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Equine > GIT > Flashcards

GIT Flashcards

1
Q

expected elevated pulse of a colicky foal <1month old

A

80-100bpm

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2
Q

expected elevated pulse of a colicky foal < 2month old

A

70bpm

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3
Q

expected elevated pulse of a colicky foal < 3month old

A

60bpm

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4
Q

why is PCV/TP not as reliable in foals as adults?

A

foals always have quite a low protein, but still okay indicator of hydration

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5
Q

what does lactate concentration indicate?

A

perfusion

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6
Q

is peritoneal fluid analysis routinely performed in foals?

A

no - dt increased complication rates vs. adults

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7
Q

what is US useful for when investigating a colicking foal?

A

GIT: intestinal motility, intestinal wall thickness, stomach size, peritoneal fluid
Umbilical structures

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8
Q

DDx for obstructive causes of colic in foals

A
  1. Non-strangulating:
    - meconium impaction
    - LI impaction
    - intussusception
  2. Strangulating
    - intestinal volvulus
    - herniation
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9
Q

DDx for congenital causes of colic in foals

A
  • intestinal atresia

- ileocolonic aganlionosis

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10
Q

ddx for misc. causes of colic in goals

A
  • gastroduodenal ulceration
  • peritonitis
  • uroperitonuem
  • umbilica/abdominal abscess
  • enterocolitis
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11
Q

what is normal foal USG

A

1.005-1.010

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12
Q

when should passage of meconium be completed by?

A

48hrs

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13
Q

lab data indicative of IVFT in foals

A

USG >1.020

Lactate >2mmol/L

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14
Q

analgesia options in colicky foal

A
  1. NSAIDs (if hydrated): flunixin, meloxiam, ketoprofen
  2. Opioids: butorphanol (can cause profound sedation)
  3. Alpha-2 agonists: xylazine (in older foals)
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15
Q

initial tx of meconium impaction

A
  • warm soapy water
  • foal standing/lateral
  • lubricate soft tubing (Foley cath)
  • 50-100mls for a 50kg foal - administered by gravity flow
  • can rpt several times (beware rectal irritation)
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16
Q

MOA of retention enema using acetylcysteine

A

4% acetylcysteine
MOA: cleaves disulphide bonds and decreases the viscosity of meconium
- keep in place for 30-45mins

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17
Q

non-infectious causes of foal diarrhoea

A
  • foal heat (assoc. w/ change in gut flora/copraphagy and starting to eat mare’s feed)
  • nutritional (ie. large quantities of milk w/ premies)
  • systemic dz (ie. dummy foals w/ impaired GIT perfusion)
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18
Q

DDx nutritional causes of foal diarrhoea

A
  • commonly in foals not able to handle large quantities of milk ie. premature/sick foals
  • milk replacers
  • lactose intolerance
  • perinatal asphyxia-assoc. D+
  • sand ingestion - typically older foals
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19
Q

parasitic causes of foal D+

A
  1. Nematodes
    - strongyloides westeri
    - parascaris equorum
    - small/large strongyles
  2. Cryptosporidium
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20
Q

viral causes of foal D+

A
  • rotavirus (most common)
  • coronavirus
  • adenovirus
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21
Q

pathogen of rotavirus in foal D+

A
  1. High contagious - transmitted by faecal-oral route
  2. Short incubation period 18-24hs
  3. Dz severity determined by: immune status, inoculation dose, age
  4. Small intestine only - denudes SI microvilli: brush border enzyme deficiency leading to inadequate digestion and osmotic D+ in the colon, compensatory crypt cell proliferation (increased secretion), production of an enterotoxin
  5. Age-related colonic compensation: worse if <30d
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22
Q

dx of rotavirus

A

faecal antigen tests

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23
Q

tx of rotavirus in foals

A
  • supportive: IV and enteral fluids
  • bismuth subsalicylate
  • ABs not indicated unless foal <2wks
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24
Q

explain protocol for maternal vaccination to prevent rotavirus

A

1st preg vaccinate in gestational months 8,9 and 10
thereafter booster during last month of preg

w/ DuvaxynR

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25
Q

list bacterial causes of foal D+

A
  • Cl.perfringens biotype A and C
  • Cl.difficile
  • Salmonella
  • Bacteroides fragilis
  • Rhodococcus equi
  • Lawsonia intracellularis
  • E.coli (rare)
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26
Q

compare CS of C.perfringens biotype C and A in foals

A
  1. biotype C: haemorrhagic D+, abdo distension, colic, circulatory shock, high mortality
  2. biotype A: signs more variable, variable mortality, include transient bloody stool, colic and fever
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27
Q

