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VMCVM GI > Horse GI Lecture 2 > Flashcards

Horse GI Lecture 2 Flashcards

1
Q

Where are the 2 places you will see ulcers in a horse due to NSAIDs?

A

1) Stomach and 2) Right Dorsal Colon

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2
Q

What do NSAIDs inhibit and as a result, cause ulcers?

A

PGE2, a constitutive/COX1 prostaglandin responsible for regulating blood flow

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3
Q

Are ulcers common in horses?

A

YES! They are far more common than we ever used to think.

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4
Q

Glandular ulcers around the pylorus are most likely due to ______.

A

NSAIDs

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5
Q

Squamous epithelial ulcers are due to ______.

A

Long periods of restricted feed

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6
Q

When and where would you see ulcers in FOALS?

A

25%-50% of sick foals in the SQUAMOUS epithelium

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7
Q

When and where would you see ulcers in ADULTS?

A

90% of Race horses; Horses in training; mostly in the squamous epithelium

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8
Q

Are squamous lesions predictive of glandular lesions?

A

NO.

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9
Q

Do ulcers cause diarrhea in adults?

A

NO

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10
Q

Do ulcers cause diarrhea in foals?

A

YES, they can

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11
Q

How do you diagnose ulcers in the horse?

A

GASTROSCOPY!

Fecal occult blood (only potentially works for dx in foals) and gastric mucosa permeability test (time) have their limitations

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12
Q

Grossly, what distinguishes acute from chronic ulcers?

A

Chronic lesions have yellow plaque-like lesions surrounding them.

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13
Q

What medications could you treat ulcers with?

A

1) Omeprazole (treat 28 days and re-check)
2) H2 blockers (multiple treatments throughout the day)
3) Sucralfate (probably not effective in treating squamous)

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14
Q

When would you use sucralfate to treat an ulcer?

A

In the GLANDULAR region. It promotes PGE2 synthesis and coats.

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15
Q

How could you treat ulcers by management?

A

1) Lifestyle: Turnout on pasture

2) ∆ Feed: Inc. Roughage and/or continuous feeding

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16
Q

Is inflammation in the stomach an emergency?

A

YES

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17
Q

Is inflammation in the upper GI tract an emergency?

A

YES

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18
Q

What are the causes of GASTRITIS?

A

1 Over-eating!!

2) Abrupt diet ∆
3) Gastric impaction
4) Delayed gastric emptying
5) 2˚ to SI Dz

19
Q

What are the causes of ULCERS?

A 
#1 Prolonged periods off feed
#2 NSAIDs
3) weaning, dz in general
4) training, breeding, showing
5) high carb diet
20
Q

What’s a major concern of grain overload?

A

Endotoxemic shock leading to laminitis and eventual Founder.

21
Q

What does gastritis look like in a horse?

A

VERY PAINFUL and VERY TOXIC. Some horses are stoic but do PE and look for toxic line!!

22
Q

What major therapy/diagnostic do you use in horses after PE?

A

NG Tube looking for Reflux!

23
Q

How do you treat gastritis?

A

NG Tube - relieve pressure, reflux and leave in place.
CHECK FOR REFLUX every 2-3 hr or when PAINFUL.
Banamine
Laminitis prevention
NO FEED 12-24 HOURS
Re-feed

24
Q

How quickly do you change diets in horses?

A

7-10 days

25
Q

How quickly can you change to pasture?

A

2-3 weeks; be cautious of LUSH pasture

26
Q

What are causes of GASTRIC IMPACTION?

A

1 Fibrous hay/feed

2) Dry pelleted feed
3) Foreign Bodies
4) Limited access to water
5) Anatomic obstruction
6) Poor dentistry

27
Q

How do you treat a gastric impaction?

A

Similar to grain overload.
No feed to impaction is resolved, reflux, fluids, fiber diet.
Identify initial cause and remove.

28
Q

What would a delayed gastric emptying look like?

A

6-8 month old FOALS. Got sick then better on milk, then weaning. Due to ulcer in duodenum or pylorus when very young and eventual stricture formation.

29
Q

Prognosis of delayed gastric emptying foals?

A

POOR

30
Q

Causes of enteritis/dpj?

A

Infectious, Dietary indiscretion, ambient heat/exercise

31
Q

What do you feel rectally for enteritis/dpj?

A

Distended SI with thickened walls

32
Q

What is key differentials between enteritis/dpj and strangulating lipoma?

A

Enteritis has a FEVER, moderately distended and some motility.
Strangulation has no fever, very dilated and NO MOTILITY.

33
Q

What would abdominocentesis show on enteritis?

A

Protein elevated

34
Q

What would abdominocentesis show on strangulating lipoma?

A

Protein AND CELLS elevated.

35
Q

How do you treat enteritis/dpj?

A

Relieve pressure, empty fluid.
Will feel better and show it.
Fluids, NSAIDs, gastroprotectants, prophylactic abx, laminitis prevention.

36
Q

How do you treat strangulating lipoma?

A

Relieve pressure, empty fluid.

They WILL NOT feel better —> SURGERY.

37
Q

What are main causes of peritonitis in horses?

A

TRAUMA, usually some form of penetration or disruption to the gut and TRANSLOCATION.
Others: ascarid migration, neonates damaged or ruptured bladder; bacterial abscesses, iatrogenic, neoplasia

38
Q

How would peritonitis present?

A

Fever, anorexic, colic mild to moderate.

39
Q

What does peritonitis feel like in horse?

A

Fibrin tags/ADHESIONS form very quickly on SEROSAL SURFACES.

40
Q

What does US show for peritonitis in horse?

A

lots of fluid in the abdomen

41
Q

What does abdominocentesis reveal for peritonitis?

A

protein, cells, +/- bacteria

42
Q

Prognosis of Peritonitis?

A

Guarded to POOR

43
Q

Treatment of severe peritonitis?

A

None recommended, very poor Px.

44
Q

Treatment of non-severe peritonitis?

A

Stabilize, identify inciting cause, remove it.
Broad Spec. Abx
Minimize inflammation and fibrin, treat endotoxemia.
Laminitis prevention.
Peritoneal LAVAGE - top to bottom drain technique

VMCVM GI (16 decks)

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