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Module 16 Week 4 Flashcards

1
Q
A
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2
Q

What are the main mechanical disorders of the oesophagus/oral cavity in a horse?

A

persistent entrapment of the epiglottis,pharyngeal mass,tongue foreign body,tongue base neoplasia,severe temporohyoid osteoarthropathy

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3
Q

What is the main anatomical abnormality of the oesophagus/oral cavity in a horse?

A

palatoschisis

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4
Q

What are the main neurological issues of the oesophagus/oral cavity in a horse?

A

guttural pouch mycosis,guttural pouch neoplasia

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5
Q

What are the clinical signs of mechanical disorders associated with dysphagia in horses?

A

gagging + neck stretching when attempting to swallow,nasal regurgitation of feed or saliva,slow feed composition,particularly slow to eat forage

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6
Q

What diagnostic investigations should be performed in a horse with dysphagia?

A

oral examination of tongue base and ranula,palpation- retropharyngeal region and oesophagus,can a stomach tube be passed?,further imaging- endoscopy and radiography

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7
Q

What is glossitis?

A

inflammation of the tongue

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8
Q

What are the clinical signs of glossitis in horses?

A

slow chewing and deglutition

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9
Q

What are the possible DDx for glossitis in horses?

A

tongue foreign body,tongue squamous cell carcinoma,sialolith

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10
Q

What diagnostics should you do in a horse with glossitis?

A

may need to place probe,radiography and CT,histopathology to rule out neoplasia

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11
Q

What are the management strategies for glossitis in horses?

A

debridement and lavage,topical or systemic metronidazole

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12
Q

What is temporohyoid osteoarthropathy?

A

bone develops arthritis of temporohyoid joint

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13
Q

What are the clinical signs of temporohyoid osteoarthropathy in horses?

A

slow chewing and deglutition,head tilt

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14
Q

What nerve may be involved in temporohyoid osteoarthropathy in horses?

A

CN VIII

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15
Q

What diagnostics should you do in a horse with temporohyoid osteoarthropathy?

A

endoscopic assessment,decreased joint movement,radiography/CT to determine the extent

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16
Q

What are the management strategies for horses with temporohyoid osteoarthropathy?

A

conservative,ceratohyoidectomy

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17
Q

What is palatoschisis?

A

cleft palate

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18
Q

How does palatoschisis present in neonate horses?

A

difficulty nursing,aspiration pneumonia,may leak water/milk out nostrils,epiglottis rests on tongue

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19
Q

How does congenital palatoschisis occur?

A

embryonic palatal folds fuse rostral to caudal

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20
Q

What is the most common form of palatoschisis in horses?

A

caudal 1/3 to 2/3 of soft palate is most common

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21
Q

What are the clinical signs of glossopharyngeal nerve damage in horses?

A

chronic nasal discharge and slow ingestion,concurrent aspiration pneumonia,intermittent epistaxis

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22
Q

What diagnostics would you do on a horse with glossopharyngeal nerve damage?

A

endoscopy of URT and guttural pouches,assess pharyngeal sensation and coordination

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23
Q

What are possible DDx of glossopharyngeal nerve damage in horses?

A

guttural pouch masses,guttural pouch mycosis

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24
Q

What is the prognosis for glossopharyngeal nerve damage in horses?

A

variable

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25
Q

What nerve is the glossopharyngeal nerve?

A

IX

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26
Q

What is the prognosis of glossopharyngeal nerve damage due to guttural pouch mycosis?

A

guarded prognosis

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27
Q

What are the clinical signs seen with acute equine dysautonomia?

A

ptyalism,dysphagia,retrogradal peristalsis

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28
Q

What does equine dysautonomia damage?

A

enteric plexus plus cranial nerve nuclei

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29
Q

What is a cause of linear oesophageal ulceration in a horse?

A

acute grass sickness,prolonged gastric reflux

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30
Q

What is a sign of linear oesophageal ulceration in a horse?