Diagnosis of clostridial D+ in foals

A
  1. Enterotoxin in C.perfringens
  2. Toxin A/B C.difficile
  3. PCR
  4. Culture
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28
Q

tx of clostridial D+ in foals

A
  1. Supportive
    - crystalloids + colloids
    - blood gas –> acid/base + lytes
    - anti-inflam/analgesia
    - nutrition - enteral/parenteral
  2. ABs: metronidazole +/- penicillin
  3. Biosponge
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29
Q

clinicopath findings assoc. w/ salmonella D+

A
  • initial degenerative neutropaenia and evidence of toxicity
  • rebound neutrophilia
  • elevated fibrinogen
  • severe hypoproteinaemia
  • lyte disturbances
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30
Q

diagnosis of salmonella in foals

A
  1. Blood culture: foals <1mo freq. bacteraemic
  2. Faecal culture: five samples spread out
  3. Faecal PCR
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31
Q

ABs to tx. salmonella D+

A

gentamicin, fluoroquinolones

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32
Q

when is parenteral nutrition required in foals?

A

if milk with-held for
>6hr in neonates
>24hrs in older foals

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33
Q

when is “GIT rest” indicated in foals?

A

rest for 12-24hrs if

colic, abdo distention, haemorrhagic D+, rotaviral or clostridial infection

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34
Q

describe parenteral nutrition protocol in colicky foal

A

Dextrose 4-8mg/kg/min IV for up to 48hrs

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35
Q

components of parenteral fluid plan in foal w/ D+

A

Deficit (% dehydrated x BW) to correct over 6hrs

Ongoing losses + maintenance = the rest

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36
Q

3 electrolyte abnormalities assoc. w/ foal D+

A
  • hyponatraemia
  • hypokalaemia
  • hypochloraemia
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37
Q

what blood gas parameters indicated tx. for metabolic acidosis

A

low CO2 + low bicarb

pH <7.25 and base deficit >10mEq

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38
Q

how do you calculate bicarb deficit?

A

Deficit = Base deficit (mEq/L) X BW (kg) x 0.5 (bicarb space)
–> replace half rapidly, then over 6hrs

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39
Q

indications for colloids IVFT in foals

A
  • severe hypovol shock
  • hypoproteinaemia
  • FPT
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40
Q

common CS of endotoxaemia in adults

A
  • fever
  • tachypnoea, tachycardia
  • dark MM
  • toxic gingival line
  • increased CRT
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41
Q

less common CS of endotox in adults

A
  • D+
  • haemorrhage
  • colic
  • ileus
  • fasciculations
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42
Q

sequelae of edotoxaemia in adults

A
  • DIC
  • laminitis
  • renal failure
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43
Q

criteria for isolation of adult horses

A

D+

+ fever OR leukopaenia

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44
Q

ddx infectious causes of adult D+

A
  • salmonella
  • clostridium difficile/perfringens
  • Coronavirus
  • Larval cyathostomiasis
  • Exotic: Neorickettsia risticii
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45
Q

ddx non-infectious causes of adult D+

A
  • dietary
  • AB induced
  • heavy metals (arsenic)
  • cantharidin (blister beetle –> leads to hypoCa)
  • NSAIDs
  • CHO-overload
  • intestinal anaphylaxis
  • acorns
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46
Q

