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Alimentary > Equine Diarrhoea > Flashcards

Equine Diarrhoea Flashcards

1
Q

Are equine diarrhoeas usually 1* or 2* GIT?

A

1*

Occasionally 2*

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2
Q

What is the funtion of the colon in horses? Foal?

A
  • Water reabsorption
  • microbial digestion of carbohydrate and protein/nonprotein nitrogen
    > less well developed in foals due to milk diet (digested by SI)
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3
Q

Which section of GIT is diarrhoea in the adult most common? In the foal?

A

LI

In foals may be SI or LI

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4
Q

What 3 stages of questioning help narrow down the DDx list?

A
  1. Age of animal?
  2. Duration of clinical signs?
  3. History - presence of risk factors [drugs, other animals affected]?
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5
Q

Give 8 DDx for neonatal foal diarrhoea

A 
1- Foal heat diarrhoea
2- Viral (esp. rotavirus) 
3- Salmonella and clostridia [can occour at ANY age] 
4- Netcrotizing enterocolitis
5- Sepsis
6- Nutritional diarrhoea 
7- Parasitic diarrhoea (strongyloides westeri)
8- Gastroduodenal ulceration
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6
Q

Define the age of a Neonate

A

< 2 weeks

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7
Q

What is foal heat diarrhoea cause by? Where did the name originate?

A
  • change in gut flora between 1-2weeks of age
  • foal is NOT SICK, just has diarrhoea
  • coincides with mares first oestrus cycle post partum
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8
Q

Give 10 DDx for older foals (10-12 months)

A

1-Cryptosporidiosis
2-Parasitic: Strongyloides Vulgaris [->colic], Cyathostominosis
3-Proliferative enteropathy: Lawsonia Intracellularis
4-Rhodococcus equi colitis
5-Viral (rotavirus) - less likely in older foals
6-Salmonella and clostridia
7-Sepsis
8-Nutiritonal
9-Gastroduodenal ulceration
10-Parasitic - S Westeri

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9
Q

Give 10 DDx for adult horses

A

1- Salmonellosis and clostridiosis
2- Parasitism (larval cyasthostominosis, strongylosis)
3- antimicrobial-associated
4- NSAID toxicity (right dorsal colitis)
5- Sand enteropathy
6- Carbohydrate overload
7-IBD (or other inflammatory or infiltrative disorders)
8- Dietary - abnormal fermentation
9- Neoplasia (10yrs+) - lymphoma, peritonitis and abdominal abscessation
10- UNDIAGNOSED!

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10
Q

What are the 2 categories when describing the duration of clinical signs?

A

> Acute: Acute onset febrile diarrhoea, animal sick, clinical signs of hypovolaemia, endotoxaemia, fever, often blood diarrhoea
Chronic: Diarrhoea for >2 weeks but usually still eating/drinking etc.

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11
Q

Give 2 causes of diarrhoea which cause acute clinical signs ONLY

A
  • Clostridiosis

- Antimicrobial-associated diarrhoea

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12
Q

Give 2 causes of diarrhoea which cause chronic clinical signs ONLY

A
  • Inflam/infiltrative disorders (IBD)

- Neoplasia (Lymphoma, peritonitis, abdominal abscessation)

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13
Q

Give 4 potential “risk factors” to help narrow down the differential list

A
  • treatment with NSAIDs [ask specifically, owners may forget flunixin/bute is a drug if been given long term! -> right dorsal colitis]
  • Anthelmintics [be aware resistance; insistent cyathostomins emerge in spring -> mechanical damage to GIT]
  • Antibiotics [Clostridium]
  • Contact with other horses/foals with diarrhoea and their ages
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14
Q

Is it important to make a definitive diagnosis?

A

Probably not

  • but you should try because could be contagious/zoonotic (eg. salmonella)
  • specific treatments useful
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15
Q

What are the 3 principles of diarrhoea therapy in horses?

