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Gastroenterology large animal > Horse stuff Exam 1 > Flashcards

Horse stuff Exam 1 Flashcards

1
Q

What are some of the causes of ‘choke’?

A

Hay, pellets, cubes
Beet pulp if not moistened first
Foreign bodies
Rapid consumption of food w/o chewing

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2
Q

Where are most esophageal obstructions located?

A

Proximal eso-, just past the larynx.

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3
Q

S/S of choke

A 
Distress
Head extension
Salivation
Nasal d/c (food/saliva)
Lethargy
Dehydration
\+/- abnormal lung sounds
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4
Q

How is choke dx?

A

Hx and s/s.
Esophageal palpation
Resistance upon passage of NG tube.
+/- endoscopy or rads

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5
Q

How is choke treated?

A

Sedate 1st! (xylazine or detomidine, torb)
Gentle passage of NG tube, lavage w/ warm water. Rest and repeat.
Eso- relaxation w/ buscopan, OT, or topical lidocaine.

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6
Q

Management of choke

A

NSAIDS
Slow return to normal diet.
Deal with underlying cause, if one found.
+/- AB’s for possible aspiration pneumonia.

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7
Q

What are the 4 basic mechanisms of GI pain?

A

Distension of a viscus
Traction on mesentery
Ischemia
Inflammation

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8
Q

What are the primary questions for any colic workup?

A 
Can pain be controlled?
SI or LI?
Strangulating or non?
Sx indicated?
Prognosis?
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9
Q

What is the most common type of colic?

A

LI non-strangulating
*Gas/spasmodic
*Lg colon impaction
80-85% resolve in the field with one treatment.

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10
Q

Subtle signs of colic

A

Anorexia
Lying down more than usual
Decreased fecal output
(normal output 10-12 piles per day)

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11
Q

Signs of moderate colic

A

Pawing
Stretching
Flank watching
Abdominal distention

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12
Q

Signs of severe colic

A

Rolling
Thrashing
Becoming cast
Facial abrasions

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13
Q

Characteristics of pain

A 
Duration
Persistence
Severity
Response to analgesics
Breed and individual variability
Severe pain replaced by depression...
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14
Q

Basic questions to ask yourself when doing a rectal palpation on colic patient

A 
Distention?
SI or LI?
Gas, fluid, feed?
Masses?
GIVE BUSCOPAN 1ST
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15
Q

Colic - when should an NG tube be placed?

A

EVERY moderate to severely painful colic!
>2-3L reflux is significant.
If >5L, keep tube in.

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16
Q

Normal characteristics of abdominal fluid in horse

A

WBC 5,000-10,000 cells/uL
TP <2 g/dl
NOTE: normal fluid does not r/o strangulation.

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17
Q

Initial tx of colic

A

Analgesia w/ drugs and gastric decompression.

Fluid therapy

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18
Q

What is the maintenance fluid requirement for horses?

A

40-50ml/kg/day

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19
Q

How is EGUS diagnosed?

A

Clinical signs and response to treatment.

Can do gastroscopy, but animal must be fasted for 12-18 hours.

20
Q

What are the risk factors for equine squamous gastric disease?

A

Diet
Exercise
Environment
NSAIDs

21
Q

What is the only FDA approved product for tx of ulcers in horses?

A

Omeprazole

22
Q

Treatment of EGUS

A

Squamous disease: omeprazole 4mg/kg PO SID x 28d. Can cut dose in half if cost a concern. Or use Ranitidine 6.6mg/kg PO TID.
Glandular disease: same as above but add sucralfate and longer duration.

23
Q

What does GDUD stand for?

A

Gastroduodenal ulcer disease

24
Q

Characteristics of GDUD

A

Foals <6mo.

Possible outflow obstruction.

25
Q

Ileal impaction colic

A

Relatively common.
SI non-strangulating
Southeastern US.
Coastal bermuda grass hay or tapeworms.

26
Q

Clinical findings w/ Ileal impaction colic

A

Pain - moderate, but can be severe
Rectal - distended SI
Reflux - initially none, but may develop.
Peritoneal fluid - typically normal, possible ^ in TS, lactate similar to plasma.

