Gastric disease Flashcards
What are the 2 halves of the equine stomach
top half: squamous/non-glandular
bottom half: glandular
separated by the margo pilcatus
List the clinical signs of gastric disease
Colic signs (particularly after eating)
Weight loss
Bucking/rearing under saddle
Resentment of girthing and leg aid
Poor performance
Changes in temperament
Varies between individuals
List 5 risk factors for gastric disease
Lack of access to forage
Lack of access to water
High carbohydrate diets
High stress environments/individuals
Other focuses of pain?
Why can a high carbohydrate diets cause gastric disease
acidifying effect on gastric juices
describe how to prep patient for gastroscopy
Horses must have food withheld for at least 12 hours
Water removed ~4 hours before?
Grazing muzzle for horses which eat bedding
List the 2 ways we restrain a horse for gastroscopy
chemical restraint
physical restraint:
- at least 3 personnel
- nose twitching
describe how er sedate horse for gastroscopy
alpha 2 agonist and a opiate
detomidine and butorphanol
Describe how we should give an IV injection to a horse
inject into proximal 1/3 of jugular vein
insert needle all the way in (no syringe attached) - ensure you have a slow drip of blood (if v fast then in artery)
attach syringe, raise vein, draw back to confirm placement and then inject
how long should we give a horse after sedation with Dom and tor before we start doing gastroscopy
5 mins ish
if, when we go into the nasal cavity, we end up being a Y shaped fissure - what does this mean?
ended up in the middle meatus, don’t want to be here because if we advance gastroscope then we will hit the ethmoid turbinates (and cause epistaxis)
which meatus do we want to be in when doing gastroscopy?
ventral
when going down the oesophagus with the gastroscope, what can help us get into it?
if horse swallows (can encourage them to do this by passing bits of water and air down the scope)
What are the colours of the different sections of stomach
light pink= non-glandular mucosa
dark pink= glandular mucosa
Describe how we grade squamous ulcerations
from 0- IV
0= no ulceration, no hyperkeratosis
IV= extensive lesions with areas of apparent deep ulceration
where are you most likely to see galndular disease
near the pylorus
where are you most likely to see squamous disease
lesser curvature
Describe how to grade glandular disease
use descriptions:
- mild/moderate/severe
- focal/multifocal/diffuse
- raised/flat/depressed
- colour: hyperaemic/haemorrhagic/fibrinosupprative
More subjective
Describe how we treat squamous ulceration
Oral omeprazole +/- oral sucralfate
Describe how to treat glandular disease
Oral misoprostol +/- oral sucralfate
harder to treat than squamous ulceration
Describe how we treat a horse for both glandular disease and squamous ulceration
long acting injectable omeprazole +/- oral sucralfate
we may need a second line treatment for ……
glandular disease
If glandular disease isn’t responding to the oral misoprostol, list the options are avaliable
- Continue on current therapy if see signs of healing
- switch to long acting injectable omeprazole
- do further diagnostics e.g. transendoscopic mucosal biopsies- not very helpful
- if this does point towards diffuse inflammation then switch to corticosteroids - dex or pred
how should we manage and maintain a horse with glandular disease (once they’ve had one bout - they are at risk of it happening again)
Husbandry and management changes
feed supplements
medication
list some husbandry management changes for horses with glandular disease
feed roughage ad lib
reduce stress
eliminate carbohydrates from diet
T/F omeprazole can be used long term in horses prone to glandular disease
True- can be targeted to high risk periods
