GI

Question 1

What are the most commonly used NSAID in post-operative colic patient ?
And what are the 3 most important factors to consider for NSAID discontinuation ?

Answer 1

Flunixin and phenylbutazone
Important factor to consider when deciding the timepoint for NSAID discontinuation following colic surgery : absence of active colic sign, pain score evaluation and absence of fever.

A survey of non-steroidal anti-inflammatory drug use in the post-operative period following equine colic surgery
eve 2023

Question 2

What is the Leaky Gut Syndrome (LGS) ?
What are the risk factors for developing LPS ?

Answer 2

Leaky gut syndrome (LGS) is an idiopathic disorder characterised by weakening of tight junction proteins (such as zonulin) in the gastrointestinal epithelium. The resulting hyperpermeability of the GI tract can trigger aberrant systemic inflammatory responses.
Whilst our combined stress test produced a clear increase in gastrointestinal
permeability, analysis of zonulin both in plasma and faeces
indicates that a decline in function of this tight junction protein
was not a major contributor. There are many other possible explanations
for the increase in gastrointestinal permeability, including decline
in function of other tight junction proteins (such as claudin and occludin),
ischaemic injury to mucus-producing cells, and/or acute stressinduced
disturbance of the gastrointestinal microbiome.
Combined transport and exercise increases gastrointestinal permeability and systemic SAA and LPS.

The combination of trailer transport and exercise increases gastrointestinal permeability and markers of systemic inflammation in horses
EVJ 2023

Question 3

Which of the following statements best summarizes the findings and clinical implications of the study on ischaemic postconditioning (IPoC) in equine jejunal ischaemia?

A) Ischaemic postconditioning significantly reduced epithelial denudation and paracellular permeability after reperfusion, but had no effect on intestinal microperfusion or tight junction protein levels.

B) Ischaemic postconditioning reduced epithelial denudation, lowered paracellular permeability, and prevented the reduction of tight junction proteins like claudin-1, claudin-2, and occludin, showing potential protective effects against ischaemia-reperfusion injury.

C) Ischaemic postconditioning led to increased intestinal microperfusion and oxygen saturation during reperfusion, resulting in a higher rate of tissue recovery and greater expression of tight junction proteins.

D) The study concluded that ischaemic postconditioning had no significant effect on reducing ischaemia-reperfusion injury, as it failed to improve histomorphology, permeability, or tight junction protein levels compared to the control group.

Answer 3

Correct Answer:

B) Ischaemic postconditioning reduced epithelial denudation, lowered paracellular permeability, and prevented the reduction of tight junction proteins like claudin-1, claudin-2, and occludin, showing potential protective effects against ischaemia-reperfusion injury.

Justifications:

A) is incorrect because IPoC did reduce intestinal microperfusion during clamping cycles, and it also prevented the reduction in tight junction protein levels during reperfusion, indicating protective effects on the intestinal barrier.

B) is correct. This statement accurately summarizes the key findings: IPoC reduced epithelial denudation, lowered paracellular permeability, and prevented the reduction of important tight junction proteins, showing potential protective effects during reperfusion.

C) is incorrect. While IPoC did reduce epithelial damage and permeability, it did not increase microperfusion or oxygen saturation during the reperfusion phase; in fact, saturation was only affected during the first clamping cycle.

D) is incorrect because the study did find significant benefits of IPoC, particularly in reducing villus denudation, decreasing permeability, and maintaining tight junction proteins, suggesting it has protective potential against ischaemia-reperfusion injury.

The effect of ischaemic postconditioning on mucosal integrity and function in equine jejunal ischaemia.
2021 EVJ

Question 4

Which of the following best summarizes the findings and clinical implications of the study on the inflammatory response in horses undergoing colic surgery using quantitative real-time PCR?

A) The study found that inflammatory genes such as IL-1β, IL-6, TNF, and CCL2 were significantly upregulated in both the mucosa and muscularis externa in colic cases compared to controls, with higher TNF expression linked to the development of post-operative reflux (POR).

B) Horses undergoing colic surgery had reduced gene expression of IL-1β, IL-6, and TNF in both the mucosa and muscularis externa, indicating a lack of inflammatory response.

C) Inflammatory gene expression was consistent between colic cases and controls, with no significant difference in the presence of post-operative reflux (POR).

D) Horses that developed post-operative reflux (POR) had significantly lower TNF expression in the mucosa, suggesting that lower levels of inflammation protect against this complication.

Answer 4

Correct Answer:
A) The study found that inflammatory genes such as IL-1β, IL-6, TNF, and CCL2 were significantly upregulated in both the mucosa and muscularis externa in colic cases compared to controls, with higher TNF expression linked to the development of post-operative reflux (POR).

Justifications:

A) is correct. This option accurately captures the study’s main findings: key inflammatory markers such as IL-1β, IL-6, TNF, and CCL2 were upregulated, and higher TNF expression in the mucosa was associated with the development of post-operative reflux (POR), a complication linked to POI.

B) is incorrect because the study found increased expression of inflammatory genes, not reduced, in horses undergoing colic surgery, indicating a significant inflammatory response.

C) is incorrect because there was a significant difference in inflammatory gene expression between colic cases and controls, particularly in horses with POR.

D) is incorrect because horses with POR actually had higher TNF expression, indicating more inflammation, not less.

Use of quantitative real-time PCR to determine the local inflammatory response in the intestinal mucosa and muscularis of horses undergoing small intestinal resection.
EVJ. Lisowski1 et al. 2021

Question 5

Which of the following best summarizes the findings of the study on Equine Omega Complete (EOC) supplementation in preventing gastric ulcers and increasing alpha-tocopherol concentrations in horses?

A) EOC supplementation effectively prevented gastric ulcer formation, similar to omeprazole, and significantly increased alpha-tocopherol levels compared to the control group.

B) EOC supplementation did not prevent gastric ulcer formation, and although it increased alpha-tocopherol concentrations, the increase was not significantly different from the control group.

C) Omeprazole had no effect on gastric ulcer prevention, while EOC effectively reduced ulcer formation and improved alpha-tocopherol concentrations.

D) EOC and omeprazole both failed to prevent gastric ulcer formation, and neither treatment had an effect on alpha-tocopherol concentrations.

Answer 5

Correct Answer:
B) EOC supplementation did not prevent gastric ulcer formation, and although it increased alpha-tocopherol concentrations, the increase was not significantly different from the control group.

Justifications:

A) is incorrect because EOC did not prevent ulcer formation, and the increase in alpha-tocopherol was not significantly different from the control group.
B) is correct. The study found that EOC did not prevent ulcers, and while it increased alpha-tocopherol, the change was not significant.
C) is incorrect because omeprazole was effective in preventing ulcers, while EOC was not.
D) is incorrect because omeprazole did successfully prevent gastric ulcer formation.