A

extreme pain on passage of a NGT

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31
Q

What is the clinical presentation of simple oesophageal obstruction in horses?

A

bilateral nasal regurg of feed and saliva,gagging/retching/neck stretching,coughing

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32
Q

How do you diagnose a simple oesophageal obstruction in horses?

A

feed material in green nasal discharge,resentment of cranial oesophageal palpation,resistance to passage of nasogastric tube,attempts to eat followed by coughing

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33
Q

How do you manage simple oesophageal obstruction in horses?

A

nasogastric tubing,broad spec antibiotics if necessary,NSAIDs,soft diet for 7 days post relief of obstruction,thoracic radiography to determine severity if choke of >12hr duration

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34
Q

Where is a simple oesophageal obstruction most likely to be found in horses?

A

dorsal oesophagus,thoracic inlet,cardia

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35
Q

What is done when placing a NGT in a horse with a simple oesophageal obstruction?

A

heavy sedation +lavage,feed material should exit via opposite nostril,may need to do multiple attempts

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36
Q

What are the clinical signs of dorsal oesophageal obstruction in horses?

A

oedema… dyspnoea,inflammation and discomfort

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37
Q

What is the management for a horse with dorsal oesophageal obstruction?

A

difficult to pass a stomach tube so heavy sedation needed,evaluate cranioventral and caudoventral lung for aspiration pneumonia

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38
Q

What are the main complications of choke?

A

deep ulceration,circumferential mucosal damage

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39
Q

What drugs can be given to minimise acidic gastroesophageal reflux?

A

sucralfate and omeprazole

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40
Q

What can be done to prevent/manage complications of choke?

A

sucralfate and omeprazole,dietary management,complete hay replacementration,serial bougienage for fibrous strictures

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41
Q

What are the DDx for secondary oesophageal obstruction in horses?

A

pulsion diverticulum,traction diverticulum,stricture formation,persistent right aortic arch

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42
Q

How do you diagnose secondary oesophageal obstructions in horses?

A

endoscopic examination following clearance of choke with insufflation,contrast radiography may be required

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43
Q

How do you manage secondary oesophageal obstructions in horses?

A

depends of cause: pulsation vs traction,surgery likely required for full thickness mural cicatrix

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44
Q

What are the clinical signs of recurrent oesophageal obstruction in horses?

A

recurrent bouts of choke depending on size of diverticulum

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45
Q

What horses is recurrent oesophageal obstruction due to dilatation common in?

A

older ones due to poor wall tone

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46
Q

What diagnostics should you do for a horse with recurrent oesophageal obstruction?

A

endoscopy,double contrast osophagram,radiographic investigation of aspiration

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47
Q

How do you manage recurrent oesophageal obstructions in horses?

A

cervical pulsatile diverticuli can be repaired surgically,can empty manually in some horses,dietary management only for larger diverticuli at thoracic inlet

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48
Q

What are the clinical signs for oesophageal strictures?

A

regurgitation of ingesta and saliva,may be history of neck trauma/bite

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49
Q

What diagnostics should you do for a horse with oesophageal strictures?

A

endoscopy,double contrast oesophagram to determine length of lesion

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50
Q

What is the treatment option of oesophageal strictures in horse?

A

full thickness lesion requires oesophagomyotomy to release mucosa

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51
Q

What is an oesophagomyotomy?

A

separation of the outer and inner layers of the oesophageal wall

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52
Q

How should you manage a horse after an oesophagomyotomy surgery?

A

reintroduction to soft diet for 10 days,then resumption of forage,monitor for further adhesions

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53
Q

What are the clinical signs of cervical oesophageal rupture in horses?

A

swelling and pain at sites of rupture,may be draining tract,subcutaneous emphysema,cardiorespiratory compromise if mediastinitis

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54
Q

How do you diagnose cervical oesophageal rupture in horses?

