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LA DX & TX I > Exam 3 - Equine Colitis > Flashcards

Exam 3 - Equine Colitis Flashcards

1
Q

what are the 6 mechanisms of diarrhea?

A
  1. hypersecretion
  2. malabsorptive
  3. inflammatory/exudative
  4. osmotic
  5. deranged motility
  6. increased oncotic pressure
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2
Q

T/F: equine diarrhea is generally related to the large intestines

A

true

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3
Q

what is free fecal water syndrome?

A

not actually diarrhea - excess water is seen at the beginning or after defecation with an otherwise healthy horse

unknown cause - may be diet related

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4
Q

what specific diagnostic tests can be used to identify the cause of diarrhea?

A

PCR/culture

imaging, ultrasound, & biopsy

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5
Q

what non-specific diagnostics can be used for medical management of equine diarrhea?

A

cbc - look for leukopenia/leukocytosis, elevated PCV, & elevated/decreased TP

biochem - fluid loss, expect low Na, K, Cl, azotemia, & albumin/globulins (oncotic pressure)

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6
Q

regardless of etiology, treatment of equine colitis relies on what?

A

supportive care - anti-inflammatories (pepto), IVF, etc

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7
Q

why do you see clinical signs in endotoxemia from colitis?

A

the body responds to the endotoxin from the cell wall of gram negative bacteria (LPS)

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8
Q

what clinical signs are associated with endotoxemia related to colitis?

A

tachycardia, pyrexia, dull/lethargy, hyperemic mucus membranes/toxic line

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9
Q

how can you prevent further absorption of endotoxin in equine colitis?

A

remove the injured intestines & use a bio sponge

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10
Q

what treatment is used in endotoxemia from colitits that binds to the endotoxin to prevent its action?

A

polymixin b & plasma

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11
Q

what medication is given in endotoxemia that reduces the production of inflammatory mediators?

A

NSAIDS

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12
Q

why provide hoof support/ice therapy to horses with endotoxemia?

A

they are at risk for developing laminitis

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13
Q

what are the most-common non-infectious causes of equine colitis?

A
  1. dietary change
  2. grain overload
  3. antibiotic associated
  4. NSAID toxicity
  5. sand enteropathy
  6. blister beetle ingestion
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14
Q

what are the clinical signs associated in colitis caused by dietary change/grain overload? clin-path abnormalitis?

A

soft-liquid feces, mild colic-abdominal distension, endotoxemia, & laminitis

dehydration, elevated lactate/anion gap

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15
Q

what is the treatment used for dietary change/grain overload equine colitis?

A

supportive care, decrease concentrate or access to rich grass/hay, slow diet alterations, & increase fiber in the diet

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16
Q

how is antibiotic associated colitis diagnosed?

A

history of antibiotics & diagnosis of exclusion

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17
Q

why do antibiotics cause colitis?

A

disrupt the normal gut flora

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18
Q

what is the treatment for antibiotic associated colitis?

A

stop the antibiotics, give oral probiotics, transfaunation, & supportive care

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19
Q

what are the clinical signs of antibiotic associated colitis?

A

mild to severe colitis

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20
Q

what is the typical history of a horse with sand impaction?

A

possible or obvious exposure to sand, sandy environment, or eating off the ground

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21
Q

what clinical signs are associated with sand impaction? clin path abnormalities?

A

colic - may result in colonic inflammation, obstruction, or rupture

diarrhea, weight loss, anorexia

lab work - mild inflammatory signs & decreased albumin

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22
Q

how is sand impaction diagnosed?

A

radiography!!! most sensitive & gold-standard

xiphoid auscultation, glove test (low sensitivity/specificity)

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23
Q

what is seen on this rad of an equine abdomen?

A

sand colic

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24
Q

what is the treatment & prevention of sand impaction?

A

psyllium mucilloid (metamucil, sand clear) - 1 gram/kg via NGT quickly SID for 3-5 days

epsom salts - 1 gram/kg via NGT with psyllium SID 3-5 days

elevate food off of the ground

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25
Q

why do we see right dorsal colitis with NSAIDS in horses?

A

there is a relatively narrow therapeutic range for nsaids & excessive dosing can cause toxicosis in a couple days

COX1 & COX 2 - selective but may be slightly less toxic to git but not kidneys

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26
Q

if using the recommend dosing of NSAIDS, when can you expect toxicosis to occur?

A

days to weeks

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27
Q

risks of developing right dorsal colitis from NSAIDS are exacerbated by what?

