Horse Flashcards
COLIC BY SIGNALMENT # AGE # REPRO STATUS # GEOGRAPHY # FEBRILE COLIC
# AGE Young - meconium impaction - atresia coli - Enteritis - Ascarid impaction, intussusception
Old
- Benign: lipoma
- Malignant: lymphoma, adenocarcinoma
- Poor dentition causing impaction
REPRO STATUS
Stallion
- Testicular torsion
- Herniation
Broodmare
- > Pregnant
- foal movement - mild colic
- foaling / abortion - vaginal discharg/open cervix
- uterine torsion - DGx rectal - Tx surg (standing flank lap / midline coeliotomy) or rolling under GA
- > Recently foaled
- uterine artery rupture - CSx mod-sev colic, CV compr - Tx sed, nsaid, tranexamic acid, blood transfusion
- dmg to uterus (tear/fluid) -> peritonitis CSx mild colic, febrile - DGx abdotap - Tx surg drainage & lavage
- dmg to GIT -> peritonitis w endotoxaemia - Tx euth
- (3 MONTHS) LARGE COLON VOLVULUS - CSx mod-sev colic, CV compr, abd distension - Tx surg emergency
GEOGRAPHY
Sand impaction - WA/SA
* DGx sea washing over sand on ausc, sand in manure
* Tx feed off ground, drench w psylium
Enterolith - WA/QLD/NSW
- obstr in LI
- Tx surg removal
HENDRA VIRUS - QLD/NSW
- Flying fox -> horse 100% death but x horse to horse -> people via blood & mucus
- CSx resp depression, ataxia, colic
- Tx vacc status, PPE
Swim colic
- severe colic within 30m of swimming
- Tx nsaids + sed + NGT OR surg
# FEBRILE COLIC Bacterial * Colitis - Clostridial / salmonella * Anterior Enteritis - Clostridial * Peritonitis (A equuli) w GI catastrophe (mixed)
Viral - Hendra
ACUTE COLITIS # Adult horses
Disruption of mucosa & normal flora -> malabsorption, hypersecretory, inflammatory
# ADULT HORSES DDx * Salmonella * Clostridial difficile / perfringens * Antimicrobials assoc * Grain overload -> diarrhoea, SIRS, laminitis * Peritonitis - GI perforation / septic / A equuli - DGx US, Abdotap * Nsaid toxicity at RDC * Mass emergence of cyathostomes
Complications
- SIRS dt endotoxaemia
- Laminits
- Thrombophlebitis
- Hypertriglyceridaemia
- Rectal prolapse
Treatment
- Isolation
- Supportive - IV fluids
- anti-inflam
- Tx laminitis - ice boots, impression material
- Anti-diarrhoea - di-tri-octahedral smectite
- Analgesia - lidocaine / butorphanol / Nsaids (except RDC)
- Anti- endotoxic - plasma, polymixinB, pentoxyfyllline, flunixine (not RDC)
Preventative
- Isolation
- Avoid mixing w cattle
- Feed roughage
- Avoid antimicrobial
ACUTE COLITIS # FOALS
# FOALS - get bacteriaemia !
DGx
- CBC & Biochem
- USx
- Faecal - salm, clos, rota, crypto, rhodo
DDx
- Salm
- Clos
- Rotavirus
- TMx carrier, foals, fomites
- malabsp + hypers -> 2ndary lactase def -> watery, yellowish/green diarrhea w/o smell
- DGx virus isolation / EM of tissue / faecal, ELISA
- Tx supp + lactase
- Crypto
- ZOONOSIS
- DGx acid fast stain of faeces
- Tx supp (self-limiting)
- Nutritional usu orphan foals - feeding Mx
- Foal heat diarrhea (first week)
- Sepsis, NE - Tx primary prob, supp
- > Older foals (6weeks - 6 months)
- Rhodococcus
- pulmonary abscess, ulcerative colitis
- DGx TTW, RG/US, faecal culture & PCR
- Tx rifampin+ macrolide, supp
- PVx hyperimmune plasma, minimise dust, separate
- Intestinal parasite
Tx
-Isolation
-IV crystalloids fluids
-Plasma
-Broadspec AM - ceph 2/3 gen, peni + aminogly + metronidazole if Clost
Gastroprotectants - omeprazole
-Anti-diarrhoea - Di-tri-octahedral smectitie, bismuth salicyalte
PVx: adequate colostrum, hygiene & biosecurity
CHRONIC DIARRHOEA
CSx
- chronic diarrhoea w wt loss
- ventral oedema
DDx
- RDC dt NSAID
- Sand enteropathy
- Cyathostomiasis
- IBD
- Alimentary lymphosarcoma
- Equine proliferative enteropathy (Lawsonia intracellularis)
CHRONIC DIARRHOEA
DDx
RDC
- Nsaid toxicity -> cox 1 inhibitor -> ulcerative colitis (RDC, stomach) & renal dz
- DGx CBC, USx
- Tx
- avoid nsaid
- fluids
- misoprostal, omeprazole, sucralfate
- low roughage
- PVx
- monitor TP
Sand enteropathy
- feed on bare ground w minimal veg -> sand accum causing inflam
- DGx ausc, sand test, RGR
- Tx
- feed off ground
- psyllium
- enterotomy
Cyathostomiasis
- DGx hypoproteinaemia, FEC
- Tx FBZ or moxi
- PVx good deworming protocol
IBD
- DGx glucose absorption test, US, biopsy, Abdotap
- Tx corts
ALS
- CSx enlarged mesenteric LN
- DGx & Tx = IBD
EPE
- dt lawsonia intracellularis in weanling foals
- DGx faecal PCR, serology, US
- Tx
- supp
- oxytet
- macrolide + rifampin
Parasitic
CSx poor hair coat, body condition, diarrhoea, ventral oedema -> colic, wt loss, failure to thrive or vague (PP)
DDx?