27
Q

Tx of Ileal impaction colic

A 
Gastric decompression
Withhold feed/water
Analgesics, IV fluid therapy
Sx intervention if not improving within 24-36hr or abnormal peritoneal fluid.
Good to excellent prognosis.
28
Q

Cecal impaction colic

A

LI non-strangulating.
Can occur spontaneously in ANY horse
Risk factors - stall confinement, broodmare near parturition, recent general anesthesia.
RARE.

29
Q

Clinical findings Cecal impaction colic

A

Pain - mild
Reflux - typically none
Peritoneal fluid - normal
Rectal - cecal distention, feed or fluid.

30
Q

Tx of Cecal impaction colic

A 
Early ID.
Withhold food/water
Enteral laxatives
IV fluids
Rupture common and sx then required. 
Guarded prognosis, better with surgery.
31
Q

Large colon impaction colic

A

LI non-strangulating.
Typically feed and sand.
Most occur at the pelvic flexure.
COMMON.

32
Q

Risk factors of Large colon impaction colic

A 
Inadequate water intake (change in weather)
Ingestion of sand
Parasite burden
Poor dentition
Sudden stall confinement
Alternate source of pain
Coarse, poor quality roughage
33
Q

S/S of Large colon impaction colic

A

Pain - mild to moderate
Reflux - variable
Peritoneal fluid - normal
Rectal - impaction, variable gas distention
Decreased gut sounds, and absent fecal output.

34
Q

Tx of Large colon impaction colic

A 
Withhold food water.
Pain management.
Enteral fluids, lubricants/laxatives, psyllium if sand.
IV fluids if reflux develops
Px - very good.
35
Q

S/S of Small colon impaction colic

A

Colic, abdominal distention, low volume diarrhea. Often winter months.

36
Q

Dx of Small colon impaction colic

A

Via rectal small colon feels friable…?

37
Q

Tx, Px, and frequency of Small colon impaction colic

A

Tx - typically medical
Px - good
RARE.

38
Q

Enterolith colic

A

LI non-strangulating.
Magnesium ammonium phosphate (struvite) calculi within intestine.
Frequency - variable, high in CA.

39
Q

Risk factors for Enterolith colic

A

Arabians >5y
Diet high in protein
High colonic luminal pH

40
Q

S/S of Enterolith colic

A

Pain - intermittent mild to moderate.
Fluid - normal
Rectal - often normal
Radiography - lack of enterolith does not r/o.

41
Q

Tx of Enterolith colic

A

Surgical removal

Restrict alfalfa <50%

42
Q

Large colon displacement
S/S
Px
Frequency

A

S/S - similar to other non-strangulating LC obstructions.
Px - good with medical or surgical therapy.
Freq - relatively common.

43
Q

Left dorsal colon displacement

A

Nephrosplenic entrapment.
Rectal - distended colon lateral to kidney, spleen may be displaced ventrally.
U/S - gas filled colon prevent imaging of left kidney, spleen may be ventral.

44
Q

Tx of Left dorsal colon displacement

A

Phenylephrine and exercise.
Rollings under general anesthesia
Surgical correction

45
Q

Right dorsal colon displacement

A

Pelvic flexure migrates cranially (medial or lateral to cecum)
Rectal - gas distention of LC, hard to definitively dx.
Tx - fluid therapy, limited exercise, sx correction.

46
Q

SI strangulation S/S

A

Pain - acute, severe
Tachycardia >80bpm, clinical evidence of toxemia.
Hemoconcentration, PCV >50%.
Rectal - distended SI, often thickened and/or edematous.
Reflux - high volume
U/S - SI distention, possibly thick walled.
Fluid - serosanguinous, ^TP, ^WBC, ^lactate.
Relatively uncommon.

47
Q

SI strangulation Tx

A

Surgical correction - resection/anastomosis.
Px - typically good, but depends on lesion location. Poor if >50% of SI affection. Survival to d/c 80-85%.
Expensive…6-10K!

Gastroenterology large animal (2 decks)

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