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?

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
what indicates moderate/8-10% dehydration?
weak pulses, CRT>3s poor jugular distention moderately increased heart rate
26
what can cause increased lactate in the absence of tissue hypoxia?
increased primary lactate production cytokine inhibition of pyruvate dehydrogenase relative thiamine deficiency decreased utilization/clearance of lactate by liver
27
what should you put PCV/TS into context with?
urine output and USG
28
what is normal USG in foals?
first 2 samples postpartum: 1.035-1.025 within 24 hours: <1.008
29
what can cause elevated creatinine?
hypovolemia/dehydration renal disease reduced renal clearance in premature foals spurious hypercreatinemia
30
how much can you bolus?
20 ml/kg over 30-60 mins
31
what fluid rate is used for post-resuscitation in adults?
50-75 ml/kg/day
32
what are the endpoints to resuscitation?
CVP 8-12 cmH2O blood lactate <2mmol/L normal acid-base urine output >0.5-1 ml/kg/hr improvement of clinical variables
33
what has significant effects on GI fluid absorption?
tonicity: hypertonic slow
34
where can ulceration occur?
terminal esophagus proximal/squamous stomach distal/glandular stomach proximal duodenum
35
what are the signs of ulcers in adults?
poor appetite, recurrent colic, poor BCS change in attitude, dullness, poor performance, stiffness asymptomatic
36
what blood test can you use for ulcers?
succeed equine fecal blood test
37
what parts of the stomach should you examine in gastroscopy?
squamous margo plicatus glandular pyloric antrum
38
what is a grade IV for equine gastric ulcer syndrome?
extensive lesions with areas of deep ulceration
39
what is the mucosal protection like in the squamous and glandular portions of the stomach?
squamous: minimal intrinsic resistance to peptic injury glandular: mucous/bicarbonate layer, prostaglandins, nitric oxide regulates mucosal blood flow
40
how can you treat equine gastric ulcer syndrome?
proton pump inhibitors: omeprazole histamine type-2 receptor antagonists antacids protectants
41
what are the risk factors for stomach impactions?
excessive dry, fibrous ingesta feeds that tend to swell after ingestion dental disease friesian breed
42
what are the clinical signs with stomach impaction?
acute and severe to chronic and mild anorexia uncontrollable colic unresponsive to therapy
43
where can you image the greater curvature of the stomach with ultrasound?
left side 9-12th ICS
44
what is abdominocentesis like with peritonitis?
elevated WBC elevated protein elevated lactate