DDx
- large strongyles
- small strongyles
- ascarids
- cestodes
- gasterophilus / bots
- strongyloides westeri
- oxyuris equi
DGx
* Hx - what dewormer? when? FEC?
Parasite
DDx
Large strongyles / strongylus sp
- adult & larvae pathogenic
- Tx FBZ, moxidectin, ivermectin kill migrating larvae
Small strongyles / cyathostomes sp
- adult non-pathogenic but mass emergence of EL3
- Tx FBZ & moxidectin (EL3!!)
Ascarids / Parascaris equorum - YOUNG
- migratory larvae affect liver & lung + SI impaction, colic, rupture
- Tx FBZ, ML
Strongyloides westeri
- L3 in milk -> diarrhoea in foals
- Tx deworming mares
Oxyuris equi / pinworms
- eggs in anus -> irritation, rubbing
- Dx sticky tape
- Tx Broadspec anthelmintics
Dictyocaulus arnfieldi / lungworm
- ingested L2 -> lungs -> coughing
- Tx ML, avoid donkeys (carriers)
Cestodes / Anoplocephala perfoliata
- at ileocaecal valve
- DGx faecal float w saturated sugar, proglottids
- Tx praziquantel, pyrantel
Gasterophilus intestinalis / nasalis / bots
- Tx ivermectin, moxidectin, fly control
Mx of anthelmintics resistance
- Goal: Control disease, prevent resistance & pasture contamination
- FEC at ERP + 4 weeks
- Diff natural immunity -> low / mod / high contaminators
- Save refugia by deworming high shedder (>500epg) & x removing all encysted larvae
- Drug choice:
- FBZ, OxiFBZ, OxFBZ, Pyrantel - adults
- Ivermectin - unencysted larvae
=> Prevent pasture contamination - Dosing interval - Do FEC -> deworm -> FEC in 2 weeks -> should reduced by >90%
- Use effective drugs or avermectins only
- Seasonal deworming
- Reduce larval numbers by pick up manure every 3-5 days
- Education
Kidney Disease
CSx:
- PUPD / oliguria / anuria
- inapp, lethargy
AKI
- Dt ATN from toxic insult or ischaemia
- Drugs eg aminoglycosides or nsaids
- Pigment nephropathy eg Hb, Myoglobin
- Oxytet
- DGx CBC, Ux
- Tx fluids, monitor
- PVx monitor if nephrotoxic drugs, slow w fluids avoid consc days oxytet
CRD
- reduced GFR dt chronic interstitial nephritis, proliferative glomerulonephritis, pyelonephritis
- DGx CBC, Ux, US, biopsy, cystoscopy & C&S
- Tx
- fluids + salt
- diet - low protein
- pyelonephritis - prolonged ABs or nephrectomy
Haematuria
Idiopathic
- DGx by exclusion, cystoscopy, US
- Tx supp
Neoplasia
- Renal - adenocarcinoma
- Bladder - TCC, SCC
Cystic calculi
- haematuria after exercise
- DGx rectal palp, US, cystoscopy - single large spiculated CaO
- Tx - fragmentation & surg removal
- PVx - grass hay diet, urinary acidification w ammonium chloride, water + salt
Urethral haemorrahge
- haematuria at end of urination / ejaculation, haemospermia
- DGx cystoscopy
- Tx resolve, partial urethrostomy
URINARY INCONTINENCE
DDx
Cystic calculi
Sabulous urolithiasis
- dt bladder paralysis
- DGx rectal palp, US, cystoscopy
- Tx catherisation & lavage
UTI
- predisp by bladder stasis -> dysuria / stranguria / pollakiuria / incontinence
- DGx Ux C&S
- Tx ABs
Neuro
- LMN lesions dt EHV1 myelitis, cauda equina neuritis
- UMN lesions
ANAEMIA
DGx approach?
DDx for internal / external haemorrhage?
Urogenital haemorrhage - CSx? Dgx? Tx?
Haemorrhagic anaemia
- Acute blood loss - DDx? CSx? Tx?
- Chronic blood loss - DDx?
Haemolytic anaemia
- > Extravascular haemolysis
- IMHA - Cause? DGx? Tx?
- NI - Cause? DGx? Tx?
