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!Equine Medicine And Surgery > Gastric Disease Syndrome > Flashcards

Gastric Disease Syndrome Flashcards

1
Q

What are the causes of gastric disease syndrome?

A

Dilation
Impaction
Rupture
Equine gastric ulcer syndrome (EGUS)
Tumors (SCC)

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2
Q

General CS associated with gastric disease syndrome

A

Painful abdomen (mild to severe)
From off feed → depression and colic (laying sternal or violent rolling)
Progression → uncontrolled pain, damage/ alteration of gastric tissue, endotoxemia → death

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3
Q

Gastric dilation

A

Secondary to intestinal ileus
Backflow of gas/ fluid into stomach (reflux)
Build up of pressure not moving through GI

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4
Q

What is gastric dilation associated with?

A

CHO, feed fermentation, proximal duodenal-jejunitis
Refeeding injury or parasites (bots)

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5
Q

CS of gastric dilation

A

Anorexia, depression, or mild to moderate signs of colic

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6
Q

Gastric dilation dx

A

Endoscopy*
Rads/ US for small horses
Emptying time test

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7
Q

What can happen with prolonged gastric dilation?

A

Damage to nerves and muscle due to over stretching
Future dilations or impactions

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8
Q

Client education for gastric dilation

A

Multiple small meals, chopped/ soaked quality hay, 1-2 tbs salt, fresh water, mash of senior chow
Gradually reintroduce normal feed
Avoid lush/ spring pasture

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9
Q

Tx for gastric dilation

A

Decompress PRN
IV fluids, electrolytes replacement, analgesics, anti-inflamms

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10
Q

Gastric impaction

A

Masses of large amounts of compacted, soft to doughy or hardened material
+/- gas or fluid
Rare (1%), fast eaters, social standing, starvation

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11
Q

What is gastric impaction associated with?

A

Lack of deworming (parasites, bots, tapeworms- Anaplocephala perfoliata)
No access to water
Consumption of large amounts of feed
Eat feeds that swell (dehydrated feed)→ consumption of material that expands with water
Refeeding a starved horse

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12
Q

Primary causes of gastric impaction

A

Functional or anatomic defects:
↓ gastric emptying, acid secretion, pyloric strictures, chronic dilation

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13
Q

Secondary causes of gastric impaction

A

Poor mastication, FB, dehydration, hepatic dz, any GI disturbance resulting in ileus, refeeding injury

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14
Q

CS of gastric impaction

A

Inappetence to acute colic
Signs of shock
Duration: hours to months

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15
Q

DX of gastric impaction

A

Gastric endoscopy: finding feed after withholding food/ water for 18- 24hr*
US (smaller horses with distended stomachs)
Peritoneal tap (transudate/ exudate, fibrous matter)
Hematology (systemic inflamm)
Rectal palpation (+/-displaced spleen)

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16
Q

Tx for gastric impaction

A

Decompress PRN, IV fluids
Breakdown mass: diocytl sodium succinate
Laxatives: MgSO4 (stomach filled halfway or less)
Anti-inflamms, analgesics, abx

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17
Q

What broad spectrum abx are given if the gastric impaction ruptures?

A

Ceftiofur + gentamicin
Crystalline penicillin + gentamicin

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18
Q

Prognosis of gastric impaction

A

Guarded to poor:
Factors: overstretched muscles/ nerves, mass too dense, altered blood flow, pressure necrosis
Euthanasia

19
Q

Client education on gastric impaction

A

Resolves: patient goes home
Multiple small meals, mash or soaked hay, hydration
Healing: 7 days for each day sick

20
Q

What happens if gastric dilation/ impaction cannot be resolved?

A

Shock, rupture then DEATH

21
Q

Gastric rupture

A

Loss of serosal/ muscle integrity from gastric distention, localized infarction from impaction/ dilation impairing blood flow or severe EGUS and perforation

22
Q

Where does the rupture occur on the stomach

A

Greater curvature

23
Q

CS of gastric rupture

A

Moderate to severe colic
Depression, toxic line
Shock
Absent gut sounds, abnormal mm, gastric reflux, gritty serosal surface (rectal)
Sweating

24
Q

What are the signs of shock?

A

Cold extremities, weak but rapid pulse, tachycardia, shallow breathing, low absent urine output, sudden cold sweat

25
Q

Full thickness GR is _________

A

Fatal

26
Q

Primary causes of gastric rupture

A

Excessive intake or fermentation of ingesta
Delayed emptying (ulcers, gastroparesis)
Slow onset of symptoms

27
Q

Secondary causes of gastric rupture

A

Intestinal obstruction aboral to stomach
Obstruction: FB, tapeworms/ bots, CHO
Enteric: ulcerative gastritis, trauma, strictures, etc
Peritoneal: ileus, peritonitis

28
Q

When do horses go into SIRS (systemic inflammatory repsonse) if they have gastric ruptures?

A

If they fit 2 or more:
T> 101.5, HR >60, RR >30
Fibrinogen >400
WBC >12.5 10^9 or <4.5 10^9, >10% band neutrophils

29
Q

Gastric rupture tx

A

NONE with grave prog and euthanasia

30
Q

Client education for gastric ruptures

A

Minimum stress
Slow down greedy horse, avoid fermented feed, gradual dietary changes

31
Q

Equine squamous gastric dz

A

Lesions in squamous region (↑ exposure to acid)
Dx: gastroscopy

32
Q

Tx of Equine squamous gastric dz

A

Gastric protectant, promote healing, ↑ roughage, fluid PRN, reduce stressors

33
Q

Equine glandular gastric dz

A

Lesions in the glandular region
Impaired mucosal defense
Dx: gastroscopy

34
Q

Mucus- bicarbonate layer

A

Mucus keeps excess acid away from mucosa
Bicarb neutralizes acid near the muscosa- gradient action

35
Q

Cellular restitution

A

Contributes to mucosal integrity via rapid cell turnover

36
Q

Epidermal growth factor

A

Potent gastric acid inhibitors
Potent stimuli of mucosal growth

37
Q

Mucosal blood flow

A

Supplies mucosa with O2, nutrients and takes away metabolic waste
Maintained by PG-E2

38
Q

Prostaglandin E2

A

Directly cytoprotective
Influences blood flow, ↑ mucus- bicarb secretion and inhibits gastric acid secretion

39
Q

Risk factors associated with EGUS

A

Stress → endogenous corticosteroids

40
Q

Other dx for EGUS

A

Admin fluids → positive response is ulcers
Oral exam
Rectal palpation/ US (rule our right dorsal colitis and thinning/ thickening of intestinal wall)

41
Q

Gastroscopy

A

If no response to tx and severe CS
Confirms ulcers
Finds lesions in squamous, glandular region

42
Q

Grades of ulcers

A

0: stomach lining intact, no reddening
1:Stomach lining intact, some reddening
2: small, single or multiple ulcers
3: large single or multiple ulcers
4: extensive ulcers

43
Q

What happens if ulcers go untreated?

A

Perforate → septic peritonitis and endotoxemia and death

44
Q

Tx of EGUS

A

IV fluids with electrolytes
Gastric protectant: oral antacids/ sucrlafate (topical), acid inhibitors- omeprazole or ranitidine/ cimetidine (systemic)
Eat good roughage

!Equine Medicine And Surgery (18 decks)

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