L02: Equine Gastro 2 Pt.1 (Sanchez) Flashcards
Duodenitis-Proximal Jejunitis (DPJ)
- inflamm. and stasis of the proximal segments of the small intestine
- may be due to salmonella, clostridium, or fungal toxins
- uncommon
CS of DPJ
- mod. pain which is typically relievedby gastric decompression
- low-grade fever
- dilated SI on rectal/ultrasound
- inc. TS on Ab tap
DPJ vs. strangulation
- DPJ has fever, strangulation usually doesn’t
- pain/HR decreases with gastric decompressionin DPJ
- peritoneal fluid: inc. protein in DPJ, serosanguinous in strang.
Tx of DPJ
-gastric decompression
-anti-inflammatories (NSAIDs, lidocaine)
-IV fluids
+/-abx, parenteral nutrition, prokinetics
Prognosis of DPJ
- good with supportive care
- may require sx, which doesn’t alter prog.
- complications: laminitis**, peritonitis, adhesions, cholangiohepatitis
most common types of Inflammatory bowel disease
lymphocytic-plasmocyticenterocolitis
eosinophilic, basophilic enterocolitis
CS of inflammatory bowel disease
weight loss
recurrent colic
severe colic (with eosinophilic enteritis)
edema
pathophysiology of IBD
interaction of multiple immune functions (possible lack of immunity to normal flora?)
Tx of IBD
steroids
immune suppressants
surgery for eosinophilic enterocolitis with obstruction
Infectious causes of ACUTE diarrhea in adult horses
Salmonella (most common!) Neorickettsia risticii(Potomac Horse Fever) Clostridium difficile Clostridium perfringens Larval cyathostomosis Coronavirus
Non-infectious causes of ACUTE d in adult horses
diet change* Abx* NSAIDs* blister beetle (less common) heavy metals (less common)
colitis aka
diarrhea
CS of colitis
-endotoxemia (–> fever, inc. HR/RR, toxic mm)
-dehyd.
-diarrhea (rarely hemorrhagic)
+/- colic, ventral edema
-inc. borborygmi
-recal exam: fluid-filled colon +/- cecum with variable distention
lab data assoc. with colitis
- neutropenia w/ L shift
- metabolic or lactic acidosis
- dec. Na/Cl/K/Ca
- azotemia
- dec. TP
- inc. liver enzymes
how do you test for N. risticii
whole blood PCR
how test for salmonella?
culture, PCR
how test for Clostridium Toxin?
ELISA
how test for Coronavirus?
PCR
basic tx of colitis
- crystalloid fluids for replacement + maintenance
- colloids
- oral fluid replacement for less severe cases
- bind intestinal free toxin
- ABX HAVE NO SIGNIFICANT EFFECT ON COLITIS!
endotoxin-related tx of colitis
NSAIDs (ie flunixin) Polymixin B (binds circulating free endotoxin) Digital hypothermia (preventative for laminitis!)
supportive care of colitis
ISOLATION
maintain catheter
wrap tail
perineal care
Exceptions for abx use (when to maybe use)
PHF
Clostridiosis
substantial leukopenia
peritonitis
potential sequelae from colitis
laminitis renal failure (from long term hypovolemia) thrombophlebitis cholangiohepatitis peritonitis fungal pneumonia
prevalence of salmonellosis detection influenced by:
amt. of diarrhea
method (fecal culture vs. PCR)
time of year (inc. summer and fall)
risk factors for salmonellosis
stress abx therapy change in diet sx nasogastric tubes wet/darkness GITdz
how long is salmonella shed?
1-2 months
salmonellosis prog.
good w/ earlytherapy
Neorickettsia risticii
- cause of Potomac Horse Fever
- infectious, NOTcontagious
- seasonal
- transmitted by fresh water snails and insects
CS of N. risticii
biphasic lethargy/anorexia/fever +/- colic, diarrhea
- can progress rapidly
- NOT a cause of chronic d
Dx of N. risticii
- whole blood PCR
- response to tx
Tx of N. risticii
Tetracyclines
Vax (questionable)
Prognosis good with early tx
laminitis common complication
what bacteria assoc. with antimicrobial-associated diarrhea?
Clostridium difficile
Clostridium perfringens affects young or adult horses?
foals
risk factors of Clostridiosis
- Abx
- Tubes, handling
- hospitalization
- age
- geography
Dx of Clostridiosis
Fecal toxin tests (enterotoxin, ELISA, PCR)
Fecal gram stain
Tx for Clostridiosis
Metronidazole
BioSponge (DTO-smectite) to bind toxin
Coronavirus CS
fever/anorexia/lethargy/+/- diarrhea (usually in colder months and short-lived)
trans. of coronavirus
fecal/oral
-outbreaks common
Dx/Tx of coronavirus
fecal PCR (tx = supportive)
Cantharidin CS
inc. TPR
D/lethargy/colic/sudden death
Lab data for Cantharidin
Dec. Ca**
Dec. Mg/TP
Dx of Cantharidin
detect toxin in serum, urine, or gastric contents
Infectious causes of CHRONIC diarrhea in adult horses
Salmonella
Parasites (giardia, strongyles)
Non-infectious causes of CHRONIC diarrhea in adult horses
IBD
neoplasia
sand
right dorsal colitis
fecal diagnostics for chronic diarrhea
- gross exam for parasites
- flotation/McMaster’s quantification
- direct smear
- culture
- sand sedimentation
- Gram stain
Tx of chronic diarrhea
-supportive: fluids, NSAIDs
+/- Abx for salmonella
-llarvicidal deworming
-withdraw meds