A

contrast oesophagram,may release feed material if debriding

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55
Q

How do you treat cervical oesophageal rupture in horses?

A

immediate establishment of drainage to prevent mediastinitis,surgical debridement essential,placement of tube orally or tube oesophagostomy ventral to site,monitor for sepsis,treatment of local cellulitis

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56
Q

What are the clinical challenges associated with cervical oesophageal rupture in horses?

A

maintenance of nutrient intake,electrolyte balance,concurrent aspiration pneumonia,management of cellulitis,possible endotoxemia and laminitis,severe emphysema

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57
Q

What are the complications associated with cervical oesophageal rupture post surgery in horses?

A

may succum to complications of endotoxemia,recurrent choke likely post recovery,laryngeal hemiplegia due to sympathetic trunk damage

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58
Q

What is the prognosis of cervical oesophageal rupture in horses?

A

guarded

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59
Q

What are the clinical signs associated with thoracic/abdominal oesophageal rupture in horses?

A

more insidious than cervical,elevated temperature and RR,progressive septic pleural effusion

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60
Q

What diagnostics should you do for horses with thoracic/abdominal oesophageal rupture?

A

oesophageal endoscopy in unexplained pleural effusions,thoracic ultrasound,thoracocentesis and cytology

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61
Q

How do you manage thoracic/abdominal oesophageal rupture in horses?

A

hopeless prognosis,rapid diagnosis most essential feature,idiopathic muscular hypertrophy of oesophagus in some cases

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62
Q

Between which intercostal spaces is a horses stomach found?

A

37145

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63
Q

What are the clinical signs for acute gastric distension in horses?

A

acute colic,possible rupture, peritonitis and endotoxemia

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64
Q

What are the clinical signs for chronic gastric distension in horses?

A

weight loss and reduced rate of feed intake,increased water intake,recurrent mild colic,pendulous abdomen +/- ventral oedema

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65
Q

What are the clinical signs for chronic gastric inflammation in horses?

A

may be asymptomatic,progressing to acute colic,change in dietary preference

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66
Q

What are the clinical signs for chronic gastric ulcers in horses?

A

loss of performance,decreased forward movement,anterior abdominal pain

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67
Q

What is the most common gastric parasitic infection in horses?

A

gastrophilus larvae

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68
Q

What are the common causes of dysmotility in the equine GIT?

A

equine dysautonomia,acute gastric dilation,gastric impaction,chronic gastric dilation

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69
Q

What are the common causes of ulceration in the equine GIT?

A

equine gastric ulceration syndrome,perforation and rupture

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70
Q

What is the most common neoplasia in the equine GIT?

A

squamous cell carcinoma

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71
Q

What are the most common causes of inflammation in the equine GIT?

A

inflammatory polyps,glandular ulceration and gastritis

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72
Q

What are the risk factors associated with acute gastric dilation in horses?

A

feed- excess or fermentable,incorrect management

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73
Q

What are the clinical signs of acute gastric dilation in horses?

A

acute abdominal pain,spontaneous nasogastric reflux,progressive acidosis,endotoxemia

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74
Q

How do you diagnose acute gastric dilation in horses?

A

based on presentation

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75
Q

What is the treatment of acute gastric dilation in horses?

A

gastric decompression and lavage,intravenous fluid support,correction of acidosis,management of endotoxemia

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76
Q

What are the endotoxemic complications of acute gastric dilation in horses?

A

laminitis,acute renal failure

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77
Q

What are the gastric complications of acute gastric dilation in horses?

A

transient loss of motility,delayed emptying,serosal tear

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78
Q

How do you manage complications of acute gastric dilitation in horses?

A

gastroscopic assessment,risk of secondary impaction,complete pelleted ration,altered feeding frequency

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79
Q

What are the risk factors for acute gastric impaction in horses?

A

poor dentition,old age,trichobenzoars,persimmon seeds,inappropriate feeding

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80
Q

What are the clinical signs associated with acute gastric impactions in horses?