Efficacy of the oral supplement, Equine Omega Complete, for the prevention of gastric ulcers and alpha-tocopherol supplementation in horses
2023 JVIM

Question 6

What are the clinical effects of transportation on gastric pH and gastric ulceration in mares ?

Answer 6

Transportation is associated with increased gastric squamous ulceration and with increased pH of gastric fluid.
These findings may be a csq of impaired gastric emptying and reflux of alkaline small intestinal content, with factors such as duodenal bile salts and short-chain fatty acids mediating mucosal injury.

Effects of transportation on gastric pH and gastric ulceration in mares
jvim 2020

Question 7

Is Serum Amyloid A elevated in horses with equine gastric ulcer syndrome?

Answer 7

No association was found between SAA concentrations and the presence or degree of squamous or glandular EGUS.

Is Serum Amyloid A elevated in horses with equine gastric ulcer syndrome?
eve 2020

Question 8

What are the effects of PBZ on gastric ulcers, intestinal permeability and fecal microbiota in horses ?

A- PBZ induces impaired barrier function and increased gastric ulceration score, but does not induce specific changes in the microbiota

B- PBZ induces impaired barrier function, increased gastric ulceration score, and induced specific changes in the microbiota

C- PBZ induces increased gastric ulceration score, but does not alter barrier function and specific changes in the microbiota.

D- PBZ induces increased gastric ulceration score and specific changes in the microbiota, but does not alter barrier function.

Answer 8

B- PBZ induces impaired barrier function, increased gastric ulceration score, and induced specific changes in the microbiota.

significant difference in the beta diversity over time in both the control and phenylbutazone plus nutritional therapeutic groups. Phenylbutazone increased amounts of bacterial 16S rDNA in circulation 3.02-fold (95% confidence interval [CI], 0.1.89-4.17), increased gastric ulceration score (glandular) by a mean of 1.1 grade (P = .02), and induced specific changes in the microbiota, including loss of Pseudobutyrivibrio of family Lachnospiraceae. These changes were attenuated by nutritional treatment

Results: Phenylbutazone increased amounts of bacterial 16S rDNA in circu

Effects of phenylbutazone alone or in combination with a nutritional therapeutic on gastric ulcers, intestinal permeability, and fecal microbiota in horses
jvim 2021

Question 9

Can omeprazole be use to prevent PBZ-induced EGUS ?

Answer 9

Administration of omeprazole ameliorated PBZ-induced EGGD, but was associated with an increase in intestinal complications. Caution should be exercised when co-prescribing NSAIDs and omeprazole in horses, particularly in association with change in management.

Impact of concurrent treatment with omeprazole on phenylbutazone-induced equine gastric ulcer syndrome (EGUS)
evj 2021

Question 10

Which fatty acid to choose to prevent the most severe gastric ulcers?

Answer 10

Long-chain polyunsaturated fatty acid supplementation (omega 3, omega 6) was associated positively with prevention or resolution of severe squamous gastric ulceration.

Long-chain polyunsaturated fatty acid supplementation increases levels in red blood cells and reduces the prevalence and severity of squamous gastric ulcers in exercised Thoroughbreds
javma 2022

Question 11

Are gastric ulcers a pathology reserved for sport and race horses?

Answer 11

An abattoir study found EGGD in 30% of feral horses demonstrating that these do not only occur in domesticated equids.

Equine gastric ulcer syndrome in adult horses (Review)
Vet J 2022

Question 12

What is the pathophysiology of ESGD and the associated risk factors ? (4 points)

Answer 12

Squamous ulceration is caused by exposure of the gastric mucosa to acid, mainly hydrochloric acid (HCl), volatile fatty acids (VFA’s) and bile acids.
Risk factors:
- High starch intake, probably because starch leads to increased production of VFA’s that reduce mucosal integrity → increased serum gastrin concentrations
- Periods of forage deprivation >6 h
- Stress → Cribbing and other stereotypies are associated with ESGD and considered to be coping mechanisms, suggesting a link with stress
- Intensity of exercise → During exercise intra-abdominal pressure increased, pushing the acidic gastric contents up against the squamous mucosa.

Equine gastric ulcer syndrome in adult horses (Review)
Vet J 2022

Question 13

What is the pathophysiology of EGGD and the associated risk factors ? (3 points)

Answer 13

EGGD is thought to be related to compromise of mucosal defence mechanisms. Histological examination of glandular gastric lesions showed a lack of ulcerative pathology, but rather of inflammation.
Risk factors :
- NSAID at inappropriate doses, mediated mainly by effects on mucosal blood flow, caused by prostaglandin inhibition. Normal use of NSAIDs does not appear to cause EGGD under field conditions and preventive use of omeprazole is not considered necessary. Reminder: caution should be exercised when co-prescribing NSAIDs and omeprazole in horses
- Stress → Both trainer and the number of caretakers were shown to increase the prevalence of EGGD in riding horses.
- Frequency of exercise → Exercising during 5 or more days per week also considerably increased the risk of horses developing EGGD and may be related to altered gastric blood flow or (physiological) stress.

Equine gastric ulcer syndrome in adult horses (Review)
Vet J 2022

Question 14

What is the correlation between endoscopic findings and histology for EGUS ?

Answer 14

When results of endoscopy, necropsy and histology were compared it became obvious that endoscopy may underestimate ulcer number and severity.

Equine gastric ulcer syndrome in adult horses (Review)
Vet J 2022

Question 15

What is the clinical relevance of sucrose permeability testing in the diagnosis of EGUS ?

Answer 15

Sucrose permeability testing is based on the fact that sucrose cannot cross the healthy gastrointestinal mucosa, but when the epithelium is injured.
Blood sucrose testing had a high sensitivity for the detection of gastric ulcers in weanling foals but the specificity was low.
And it was found to be neither sensitive nor specific in adult horses with EGUS.

Equine gastric ulcer syndrome in adult horses (Review)
Vet J 2022

Question 16

What is the clinical relevance of fecal occult blood test in the diagosis of EGUS ?

Answer 16

The fecal occult blood test also has a low sensitivity for detecting EGUS.

Equine gastric ulcer syndrome in adult horses (Review)
Vet J 2022

Question 17

What is the reliability of EGUC ordinal grading system (0-4) for EGGD in horses ?

Answer 17

Inter- and intra-observer reliability were substantial for glandular mucosa using the EGUC scale.
Current recommendations are to use descriptive terminology for EGGD (Consensus 2015), but further refinement seems desirable.

Equine gastric ulcer syndrome in adult horses (Review)
Vet J 2022
Interobserver and intraobserver reliability for 2 grading systems for gastric ulcer syndrome in horses
jvim 2021

Question 18

Which prophylactic treatment for EGUS is preferable between omeprazole (1 mg/kg q24h) and sucralfate (20 mg/kg q8h) in horses exposed to a combined feed-fast and NSAID administration ?

Answer 18

Omeprazole was superior to sucralfate for mitigating gastric lesion severity in healthy horses exposed to a feed-fast/NSAID model.