A

dehydration, sepsis

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28
Q

how is right dorsal colitis from NSAID toxicity diagnosed & treated?

A

history, ultrasound, & diagnosis of exclusion

misoprostol & sucralfate, change the diet to a low bulk food (eliminate hay), corn, oil, psyllium

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29
Q

what are the 2 most common lab abnormalities seen in blister beetle toxicosis?

A

hypocalcemia & hypomagnesemia

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30
Q

what are the clinical signs of cantharidin toxicity?

A

ulcerations through out the gi tract, synchronous diaphragmatic flutter, muscle contraction/3rd eyelid protrusion, usually more than 1 horse affected

fatality of 50% or higher

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31
Q

how is cantharidin toxicity treated?

A

IVF with calcium

charcoal or biosponge

gastroprotectants

32
Q

what are the 4 bacterial infectious causes of diarrhea in horses?

A
  1. salmonella
  2. clostridial - perfringens & difficile
  3. potomac horse fever
  4. lawsonia intracellularis - younger horses
33
Q

what is the most common viral infectious cause of diarrhea in horses?

A

coronavirus

34
Q

what is the most common infectious parasitic cause of diarrhea in horses?

A

small strongyles

35
Q

what is the most frequent isolate of salmonella in horses?

A

salmonella enterica serovar typhimurium

36
Q

T/F: horses aren’t considered to be carriers of salmonella, but asymptomatic shedders can shed a very small amount

A

true

37
Q

why do teaching hospitals carry the greatest risk of salmonella outbreaks?

A

the horses are stressed & potentially immunocompromised - colic & antibiotic use, so some horses may shed it

38
Q

what are the biggest components of clinical signs of salmonella in horses?

A

gi problems 35-60%
lameness 17%
asymptomatic 1-5%

39
Q

what is the pathogenesis of salmonella?

A

the animal ingests the organism & mucosal invasion & adhesion occurs (enterotoxins released)

intestinal fluid secretions, activation of local inflammation, LPS systemic responses, malabsorption, & bacteremia

40
Q

what clinical signs are associated with salmonella?

A

asymptomatic!!!!

colic, enterocolitis, pyrexia, & endotoxemia

41
Q

what would you expect to see on lab work of a horse with salmonella?

A

leukopenia characterized by a neutropenia with a toxic left shift

dehydration, hypoproteinemia, electrolyte derangements with fluid loss

42
Q

how is salmonella diagnosed?

A

multiple fecal samples on all horses with diarrhea

3-5 samples all 12-24 hours apart (liquid samples less likely to be positive), shedding is intermittent

fecal or reflux culture

PCR - good screening tool, if positive, culture recommended for serotyping

43
Q

why do you run so many fecals when looking to discharge a salmonella horse from the hospital?

A

they can shed it for 4-6 weeks up to several months after clinical signs have resolved - you must isolate them for 6 weeks or until you have 5 negative tests

44
Q

T/F: you must isolate a salmonella horse for 6 weeks or until you have 5 negative tests before considering them cleared of the infection

A

true

45
Q

how is salmonella treated?

A

supportive care, manage endotoxemia (endoserum/plasma), antibiotics (enrofloxacin) but may prolong illness, consider bacterial translocation in very sick animals

transfaunation & probiotics to support colonic microbes

46
Q

how is salmonella prevented/controlled?

A

good biosecurity, isolation of infected individuals, & screening in some hospitals

47
Q

what toxins are associated with clostridium difficle?

A

toxins A & B

48
Q

what toxins are associated with clostridium perfringens?

A

toxins A & C

49
Q

what are the clinical signs of clostridial infections in horses?

A

similar to salmonella, perfringens especially in foals may be hemorrhagic, & may cause sudden death

50
Q

what is the common history of horses with clostridial infections?

A

often associated with antibiotic use

51
Q

how are clostridial infections diagnosed?

A

identify toxins with PCR or ELISA

organisms are apart of the normal microbiome - culture doesn’t tell you much

52
Q

what is the treatment for clostridial infections in horses?

A

metronidazole or penicillin, bio sponge, antidiarrheal, & something to bind exotoxins

53
Q

what is the etiology of potomac horse fever?

A

neorickettsia risticii

54
Q

what is the pathogenesis of potomac horse fever?

A

agent infects peripheral monocytes & macrophages, colonic & small intestinal epithelial cells, & colonic mast cells

55
Q

what are the clinical signs associated with potomac horse fever?