A

acute colic at presentation,endotoxemia,possible rupture

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81
Q

What diagnostics should be done in a horse with acute gastric impactions?

A

resistance to stomach tube,transcutaneous ultrasonography,gastroscopy

82
Q

What is the treatment for acute gastric impactions in horses?

A

gastric lavage- remove soluble material,continuous lavage,assess- vitals, daily gastroscopic examination, may take 3-6 days to resolve

83
Q

What is the prognosis of acute gastric impactions in horses?

A

depends on aetiology

84
Q

How do you perform a continuous lavage in horses?

A

5 l/hr as a continuous infusion via indwelling tube,position in terminal oesophagus,alternate electrolytes with water to prevent Na+ overload,daily mineral oil

85
Q

What is the suspected risk factor associated with chronic gastric impaction in horses?

A

increased in warmbloods

86
Q

What are the clinical signs associated with chronic gastric impaction in horses?

A

failure to gain weight/weight loss,change in abdominal silhouette,change in demenour,ventral oedema,acute colic +/- prior recurrent colic

87
Q

What diagnostics should be done on a horse with chronic gastric impaction in horses?

A

resistance to stomach tube,enlarged gastric outline,stomach may be palpable,gastroscopy - impaction often vertically stacked,may be up to oesophageal cardia

88
Q

What is the treatment for a horse with chronic gastric impaction in horses?

A

prolonged continuous gastric lavage,aim to empty stomach

89
Q

What management should be done for a horse with chronic gastric impaction?

A

permanent turnout,no forage other than grass,completed pelleted ration if required

90
Q

What is the prognosis for a horse with chronic gastric impaction?

A

progressive further dilation of stomach,spontaneous rupture possible,2-4 years from presentation

91
Q

What are the risk factors for squamous erosion and ulceration in horses?

A

decreased access to grazing,high intake of concentrate rations,prolonged periods without forage,intensive training at > 70% VO2max,other GI disorders,NSAIDs,crib-biting,pregnancy

92
Q

What are the clinical signs of squamous erosion and ulceration in horses?

A

loss of production,decreased feed intake,colic as severity increases

93
Q

What diagnostics can be done on a horse with squamous erosion and ulceration in horses?

A

gastroscopy,sucrose absorption may be herd screening tool

94
Q

What is the treatment for squamous erosion and ulceration in horses?

A

omeprazole,tapered dose for 2 weeks,sucralfate

95
Q

How should you manage a horse with squamous erosion and ulceration in horses?

A

increase access to forage and grazing,decrease or stop concentrate feed,decreased intensity of exercise,chaff feeds prior to exercise,reduce other stressors

96
Q

How do you prevent squamous erosion and ulceration in horses?

A

improved management to reduce risk factors, gastrogard

97
Q

What should you take into consideration when scoring squamous erosion and ulceration in horses?

A

surface area,depth,crater lesions?

98
Q

Where should you score on a horse with glandular ulceration?

A

cardia,fundus,antrum,pylorus

99
Q

What is the gross appearance of glandular ulceration in horses?

A

Erythema, flat haemorrhagic, raised haemorrhagic, flat diphtheritic, raised diphtheritic, combination.

100
Q

How do you treat glandular ulceration in horses?

A

Omeprazole, reassessment prior to reducing, sucralfate.

101
Q

What is the treatment for refractory lesions in horses?

A

Diphtheritic membrane or inflammation, doxycycline in sucralfate carrier.

102
Q

What is the treatment for inflammatory polyps?

A

Longer treatment course, lifelong management to prevent obstruction of pyloric canal.

103
Q

What are the presenting signs of equine glandular polyps?

A

Recurrent colic, weight loss, short episodes of acute pain.

104
Q

What is seen on histopath of equine glandular polyps?

A

Hyperkeratotic surface, neutrophilic inflammatory layer, more deep biopsies required.