Effect of omeprazole and sucralfate on gastrointestinal injury in a fasting/NSAID model
evj 2022

Question 19

Does curcumin extract or Harpagophytum species result in gastric ulceration ?

Answer 19

Supplements containing turmeric (Curcuma longa) and devil’s claw (Harpagophytum species) did not cause or worsen gastric ulcers or alter health parameters after 28 days of feeding.

Effect of an oral supplement containing curcumin extract (Longvida) on lameness due to osteoarthritis and gastric ulcer scores
eve 2022
Effects of supplements containing turmeric and devil’s claw on equine gastric ulcer scores and gastric juice pH
eve 2022

Question 20

What is the clinical efficacy and safety of a long-acting IM omeprazole in EGUS ?

Answer 20

5 mg/kg bwt intramuscular injection of LAO-USA once a week for four doses
Both ESGD and EGGD improved within 28 days, but injection reactions included oedema, heat and pain at the injection site. The number of injection site reactions increased following each dose.

Clinical efficacy, safety and pharmacokinetics of a novel long-acting intramuscular omeprazole in performance horses with gastric ulcers
eve 2022

Question 21

What is the potential clinical efficacy of porcine hydrolysed collagen (PHC) on gastric ulcer scores, gastric juice pH, and gastrin concentration in horses ?

Answer 21

The PHC fed to horses enhanced the effects of omeprazole on increased gastric juice pH, inhibited gastrin secretion after feeding and resulted in fewer nonglandular ulcers after long-term feeding (56 days) in stall-confined horses undergoing intermittent feeding.
EGGD ?

The effect of porcine hydrolysed collagen on gastric ulcer scores, gastric juice pH, gastrin and amino acid concentrations in horses
eve 2022

Question 22

What is the clinical impact of partial substitution of concentrates by dehydrated alfalfa ?

Answer 22

Feeding pelleted dehydrated alfalfa could help to reduce the incidence and severity of EGGD.

Effect of diet composition on glandular gastric disease in horses
jvim 2023

Question 23

Is it important to use tapering protocols of omeprazole in horses ? And why ?

Answer 23

• Serum gastrin concentrations increased in response to omeprazole treatment but returned to baseline within 2 to 4 days after the last dose of omeprazole.
• No effect of treatment or discontinuation was seen in serum chromogranin A concentrations.
• Rebound gastric hyperacidity seems unlikely in horses and our results do not support the use of tapering protocols in horses.

Evaluation of the effects of medium-term (57-day) omeprazole administration and of omeprazole discontinuation on serum gastrin and serum chromogranin A concentrations in the horse
jvim 2023

Question 24

What is the best dosing intervals of extended-release injectable omeprazole in the treatment of ESGD and EGGD ?

Answer 24

• The proportions of horses with EGGD healing in association with ERIO used at 5-day intervals were higher than associated with treatment at 7-day intervals.
• For ESGD, there was no significant difference between the 2 protocols.
• The use of ERIO at 5-day intervals might be more appropriate than the 7-day interval that is used currently.
• Prevalence of injection-site reaction → 1%

Five- versus seven-day dosing intervals of extended-release injectable omeprazole in the treatment of equine squamous and glandular gastric disease
evj 2024

Question 25

Is oral esomeprazole more protent than omeprazole in horses ?

Answer 25

Oral-buffered esomeprazole was a more effective treatment for ESGD (and concurrent EGGD) than oral-buffered omeprazole.

Comparison of oral esomeprazole and oral omeprazole in the treatment of equine squamous gastric disease
evj 2024

Question 26

In horses diagnosed with gastric impactions, which of the following is true regarding the prognosis and management of lone gastric impactions (LGI)?

A) LGI are less likely to require long-term dietary management compared to CGI.
B) LGI resolves more quickly compared to CGI, with shorter hospital stays.
C) LGI horses are more likely to experience gastric rupture and require long-term dietary changes.
D) LGI horses show more acute clinical signs compared to CGI.

Answer 26

Answer: C

Justifications:

A): Incorrect. Horses with LGI were significantly more likely to require long-term dietary management (72.7%) compared to CGI (25%)​.

B): Incorrect. LGI resolves more quickly (median 2 days) compared to CGI (median 4 days), but there is no significant difference in hospital stay​.

C): Correct. LGI horses were more likely to experience gastric rupture (29.6%) and required long-term dietary management more often​.

D): Incorrect. LGI horses had longer-lasting clinical signs, while CGI cases showed more acute onset.

Clinical presentation and outcome of gastric impactions with or without concurrent intestinal lesions in horses. 2023

Question 27

In the study on plasma concentrations of serum amyloid A (SAA) and lipopolysaccharide-binding protein (LBP) in horses with laminitis caused by hindgut acidosis (HGA), which of the following statements are clinically accurate?

A. Horses fed a high-forage diet (70:30 forage-to-concentrate ratio) showed significant increases in laminitis severity, LBP, and SAA levels by Day 20.

B. Horses fed a high-concentrate diet (30:70 forage-to-concentrate ratio) showed significant increases in plasma LBP and SAA concentrations, along with laminitis severity scores, particularly by Day 20.

C. The study suggests that LBP may be a more sensitive marker than SAA for the early identification of HGA and laminitis in horses on high-carbohydrate diets.

D. Cecal pH and volatile fatty acids (VFA) levels remained stable across both diet groups, with no significant changes due to diet composition.

E. The increase in LBP observed in horses with HGA may be due to endotoxins released from gram-negative bacteria as a result of decreased cecal pH.

Answer 27

Correct answer: 2. B, C, E

Explanation:

A is incorrect: Horses on the high-concentrate (30:70) diet, not the high-forage (70:30) diet, exhibited significant increases in laminitis severity, LBP, and SAA levels.

B is correct: Horses on the 30:70 diet showed notable increases in plasma LBP, SAA concentrations, and laminitis severity, especially by Day 20.
“On day 20, a significant increase in the concentration of SAA was observed in horses fed a high-concentrate diet, in contrast to the initial stage of the study.
LBP levels in the plasma were significantly elevated on days 10 and 20 in horses fed a high-concentrate diet.
Based on our findings, it is recommended that the evaluation of plasma LBP concentrations is more effective than SAA for the early identification of HGA in horses fed a high-grain diet.”

C is correct: The study suggests that LBP could be a more sensitive marker than SAA for early detection of HGA and laminitis in horses on high-carbohydrate diets.

D is incorrect: Cecal pH and VFA levels showed significant changes, particularly in horses on the high-concentrate diet.

E is correct: The increase in LBP is likely due to endotoxins from gram-negative bacteria as a result of decreased cecal pH, consistent with the study’s findings.

Plasma concentration of serum amyloid A and lipopolysaccharide binding protein in horses with laminitis resulted from hindgut acidosis 2024

Question 28

In a study on the effects of intravenous ascorbic acid (AA) on oxidative stress in healthy adult horses, which of the following statements accurately summarize the findings?

