Lecture 5: Approach to Medical Diseases of the Equine Small Intestine Flashcards
What is anterior enteritis
Inflammatory/infectious disease of the duodenum and proximal jejunum
What infections is anterior enteritis associated with
Clostridia spp, salmonella spp, or idiopathic
What is anterior enteritis characterized by
Voluminous SI secretions, functional ileus, copious gastric reflux
What is the pathophysiology of AE
- C-diff spores ingested in stomach
- Spores then pass through pylorus to the duodenum
- Proximal SI is rich in bile acids secreted the major duodenal papilla
- Spores interact with the bile and germinate into vegetative cells
- These cells then multiply, colonize, and produce toxins cause the epithelial damage and inflammation that ultimately leads to ileus and colic signs
What are the clinical characteristics of horses with Anterior enteritis
- Increase HR- due to pain from gastric distention
- Increase reflux
- Fever
What is the other primary differential when considering anterior enteritis
Strangulating SI lesion
What are some complications of anterior enteritis
Laminitis (endotoxins), arrhythmias (increase HR), ascending hepatic/pancreatic disease, peritonitis
What are the therapeutic goals for Anterior Enteritis
- Remove excess GI secretions
- Restore normal GI motility
- Maintain hydration and volume status
- Maintain electrolyte balance
- Maintain colloid osmotic pressure (20 mm Hg)
- Maintain a positive energy balance
- Prevent laminitis
- Address inflammation and endotoxemia
What is a likely cause of equine proliferation enteropathy
Law Sonia intracellularis
What age group primarily gets equine proliferative enteropathy
Weaklings (4-6 months)
What does a horse with equine proliferative enteropathy present with/like
Weight loss, unthriftiness, edema, depression, fever
How can you diagnose equine proliferative enteropathy
Clinical signs, serology, fecal PCR
What is the most common change on blood work in horses with equine proliferative enteropathy
Hypoproteinemia
What is the treatment for equine proliferative enteropathy
Long term antibiotics
What are some common comorbidities of equine proliferative enteropathy
Parasites, gastric ulcers, other infections
What are the therapeutic goals for equine proliferative enteropathy
- Eliminate organism
- Restore protein levels to normal range
- Restore volume and hydration
- Restore patient to a proper plane of nutrition
- Treat co-morbidities
- Initiate biosecurity measures
What age group does IBD occur
Any age
How do horses with IBD present
Weight loss +/- colic +/- diarrhea
What is the treatment for IBD
Corticosteroids, surgical excision, parasite control, diet
What is the prognosis for longterm survival in horses with IBD
Poor to moderate due to repeated colics and long term use of corticosteroids
What is Eosinophilic enterocolitis
Infiltration of eosinophils and lymphocytes into the mucosa of the SI and large colon
What is idiopathic focal Eosinophilic enteritis
Intramural masses or bands within the SI, possibly representing an acute, focal exacerbation of diffuse infiltrate
What is multisystemic Eosinophilic epitheliotropic disease
Infiltration of eosinophils into other tissues such as skin, lungs, and liver in addition to GIT
What is granulomatous enteritis
Infiltration of lymphocytes and macrophages most severely in ileum. Horses with granulomatous enteritis occasionally have granulomatous in other organs such as lungs and liver