Final Exam Flashcards
What are causes of acute colitis in adult horses?
Salmonella Clostridum difficile and perfringens Enterotoxemia Potomac Horse Fever (late spring to early fall) Antimicrobial induced diarrhea
What are causes of acute colitis in foals?
Salmonella Clostridium difficile and perfringens Gastric ulcers Rota virus Compromised GIT Antimicrobial induced diarrhea Foal heat diarrhea Equine proliferative enterotoxemia (L. intracellularis)
What are causes of chronic colitis in adult horses?
Cyathostomiasis
Sand impaction
IBD**
What are causes of chronic colitis in foals?
Villous atrophy (secondary to clostridium) Lactose intolerance
What are clinical signs of acute colitis?
Explosive watery diarrhea Malodorous feces Colic Dehydration (skin tent, prolonged CRT and jugular refill) Depression (electrolyte imbalances in the neurons) Laminitis Anorexia Pyrexia Tachycardia Dry or toxic mucous membranes
In what percent of adult colitis cases is a definitive diagnosis reached?
Definitive diagnosis is obtained in only about 30-50% of cases
Clinical pathology, biochemistry, and hematology abnormalities with acute colitis (same as for salmonellosis)
Leukopenia (left shift, toxic neutrophils, lymphopenia)
Metabolic acidosis (losing bicarb, hyponatremia, hypochloremia, hypokalemia, hypocalcemia)
Increase PCV and lactate
Protein and fibrinogen may be up or down
Azotemia
Salmonella colitis
ALWAYS has to be ruled out due to zoonotic potential and risk of hospital outbreak
Associated patient abnormalities with Salmonella
Acute profuse diarrhea Endotoxemia CV shock Vascular leaking Coagulopathy
Clinical signs of salmonellosis
Febrile
Tachycardic (± tachypnic)
Dehydrated
How can we test for Salmonella?
Multiple culture or PCR as it is shed intermittently, each sample needs to be minimum 5-10g of feces
Treatment and prevention of salmonellosis
Aggressive supportive care Antimicrobials Endotoxemia therapeutic protocol High biosecurity Repeat fecal culture and PCR
Potomac Horse Fever causative agent
Neorickettsia risticii
Clinical signs of Potomac Horse Fever
Biphasic fever
Laminitis
Colitis
Diagnosis of PHF
Paired serum titers and IFAT; confirmation with identification of parasite in WBCs in acute phase
Treatment of PHF
IV oxytetracycline
Supportive therapy
Laminitis prevention (ice bandages)
T or F: There is a vaccine for PHF.
True
Etiology of Equine Proliferative Enteritis
Lawsonia intracellularis
Clinical signs of Equine Proliferative Enteritis
Lethargy Depression Peripheral edema Diarrhea Colic Weight loss
Typical age for horses affected by Equine Proliferative Enteropathy
Young (6 months old)
Diagnosis of EPE
Clinical signs
Ultrasound showing thickening of SI wall
Hypoproteinemia
Positive serology or molecular detection in feces
Treatment of EPE
Antimicrobial (macrolide + oxytetracycline/chloramphenicol) for 2-3 weeks
Correct hydration, electrolyte derangements, and azotemia if present
Etiology of pyogranulomatous pneumonia
Rhodococcus equi
If Rhodoccus equi is causing enterocolitis, where in the GIT is the lesion?
Ulcerative enteritis in the Peyer’s patches of the ileum (may extend to cecum and colon)
Treatment of Rhodoccus equi
Macrolides
Supportive therapy
Clostridial colitis (antimicrobial associated enterocolitis) histories
Farm outbreak in foals
Horse recently treated with antimicrobials
Mares when foal is being treated for R. equi
Untreated horse with diarrhea
Clostridial toxin A does what?
Induces release of substance P (neurotransmitter) at the dorsal root ganglia
This is cytotoxic
Clostridial toxin B does what?
Enterotoxigenic activity and is cytotoxic (necrotizing and hemolytic)
What might be visible on a radiograph of clostridial colitis?
Gas and fluid distended intestine with intramural gas
Diagnosis of clostridial colitis
Quantitative culture (normal flora) PCR
How can we differentiate C. difficile from other clostridium?
Immediate submission of samples
Sending in large samples
Transportation of sample frozen and in air-tight containers
Cytotoxin assay [differentiates from C. perfringens]
Treatment of clostridial colitis
Supportive care
Metronidazole (or vancomycin if resistant to metronidazole)
Which two organisms are more commonly associated with neonatal enterocolitis than with adult acute colitis?
Cryptosporidium spp
Giardia spp
Inflammatory bowel disease is named based on what?
Histopathological findings
Clinical presentation of IBD
Progressive diarrhea Weight loss Good appetite Intermittent colic Dermatitis Peripheral edema (hypoproteinemia)
Treatment of IBD
Steroids
Probiotics
Blister beetle toxicosis is caused by what?
Cantharidin absorption consumed in beetle infested alfalfa
What is the fatality rate of blister beetle toxicosis?
> 50%
How does cantharidin cause ulceration?
It is an irritant causing cell damage and necrosis on contact
What electrolyte derangements associated with cantharidin toxicosis have not been explained?
Hypomagnesemia
Hypocalcemia (may be loosely associated with hypoalbuminemia)
Diagnosis of cantharidin toxicosis via…
Beetle ID
History
Concentration of cantharidin in gastric juice, intestinal content, and urine
Treatment of cantharidin toxicosis
Supportive care Electrolyte supplementation Oral absorbents (mineral oil) Laminitis prevention Endotoxemia treatment protocol
Other things that can cause diarrhea
Acorn toxicity NSAID toxicity Grain overload Intestinal LSA Peritonitis Heavy metal toxicosis Sand colic Enteric pythiosis Anaphylaxis Stress (don't we all know it...)
When treating a colitis patient, after normovolemia has been attained what are two tests that can help us determine adequate fluid delivery?
Serial central venous pressure
Serial lactate
Endoserum (endotoxin neutralizer) is made how?
Horses are vaccinated with a recombinant mutant of S. typhimurium and the antibodies are harvested
How does Polymyxin B work?
Polymyxin B binds to the lipid A region of the endotoxin, thus neutralizing it
What is the most effective NSAID for preventing endotoxin-induced prostanoid synthesis?
Flunixin meglumine
What drug may be beneficial in preventing laminitis?
Pentoxifylline
What are functions of the liver
Process nutrients from food
Store glucose, vitamins, and minerals
Maintain immune function
Remove toxins from the blood
What percentage of the liver has to be damaged for clinical signs to present?
70-80% of the liver being damaged will result in abnormal function or failure
Clinical abnormalities associated with liver damage
Icterus Photosensitization Hepatoencephalopathy Coagulopathies Colic Pruritus Ascites Weight loss Diarrhea Rectal prolapse Fecal color change Dyspnea (pharyngeal or laryngeal collapse)
Clinical signs of acute liver dysfunction
Depression Hepatic encephalopathy Icterus Colic Anorexia