Horse GI Lecture 2 Flashcards
Where are the 2 places you will see ulcers in a horse due to NSAIDs?
1) Stomach and 2) Right Dorsal Colon
What do NSAIDs inhibit and as a result, cause ulcers?
PGE2, a constitutive/COX1 prostaglandin responsible for regulating blood flow
Are ulcers common in horses?
YES! They are far more common than we ever used to think.
Glandular ulcers around the pylorus are most likely due to ______.
NSAIDs
Squamous epithelial ulcers are due to ______.
Long periods of restricted feed
When and where would you see ulcers in FOALS?
25%-50% of sick foals in the SQUAMOUS epithelium
When and where would you see ulcers in ADULTS?
90% of Race horses; Horses in training; mostly in the squamous epithelium
Are squamous lesions predictive of glandular lesions?
NO.
Do ulcers cause diarrhea in adults?
NO
Do ulcers cause diarrhea in foals?
YES, they can
How do you diagnose ulcers in the horse?
GASTROSCOPY!
Fecal occult blood (only potentially works for dx in foals) and gastric mucosa permeability test (time) have their limitations
Grossly, what distinguishes acute from chronic ulcers?
Chronic lesions have yellow plaque-like lesions surrounding them.
What medications could you treat ulcers with?
1) Omeprazole (treat 28 days and re-check)
2) H2 blockers (multiple treatments throughout the day)
3) Sucralfate (probably not effective in treating squamous)
When would you use sucralfate to treat an ulcer?
In the GLANDULAR region. It promotes PGE2 synthesis and coats.
How could you treat ulcers by management?
1) Lifestyle: Turnout on pasture
2) ∆ Feed: Inc. Roughage and/or continuous feeding
Is inflammation in the stomach an emergency?
YES
Is inflammation in the upper GI tract an emergency?
YES
What are the causes of GASTRITIS?
1 Over-eating!!
2) Abrupt diet ∆
3) Gastric impaction
4) Delayed gastric emptying
5) 2˚ to SI Dz
What are the causes of ULCERS?
#1 Prolonged periods off feed #2 NSAIDs 3) weaning, dz in general 4) training, breeding, showing 5) high carb diet
What’s a major concern of grain overload?
Endotoxemic shock leading to laminitis and eventual Founder.
What does gastritis look like in a horse?
VERY PAINFUL and VERY TOXIC. Some horses are stoic but do PE and look for toxic line!!
What major therapy/diagnostic do you use in horses after PE?
NG Tube looking for Reflux!
How do you treat gastritis?
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
How quickly do you change diets in horses?
7-10 days
How quickly can you change to pasture?
2-3 weeks; be cautious of LUSH pasture
What are causes of GASTRIC IMPACTION?
1 Fibrous hay/feed
2) Dry pelleted feed
3) Foreign Bodies
4) Limited access to water
5) Anatomic obstruction
6) Poor dentistry
How do you treat a gastric impaction?
Similar to grain overload.
No feed to impaction is resolved, reflux, fluids, fiber diet.
Identify initial cause and remove.
What would a delayed gastric emptying look like?
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.
Prognosis of delayed gastric emptying foals?
POOR
Causes of enteritis/dpj?
Infectious, Dietary indiscretion, ambient heat/exercise
What do you feel rectally for enteritis/dpj?
Distended SI with thickened walls
What is key differentials between enteritis/dpj and strangulating lipoma?
Enteritis has a FEVER, moderately distended and some motility.
Strangulation has no fever, very dilated and NO MOTILITY.
What would abdominocentesis show on enteritis?
Protein elevated
What would abdominocentesis show on strangulating lipoma?
Protein AND CELLS elevated.
How do you treat enteritis/dpj?
Relieve pressure, empty fluid.
Will feel better and show it.
Fluids, NSAIDs, gastroprotectants, prophylactic abx, laminitis prevention.
How do you treat strangulating lipoma?
Relieve pressure, empty fluid.
They WILL NOT feel better —> SURGERY.
What are main causes of peritonitis in horses?
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
How would peritonitis present?
Fever, anorexic, colic mild to moderate.
What does peritonitis feel like in horse?
Fibrin tags/ADHESIONS form very quickly on SEROSAL SURFACES.
What does US show for peritonitis in horse?
lots of fluid in the abdomen
What does abdominocentesis reveal for peritonitis?
protein, cells, +/- bacteria
Prognosis of Peritonitis?
Guarded to POOR
Treatment of severe peritonitis?
None recommended, very poor Px.
Treatment of non-severe peritonitis?
Stabilize, identify inciting cause, remove it.
Broad Spec. Abx
Minimize inflammation and fibrin, treat endotoxemia.
Laminitis prevention.
Peritoneal LAVAGE - top to bottom drain technique