A. All doses of AA (25, 50, and 100 mg/kg) significantly reduced plasma dROM levels at 2 and 6 hours post-administration.

B. Only the 100 mg/kg dose of AA significantly reduced dROM levels at 2 hours, with levels returning to baseline by 6 hours.

C. Plasma antioxidant capacity (PAC) and reactive oxygen species (ROS) levels in neutrophils and erythrocytes were unaffected by AA at any dose.

D. Plasma AA concentrations increased in a dose-dependent manner and remained elevated at 6 hours.

E. The study recommends 50 mg/kg AA for reducing oxidative stress due to its effects on ROS in neutrophils.

Answer 28

Correct Answer: 2. B, C, D

Explanation:

B is correct: Only the 100 mg/kg dose reduced dROM levels, and effects were temporary (baseline levels by 6 hours).
C is correct: PAC and ROS in neutrophils and erythrocytes were unaffected by any AA dose.
D is correct: Plasma AA concentrations rose in a dose-dependent manner and remained elevated at 6 hours.
A is incorrect because not all doses impacted dROM.
E is incorrect as the study did not recommend the 50 mg/kg dose for reducing oxidative stress.

2023 Effects of intravenous administration of ascorbic acid (vitamin C) on oxidative status in healthy adult horses

Question 29

In a 12-year-old Quarter Horse gelding with chronic colic and weight loss due to lymphocytic myenteric ganglionitis (MG) associated with equine herpesvirus infection, which of the following statements is TRUE regarding diagnosis and management?

A. Myenteric ganglionitis can be reliably diagnosed in horses through partial-thickness intestinal biopsies.

B. Treatment options for Chronic Intestinal Pseudo-Obstruction (CIPO) in horses are generally successful, with long-term survival expected.

C. Full-thickness biopsies provide greater diagnostic value in cases of suspected myenteric ganglionitis in horses.

D. Neuronal degeneration in CIPO cases is primarily managed with surgical removal of affected intestinal sections in horses, with successful long-term outcomes.

Answer 29

Correct Answer: C. Full-thickness biopsies provide greater diagnostic value in cases of suspected myenteric ganglionitis in horses.

Explanation:

Option A: False. Partial-thickness biopsies are often limited in diagnosing myenteric ganglionitis effectively, as shown in equine cases where full-thickness biopsies are recommended to better capture enteric neuropathy characteristics.

Option B: False. The prognosis for CIPO in horses is typically poor, as even with prokinetics, dietary management, and corticosteroids, recurrence of symptoms and complications such as intestinal rupture often lead to euthanasia. (fair to moderate -> 65% survive 3y -> paper valentina IBD

Option C: True. Full-thickness biopsies are indeed more reliable for identifying myenteric ganglionitis, especially in cases involving recurrent intestinal impactions.

Option D: False. Surgical interventions in horses with CIPO, including resection, have not shown successful long-term outcomes due to the disease’s complex and recurrent nature.

2023 Lymphocytic myenteric ganglionitis associated with equine herpesvirus infection: A cause of chronic intestinal pseudo-obstruction and recurrent colic in an adult horse

Question 30

Based on the study’s findings, which of the following diets is most likely to result in spontaneous healing of severe Equine Gastric Ulcer Syndrome (EGUS) in horses?

A. Whole oat grains at 2 g starch/kg body weight per meal with hay ad libitum (OS2)

B. Pasture turnout (PST)

C. Whole oat grains at 1 g starch/kg body weight per meal with hay ad libitum (OS1)

D. Hay fed ad libitum (HAY)

Answer 30

Correct Answer: B. Pasture turnout (PST)

Justification:

Option A (OS2): Horses fed 2 g starch/kg body weight per meal had an increased risk of ulceration and a higher likelihood of acute gastritis.

Option B (PST) is correct: The study showed that pasture turnout provided the best outcomes, with spontaneous healing of severe EGUS, particularly in the squamous mucosa.

Option C (OS1): This low-starch diet still posed some risk for EGUS, with increased ulceration in the antrum.

Option D (HAY): Ad libitum hay showed positive results but was less effective than pasture turnout for spontaneous healing of severe EGUS.

Equine gastric ulcer syndrome in horses fed hay, hay plus different amounts of oats or with pasture turnout

Question 31

A 10-year-old gelding used in a university teaching program undergoes monthly gastroscopies as part of a study. The horse shows mild girthing pain but no other clinical signs. Based on the findings of this study, which of the following statements is most likely to be true?

A) The horse’s ESGD and EGGD lesions will remain stable over the three-month period without treatment.

B) If the horse has ESGD, it will definitely worsen without acid suppressive treatment.

C) The horse’s ESGD or EGGD lesions may improve or deteriorate within a month without treatment.

D) Girthing pain is a definitive indicator of severe EGUS in teaching horses.

Answer 31

Correct answer: C) The horse’s ESGD or EGGD lesions may improve or deteriorate within a month without treatment.

Justification:
The study found that “Both ESGD and EGGD lesions can improve or deteriorate in a month’s time, without acid suppressive treatment.”

The researchers observed that ESGD grades changed in 5/13 horses between the first and second gastroscopies, and in 4/13 horses between the second and third gastroscopies, without any treatment.

EGGD classifications also changed in 5/12 horses between the first and second gastroscopies, and in 2/13 horses between the second and third gastroscopies.

The study suggests that management factors and stress from handling by multiple people during teaching may contribute to EGUS development, which could explain the fluctuations in lesion severity.

A 3 month longitudinal evaluation of the prevalence of ESGD and EGGD in a group of teaching horses

Question 32

According to the study, which of the following is TRUE regarding the treatment of Equine Glandular Gastric Disease (EGGD) in horses with concurrent Inflammatory Bowel Disease (IBD)?

A. Horses with IBD showed significant improvement in EGGD lesion scores when treated with intramuscular omeprazole (IMOM).

B. The presence of IBD tends to reduce the effectiveness of EGGD treatment, and some horses with IBD had worsened EGGD scores after IMOM treatment.

C. Oral omeprazole alone is equally effective for EGGD in horses with or without IBD.

D. Intramuscular omeprazole is not recommended for EGGD treatment due to its lack of efficacy across all cases.

Answer 32

Correct Answer: B. The presence of IBD tends to reduce the effectiveness of EGGD treatment, and some horses with IBD had worsened EGGD scores after IMOM treatment.

Justification:

Option A is incorrect: Horses with concurrent IBD did not show significant improvement in EGGD lesion scores with IMOM; in fact, some cases worsened.

Option B is correct: The study found that IBD may negatively impact the treatment outcome for EGGD, with some horses experiencing worsened scores post-IMOM.

