 weeks)
- Gram negative infections - E.coli, Salmonella, Actinobaccilus

Fungal - immunocompromised foals
- Cadida/mucor

Protozoal
- Cryptosporidium

Parasitic
- Strongyloides westerii
- Parascaris equorum
- Strongylus vulgaris

20
Q

Foal diarrhoea 10 days - 6 weeks
Non infectious

A

Foal heat up to two weeks
Secondary to meconium impaction
Errors in feeding - post enteritis lactose intolerance
Gastric ulceration
Sand enterocolitis
Antibiotic induced diarrhoea - oral administration

21
Q

Risk factors - neonatal foal D+

A

Pre-existing disease
Failure of passive transfer – predisposed to more
Poor hygiene in peripartum period
High stocking density
Antimicrobial administration
Milk replacer therapy

22
Q

Aims of treatment of neonatal D+

A
  • Treatment of underlying cause
  • Treatment of the consequences of diarrhoea
  • Fluid/electrolyte loss
  • Bacterial translocation
  • Albumin loss
  • Nutrition – prevent from nursing to provide enteral rest – nutrition alternate way
23
Q

Treatment of neonatal D+

A

First – history and physical exam
Second – Haematology and biochemistry
Third – Further diagnostics – ultrasound, faecal cultures, or PCR
In order of severity of sickness

24
Q

Aims of diagnostic investigation for D+

A
  • Determine likely cause for D+
  • Determine need for supportive therapy
  • Determine need to specific therapy
  • Determine risk to in-contact horses and personnel
25
Q

Management of equine D+

A

Fluid replacement
- Mild/moderate - drinking +/- NGT
- Severe - IVFT - Hartmanns - decreasing oncotic pressure
May need KCl, NaHCO3 and general Na supplementation

Anti-inflammatory - negative effects on colon

Analgesia
- NSAIDs - flunixin (other COX2 selective - colon)
- Xylazine, detomidine, butorphanol
- CRI - Butorphanol, lidocaine, ketamine

Antimicrobials - only if neutropenic or signs of sepsis

Probiotics - faceal transfaunation NGT

Adsorbants - biosponge - SID-BID NGT

Nutrition - complete pelleted diet - no grain, no hay
- If inappetant - good quality grass hay better than nothing
- Can add oil for added calories

26
Q

Sepsis with acute D+ management

A

Circulatory support - dobutamine

Flunixin - may help block parts of sepsis cascade - lower dose

Cryotherapy - critical - laminitis secondary to colitis
- Constant low hoof temperature - replace ice every 2h 24h/day

Plasma - expensive - 7-10 litres
- Toxin neutralisation

Pentoxyfyline - suppresses proinflammatory cytokines, increased RBC deformability

Polymixin B - Prevents initiation of proinflammatory cascade

27
Q

Management of mild D+ and normovolaemia

A

Diet - simple grass or pelleted diet
No grains
+/- Biosponge
Monitoring

28
Q

Management of neonatal D+

A

Consider referral
IVFT - careful with Na and acid base
Antimicrobials - sepsis related, FPT
GI rest - 24-48 hours
- Partial or total parenteral nutrition
Supportive care
Secondary infections

Equine (18 decks)

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