lab findings assoc. w/ adult D+

A
  1. Acidaemia: bicarb loss in D+, lactic acidosis
  2. Lytes; Hypo Na, Cl, K (loss), hypoCa (incr. loss of protein-bound calcium, decreased intake)
  3. Hypoproteinaemia (hypoalbumin)
  4. Neutropaenia w/ toxicity and left shift
  5. Inc. PCV/Lactate
  6. Eleavted liver enzymes + pre-renal azotaemia
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47
Q

salmonella risk factors in adult D+

A
  • transportation
  • dietary change
  • recent ABs
  • recent sx
  • other GIT dz
  • wet, dark conditions
  • common use of nasogastric tubes
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48
Q

describe dx of salmonella through faecal cultures

A
  • five faecal cultures/samples no closer than 12 hours apart

- not sensitive dt intermittent shedding + dilution of bacteria in D+

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49
Q

risk factors for clostridial D+

A
  • neonates
  • hospitalisation
  • AB use
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50
Q

tx of larval cyathostomiasis in adults

A
  • larvicidal doses of fenbendazole

- moxidectin

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51
Q

what can cause sudden emergence of hypobiotic larvae to cause larval cyathostomiasis D+ in adults?

A
  • stress: sx, hot weather, handling
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52
Q

NSAID tox is associated with?

A

Right dorsal colitis

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53
Q

tx of Right dorsal colitis

A
  1. Reduce work of gut via diet mod
  2. Metronidazole
  3. PGs
  4. Corn oil
  5. Sucralfate
  6. Low dose psyllium
  7. AVOID NSAIDSSSS
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54
Q

arms of colitis management

A
  1. IVFT and lytes
  2. Preservation of colloid oncotic pressure
  3. Suppression of inflam
  4. Mucosal repair
  5. Maintain adequate calorific intake
  6. Minimise complications
  7. Nursing/supportive
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55
Q

maintenance fluids for adult/day vs neonate/day

A 
adult = 60ml/kg/day
neonate = 100ml/kg/day
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56
Q

initial fluid rates in L/hr for dehydration

  • mild
  • mod
  • severe
A

mild 2-5L/hr
mod 5-10L/hr
severe >10L/hr

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57
Q

fluid deficit correction timeframe

A

half over 3-6hrs, rest over 24hs

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58
Q

parameters useful to assess IVFT

A
  • HR
  • mentation
  • Urine production
  • PCV/Ts
  • Lactate
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59
Q

indicated fluid choice if horse in circulatory shock + hypoproteinaemic

A
  • synthetic products at 10ml/kg (penta/hetastarch)

- plasma 2-8L

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60
Q

list 4 anti-endotoxic drugs to manage inflm

A

1 NSAIDs - flunixin

  1. Pentoxyfylline
  2. Polymyxin B
  3. Plasma
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61
Q

tx neorickettsia w/ what ABs?

A

tetracyclines

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62
Q

tx clostridial diseases w/ what ABs?

A

metronidazoles

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63
Q

ABs indicated w/

A
  • severe neutropaenia
  • immunocomp (foals)
  • bacterial causes
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64
Q

actions of biosponge

A

absorbs clostridial and endotoxins

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65
Q

management of laminitis/DIC in colitis cases

A
  • ice feet
  • dalteparin
  • plasma
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66
Q

ddx inflammatory causes of chronic D+

A
  • chronic salmonellosis
  • parasitism
  • granulomatous enteritis/colitis
  • neoplasia
  • sand
  • mycobacteria
  • NSAID tx
  • intra-abdominal abscessation
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67
Q

ddx non-inflammatory causes of chronic D+

A
  • dysbiosis: NSAIDs, ABs, dietary stress
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68
Q

arms of management of chronic D+

A
  1. Diet: fibre, grass, lytes water
  2. ABs/Anti-protozoala: metronidazole
  3. Transfaunation
    +/- corticosteroids?
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69
Q

causes of duodenitis/proximal jejunitis

A
  • clostridium difficile
  • salmonella
  • mycotoxins
    +/- feeding practices?
70
Q

characteristics of duodenitis/prox. jejunitis

A
  • non-strangulating functional obstruction
71
Q

typical findings (Ps) of duodenitis/proximal jejunitis

A
  1. Pain: mod to severe, progressive, relieved by gastric decompression
  2. Paunch: minimal to none
  3. Pulse: usu HR >80, reduced by gastric decompression
  4. Perfusion: dry, dark mm, > CRT
  5. Peristalsis: absent
  6. Percussion: none
  7. Pass a tube: large volume reflux +/- blood tinged
  8. Palpation: dilated, compressible SI
    9 .PCV/TS/Lactate: all increased, responds to IVFT
  9. Peritoneal fluid: elevated WBS and TS, but not RBCs
  10. Pictures: US - dilated, thick walled SI
72
Q