Option C is incorrect: Oral omeprazole alone was less effective for EGGD, particularly in horses with IBD (difference with injectable omeprazole that is effective for both EGUS)

Option D is incorrect: Intramuscular omeprazole is generally effective for EGGD but may be less so in cases with concurrent IBD.

Retrospective comparison of different treatments of EGUS and the inflluence of IBD

Question 33

In a study comparing the fecal microbiota of healthy horses to horses with colitis, which of the following findings was observed regarding horses with colitis and their survival outcomes?

A. The microbiota composition was identical between surviving and non-surviving colitis horses.

B. Non-surviving colitis horses showed an enrichment of Enterobacteriaceae, Pseudomonas, Streptococcus, and Enterococcus.

C. Colitis horses that developed laminitis showed no enrichment of specific bacterial groups compared to healthy horses.

D. Differences in the fecal microbiota were more pronounced between laminitis and non-laminitis colitis horses than between survivors and non-survivors.

Answer 33

Correct Answer: B. Non-surviving colitis horses showed an enrichment of Enterobacteriaceae, Pseudomonas, Streptococcus, and Enterococcus.

A is incorrect: The study found that non-surviving colitis horses had distinct microbiota, particularly with an enrichment of certain bacterial groups.

B is correct: Non-surviving colitis horses had significant enrichment of Enterobacteriaceae, Pseudomonas, Streptococcus, and Enterococcus.

C is incorrect: Horses with laminitis were also enriched in specific bacterial groups, such as Enterobacteriaceae, Streptococcus, and Lactobacillus, though the overall microbiota composition was not significantly different from non-laminitis horses.

D is incorrect: Microbiota differences were more prominent between healthy and colitis horses than between laminitis and non-laminitis or survivor and non-survivor subgroups.

Fecal microbiota of horses with colitis and its association with laminitis and survival during hospitalization 2022

Question 34

A 5-day-old Franches-Montagnes filly is presented with apathy, reluctance to nurse, fever, abdominal distension, and diarrhea. Blood work reveals severe hypertriglyceridemia (35 mmol/L) and elevated lipase activity (150 U/L). Which of the following is the most likely diagnosis?

A) Neonatal septicemia
B) Hypertriglyceridemia-induced pancreatitis
C) Rotavirus infection
D) Congenital heart defect
E) Meconium impaction

Answer 34

The correct answer is B) Hypertriglyceridemia-induced pancreatitis.

Explanation:
The clinical presentation and laboratory findings strongly suggest hypertriglyceridemia-induced pancreatitis. This diagnosis is supported by:

1. The age and breed of the foal match the case series description.
2. The clinical signs (apathy, reluctance to nurse, fever, abdominal distension, and diarrhea) are consistent with those reported in the study.
3. Severe hypertriglyceridemia (35 mmol/L) is a key feature, far exceeding the reference interval (0.16–0.73 mmol/L).
4. Elevated lipase activity (150 U/L) is also observed, above the reference interval (9–21 U/L).

While other conditions like neonatal septicemia or rotavirus infection might present with similar clinical signs, the extreme hypertriglyceridemia and elevated lipase activity strongly point towards pancreatitis as the primary issue. The study emphasizes that pancreatitis should be considered in the differential diagnosis of sick foals with these symptoms, especially when high triglyceride levels are present.

A candidate variant in the LMF1 gene for hypertriglyceridemia has been identified.
CLINICAL RELEVANCE
Pancreatitis should be considered in the differential diagnosis of sick foals with diarrhea, colic, and possibly neurologic signs, especially those
with high triglyceride levels. Since a genetic predisposition seems to be associated with hypertriglyceridemia and pancreatitis, genetic testing
and strict avoidance of carrier x carrier matings should be implemented to prevent this fatal condition in the future.

ECEIM CONGRESS 2024

Question 35

A 10-year-old Thoroughbred gelding is presented to your equine hospital with signs of acute colic. On initial examination, the horse shows marked abdominal pain, has a rectal temperature of 38.5°C, and small intestinal distention is palpated on rectal examination. Blood glucose concentration is 8.2 mmol/L. Peritoneal fluid analysis reveals serosanguineous fluid with an L-lactate concentration of 6.5 mmol/L, while the blood L-lactate concentration is 3.2 mmol/L.
Based on the study by Long et al., which of the following statements is most accurate regarding the prediction of intestinal strangulating obstruction (SO) in this case?

A) The peritoneal fluid L-lactate concentration alone is the best predictor of SO.

B) The ratio of peritoneal:blood L-lactate concentration is the most reliable indicator of SO.

C) A multivariable model including clinical and laboratory variables would provide the best prediction of SO.

D) Blood L-lactate concentration is the most important single factor in predicting SO.

E) Rectal temperature is the most significant variable in determining the likelihood of SO.

Answer 35

The correct answer is C) A multivariable model including clinical and laboratory variables would provide the best prediction of SO.

Explanation:
The study by Long et al. demonstrated that multivariable models incorporating multiple admission variables performed better in predicting intestinal strangulating obstruction (SO) than individual variables or simple ratios.

The study developed two models for predicting SO, with the second model (including peritoneal fluid analysis) showing outstanding discrimination (AUC ROC: 0.91).
This model included marked abdominal pain, rectal temperature, serosanguineous peritoneal fluid, peritoneal-blood L-lactate, and peritoneal:blood L-lactate ratio.

The study concluded that blood and peritoneal fluid L-lactate concentrations should be interpreted in conjunction with other clinical variables, rather than alone or as a simple ratio.

The multivariable approach achieved higher sensitivity (85%), specificity (80%), and accuracy (82%) compared to individual variables.

Use of multiple admission variables better predicts intestinal strangulation in horses with colic than peritoneal or the ratio of peritoneal:blood L-lactate concentration 2023

Question 36

A 12-year-old Warmblood gelding is presented to your equine hospital in late January with a 2-day history of fever (40.1°C), anorexia, and mild colic. On physical examination, the horse has slightly dry mucous membranes, a heart rate of 52 bpm, and scant feces in the rectum. Initial bloodwork reveals a white blood cell count of 2.8 x 10^9/L (reference range: 5.0-11.6 x 10^9/L) with a neutrophil count of 1.1 x 10^9/L (reference range: 2.6-6.8 x 10^9/L) and a lymphocyte count of 1.4 x 10^9/L (reference range: 1.6-5.8 x 10^9/L). Serum biochemistry shows mild hypoproteinemia and hyperglycemia. Which of the following is the most appropriate next step in management?

A) Immediately start broad-spectrum antibiotics and perform nasogastric intubation

B) Collect a fecal sample for Salmonella culture only

C) Administer flunixin meglumine and monitor for 24 hours before further diagnostics

D) Perform abdominal ultrasound and collect fecal samples for both Salmonella culture and equine coronavirus (ECoV) PCR

E) Isolate the horse and wait for development of diarrhea before further testing

Answer 36

The correct answer is D) Perform abdominal ultrasound and collect fecal samples for both Salmonella culture and equine coronavirus (ECoV) PCR.

