Evaluation of the Gastrointestinal System Flashcards
What is the most common first sign of colic seen my owners? What else is seen?
not eating
- excessive rolling or lying down
- stretching out
- pawing
- kicking at belly
- looking or biting at sides
- lip curl
What general and focused observations are used on physical exams to help diagnose GI issues?
hydration, endotoxemia, septicemia
gut sounds, feces
What are some CBC and inflammatory markers used for diagnosing GI disease?
leukopenia - neutropenia
increased SSA and fibrinogen
What are some biochemistry markers used for diagnosing GI disease?
- lactate - poor prognosis if >6 mmol/L or peritoneal lactate 2x serum
- glucose - poor prognosis if >300 mg/dL, also increased with stress
- electrolytes - acidosis
- BUN/creatinine - dehydration
- increased GGT - right dorsal displacement
How are heart rate, CRT, PCV, TP, and Cr affected by GI disease? MM moisture/color?
all increase progressively as dehydration increases + loss of skin turgor
becomes progressively dry and red/cyanotic
How is a nasogastric tube placed?
- nose twitch and sedation with alpha-agonists
- start with horse’s head extended and pass the tube through the ventral meatus
- flex the neck and continue passing the tube down the esophagus and into the stomach
(flexion avoids aspiration pneumonia)
helps evaluate stomach since horses are unable to vomit
How can nasogastric tube placement be used as treatment?
- routine medication administration
- relieve choke
- nasogastric decompression
What are the most common complication associated with nasogastric tube placement?
- bleeding due to rupture of small vessels or trauma to the ethmoid with improper placement through the middle meatus
- aspiration
- perforation of esophagus or stomach
What medication is used to decrease spasms associated with rectal exams?
Buscopan or epidurals
What structures are commonly palpated on rectal exams?
- aorta - dorsal
- left kidney - caudal pole
- spleen - left abdomen
- band of cecum, pelvic flexure - forward on midline
What are some abnormal findings on a rectal exam?
- crepitus
- irregular or rough surfaces
- thickened walls
- masses
- firm tubular small bowel
- tight bands
- painful areas
- gas-filled or impacted large intestine
What is the most common complication associated with rectal exams?
rectal tear —> pink/red on glove
What is being palpated in this picture?
a. small colon
b. small intestine
c. cecum
d. pelvic flexure
D
The horse being palpated on the right picture is also experiencing a hoof abscess and is stabled on straw. What is the most likely problem?
a. impaction
b. tympany
c. volvulus
d. left dorsal displacement
A
What are the 2 pieces of equipment used for adominocentesis? What helps guide?
- needle - through ventral midline, at least 2 in especially if patient has a high BCS
- teat cannula - abdominal wall needs to be punctured with blade, R of midline away from spleen
ultrasound
Endoscopy, esophagus:
- normal folds
- inflation needed to observe entire circumference
Endoscopy, esophagus:
circumferential ulcer, strangulation
Left abdominal gastric ultrasound:
left side over chest
Left nephrosplenic ultrasound:
- left paralumbar fossa
- spleen = homogenous
Right liver, duodenum, colon ultrasound:
behind diaphragm
Right kidney:
What part of the intestine is distended in this ultrasound?
small intestine - stacked bowels
In what horses is radiography most commonly used? What does it observe?
foals
concretions in intestines, fluid in abdomen
How are absorption tests performed?
- 18-24 hr fast
- collect a baseline blood sample
- 10% solution 0.1-1 g/kg per NG tube is administered
- collect blood every 30 mins for 4 hours
- should observe a peak at 60-120 mins
with malabsorption, the peak will be much lower