105
Q

What is the prognosis of equine glandular polyps?

A

Depends on size and response to treatment.

106
Q

What are the main potential causes for weight loss in horses?

A

Insufficient food intake, dental disease or mouth pain, parasitism, decreased absorption of nutrients, intestinal disorders causing diarrhoea, decreased assimilation of nutrients, protein losing nephropathy.

107
Q

What is a symptom of both acute and chronic colic?

A

Weight loss.

108
Q

How to prevent colic in horses?

A

Daily routine, daily access to grass, avoid excessive grain, divide concentrate feed into >2 small meals, don’t feed from ground, 6 monthly dental exam, avoid medications unless prescribed by vet, count droppings.

109
Q

What are the causes of chronic and recurrent colic associated with the stomach of a horse?

A

Gastric ulceration, gastric dilation, pyloric outflow problem, neoplasia.

110
Q

What are the causes of chronic and recurrent colic associated with the small intestine of the horse?

A

Ascarid impaction, idiopathic focal eosinophilic gastroenteritis, mild non-strangulating infarction, inflammatory bowel disease, ileum hypertrophy, adhesions.

111
Q

What are the causes of chronic and recurrent colic associated with the large colon of the horse?

A

Impaction, sand impaction, enterolith, mild non-strangulating infarction, right dorsal colitis, granulomatous enteritis, chronic salmonellosis.

112
Q

What are the causes of chronic and recurrent colic associated with the caecum of the horse?

A

Impaction/ atony, sand, intussusception, enterolith.

113
Q

What are the causes of chronic and recurrent colic associated with the small colon/ rectum of the horse?

A

Impaction, faecolith/ foreign body, mesocolon tear, enterolith, peri-rectal abscess.

114
Q

What are the causes of chronic and recurrent colic associated with the peritoneum of the horse?

A

Adhesions, chronic peritonitis, abdominal abscesses, neoplasia.

115
Q

What are the causes of chronic and recurrent colic associated with the liver of the horse?

A

Cholelithiasis, chronic active hepatitis, echinococcosis.

116
Q

What are the causes of chronic and recurrent colic associated with the urinary system of the horse?

A

Urolithiasis, cystitis, pyelonephritis, renal haemorrhage.

117
Q

What are the presenting signs of sand enteropathy in the large colon?

A

Colic, diarrhoea, decreased borborygmi, fever, neutrophilia.

118
Q

How do you diagnose sand enteropathy in the large colon of horses?

A

Radiography is the best, US can be good for follow up, faecal sand sediment is unreliable.

119
Q

What is the treatment for sand enteropathy in the large colon of horses?

A

Daily combination of mineral oil and psyllium by nasogastric tube, IVFT, NSAIDs if required.

120
Q

What is the prognosis after sand enteropathy in the large colon of horses?

A

90% survived to discharge, 50% euthanased subsequent to surgery.

121
Q

What investigations should you do on initial visit of horses with weight loss +/- chronic colic?

A

History, clinical exam, rectal, dental exam, clinical chemistry, faecal examination + larval evaluation, abdominocentesis and cytology.

122
Q

What further tests can be done on a horse with weight loss +/- chronic colic once at the referral centre?

A

Gastroscopy +/- biopsy, abdominal US, abdominal radiography, tests of gastrointestinal motility, laparotomy +/- biopsies.

123
Q

How many hours a day would a horse voluntarily graze for?

A

14-16 hours.

124
Q

Does a horse’s stomach stretch much?

125
Q

What cells produce a continuous supply of HCL in horses?

A

Parietal cells of glandular mucosa under stimulation of histamine and gastrin.

126
Q

What buffers the HCL produced in the stomach of horses?

A

Salivary bicarbonates.

127
Q

What should you consider when trying to manage chronic colic/ weight loss in horses?