- > Intravascular haemolysis
- Heinz bodies anaemia - Cause? CSx? DGx? Tx
- Bacterial infections -> haemolysins eg Staph aureus
Inadq rbc production
-> Anaemia of chronic Dz
Urogenital haemorrhage
- Tx
- IVFT
- ABs
- NSAIDs
- Antifibrinolytic (formaline / tranexamic acid / aminocaproic acid)
- Blood transfusion - reason for & against? max volume? Formula?
JAUNDICE / HYPERBILIRUBINAEMIA
DDx
Liver Dz
# Pyrrolizidine toxicity
- cause? csx? dgx? tx?
NI
- Cause? DGx? Tx? Pvx?
- Fasting animals
- Pre / hepatic / Post
- Intravascular vs extravascular
NI
CSx Hyperbilirubinaemia, Hbaemia/uria, Inflammatory leukogram
APPROACH TO COLIC
How to manage rectal tear during rectal palp
MEDICAL COLIC
- Hypermotility
- Hypomotility -> large colon impaction
- GI ulceration
Referral
SURGICAL COLIC
- differentiate strangulation vs non-strangulation & SI vs LI -> DDx
CSx Approach Mild Moderate Severe
Rectal tear - mucosa only or + underlying structure
Hypermotility
- spasmodic colic but otherwise well
- Tx buscopan + NSAIDs
Hypomotility -> large colon impaction * CSx - reduced manure, rectal palp * DGx * Aetx diet (high carbs, low fibres), poor fluid intake, poor dentition / fibrous feed * Tx - nsaids - enteral fluid by NGT - Na bicarbs/KCl, oils, epsom salt - IV fluids - address RF -- dietary (70 fibres / 30 carbs & gradual introduction & avoid sudden change) -- intensive / no exercise -- parasitism -- lack turnover -- stress DDx: caecal impaction * CSx - sudden chg in mx, hospitalised for ortho * DGx * Tx surg
GI ulceration -> colic or PP
- CSx
- Aetx - high carbs -> acidification -> ulceration
- DGx - gastroscopy, respond to Tx
- Tx
- proton pump inhibitor - omeprazole
- H2 antagonist - ranitidine
- sucralfate - protective layer
- increase roughage/turnout
- NSAIDs induced ulceration
- by reducing blood flow to stomach & RDC
- CSx seen w GI ulceration
- Tx adequate / no nsaids, low roughage diet
Referral
- sedation & analgesia
- truck > float
- alternative, euth
SURGICAL COLIC Strangulating vs non-strangulating - CV, Abdotap SI vs LI - NGT, US, rectal => DDx * RDD vs LDD - rectal vs US (NSE) - RDD - surg - LDD - phenylbenzamine, lunging, rolling UGA
- strangulating SI vs AE
- CSx reflux (pain relief after reflux), dull, febrile, abdotap inflam
- hypomotility assoc w Clostridial, high carbs
- Tx intensive mx
- reflux to decompress
- NPO
- iv fluids
- nsaids + metronidazole
Surgical Mx
- non-strangulating
- repositioning, decompression (needle suction for gas or pelvic flexure enterotomy for evacuation)
- strangulating
- untwist & reposition, decompress check viability, resection & anastomosis
Post op Mx
IVFT, electrolytes, broadspec ABs, analgesia, gradual refeeding, hospitalise for 1 week
Complications & Tx:
* ileus - reflux, IVFT
* endotoxaemia + laminitis - IVFT, hyperimmune plasma, polymixinB, iceboots
* inflam/adhesion/stricture - good surgical technique
Discharge
* 6 weeks box 6 weeks yard -> 12 weeks for linea alba regain full strength
* complication - incisional infection - Tx drainage, ABs & C&S, nsaids
Px - RECURRENCE
LI displacement > SI R&A > LI volvulus
NEONATES
Neonatal sepsis
Neonatal encephalopathy
Uroabdomen
Neonatal sepsis
CSx
Aetx infection -> SIRS (proinflam + compensatory CARS = MARS) -> MODS
- acquired from resp, GI, omphalitis, in utero -> risk septic arthritis & osteomyelitis
Tx
* IVFT
* Intra-nasal O2
* Abs - pen/gen/amikacin
* Nutrition / Enteral feeding / plasma transfusion
* Nursing & supp care
Neonatal encephalopathy
CSx - within 72hrs - poorly coordinated suck reflex & loss affinity for mare
Aetx period of hypoxia dt dystocia / C-section / in-utero infection -> affect GI, kidney, lung
Tx
* Prevent sepsis - broadspec & FPT
* Tx seizure - diazepam / midazolam, phenobarb
* Hypothermia (32-34) to protect nerves
* NSAIDs - flunixin
* IVFT
* Intra-nasal O2
* Nutrition / enteral feeding
* Nursing & supp care & careful monitoring of GI & renal function
Uroabdomen CSx DGx * Post-renal azotaemia * USx * fluid analysis - peritoneal fluid [creatinine] > 2 x plasma [creatinine] Tx * Tx hyperkalaemia - Ca gluconate, insulin + dextrose, sodium bicarbs * Peritonael drainage * IVFT * Surgery repair -> indwelling cathere * Nursing & supp care
