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A. Equine and Camelid Medicine and Surgery > Gastrointestinal Disease of the Horse Part II > Flashcards

Gastrointestinal Disease of the Horse Part II Flashcards

1
Q

what percent of dehydration is clinically detectable?

A

only 5% and above

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2
Q

what can you use to evaluate hypoperfusion in laboratory tests?

A

lactate
creatinine
PCV/TS
urine specific gravity
cardiac filling pressure
blood pressure

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3
Q

what is elevated lactate?

A

> 2 mmol/L

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4
Q

what can cause marked hyperlactatemia (>4mmol/L)?

A

hypoperfusion
severe hypoxemia
severe anemia
can happen in absence of tissue hypoxia

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5
Q

in whom is PCV/TS potentially a poor indicator of circulatory status?

A

foals

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6
Q

what is the range of urine specific gravity in adult horses?

A

1.020-1.050

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7
Q

what can cause spurious hypercreatinemia?

A

placental dysfunction
perinatal asphyxia

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8
Q

what is perinatal asphyxia?

A

swallowing of fetal fluids
happens if under fetal distress

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9
Q

in whom is central venous or cardiac filling pressure useful for?

A

most for neonates
need a central line

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10
Q

a central venous pressure < ___________ may indicate a need for increased fluid therapy

A

2 cmH2O

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11
Q

what is the goal for central venous pressure of resuscitation?

A

8-12 cmH2O

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12
Q

what fluid rate is used for adults after resuscitation?

A

50-75 ml/kg/day

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13
Q

when are oral fluids better than intravenous fluids?

A

treatment of large colon disease
following water deprivation

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14
Q

does glucose and temperature of gastrointestinal fluid absorption matter?

A

minimal effect

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15
Q

are chronic colics commonly cardiovascularly stable?

A

yes

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16
Q

how common is equine gastric ulcer syndrome in adults?

A

80-90% active racehorses
up to 60% other performance horses

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17
Q

how long should you fast a horse before gastroscopy?

A

12-18 hours

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18
Q

what might a gastroscopy for equine gastric ulcer syndrome underestimate?

A

extent of gastric ulcers
severity or depth of squamous ulcers
may miss glandular or duodenal gastric ulcers

19
Q

how does sucralfate work?

A

reacts with HCl: acid buffer
binds to proteins: protective barrier
absorbs bile acids
increases prostaglandin E

20
Q

why are fresians thought to present with progressive dilation of the stomach?

A

primary neurological or structural dysfunction suspected

21
Q

how can stomach impaction be diagnosed?

A

ultrasound
endoscopy
surgery potentially

22
Q

what can be found on physical exam with peritonitis?

A

fever

23
Q

what are the causes of peritonitis?

A

diagnostic complications
surgical complications
primary gastrointestinal disorders

24
Q

how can you treat peritonitis?

A

eliminate cause
antimicrobials
analgesia
supportive care

25
Q

what indicates moderate/8-10% dehydration?

A

weak pulses, CRT>3s
poor jugular distention
moderately increased heart rate

26
Q

what can cause increased lactate in the absence of tissue hypoxia?

A

increased primary lactate production
cytokine inhibition of pyruvate dehydrogenase
relative thiamine deficiency
decreased utilization/clearance of lactate by liver

27
Q

what should you put PCV/TS into context with?

A

urine output and USG

28
Q

what is normal USG in foals?

A

first 2 samples postpartum: 1.035-1.025
within 24 hours: <1.008

29
Q

what can cause elevated creatinine?

A

hypovolemia/dehydration
renal disease
reduced renal clearance in premature foals
spurious hypercreatinemia

30
Q

how much can you bolus?

A

20 ml/kg over 30-60 mins

31
Q

what fluid rate is used for post-resuscitation in adults?

A

50-75 ml/kg/day

32
Q

what are the endpoints to resuscitation?

A

CVP 8-12 cmH2O
blood lactate <2mmol/L
normal acid-base
urine output >0.5-1 ml/kg/hr
improvement of clinical variables

33
Q

what has significant effects on GI fluid absorption?

A

tonicity: hypertonic slow

34
Q

where can ulceration occur?

A

terminal esophagus
proximal/squamous stomach
distal/glandular stomach
proximal duodenum

35
Q

what are the signs of ulcers in adults?

A

poor appetite, recurrent colic, poor BCS
change in attitude, dullness, poor performance, stiffness
asymptomatic

36
Q

what blood test can you use for ulcers?

A

succeed equine fecal blood test

37
Q

what parts of the stomach should you examine in gastroscopy?

A

squamous
margo plicatus
glandular
pyloric antrum

38
Q

what is a grade IV for equine gastric ulcer syndrome?

A

extensive lesions with areas of deep ulceration

39
Q

what is the mucosal protection like in the squamous and glandular portions of the stomach?

A

squamous: minimal intrinsic resistance to peptic injury
glandular: mucous/bicarbonate layer, prostaglandins, nitric oxide regulates mucosal blood flow

40
Q

how can you treat equine gastric ulcer syndrome?

A

proton pump inhibitors: omeprazole
histamine type-2 receptor antagonists
antacids
protectants

41
Q

what are the risk factors for stomach impactions?

A

excessive dry, fibrous ingesta
feeds that tend to swell after ingestion
dental disease
friesian breed

42
Q

what are the clinical signs with stomach impaction?

A

acute and severe to chronic and mild
anorexia
uncontrollable colic unresponsive to therapy

43
Q

where can you image the greater curvature of the stomach with ultrasound?

A

left side
9-12th ICS

44
Q

what is abdominocentesis like with peritonitis?

A

elevated WBC
elevated protein
elevated lactate

A. Equine and Camelid Medicine and Surgery (56 decks)

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