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Foal.NeonatalGI Flashcards

1
Q

Why should alpha 2 adrenergic agonists used with caution in neonates?

A

Due to their depressive effect on the cardiopulmonary system

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2
Q

Causes of diarrhea in young foals

A

bacteria
bacterial toxins
viruses
nutrition
parasites
antibiotic usage

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3
Q

At what age does the natural GI flora develop to an adult in foals?

A

60 days of age

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4
Q

What is the most important bacteria mediator of systemic sepsis in newborn foals?

A

Escherichia coli

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5
Q

Is E. coli a pathogen implicated in foal diarrhea?

A

No, E. coli is not likely to cause diarrhea in foals

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6
Q

Which clostridial toxins occur most commonly in foals?

A

Clostridium perfringens- biotypes A & C
Clostridium difficile

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7
Q

At what age range does clostridium cause diarrhea in foals?

A

Usually less than 36 hours of age
– with high mortality and outcomes rarely influenced by treatment

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8
Q

Clostridium perfringens, Biotype C produces which toxins?

A

alpha
beta
enterotoxin

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9
Q

What two principle toxins are produced by C. difficile?

A

enterotoxin (toxin A)
Cytotoxin (toxin B)

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10
Q

Besides the primary “big pathogens” of diarrhea in foals, what other bacteria are implicated in causing diarrhea in foals?

A

Bacteroidis fragilis (gram neg anaerobic rod)
Enterococcus (Group D Streptococcus) durans
Aeromonas hydrophila
Rhodococcus equi

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11
Q

What is the most common source of Salmonella to foals?

A

Mares shedding salmonella
**rare that both develop disease

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12
Q

In contrast to adult infections, detectable bacteremia occurs commonly in affected foals, with what bacterial pathogen?

A

Salmonella

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13
Q

What is the most common viral cause of diarrhea in foals?

A

Rotavirus

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14
Q

How many groups of rotavirus are there? and which is the most common cause of diarrhea in foals?

A

7 known groups (A-G)
- Gorup A, serotype G3 most common serotype

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15
Q

Why are there many variations of rotavirus?

A

Rotaviruses have the ability to change their surface proteins over time
– rearrangement gene segments takes place during coinfections with other strains

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16
Q

Rotavirus pathogenesis:
Where does rotavirus replicate?

A

invades lining of the proximal small intestine
–> villous cell death and resultatnt loss of absorptive area

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17
Q

Rotavirus pathogenesis:
Mechanisms involved in diarrhea

A
  1. loss of absorptive capacity coupled with a decrease in lactase production can lea to an osmotic load of undigested lactose delivered to an immature hind gut
  2. compensatory crypt cell proliferation may cause an increase in intestinalis secretion
  3. virus produces an enterotoxin that causes or contributes to the development of diarrhea
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18
Q

Which rotavirus enterotoxin and cytotoxin is primarily responsible for diarrhea?

A

NSP4
-nonstructural glycoprotein of rotavirus released from virus infected enterocytes
-noncompetitive inhibitor of Na-glucose symporter and enhances intestinal chloride secretion

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19
Q

What age range is rotavirus diarrhea seen in foals?

A

between 2 and 160 days, most common younger than 60 days old

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20
Q

What is a common parasite of foals?

A

streongyloides westeri

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21
Q

When are foals exposed to Strongyloides westeri?

A

early infection occurring through mare’s milk

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22
Q

Cryptosporidium differs from coccidia by which factors?

A
  1. differs in size: 4-6 microm compared with 23 to 34 microm for other coccidia
  2. host specificity (not host specific)
  3. pathogenesis (only invades epithelium)
  4. drug sensitivity (resistant to many drugs)
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23
Q

Is cryptosporidium has bene difficult to pharmacologic control, what drugs may be efficacious?

A

paromomycin
nitazoxanide
azithromycin

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24
Q

Shedding of Cryptosporidium in foals occurs bettween what age range?

A

4 to 19 weeks of age, and persisted no more than 4 weeks.

