Equine weight loss and chronic colic Flashcards
What are common causes of weight loss?
- Dental disorders
- Parasitism
- Inadequate diet - malnutrition, inability to compete for feed
- PPID
- Liver disease
- Malabsorption + protein losing enteropathy
What are other less common causes of weight loss?
- Chronic diarrhoea
- Abdominal Abscess
- Renal Disease
- Cardiac disease
- Chronic thoracic disease
- Non-GI Neoplasia
- Equine grass sickness
What is chronic / recurrent colic?
- Behavioural manifestation of visceral pain - GI
- stretch
- inflammation
- ischaemia
- muscle spasm
- Colic signs of variable intensity >48hrs (chronic)
- Shorter periods of colic pain which recur at variable intervals (Recurrent)
What history should be noted with recurrent colic?
- Number / nature of previous colic / abdominal signs
- Faecal output, diarrhoea / weight loss / medical conditions
- Diet + changes
- Worming / FEC
- Dental problems / quidding
- Crib biting / wind sucking
- Sand pastures / turnout
What history should be noted with weight loss?
- Rule out obvious simple causes e.g. recent diet change, dental disorders etc
- Assess exposure to infectious causes e.g. worming history, environment, drug history
- Determine if in “ACUTE” or “CHRONIC” categories
- Associated localizing history e.g colic / diarrhoea / coughing / polyuria
- rule out other causes - pregnancy , heart disease, PPID, others
With chronic GIT disease a full exam should be done, what else should be done?
- Oral Examination
- Blood and faecal tests
- Rectal
- Nasogastric tube
- Abdominal ultrasound
- Peritoneal fluid
- Gastroscopy
- Oral glucose absorption test
- Intestinal biopsy
- Exploratory surgery
What do we look for on abdominal ultrasound?
- Position
- Intestinal wall thickness
- Lumen diameter
- Motility
- Abnormal structures
- Peritoneal effusions
What are further tests that could be done?
- Oral glucose absorption test
– Absorption test vs. tolerance
– Small intestinal only - Rectal Biopsy
- Gastroscopy
- (Duodenal biopsy)
- Exploratory laparotomy / laparoscopy - costly + risky (last resort)
What is the oral glucose absorption test?
– Fast overnight
– Baseline blood glucose
– 1 gm/kg glucose as 20% solution by nasogastric tube
– keep horse calm (do not sedate with alpha 2’s)
– Measure blood glucose every 30 minutes
- Indicates SMALL INTESTINAL absorption
What is inflammatory bowel disease?
- Lymphocytic-plasmacytic enteritis
- Eosinophilic enteritis
- Granulomatous enteritis
- Inflammatory cells in intestinal wall - leading to malabsorption and protein-loss
– Diagnosis: thickened wall on U/S
– Biopsy
– Diagnosis of exclusion
What are Ddx for IBD?
- cyathostomosis
- mixed strongyle infection
- idiopathic
- infiltrative bowel diseases
- Neoplasia
- Lawsonia (foals 3- 11 months)
Other than bowel epithelium what else is affected?
- Skin, around coronary band, pancreas + liver (MEED - multisystemic eosinophilic epitheliotropic disease)
Tx = dexamethasone
What is seen in horses with lymphoma + other forms of disseminated neoplasia?
– fever
– weight loss
– peritonitis
– pleural effusion
– abdominal distension
– intra-abdominal mass palpable per rectum
– Hypercalcaemia/haemolysis/cachexia of malignancy
Other than lymphoma what are other common neoplasias?
- Leiomyoma
- Myxosarcoma
- Gastric or Adenocarcinoma
- Melanoma
What is Tx of IBD?
Non-specific
* Prednisolone
* Dexamethasone
– Given in the morning, monitor for signs of laminitis and infection
* Dietary management
– High quality
– Digestible
* Anthelmintics