ABs for duodenitis

A

penicillin (IM)
metronidazole (per rectum)

– targets clostridials + some gram -ves

73
Q

ddx causes for septic peritonitis

A
  • urine
  • bile
  • lymph/chyle
  • neoplastic
  • FB
74
Q

pathogen assoc. w/ primary peritonitis

A

Actinobacillus equuli

75
Q

peritoneal fluid characteristics w/ septic peritonitis

A

Increased: WBCs, protein, lactate, % neuts
Decreased: pH, glucose

76
Q

tx of primary peritonitis

A
  1. ABs: pen, tetracyclines

2. NSAIDs

77
Q

tx. of secondary peritonitis

A
  1. ABs: broad spec inc. anaerobes
  2. NSAIDs
  3. Tx underlying dz + endotozaemia
  4. Prevent complications
  5. Abdominal lavage and drainage
78
Q

px of primary vs. secondary peritonitis

A
  1. Primary = good

2. Secondary = guarded

79
Q

ddx for inflammatory bowel diseases

A
  • malabsorptive, infiltrative dz
  • idiopathic IBD
  • MEED
  • lymphosarcoma
  • proliferative enteropathy
  • mycobacterium
80
Q

typical IBD presentation

A
  • young, STBs
  • weight loss w/ good appetite
  • oedema dt hypoprotein.
    +/- D+
81
Q

3 types of IBD

A
  1. Granulomatous
  2. Lymphocytic- plasmacytic
  3. Eosinophilic
82
Q

IBD investigation/tests

A
  1. CBC: mild anaemia
  2. Biochem; hypoalbuminaemia
  3. UA: rule out PL-nephropathy
  4. Document malabsorption: glucose/xylose absorption test
  5. Biopsies
83
Q

management and px of IBD

A
  • corticosteroids +/- other immunosuppresants
  • sx if focal dz
  • difficult management - poor px
84
Q

what does MEED stand for?

A

multisystemic eosinophilic epitheliotropic disease

85
Q

eosinophilic syndrome effects the GIT and….

A

the skin

86
Q

tx and px for eosinophilic syndrome

A
  1. Immunosuppresive tx

2. Poor px

87
Q

compare lymphoma type px

A
  1. Poor px in alimentary, mediastinal, multicentric

2. Good in cutaneous

88
Q

causative agent of proliferative enteropathy in weanlings

A

Lawsonia intracellularis

89
Q

tx and px of proliferative enteropathy

A
  1. Tetracyclines

2. Fair prognosis - may have growth restriction

90
Q

pathogen of proliferative enteropathy

A

epithelial proliferation dt L.intracellularis –> thick wall SI –> malabsorption –> hypoalbuminaemia
+/- colic, fever, D+

91
Q

dx of proliferative enteropathy

A

serology and faecal PCR

92
Q

ddx for weight loss

A
  1. Decreased energy intake: limited access to feed/inappropriate feed, dysphagia, malabsorption/digestion, anorexia
  2. Increased energy requirements: physiologic, cachexia, sepsis/surgical/dz stress, ageing
93
Q

top 3 causes of weight loss

A
  1. Dietary problems
  2. Dental disease
  3. Parasite burdens
94
Q

CS of colic assoc. pain

A

recumbency, stretching, bruxism, Flehmen response, arching of neck, flank watching or biting, pawing, kicking at belly, rolling, posturing to lay down, sweating, posturing to urinate