Explanation:

Seasonality: ECoV is more prevalent in colder months (January in this case).
Clinical signs: Fever, anorexia, and mild colic are consistent with both ECoV and Salmonella infections.
Hematological findings: Leukopenia with neutropenia is observed in both ECoV and Salmonella infections.
Biochemical changes: Hypoproteinemia and hyperglycemia are reported in ECoV cases.
Fecal consistency: Absence of diarrhea does not rule out enteric infections.

2020- Evaluation of safety, humoral immune response and faecal shedding in horses inoculated with a modified-live bovine coronavirus vaccination

2022 Serosurveillance of equine coronavirus infection amongThoroughbreds in Japan

Question 37

A 5-year-old Thoroughbred gelding presents with recurrent mild colic, poor body condition, and slow eating. Gastroscopy reveals grade 4 squamous ulceration and a narrowed pyloric region with reduced motility. Which of the following statements best describes the relationship between equine squamous gastric disease (ESGD) and delayed gastric emptying in this horse?

A) Primary ESGD is caused by delayed gastric emptying and results in secondary gastric distention and acid exposure.

B) Secondary ESGD results from delayed gastric emptying, leading to increased acid exposure and gastric distention.

C) ESGD is unrelated to gastric emptying rates and primarily results from dietary factors.

D) Delayed gastric emptying is a direct consequence of primary ESGD due to increased acid production.

E) Gastric distention due to delayed emptying has no impact on ESGD development.

Answer 37

The correct answer is B) Secondary ESGD results from delayed gastric emptying, leading to increased acid exposure and gastric distention.

Explanation:

Secondary ESGD occurs when delayed gastric emptying causes gastric distention, which increases acid exposure to the squamous mucosa.

The paper emphasizes that secondary ESGD is less common than primary ESGD but can occur as a direct consequence of delayed gastric emptying.

The condition involves chronic exposure of the squamous mucosa to acid due to prolonged retention of stomach contents.

Primary ESGD is typically associated with factors related to domestication and management practices, not directly with delayed gastric emptying.

Equine squamous gastric disease and delayed gastric emptying – the chicken or the egg? 2022

Question 38

A 3-year-old Warmblood gelding is presented with a 4-month history of poor body condition, slow eating, and recurrent mild colic episodes. Physical examination reveals no significant abnormalities. Blood work shows mild hypoalbuminemia (27 g/L). Abdominal ultrasound reveals the stomach extending to the 15th left intercostal space. Gastroscopy shows grade 4 squamous ulceration and a depressed fibrinosuppurative pyloric lesion with absent pyloric motility.
Which of the following statements is most accurate regarding the diagnosis and prognosis of this case?

A) The clinical presentation is atypical for chronic severe pyloric lesions, and further diagnostics should focus on ruling out other causes of weight loss and colic.

B) The gastroscopic findings are consistent with chronic severe pyloric lesions, but the prognosis is excellent with medical management alone.

C) Surgical intervention with gastrojejunostomy is the only viable treatment option and has been shown to have excellent long-term outcomes in horses under 3 years of age.

D) The clinical and diagnostic findings are consistent with chronic severe pyloric lesions, and the horse has a guarded prognosis due to its young age at diagnosis.

E) Transendoscopic biopsy of the pyloric lesion is essential for definitive diagnosis and should be performed before initiating any treatment.

Answer 38

The correct answer is D) The clinical and diagnostic findings are consistent with chronic severe pyloric lesions, and the horse has a guarded prognosis due to its young age at diagnosis.

The clinical presentation (poor body condition, slow eating, recurrent colic) is consistent with chronic severe pyloric lesions.

The gastroscopic findings of severe squamous ulceration and a fibrinosuppurative pyloric lesion with absent motility are typical of the condition.

Ultrasonographic evidence of gastric distension (stomach extending to the 15th intercostal space) supports delayed gastric emptying.

The study found that horses diagnosed at 3 years of age or younger were significantly less likely to survive long-term compared to older horses.
While various treatments were attempted in the study, no single approach showed consistently superior outcomes, especially in younger horses.

Equine squamous gastric disease and delayed gastric emptying – the chicken or the egg? 2022

Question 39

Which factor was NOT associated with decreased survival in horses with acute diarrhoea?
A) High creatinine levels
B) High L-lactate levels
C) Presence of systemic inflammatory response syndrome (SIRS)
D) Geographic location

Answer 39

Correct Answer: D) Geographic location

2023 Survival Rates and Factors Associated with Survival and Laminitis of Horses with Acute Diarrhoea

Question 40

What pathogen was associated with a higher likelihood of developing laminitis in horses with acute diarrhoea?
A) Salmonella spp.
B) Neorickettsia risticii
C) Clostridioides difficile
D) Equine Coronavirus

Answer 40

Correct Answer: B) Neorickettsia risticii

• **C. difficile-positive horses had higher odds of non-survival (OR: 2.69).
• N. risticii-positive horses had higher odds of developing laminitis (OR: 2.76).

2023 Diagnostic Approaches, Aetiological Agents, and Their Associations with Short-term Survival and Laminitis in Horses with Acute Diarrhoea

Question 41

A 10-year-old Thoroughbred gelding is admitted to your hospital with acute diarrhea. On presentation, the horse has a heart rate of 60 bpm, respiratory rate of 24 rpm, temperature of 39°C, and WBC count of 4,500 cells/μL. Blood work reveals a creatinine of 180 μmol/L and L-lactate of 3.2 mmol/L. Based on the findings of this study, what is this horse’s approximate survival probability?
A) 85%
B) 75%
C) 60%
D) 50%

Answer 41

Correct answer: C) 60%
Explanation: The horse meets SIRS criteria (2 or more of: HR>40, RR>20, T>38.5°C, WBC < 5300). It also has elevated creatinine (>159 μmol/L) and L-lactate (>2.8 mmol/L) The study found that horses with SIRS and elevated L-lactate had a 59% survival rate, which is closest to the 60% option.

2023 Survival rates and factors associated with survival and laminitis of horses with acute diarrhoea admitted to referral institutions

Question 42

A 12-year-old Warmblood gelding presents with weight loss, intermittent fever, and peripheral lymphadenopathy. You suspect lymphoma and run a** serum thymidine kinase 1 (TK1)** assay. The result comes back as 3.5 U/L. Based on the findings of this study, which of the following statements is most accurate?
A) The TK1 result confirms the diagnosis of lymphoma
B) The TK1 result rules out lymphoma
C) The TK1 result is not reliable for diagnosing lymphoma in horses
D) The TK1 result indicates the horse has inflammatory disease
E) The TK1 result suggests the need for immediate chemotherapy

Answer 42

C) The serum TK1 result is not reliable for diagnosing lymphoma in horses

This question tests understanding of the study’s main finding that TK1 was not predictive of lymphoma in horses, contrary to previous assumptions.