A
  1. Address fluid loss
  2. Address inflamation and endotoxaemia
  3. Address specific cause
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16
Q

How are fluid therapy dose rates calculated?

A
  1. Deficits (ie. % dehydrated; estimated by poor jugular fill, skin tent, sunken eyes etc. meaning 5%, anything above this = more so)
  2. Maintenance (2-4ml/kg/hr)
  3. Ongoing losses (estimate, can be <100l/day)
17
Q

What is the average weight of a horse? Foal?

A

500kg

50kg

18
Q

What is endotoxin? When may it cause a problem?

A
  • Part of the outer membrane of gram -ve bacteria, normally present in gut due to commensal gut flora (fermentation and digestion of cellulose)
  • Released during cell death
  • Normal mucosal barrier prevents access to circulation
    > mucosal barrier breakdown -> endotoxaemia
19
Q

Why is endotoxaemia a particular problem in horses?

A

Have a very low tolerance of endotoxin cf. other species.

  • endotoxin in circulation interacts with cells (eg. macrophages)
  • Initiates systemic inflammation
  • clinical signs of endotoxaemia = depression, tachycardia, tackpnoea, fever, colic, diarrhoea, hyperaemic toxic membranes
  • CV and GI dysfunction, shock, organ failure, death
20
Q

How is the diagnosis of endotoxaemia confirmed?

A
  • clinical signs
  • usually LOW white cell count (as all migrated to infectino site)
  • LOW neutrophil count
  • Immature band neutrophils
    > Endotoxin assay possible but low sensitivity and takes a long time to complete
21
Q

What 4 ways may endotoxaemia be treated?

A

1 - prevent movement of endotoxin -> circulation
2 - neutralise it before it interacts with inflammatory cells
3 - prevent synthesis, release or activation of inflammatory mediators
4 - prevent endo-toxin induced cellular activity

22
Q

How can you prevent movement of endotoxin -> circulation?

A

Remove sections of necrotic gut

23
Q

How may endotoxin be neutralised to prevent it interacting with inflammatory cells?

A
  • Polymixin B
  • Hyperimmune plasma (USA only)
  • Pentoxyfilline
  • Flunixin
24
Q

How can you prevent the synthesis, release or activation of inflammatory mediators?

A
  • Pentoxyfylline prevents release of inflammatory mediators from cells (IL1, TNF, IL6 etc.)
  • Flunixin blocks PG production [may cause GIT problems so use with care!]
25
Q

Which stage is the best to treat to prevent endotoxaemia?

A

Neutralise the endotoxin (polymixin B or plasma)

26
Q

What are the effects of endotoxaemia in foals?

A

SImilar ot horses

27
Q

What usually causes endotoxaemia in foals?

A

Sepsis or bacteraemia (rather than GIT barrier compromise - LI less well developed, smaller bacterial population?)

28
Q

What must be considered when treating foals for endotoxaemia?

A

Undeveloped kidneys -> concerns with nephrotoxicity cuased by flunixin and polymixin B

29
Q

What treatments are advocated for foals with endotoxaemia?

A

plasma, antibiotics [would not be appropriate in adults]

30
Q

What drug is used to treat clostridium?

A

Metronidazole

31
Q

Do horses with endotoxaemia require hospitalisation?

A

Most tests etc. do not require hospitalisation.
BUT keeping up with fluid requirements (50-100l/day, potentialy IV) challenging in practice (time consuming and not ecomonic)
- If fluid requirements can be met by drinking probably ok to stay at home
- Be OVER CAUTIOUS with foals as can deteriorate very rapidly
- Contagious? - think of other horses on farm (isolation at hosptial)

32
Q

How does fluid treatment for foals differ to adults?

A

Smaller volumes can be given as intermittent frequent boluses to avoid fluid being urinated out
OR
Separate mare and foal for continuous fluids

Alimentary (30 decks)

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