95
Q

considerations when assessing pain

A
  • duration
  • severity: response to analgesics
  • persistance
  • visceral or parietal
96
Q

appropriate analgesic protocols to manage colic pain + facilitate exam

A
  1. Xylazine 0.4-0.6mg/kg IV
  2. Detomidine 0.01-0.02mg/kg +/- opioid
  3. Flunixin 1.1mg/kg
97
Q

paunch locations + indications

A
  1. Dorsal: large colon/caecum
  2. Ventral: fluid - ascites/rupture/haemoperitoneum
  3. SI; only in neonates
  4. Cranioventral L - stomach
  5. Abdominal distention –> large intestinal
98
Q

expected pulse with strangulating colic

A

> 80

99
Q

ddx increased peristalsis

A
  • spasmodic
  • impending colitis
  • early obstruction
100
Q

ddx reduced peristalsis

A

anything that reduce GI function

- colics, sedatives, prolonged fasting

101
Q

dorsal pings indicate

A

large intestinal obstruction

102
Q

large volume reflux is assoc. w/

A

gastric or SI obstruction/lesion

103
Q

what net reflex V is normal?

A

<2L

104
Q

drugs to safely facilitate rectal palpation

A
  • sedation
  • intrarecal lidocaine
  • IV scopolamine (muscarinic antagonist)
  • IV buscopan - relax rectum but gets tachycardic
105
Q

PCV/TS dissociation is a..

A

poor prognostic indicator

106
Q

size needle to collect peritoneal fluid

A

18G

107
Q

normal peritoneal fluid lactate

A

<2mmol/L

108
Q

peritoneal lactate level indicative of strangulating lesion

A

> 6mmol/L

109
Q

areas to assess via US

A
  1. Stomach: full of fluid –> pass a tube
  2. Small intestine - dilated/immotile?
  3. Left kidney/spleen - left dorsal displacement?
  4. Colon
  5. Chest - check for fluid build up
110
Q

Ddx. small intestinal non-strangulating obstructions

A
  • impactions
  • intussusceptions
  • idiopathic focal eosinophilic enteritis
111
Q

tx of ileal impactions

A
  1. Analgesia; good response
  2. Gastric decompression: rpts
  3. NPO-IVFT
  4. Sx
112
Q

ascarids assoc. w/ ileal impactions of weanlings

A

Parascaris equorum

113
Q

presentation of ascarid assoc. ileal impactions

A

weanlings

- assoc. w/ deworming –> obstruction+/- rupture

114
Q

ddx. large intestine non-strangulating obstructions

A
  1. impactions: caecal, colonic (sand)
  2. Displacements: RD/LD DLC, Pelvic flexure retroflexion, non-strang. volvulus
  3. Intussusceptions
  4. Enterolithiasis
115
Q

what tape worm is assoc. w/ caecal intussusceptions?

A

Anoplocephela perfoliata (tx. w/ praziquantel)

116
Q

CS of caecal impactions

A
  • reduced faecal output + appetite

- reduced ileocaecal flush

117
Q

sequelae of caecal impactions

A

propensity to spontaneously rupture

118
Q

compare cause and prognosis for primary vs. secondary caecal impactions

A
  1. Primary: hard/ingesta filled –> fair px

2. Secondary: fluid-filled, assoc. post-GA, pain –> guarded px

119
Q

when is sx intervention for caecal impactions indicated?

A
  1. 8-12hs after signs dt rupture risk
120
Q

risk factors for large colon impaction

A

sand, parasites, dental disease, decreased water intake, inadequate exercise, poor quality fibre, recent changes in feed, recent changes in stabling

121
Q

common sites of large colon impaction

A

pelvic flexure > dorsal colon

122
Q

medical tx for large colon impactions

A
  1. Analgesia: xylazine to examine vs flunixin to tx
  2. Light exercise: hand walking
  3. W/hold feed
  4. Intestinal lube: mineral oil/osmotic agents (magnesium sulphate), sodium sulphate
  5. IVFT/enteral isotonic salt solution
123
Q

psyllium tx protocol for sand enteropathy

A
  1. Psyllium 1g/kg daily by NGT for 3-14d in oil

2. Add MgSO4 for 4 days

124
Q

signalment for enterolithiasis

A

arabians > 5yo

  • intestinal calculi: magnesium ammonium struvite –> forms around nidus over years
  • diet high in Mg and protein + alkaline –> lucerne/QLD
125
Q

describe US supportive of LDDLC

A

skin –> spleen –> colon (no kidney)

