IBD Flashcards
What is the dx protocol of IBD
CBC and chemistries, carb absorption test, rectal bx, abdominal US and palpation per rectum
D-xylose and glucose absorption test*
Grain test
Glucose absorption test
Norm: 85% ↑ within 2 hrs, return of baseline in 4hr
Partial malabsorption: > 15% but <85% ↑
Total malabsorption: <15% (lymphosarcoma)
Grain test
4 hr fast
Glucose elevated above 100 mg/dl @ 1 hr and remain elevated for another hr
Abdominal US
Curvilinea array
Normal SI: <3 mm
Normal LI: <7 mm
What are the results total protein?
1/2 horses have ↓ serum/ plasma protein: low albumin (globulin still produced) from loss
Rectal bx
Thickened intestine
Enlarged mesenteric LNs
Granulomatous enteritis (GE)
Diffuse lesions in the SI
In young horses
CS of GE
WL, anemic, malabsorb glucose
1/3 have diarrhea, depression, death
Dx of GE
Histopath: sheets of macros and granulomas in mucosa and submucosa
Rectal bx (50%)
Prognosis of GE
Grave, almost all die despite tx
Tx of GE
Corticosteroids, sx removal of diseased gut
Change in diet (reduce or eliminate grain)
Lymphocytic plasmacytic enterocolitis (LPE)
No predilection for breed and age
Few reported cases (<20)
LPE CS
WL +/- diarrhea or recurrent episodes of colic
Clin path: anemia and hypoalbuminemia
LPE DX
Carbohydrate test abnormal
Rectal bx: ↑ plasma and lymphoid cells in LP
LPE prognosis
LPE tx
Multisystemic eosinophilic epitheliotrophic dz (MEED)
Eosinophilic infiltration of the intestine (more large colon), skin, liver and pancreas
Young standardbred and Tbs
MEED CS
WL and often with diarrhea
Exudative dermatitis of the face, limbs and ventrum
Ulcerative coronitis, loss of chestnuts
Anemia, hypoalbuminemic, ↑ GGT
MEED dx
Carbohydrate test
Rectal bx: eosin granulomas with vasculitis and fibrinoid necrosis of intramural vessels (50% +)
MEED prognosis
MEED tx
Eosinophilic enterocolitis (IFEE and DEE)
Eosinophilic infiltrates restricted to GI tract
IFEE and DEE CS
Abdominal pain only
IFEE and DEE dx
Necropsy or exploratory celiotomy (reddened plaques of tissue)
Circumferential mural bands in S and LI
IFEE and DEE prognosis
Excellent
IFEE and DEE tx
SI: analgesic alone maybe, glucos, anthelmintics and resection of intestine containing mural bands
LI: Removal of colonic contents, partial resection
Fecal transfaunation
Restores normal bacterial flora in the gut
Fresh manure off the ground directly from cecum after euthanasia → mix with warm water and blend → strain → 2-3 L via NG intubation → once to twice a day