Clinical performance of a commercially available thymidine
kinase 1 assay for diagnosis of lymphoma in 42 hospitalized
horses (2017-2020)

Question 43

Which of the following statements about postoperative monitoring in equine colic patients is correct?
A) Physical examinations should be performed every 2-3 hours throughout the entire postoperative period.
B) Tachycardia (60-70 bpm) is expected for the first 72 hours after surgery.
C) Fecal output typically returns to normal within 24 hours postoperatively.
D) Fluid administration rates should be checked at least hourly to ensure accuracy.
E) Pain assessment using numerical scales is not recommended in the postoperative period.

Answer 43

**Answer: D) Fluid administration rates should be checked at least hourly to ensure accuracy.

Explanation: The other options are incorrect:
A) Physical examinations are initially performed every 4-6 hours, not 2-3 hours then spaced them.
B) Tachycardia is expected for the first 24-40 hours, not 72 hours.
C) Reduced fecal output is expected for several days postoperatively. (1st feces within 8h)
E) Pain assessment using numerical scales (e.g., Composite Pain Score, Equine Acute Abdominal Pain Score) is considered valuable.

Basic Postoperative Care of the Equine Colic Patient. 2023 VETCLINIC

Question 44

Which of the following statements about laboratory tests in postoperative equine colic patients is correct?
A) Complete blood counts (CBCs) should be performed every 6 hours in all postoperative colic patients.
B) Blood L-lactate concentration should be greater than 1 mmol/L in horses receiving IV fluids.
C) Packed cell volume and total solids (PCV/TS) should be monitored every 6 hours in horses with reflux, diarrhea, or evidence of systemic inflammatory response syndrome (SIRS).
D) Serum biochemistry profiles should always be repeated daily in all postoperative colic patients.
E) Persistent leukocytosis on serial blood leukocyte count is a negative prognostic indicator for survival following colic surgery.

Answer 44

Answer: C) Packed cell volume and total solids (PCV/TS) should be monitored every 6 hours in horses with reflux, diarrhea, or evidence of systemic inflammatory response syndrome (SIRS).

Explanation: This statement is correct according to the information provided in the paragraph. The other options are incorrect:
A) CBCs are recommended every 24 to 48 hours, not every 6 hours.
B) Blood L-lactate concentration should be less than 1 mmol/L in horses receiving IV fluids.
D) The frequency of serum biochemistry profiles depends on the patient’s condition and can be as infrequent as every 72 hours in stable patients.
E) Persistent leukopenia, not leukocytosis, is mentioned as a negative prognostic indicator.

Basic Postoperative Care of the Equine Colic Patient. 2023 VETCLINIC

Question 45

One day (24h later) after a colic surgery, you measure the TG that are 300mg/dl, do you think it’s normal or abnormal?

Answer 45

Yes often seen until 36h.

In one study of horses undergoing exploratory celiotomy, 58% of horses experienced a mild hypertriglyceridemia (50–250 mg/dL) and 38% experienced moderate hypertriglyceridemia (250–500 mg/dL) in the first 24 to 36 hours postoperatively.
However, persistent and severe hypertriglyceridemia (ie, >500 mg/dL) will result in lethargy and inappetence

In horses with mild-to-moderate hypertriglyceridemia (100–500 mg/
dL), supplementation with oral Karo syrup (0.15 mL/kg by mouth every 8 hours) may be sufficient, as long as enteral nutrition is also being provided. Horses with plasma triglyceride greater than 500 mg/dL will likely need nutritional support such as IV dextrose supplementation with or without insulin therapy

Basic Postoperative Care of the Equine Colic Patient. 2023 VETCLINIC

Question 46

Which of the following statements about ancillary tests in postoperative colic patients is correct?
A) Routine abdominal ultrasound should be performed on all postoperative patients
B) Nasogastric intubation is recommended for any horse with a heart rate above 60 beats/minute
C) Transabdominal sonography can reliably differentiate between functional ileus and mechanical obstruction
D) Leaving a nasogastric tube in place for extended periods may lead to sinusitis

Answer 46

Answer: D) Leaving a nasogastric tube in place for extended periods may lead to sinusitis

Basic Postoperative Care of the Equine Colic Patient. 2023 VETCLINIC

Question 47

Regarding biosecurity monitoring in equine colic patients, which of the following is true?
A) Colic surgery is not considered a risk factor for Salmonella shedding
B) Salmonella testing is typically performed only when clinical signs of infection are present
C) Routine Salmonella culture or PCR following colic surgery is standard practice in many hospitals
D) Salmonella shedding always occurs after the development of clinical signs such as diarrhea or pyrexia

Answer 47

Answer: C) Routine Salmonella culture or PCR following colic surgery is standard practice in many hospitals

Basic Postoperative Care of the Equine Colic Patient. 2023 VETCLINIC

Question 48

Which of the following statements about antimicrobial use in equine colic surgery is correct?
A) A single dose of preoperative antimicrobials is always sufficient for prophylaxis
B) Extended prophylaxis beyond a single postoperative dose is uncommon
C) Potassium penicillin and gentamicin are commonly used in routine colic surgery
D) Longer duration of antimicrobial administration decreases the risk of surgical site infections

Answer 48

Answer: C) Potassium penicillin and gentamicin are commonly used in routine colic surgery

Justification:
3 days vs 5 days of treatments no benefits in preventing surgical site infection.

! resistance 92% of organisms isolated from SSIs after colic surgery were penicillin-resistant, whereas 18% were gentamicin resistant.

Escherichia coli, a normal commensal organism in the gastrointestinal
tract of most mammals, is one of the most commonly isolated organisms from infected
incisions after colic surgery

the most common antimicrobials used in colic surgery are potassium penicillin (22,000 IU/kg IV every 6 hours) and gentamicin (6.6 mg/kg IV every 24 hours) although duration of use varies between surgeons.

Basic Postoperative Care of the Equine Colic Patient. 2023 VETCLINIC

Question 49

Which of the following statements about postoperative feeding in colic patients is correct?
A) Feeding should be delayed until normal borborygmi and fecal production return
B) Early refeeding may help prevent postoperative large colon impactions and displacements
C) Fecal production typically returns to normal within 24 hours postoperatively
D) Concentrate feeds are preferred over roughage for initial refeeding

Answer 49

Answer: B) Early refeeding may help prevent postoperative large colon impactions and displacements

Basic Postoperative Care of the Equine Colic Patient. 2023 VETCLINIC

Question 50

Which of the following is recommended for horses with signs of endotoxemia due to the risk of laminitis?
A) Polymyxin-B
B) Hyperimmune plasma
C) Continuous digital cryotherapy
D) Enteral adsorbents

Answer 50

Answer: C) Continuous digital cryotherapy

Basic Postoperative Care of the Equine Colic Patient. 2023 VETCLINIC

Question 51

What percentage of horses that survive to discharge after colic surgery typically return to their previous athletic potential?
A) 40-60%
B) 63-85%
C) 90-95%
D) 98-100%

Answer 51

Answer: B) 63-85%

Basic Postoperative Care of the Equine Colic Patient. 2023 VETCLINIC

Question 52

What percentage of organisms isolated from surgical site infections (SSIs) after colic surgery were penicillin-resistant?
A) 72%
B) 82%
C) 92%
D) 98%

Answer 52

Answer: C) 92%
Justification: The text mentions “In one study, 92% of organisms isolated from SSIs after colic surgery were penicillin-resistant, whereas 18% were gentamicin-resistant.