126
Q

action of LDDLC

A

left colon rotates on axis and moves dorsally to spleen

–> can become trapped in nephrosplenic space

127
Q

risk for LDDLC

A
  • crib biting

- changes in feed

128
Q

conservative management of LDDLC

A
  • conservative: fast + IVFT + analgesia
  • shrink spleeN: phenylephrine, exercise
  • rolling under GA…
129
Q

US findings supportive of RDDLC

A

mesenteric vessels against body wall

130
Q

what % of RDDLCs need sx intervention?

A

> 50%

131
Q

what degree of torsion usu results in a non-strangulating volvulus and vasculature not compromised?

A

<180 degrees

132
Q

ddx. small intestinal strangulating obstructions

A
  • volvulus
  • mesenteric rents (inc. gastrosplenic lig)
  • epiploic foramen entrapment
  • pendunculated lipoma
  • mesodiverticular bands
  • hernias
133
Q

tx options for strangulating small intestinal obstructions

A
  • sx or euthanasia
134
Q

periparturient broodmares have a higher risk of…..

A

large intestinal volvulus

135
Q

ddx for recurrent colic

A
  • spasmodic
  • lymphoma
  • obstructions: ileal, colonic
  • adhesions
  • intussusceptions
  • EGUS
  • gastric impaction
  • enterolithiasis
  • inflam dz
  • idiopathic
  • others
136
Q

define chronic colic

A

persistent colic > 3days (w/out analgesia)

137
Q

ddx chronic colic

A
  • colon impaction
  • peritonitis
  • enterocolitis
  • colonic displacement
138
Q

predisposing factors to choke

A
  • poor dentition
  • dry feed
  • dehydration
  • sedation
  • bullying
  • rapid/glutinous feeding behaviour
139
Q

CS of choke

A
  • head/neck extension
  • retching
  • ptyalism
  • feed/saliva at nares
140
Q

areas of narrowing assoc. w/ choke

A
  1. Caudal to larynx
  2. Thoracic inlet
  3. Heart base
  4. Diaphragmatic hiatus
141
Q

management of choke

A
  1. Sedation
  2. Gentle lavage and pressure w/ head down
  3. Motility mod drugs: oxytocin (relaxes smooth muscle in oesophagus)

–> if unsuccessful: IVFT for 12-24hrs –> anaesthesia w/ cuffed nasogastric/ETT –> sx last resort

142
Q

complications of choke

A
  1. Aspiration pneumonia
  2. Repeat choke
  3. Stricture/rupture
143
Q

causes of recurrent choke

A
  • strictures
  • oesophageal dysmotility
  • other mechanical problems: diverticula, cyst, tumour, abscess
144
Q

neonatal cardiac gland disease CS

A

well foals –> sudden death

145
Q

pathogenesis of gastroduodenal ulcer disease in weanlings/late suckling foals

A

initally diffuse duodenitis –> delayed gastric emptying –> acid erosion and reflux –> pyloric stenosis –> acute colic

146
Q

CS of gastroduodenal ulcer disease in weanlings/late suckling foals

A

early/missed signs: lethargy, D+, mild colic, reduced feed intake
later: post-prandial colic, ptyliasm, bruxism, posturing, lying on back

147
Q

management of gastroduodenal ulcer disease in weanlings/late suckling foals

A
  • PPI
  • Sucralfate
  • Bethanechol
  • Nutrition/fluids
  • Analgesia (not NSAIDs…)
148
Q

risk factors assoc, w/ squamous disease

A
  • high conc. feeds/ meal eating
  • low forage
  • isolation
  • time in training
  • crib biting/radio listening
149
Q

risk factors assoc, w/ glandular disease

A
  • WBs
  • exercise >4d/wk
  • multiple handlers/riders
150
Q

squamous disease pathophys

A

inc. histamine + gastrin + acetylcholine + PGs to stim H+ secretion –> splash onto non-glandular epithelium

