Lecture 7: Approach to Heptaobiliary and Lymphatic Disease

Question 1

What are some infectious causes of impending diarrhea causing colic signs with fever

Answer 1

salmonella, clostridia, coronavirus

Question 2

what are some drug induced causes of impending diarrhea with signs of colic and fever

Answer 2

antibiotics, NSAIDS

Question 3

t or f: horses that present with colic and fever who end up having GI tract rupture/ leakage secondary to obstruction deteriorate rapidly

Answer 3

true

Question 4

uncomplicated colics such as gas colic and simple colic do not have a __

Answer 4

fever

Question 5

what are some causes of peritonitis in horses

Answer 5

post surgical leakage from GI or reproductive tract, rectal tear,GI rupture, uterine rupture, actinobacillus equuli

Question 6

how do you tx peritonitis in horses caused by post surgical tear, rectal tear, GI rupture or uterine tear

Answer 6

resolve cause, antibiotics, peritoneal lavage

Question 7

what is prognosis for peritonitis causes by leakage from GI or reproductive tract

Answer 7

poor to moderate

Question 8

what is etiology of actinobacillus equuli

Answer 8

translocation or secondary to parasite migration

Question 9

how do you tx actinobacillus equuli

Answer 9

penicillin or trimethoprim sulfamethoxazole

Question 10

what is prognosis for peritonitis caused by A. Equuli

Answer 10

excellent

Question 11

what liver enzymes are high in horses with liver diasease

Answer 11

GGT and SDH

Question 12

what are choleliths

Answer 12

stones distributed on parenchyma of liver

Question 13

how do you dx choleliths

Answer 13

ultrasound

Question 14

how do you tx choleliths

Answer 14

DMSO, antibiotics

Question 15

what is Theiler’s disease

Answer 15

acute hepatitis

Question 16

what is Theilers disease/ acute hepatitis associated with

Answer 16

parvovirus

Question 17

acute hepatitis/ theilers disease often associated with recent history of __administration

Answer 17

serum/plasma product (ex: tetanus antitoxin)

Question 18

what is the likely cause of chronic active hepatitis

Answer 18

immune mediated

Question 19

what type of cells are infiltrating in chronic active hepatitis

Answer 19

lymphocytic-plasmacytic infilatration

Question 20

how do you tx chronic active hepatitis

Answer 20

corticosteroids

Question 21

what is the etiology of pyrrolizidine alkaloid toxicity

Answer 21

cross-linking of hepatocyte DNA

Question 22

what signs are pathopnuemonic for pyrrolizidine alkaloid toxicity

Answer 22

megalocytosis, biliary hyperplasia, bridging portal fibrosis

Question 23

what would you expect the levels of GGT, indirect and direct bilirubin to be in a patient with liver disease

Answer 23

elevated

Question 24

what would you expect the levels of total protein and albumin to be in patient with liver disease

Answer 24

low

Question 25

Patient presents with colic signs, depressed, icteric, febrile, and tachycardia. Perform abdominal ultrasound. What is wrong with liver here

Answer 25

choleliths present

Question 26

What would you expect the levels of SDH and bile acids to be in patient with choleliths or liver disease

Answer 26

elevated

Question 27

patient dx with choleliths on ultrasound, you perform a liver biopsy- why perform if you already have dx

Answer 27

prognosis, culture

Question 28

what is tx plan for choleliths

Answer 28

1. Hospitalization
2. Broad spectrum antibiotics
3. IV fluids- DMSO, dextrose
4. Anti-inflammatories

Question 29

what is etiology of hepatoencephalopathy

Answer 29

failure of liver to metabolize ammonia to urea, occurs with liver dysfunction, portosystemic shunts

Question 30

what are some signs of hepatoencephalopathy

Answer 30

depression or excitement, wandering aimlessly, head pressing, increased serum ammonia

Question 31

what is tx for hepatoencephalopathy

Answer 31

1. Tx liver disease
2. Sedation
3. Dietary modifications: increased branch chain amino acids, low protein, high starch
4. Neomycin
5. Lactulose

Question 32

how does neomycin work to tx hepatoencephalopathy

Answer 32

reduces ammonia production in the GI tract

Question 33

how does lactulose work to tx hepatoencephalopathy

Answer 33

draws ammonia into the GI tract from circulation

Question 34

t or f: horses of any age can get lymphoma

Answer 34

true

Question 35

what types of lymphoma can horses get

Answer 35

B cell, T cell, T cell rich B cell

Question 36

what is the most common location for lymphoma in horses

Answer 36

intestinal

Question 37

what are some clinical signs of lymphoma in horses

Answer 37

1. Weight loss most common
2. Unthrifty
3. Recurrent fevers
4. Skin lesions

Question 38

what are some common alterations in lab work in horse with lymphoma

Answer 38

1. Anemia
2. Gammopathies
3. Paraneoplastic syndromes

Question 39

gammopathies are most common in what type of lymphoma

Answer 39

B cell

Question 40

how do you dx lymphoma

Answer 40

biopsy or necropsy

Question 41

what is prognosis for lymphoma in horses

Answer 41

poor

Question 42

what is tx for lymphoma in horses

Answer 42

corticosteroids

Question 43

how is C. Pseudotuberculosis transmitted

Answer 43

horn flies, stable flies, house flies

Question 44

what are the three presentations of C. Pseudotuberculosis in horses

Answer 44

1. External abscesses (pigeon fever)
2. Internal abscesses
3. Ulcerative lymphangitis

Question 45

what are some signs of C. Pseudotuberculosis with external abscesses

Answer 45

caseous abscesses in pectoral region, thick capsule
Lameness

Question 46

what antibiotics tx C. Pseudotuberculosis with external abscesses

Answer 46

doxycycline, fluoroquinolones, sulfonamides

Question 47

what signs are common with C. Pseudotuberculosis causing ulcerative lymphangitis

Answer 47

swollen, painful limbs, chains of nodules that abscess and ulcerated