Basic Postoperative Care of the Equine Colic Patient. 2023 VETCLINIC

Question 53

What percentage of horses presenting for treatment of acute abdominal disease are hyperglycemic on admission?
A) 25-30%
B) 35-40%
C) 45-50.2%
D) 60-65%

Answer 53

Answer: C) 45-50.2%

severe >195mg/dl at admission -> poor prognosis

Basic Postoperative Care of the Equine Colic Patient. 2023 VETCLINIC

Question 54

What is the specificity and sensitivity of sonographic identification of distended small intestine for small intestinal strangulation?
A) 63-65%
B) 73-76%
C) 85-90%
D) 100%

Answer 54

Answer: B) 73-76%

Abdominal-Sonographic-Evaluation_2023

Question 55

What is the specificity of sonography in detecting sand accumulations in horses?
A) 67.5%
B) 77.5%
C) 87.5%
D) 97.5%

Answer 55

Answer: C) 87.5%

Abdominal-Sonographic-Evaluation_2023

Question 56

Which of the following statements about transabdominal large intestinal trocarization in horses with colic is correct?

A) The procedure is associated with a high risk of fatal complications
B) It should only be performed if consent for surgery has not been obtained
C) Multiple trocarization procedures are associated with improved survival
D) 73% of horses that underwent the procedure survived to hospital discharge

Answer 56

Answer: D) 73% of horses that underwent the procedure survived to hospital discharge
228 equids that underwent large intestinal trocarization, 167 (73%) survived to hospital discharge.

A) is incorrect because the study found that none of the equids died or were euthanized due to complications from the trocarization procedure itself.
B) is incorrect because the study did not restrict the procedure only to cases without surgical consent. In fact, some horses underwent both trocarization and surgery.
C) is incorrect because the study found that performing multiple trocarization procedures was actually associated with increased odds of non-survival, likely due to more severe underlying conditions rather than the procedure itself.

2020 transabdominal large intestinal trocarization

Question 57

How is the prognosis for a mare and her foal undergoing surgery?

Answer 57

LCV surgery:
91.1% were bred after surgery **81.7% of bred mares had
at least one foal after surgery. **

Uterine torsion:
no difference of fertility after
90.5% of mares and 82.3% of foals survived to hospital discharge as well as to foaling.
93.5% became pregnant

When uterine torsion occurred before 320 days gestation, both mare and foal outcomes were more favourable

2020 Clinical insights: Update on colic

Question 58

Risk factors for intermittent colic

Answer 58

1. previous abdominal surgery,
2. consuming coastal grass hay,
3. being more than 8 years of age,
4. being of the Arabian breed,
5. being a gelding,
6. having a recent change in diet,
7. dental disease,
8. cribbing/wind-sucking and
9. weaving behaviour
10. living in an environment with a high density of horses

reducing risk w/ increasing time at pasture

Recurrent Colic vet clinic

Question 59

How the frequency of colic could help you in your ddx and suspected outcome?

Answer 59

very frequent (3 colic/month) bouts of recurrent colic are likely to have more serious diseases and a higher mortality (50 %) rate (eg:lymphoma, intussusception etc.)

less frequent bouts (3 or + / year) of transient colic, which are more likely to have recurrent non-specific, “spasmodic” colic (4 % mortality)

Horses with recurrent bouts of prolonged colic ((3 or + / year but prolonged) are more likely to have motility issues (resulting in repeated colonic impactions for example) or partial intestinal obstruction. (30 % mortality)

2023 Recurrent Colic

Question 60

what do we know about cajal cells and myenteric ganglionitis ?

Answer 60

Dysfunctional ICCs primarily cause motility disorders due to their pacemaker role, whereas myenteric ganglionitis causes motility issues through inflammation and disruption of neural pathways.

ICC dysfunction is often a result of cellular loss or damage, while myenteric ganglionitis involves immune-mediated inflammation targeting nerve cells.

Neurotropic viruses, such as equine herpesvirus, were suspected in most cases of **myenteric ganglionitis **and confirmed in some of them.

The importance of full-thickness biopsies for comprehensive diagnosis in non-responsive cases

2024 The subtle link between myenteric ganglionitis and inflammatory bowel disease

Question 61

Which breed has been reported to be at increased risk for recurrent colic?
A) Thoroughbred
B) Quarter Horse
C) Arabian
D) Warmblood

Answer 61

Correct answer: C) Arabian

Recurrent Colic vet clinic

Question 62

Which of the following is NOT mentioned as a common clinical sign of recurrent colic?
A) Weight loss despite good appetite
B) Mild, recurrent abdominal pain
C) Chronic or intermittent diarrhoea
D) Persistent fever

Answer 62

Correct answer: D) Persistent fever

Recurrent Colic vet clinic

Question 63

Which diagnostic test is described as potentially useful for assessing small intestinal absorptive function in horses with suspected inflammatory bowel disease (IBD)?
A) Complete blood count
B) Rectal biopsy
C) Glucose absorption test
D) Abdominal radiography

Answer 63

Correct answer: C) Glucose absorption test

Recurrent Colic vet clinic

Question 64

According to recent studies, what percentage of horses with inflammatory bowel disease (IBD) survive at least 3 years?
A) 25%
B) 45%
C) 65%
D) 85%

Answer 64

Correct answer: C) 65%

Recurrent Colic vet clinic

Question 65

What is described as the treatment of choice for horses diagnosed with inflammatory bowel disease (IBD)?
A) Antibiotics
B) Corticosteroids
C) Probiotics
D) Surgery

Answer 65

Correct answer: B) Corticosteroids

Recurrent Colic vet clinic

Question 66

A) Geriatric horses had a better survival rate and lower inflammatory markers compared to young adult horses
B) There was no significant difference in survival rates between age groups, and inflammatory cytokine levels were similar
C) Geriatric horses had significantly higher mortality, higher IL-6 and TNF-α levels, and longer hospitalization compared to young adults
D) Age had no impact on survival, but geriatric horses showed lower inflammatory markers

Answer 66

Correct answer: C) Geriatric horses had significantly higher mortality, higher IL-6 and TNF-α levels, and longer hospitalization compared to young adults

2021 - Sage - Assessment of the impact of age and of blood‐derived inflammatory markers in horses