A

Lack of dietary forage, consumption of large concentrate feeds, exercise on empty stomach, high intensity exercise, crib-biting.

128
Q

How can a lack of dietary forage impact the GIT of a horse?

A

Gastric pH will continue to decrease and become more acidic which allows for breach of gastric mucosa.

129
Q

Why does consumption of large concentrate feeds impact the GIT of a horse?

A

Fermentation of high starch feeds within the stomach results in production of additional VFAs that potentiate mucosal damage; also leads to decreased saliva production therefore less bicarb is present to neutralise the acid.

130
Q

Why does exercise on an empty stomach impact the GIT of a horse?

A

Increased intra-abdominal pressure during exercise meaning gastric acid is more likely to coat the squamous mucosa.

131
Q

Why does high intensity exercise have an impact on the GIT of a horse?

A

Prolonged canter/ gallop work results in reduced mucosal blood flow resulting in a decreased capacity for pre-existing ulceration to heal.

132
Q

What are the risk factors associated with equine gastric ulcer syndrome?

A

Elite athletes, insufficient forage/ grazing, excessive dietary starch intake, concurrent illness, crib biting.

133
Q

What are the early clinical signs associated with equine gastric ulcer syndrome?

A

Reduced rate of eating, decreased interest in concentrates, discomfort on girthing, reduced coat quality, changes in performance.

134
Q

What are the later signs of equine gastric ulcer syndrome?

A

Loss of performance, poor appetite, pain after eating, reduced body condition, dullness, weight loss, lethargy, chronic colic.

135
Q

What are the treatment options for equine gastric ulcer syndrome?

A

Managemental and feeding changes, decreased exercise, stop feed concentrated, increased grazing or forage, additional alfalfa.

136
Q

What are the clinical signs of inflammatory bowel disease in horses?

A

Weight loss, low protein, colic, thickened small intestine, no diarrhoea normally.

137
Q

How do you diagnose inflammatory bowel disease in horses?

A

Intestinal biopsies via gastroscope, laparoscopic, laparotomy.

138
Q

What are the potential causes of inflammatory bowel disease?

A

Eosinophilic enteritis, MEEDS, lymphocytic-plasmacytic enteritis, lymphoma.

139
Q

What is the prognosis of inflammatory bowel disease in horses?

A

Guarded- dependent on severity of pathology.

140
Q

What are the principles of treatment of inflammatory bowel disease in horses?

A

Immunosuppressive therapy, increase nutrient and protein content to diet.

141
Q

What drug is used for immunosuppressive therapy in horses?

A

Prednisolone.

142
Q

What is the life expectancy of lymphocytic-plasmacytic IBD and lymphoma in horses?

A

6-12 months.

143
Q

What is the prognosis of eosinophilic inflammatory bowel disease in horses?

A

Better prognosis, more responsive to steroid treatment.

144
Q

What are important history questions to ask about horses with acute diarrhoea?

A

Inappetent? Change in diet or environment? Recent meds? Any other horses affected? Access to toxins or other feeds?

145
Q

What should you assess on a clinical exam of a horse with acute diarrhoea?

A

Vitals normal? Intestinal borborygmi sounds, physical evidence of diarrhoea, dehydration status, concurrent illness.

146
Q

What management should you do for a horse who is experiencing nutritional diarrhoea?

A

Replace new diet with simple soaked hay ration without concentrates and then the diarrhoea should resolve over few days.

147
Q

What are key warning signs of diarrhoea in horses suggesting that it is not nutritionally caused diarrhoea?

A

Evidence of endotoxemia, tachycardia in absence of severe colic, pyrexia, hypermotile bowel, taut taenial bands on rectal palp due to heavy fluid content in the large colon and caecum.

148
Q

What would be seen on clinical pathology of a horse with acute diarrhoea?

A

Rise in PCV and TP first, with subsequent splitting to high PCV and low TP, increase in lactate, leukopenia and neutropenia.