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25
What is the treatment of Giardia?
metronidazole
26
What is Giardia commonly coinfected with?
Crytosporidium
27
Nutritional causes of diarrhea in foals incldue
overingestion of milk (overfeeding orphaned foals, overingestion if mare & foal are separated)
28
What agents caused damage to epithelial cells that may cause prolongation of diarrhea because of lactase deficiency?
rotavirus clostridium
29
when do foals develop "foal heat" diarrhea?
Between 5 to 14 days of life
30
What is the most likely cause of "foal heat" diarrhea in foals?
with establishment of normal flora in teh hind gut
31
At what dose do you supplement potassium in foals?
15 to 20 mEq/L
32
What are the main components of therapy in diarrhea in neontal foal?
1. fluid therapy (either oral or intravenous) 2. intestinal protectants/adsorbents 3. antibiotics (bacteremia or clostridiosis)
33
Ideally milk should not be withheld from foals with diarrhea, howver when are the exceptions?
foals with colic or those with bloody diarrhea
34
At what level of albumin in foals, is plasma transfusion warranted?
albumin < 20g/L total plasma protein <42 g/L
35
Prevention and control of diarrhea in foals?
-minimizing population density -separating age groups -providing appropriate sanitation & hygiene -obtaining adequate colostrum of good quality
36
Abdominal radiographic lesion: produce hairpin or stacked loops?
obstructive small intestinal disease: mesenteric volvulus or an intussusception
37
For an upper GI series, how much barium sulfate is administered via nasogastric tube?
barium sulfate: 5 ml/kg films taken at 0, 5, 15, 30, 150 and 270 minutes
38
What are examples of congenital anomalies seen in foals, that should be considered when foals have colic signs?
atresia coli atresia recti atresia ani whit foals born to overo-overo or overo-overo matings-- intestinal agangliosis (lethal white foals)
39
Which sex in foals is more susceptible to meconium impactions?
colts-- narrower pelvic canal
40
What are the supplies and procedure for a retention enema in foals?
-mix 150 ml water with 6 g acetylcysteine powder & 20 g of sodium bicarbonate (baking soda) -insert 12 to 14 french, cuffed foal urinary catheter into rectuma nd inflate cuff -infuse 120 to 180 ml of retention enema solution and plug end of catheter - tape to tail loosely and leave in place for at least 15 minutes
41
Besides soapy water enemas/retention enemas, what other supportive therapy can be performed for meconium impactions?
-IV fluids -oral fluids -laxatives : mineral oil 60-120 mls with 0.5 to 1 oz of psyllium, 60 to 120 ml of milk of magnesia -analgesics
42
What is a relatively common cause of abdominal distention & depression in neonatal foals?
uroperitoneum
43
Why does congenital uroperitoneum in foals occurs?
d/t failure of dorsal wall of bladder to close during development
44
Traumatic rupture of bladder during birth most commonly occurs d/t external pressure on bladder. Which sex most commonly occurs to?
colts
45
Besides traumatic or congenital forms of bladder rupture, what are other causes of bladder rupture in foals?
=ischemic necrosis or infection of urinary bladder or urachus in compromised foal -critically ill, recumbent foals rupture bladder when lifted & turned -foals with botulism rupture bladder secondary to atony & chronic overdistention -secondary to foal infection of umbilical arteries &/or urachus or ischemic necrosis of apex of bladder
46
C/S of uroperitoneum in foals?
-history o normal urination, then stopped -loss of suckle -mild colic -increasing abdominal distention -worsening depression -increased HR & RR -become increasingly weak & dyspneic (may present with CV collapse)
47
What are laboratory findings commonly associated with uroperitoneum?
-INC creatinine/BUN -hyperkalemia -hyponatremia -hypochloremia -metabolic acidosis
48
Pathogenesis of uroperitoneum hyperkalemia and hyponatremia in foals?
-urine potassium concen. higher in serum -urine sodium concen. lower than in serum --> net effect of partial equilirbium across a semi-permeable membrane--> hyponatremia & hyperkalemia
49
Foals with uroperitoneum have electrolyte abnormalities similar to what other diseases?
renal failure blocked urethra white muscle disease enteritis
50
Diagnosis of uroperitoneum
-ab U/S: lg vol of free, nonechogenic fludi w/in abdomen and small, irregularly shaped, collapsed bladder -abdominocentesis: free flow of peritoneal fluid: low cell count, low specific gravity, 2x CREA of peripheal blood
51
What can be injected into the bladder of a foal to help diagnosis a ruptured bladder?
new methylene blue **using urinary catheter **few minutes later peritoneal fluid sample will have a blue color
52
How to correct hyperkalemia in foals with uroperitoneum prior to surgery?
0.1 to 0.2 U/kg subcu or IV accompanies by continuous IV dextrose infusion (4 to 8 mg/kg/min)
53
What is the prognosis for an uncomplicated bladder rupture in a foal?
>80% survival **animal is stabilized prior to anesthesia
54
What are examples of metabolic and infectious causes of ileus in foals?
-hypokalemia -hypocalcemia -hypoxic-ischemic bowel injury -bowel obstruction -peritonitis -enterocolitis -endotoxemia
55
Hypocalcemia is commonly associated with what in foals?
prematurity decreased dietary intake excessive bicarbonate administration diuretic therapy conditions- asphyxia, toxemia & sepsis (stim release of cortisol & catecholamines)
56
peritonitis in foals i most commonly associated with:
-intraabdominal abscessation -severe enteritis - gastorduodenal ulcer disease - generalized septicemia
57
What are the most common causes of enteritis in foals?
- rotavirus -Clostridia sp. -Salmonella sp. - dietary changes
58
What are predisposing factors to necrotizing enterocolitis?
-ischemic or hypoxic gut injury -presence of intraluminal gut bacteria -enteral feeding
59
Pathogenesis of necrotizing enterocolitis?
-Gi ischemia - dec mucosal cell meatbolism -decrased mucous layer - enzymes break down the mucosal barrier -intraluminal bact invade & multiple in bowel wall
60
However rare, what is are the most common causes of hemoperitoneum in foals?
-umbilical vessels -rupture of spleen or liver secondary to trauma

G.I. (7 decks)

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