IBD

Question 1

What is the dx protocol of IBD

Answer 1

CBC and chemistries, carb absorption test, rectal bx, abdominal US and palpation per rectum
D-xylose and glucose absorption test*
Grain test

Question 2

Glucose absorption test

Answer 2

Norm: 85% ↑ within 2 hrs, return of baseline in 4hr
Partial malabsorption: > 15% but <85% ↑
Total malabsorption: <15% (lymphosarcoma)

Question 3

Grain test

Answer 3

4 hr fast
Glucose elevated above 100 mg/dl @ 1 hr and remain elevated for another hr

Question 4

Abdominal US

Answer 4

Curvilinea array
Normal SI: <3 mm
Normal LI: <7 mm

Question 5

What are the results total protein?

Answer 5

1/2 horses have ↓ serum/ plasma protein: low albumin (globulin still produced) from loss

Question 6

Rectal bx

Answer 6

Thickened intestine
Enlarged mesenteric LNs

Question 7

Granulomatous enteritis (GE)

Answer 7

Diffuse lesions in the SI
In young horses

Question 8

CS of GE

Answer 8

WL, anemic, malabsorb glucose
1/3 have diarrhea, depression, death

Question 9

Dx of GE

Answer 9

Histopath: sheets of macros and granulomas in mucosa and submucosa
Rectal bx (50%)

Question 10

Prognosis of GE

Answer 10

Grave, almost all die despite tx

Question 11

Tx of GE

Answer 11

Corticosteroids, sx removal of diseased gut
Change in diet (reduce or eliminate grain)

Question 12

Lymphocytic plasmacytic enterocolitis (LPE)

Answer 12

No predilection for breed and age
Few reported cases (<20)

Question 13

LPE CS

Answer 13

WL +/- diarrhea or recurrent episodes of colic
Clin path: anemia and hypoalbuminemia

Question 14

LPE DX

Answer 14

Carbohydrate test abnormal
Rectal bx: ↑ plasma and lymphoid cells in LP

Question 15

LPE prognosis

Question 16

LPE tx

Question 17

Multisystemic eosinophilic epitheliotrophic dz (MEED)

Answer 17

Eosinophilic infiltration of the intestine (more large colon), skin, liver and pancreas
Young standardbred and Tbs

Question 18

MEED CS

Answer 18

WL and often with diarrhea
Exudative dermatitis of the face, limbs and ventrum
Ulcerative coronitis, loss of chestnuts
Anemia, hypoalbuminemic, ↑ GGT

Question 19

MEED dx

Answer 19

Carbohydrate test
Rectal bx: eosin granulomas with vasculitis and fibrinoid necrosis of intramural vessels (50% +)

Question 20

MEED prognosis

Question 21

MEED tx

Question 22

Eosinophilic enterocolitis (IFEE and DEE)

Answer 22

Eosinophilic infiltrates restricted to GI tract

Question 23

IFEE and DEE CS

Answer 23

Abdominal pain only

Question 24

IFEE and DEE dx

Answer 24

Necropsy or exploratory celiotomy (reddened plaques of tissue)
Circumferential mural bands in S and LI

Question 25

IFEE and DEE prognosis

Answer 25

Excellent

Question 26

IFEE and DEE tx

Answer 26

SI: analgesic alone maybe, glucos, anthelmintics and resection of intestine containing mural bands
LI: Removal of colonic contents, partial resection

Question 27

Fecal transfaunation

Answer 27

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