A

febrile, poor appetite, mild to severe gi signs, laminitis in 30% of cases

56
Q

what clin path abnormalities would you expect in a horse with potomac horse fever?

A

leukopenia & hypoproteinemia

57
Q

what is the treatment used for PHF?

A

oxytetracycline - 6.6mg/kg IV, clinical signs typically improve within 48 hours

protect their feet!!!

58
Q

what prevention is used for PHF?

A

insect control (aquatic snails)

vaccine isn’t great but may be useful in endemic areas

59
Q

when are horses typically affected by coronavirus?

A

winter - fecal oral transmission

60
Q

what are the clinical signs of coronavirus in horses?

A

generally self limiting with clinical signs for 7-10 days & shedding up to 25 days

leukopenia or leukocytosis on labs

asymptomatic, encephalopathy secondary to hyperammonia in miniature horses, fever, lethargy, anorexia, enterocolitis/colic, co-infection in foals with rotavirus or c. perfringens

61
Q

what are some chronic causes of colitis (diarrhea) causing weight loss?

A

parasites, sand enteropathy, chronic salmonella, & inflammatory/infiltrative bowel disease or alimentary lymphoma

62
Q

what classifies as chronic diarrhea in horses?

A

duration greater than 3-4 weeks - feces may be normal, soft, or liquid

can be inflammatory or physiologic

63
Q

what is the typical history of an animal with chronic diarrhea & weight loss from parasites?

A

small strongyles - poor parasite control, anthelmintic resistance, & PPID horses

64
Q

what may you see on lab work of a horse with chronic diarrhea & weight loss from parasites?

A

low albumin & mild anemia

65
Q

what clinical signs are associated with small strongyles causing chronic diarrhea?

A

weight loss, diarrhea, colic, & edema

66
Q

what is the pathophysiology of small strongyles?

A

adult parasites feed on cecal & colonic mucosa causing irritation/hemorrhage

ingested L3 larvae migrate in the wall of the cecum/colon & encyst to induce inflammatory response

encysted larvae emergence - acute signs

67
Q

how are small strongyles diagnosed? how are they treated?

A

fecal egg count

fenbendazole & moxidectin

68
Q

what are the 4 types of inflammatory bowel disease?

A
  1. granulomatous enteritis
  2. eosinophilic enteritis
  3. lymphoplasmacytic enteritis
  4. lymphoma
69
Q

how is IBD diagnosed?

A

diagnosis of exclusion - horse with a history of chronic weight loss with diarrhea/colic for weeks to months

may have a ravenous appetite & rectal exam may reveal thickened colon or enlarged lymph nodes

70
Q

what may be seen on lab work of an IBD horse?

A

mild anemia, hypoproteinemia, peripheral lymphocytosis is rare

71
Q

what may be seen on ultrasound of a horse with IBD?

A

thickened intestinal walls, increased peritoneal fluid, & enlarged lymph nodes

72
Q

what are the pros & cons of using a rectal biopsy to diagnose IBD?

A

pros - easy to do

cons - low sensitivity, just because you don’t see it doesn’t mean it’s not present

73
Q

what is the treatment used for IBD?

A

steroids - may relapse when discontinued

eventual euthanasia

74
Q

a 5 y/o QH gelding broke into the feed shed & engorged himself on the mare/foal feed bag, eating almost all of it. now he has diarrhea, and you are icing the feet to prevent laminitis. which of the following is the most likely explanation for why this horse developed colitis?

a. clostridial difficile overgrowth
b. salmonella infection
c. colonic pH is acidotic
d. colonic pH is alkaline

A

c. colonic pH is acidotic

75
Q

which diagnostic result listed below would be the most supportive of sand enteropathy in an adult horse?
a. history of living in a sandy environment
b. auscultation of the xiphoid & feeling like you’re at the beach
c. sand sedimentation seen in a fecal float within a rectal sleeve fingertip
d. abdominal radiographs with evidence of opaque material ventrally

A

d. abdominal radiographs with evidence of opaque material ventrally

76
Q

how much water is secreted daily by the equine gi tract?

A

40% of body weight

77
Q

what is the pathophysiology of grain overload causing diarrhea?

A

high carb load overwhelms the small intestines ability to process/absorb them so an increased amount enters the large intestines

increase in the growth rate of the lactic acid producing bacteria and a dying off of gram-negative bacteria releasing endotoxins due to the overwhelming acid environment - causes acidotic pH in colon

LA DX & TX I (45 decks)

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