149
Q

What cascade leads to mucosal damage in acute colitis and typhlitis in horses?

A

Chemotaxis -> neutrophil infiltration -> superoxide regeneration -> mucosal damage.

150
Q

What are the main consequences of increased LI permeability in horses?

A

Loss of fluid and proteins from LI mucosa, absorption of endotoxin through compromised mucosa.

151
Q

What are the systemic issues that can arise due to endotoxin absorption?

A

Fulminant endotoxemia, hypoproteinaemia, electrolyte derangement, hypovolaemia, decreased cardiac output.

152
Q

What signs may be seen concurrently with acute colitis and typhlitis in horses?

A

Concurrent mucosal ulceration, infarction, serosal inflammation.

153
Q

What causes profound dehydration in acute colitis and typhlitis?

A

Hypersecretion of sodium and fluid.

154
Q

What is the result of rapid enteric protein loss in horses with acute colitis and typhlitis?

A

Low colloid oncotic pressure making it difficult to maintain hydration status.

155
Q

What is a metabolic consequence of acute colitis and typhlitis in horses?

A

Catabolism leading to very rapid weight loss.

156
Q

What is a clinical sign associated with motility in acute colitis and typhlitis?

A

Hypermotility and caecal/ colonic/ rectal pain.

157
Q

What determines the progression of endotoxemia in acute colitis and typhlitis in horses?

A

Severity of mucosal damage and endotoxin absorption.

158
Q

What complications can arise from endotoxemia in acute colitis and typhlitis in horses?

A

Neutropenia, consumption of clotting factors, fibrinolysis and thrombocytopenia, SIRS with possible progression to DIC.

159
Q

What is a chronic sequelae of severe intestinal pathology from acute colitis and endotoxemia in horses?

A

Uncontrollable endotoxin absorption and very high mortality, acute renal failure, thrombophlebitis, laminitis, DIC.

160
Q

What infectious causes of colitis mainly affect foals?

A

C. perfringens, C. piliforme, Rhodococcus equi, lawsonia intracellularis, rotavirus.

161
Q

How do diagnose acute colitis early in horses?

A

Thickened folds of oedematous colonic +/- caecal mucosa.

162
Q

What are the clinical signs associated with the early diagnosis of acute colitis in horses?

A

Lethargy, tachycardia, pyrexia, prolonged CRT, increased gut sounds.

163
Q

What is seen on clin path of a horse with early acute colitis?

A

Neutropenia, left shift, toxic changes.

164
Q

In what circumstances should a horse be placed in isolation?

A

If they have diarrhoea, without diarrhoea but with hypermotile bowel, pyrexia and neutropenia.

165
Q

How many negative samples of salmonella culture are required to prove cessation of shedding?

166
Q

What is the aetiology of right dorsal colitis in horses?

A

Causal link to administration of oral NSAIDs.

167
Q

How do NSAIDs cause right dorsal colitis in horses?

A

Local inhibition of prostaglandins reduces mucosal blood flow, lower incidence with COX 2 specific but not necessarily.

168
Q

What are the presenting signs of a horse with right dorsal colitis?

A

Pitting oedema, hypoproteinemia, soft droppings progressing to diarrhoea, necrosis of RDC may occur, haemorrhagic diarrhoea may occur.

169
Q

How do you diagnose right dorsal colitis in horses?

A

Stop NSAIDs use, US colon and caecum, evaluate clinpath and determine severity.

170
Q

What supportive care should you give to a horse with acute colitis?

171
Q

Why should you give IVFT to a horse with acute colitis?

A

To help resolve fluid deficits, electrolyte deficits, acid-base disturbances, colloid oncotic pressure.

172
Q

What 3 things should you use to estimate the volume required for IVFT of a horse with acute colitis?

A

Volume deficit, electrolyte requirement, safe replacement rate.

173
Q

Why is the removal of lipopolysaccharide absorption challenging in acute colitis of horses?