151
Q

dx of EGUS

A

gastroscopy only definitive way to diagnose EGUS

152
Q

squamous disease grades

A

1 - hyperkeratosis
2 - single, small ulcer
3- large, extensive, single ulcer
4 - extensive, deep, coalescing

153
Q

glandular disease classification

A
  1. Severity
  2. Location
  3. Dist: focal/multifocal/diffuse
  4. Descriptors: flat/ raised/ depressed + erythematous/fibrinonecrotis/haemorrhagic
154
Q

timing of omeprazole admin

A
  1. 8hours fasted - 30-60mins before feeding –> high plasma conc. when proton pump activation w/ feed
155
Q

what breed of horse is predisposed to gastric rupture?

A

TBs

156
Q

most common gastric neoplasia of geriatric horses

A

SCC

157
Q

CS for chronic liver dz

A
  • anorexia, decreased appetite, weight loss, lethargy
  • change in demeanour
  • photosensitive dermatitis
158
Q

early signs of HE

A

yawning, aimless wandering, mild ataxia, decreased awareness

159
Q

later signs of HE

A

head pressing, somnolence, aggressive, recumbency

160
Q

clin path indicative of liver dz

A
  1. GGT and ALP –> biliary epithelium (inducible)
  2. Bilirubin indicative of liver function - not sensitive or specific - anorexia can increased 2-3x
  3. Hepatocellular enzymes: SDH, GLDH, AST
  4. Serum bile acids –> indicative of liver function
161
Q

cause of HE

A

high levels of CSF ammonia in brain -> accum glutamine –> cytotoxic + oedema

162
Q

ddx chronic liver dz

A
  • pyrrolizidine alkaloid toxicosis
  • neoplasia
  • liver abscess
  • chronic active hepatitis
  • cholelithiasis
163
Q

location to perform a liver biopsy

A

12-15ICS btwn lines formed from tubercoxae to shoulder + elbow

164
Q

plants that cause pyrrolizidine alk tox

A
  • paterson’s curse (Echium plantagineum)
  • common heliotrope
  • rattlepod (crotalaria sp)
  • ragwort
  • cotton fireweed (senecio spp.)
165
Q

biopsy characteristics of pyrrolizidine alk. tox

A
  • megalocytosis
  • biliary hyperplasia
  • periportal fibrosis
166
Q

dietary modifications to manage chronic liver diz

A
  1. Limit protein
  2. Maintaine adequate calories
  3. Grass hay (not lucerne)
  4. Sorghum/cracked corn/beet pulp: high ratio of BCAAs: AAs
167
Q

difference w/ tx of equine HE and small animals

A

in equine you do NOT use antimicrobial to decrease ammonia producing flora as you do with dogs/cats
- in horses still use lactulose (+ mineral oil) to decreased GI absorption of digested protein

168
Q

ddx for acute liver disease

A
  1. Theilers
  2. Cholangiohepatitis (*E.coli)
  3. Bacterial: Clostridium piliformis (tyzzers), Cl.novyi B (Blacks dz)
  4. Viral: EIA, EVA, EVH-1 (neonates)
  5. Toxic: blue/green algae, mycotoxins
  6. Acute biliary obstruction: chronic right dorsal displacement vs. cholelithiasis
169
Q

signalment of theilers dz

A
  • often 4-10wks post tetanus antitoxin - assoc. w/ Flaviviridae
  • summer, autumn
  • > 2yo
  • broodmares 1-3mth post foaling
170
Q

Mortality % of theilers

A

90 - rapid hepatic failure over 2-7d

171
Q

compare primary and secondary cholangiohepatitis causes

A
  1. Primary: ascending bacterial infection from SI (E.coli)

2. Secondary: sequelae to cholelithiasis, chronic active hepatitis, hepatic neoplasia

Equine (7 decks)

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