A

Removal of the source is often impossible.

174
Q

What is the recommended approach for managing reflux in anterior enteritis to prevent LPS absorption?

A

Frequent removal of reflux.

175
Q

What are some methods to prevent lipopolysaccharides in the GIT of horses?

A

High volume activated charcoal, oral dosing with liquid paraffin, biosponge.

176
Q

Why is it important to neutralise circulating lipopolysaccharides in horses?

A

To prevent the activation of inflammatory cells.

177
Q

What is a method of neutralising circulating lipopolysaccharides in horses?

A

Immunotherapy using antiserum and hyperimmune plasma.

178
Q

What can you use to bind to circulating lipopolysaccharides in horses?

A

Polymyxin B.

179
Q

What does polymyxin B do?

A

Cationic polypeptide antibiotic that binds to lipid A, low doses required, antimicrobial doses.

180
Q

What can be used to reduce lipopolysaccharide mediated inflammation in horses?

A

NSAIDs, corticosteroids, pentoxifylline, antioxidants, phospholipids.

181
Q

What is the treatment for acute laminitis?

A

Decrease digital metabolic rate as this decreases the glucose requirement, decrease MMP activity, decrease pro-inflammatory cytokine production, decrease neutrophil influx.

182
Q

What is transfaunation?

A

Transferring healthy gut microbes from the feces of a donor horse to the gastrointestinal tract of a recipient horse.

183
Q

What constitutes an ideal donor for transfaunation in horses?

A

Negative for known pathogens, good BCS with normal faecal consistency.

184
Q

How do you do faecal transfaunation in horses?

A

Fresh sample mixed with warm water, dissolved and filtered, administered via NGT up to twice daily.

185
Q

How do you manage long term colitis?

A

Fluid therapy, monitor vital parameters, clinpath parameters and ultrasound progression of mucosal inflammation, low residue diet in long term to aid mucosal healing, high fibre cubes or grass rather than hay for 6-8 weeks.

186
Q

What infectious agents have a high mortality when they cause per-acute colitis?

A

Salmonella and C. difficile.

187
Q

What are the possible sequelae to severe colitis in horses?

A

Marked weight loss, severe hypoproteinemia, thrombophlebitis, high risk of laminitis, death in high % due to overwhelming endotoxemia.

188
Q

What is classified as chronic diarrhoea in horses?

A

> 7 day duration.

189
Q

What do horses with chronic diarrhoea tend to present like?

A

Systemically healthy +/- weight loss.

190
Q

What should you investigate in a horse with chronic diarrhoea?

A
  1. Dietary evaluation, 2. Dental assessment, 3. Haem/ biochem, 4. Faecal parasitology and bacterial culture, 5. Histopathology investigation, 6. Abdominal US and peritoneal fluid analysis.
191
Q

What management changes should you make to help patients with chronic diarrhoea?

A

Correct dental or parasite problems, diet- hay rations with no concentrates for 4 weeks minimum.

192
Q

What do horses with chronic diarrhoea tend to present like?

A

Systemically healthy +/- weight loss

193
Q

What should you investigate in a horse with chronic diarrhoea?

A
  1. Dietary evaluation
  2. Dental assessment
  3. Haem/biochem
  4. Faecal parasitology and bacterial culture
  5. Histopathology investigation
  6. Abdominal US and peritoneal fluid analysis
194
Q

What management changes should you make to help patients with chronic diarrhoea?

A

Correct dental or parasite problems
Diet - hay rations with no concentrates for 4 weeks minimum
Sulphasalazine if inflammation of LI
Codeine phosphate
Faecal transfaunation

195
Q

What is codeine phosphate used for in management of chronic diarrhoea in horses?

A

Used to decrease intestinal secretions but may induce impaction colic

196
Q

How long can viral diarrhoea last in horses?

A

2 days - 6 months

197
Q

What are the clinical signs of viral diarrhoea in horses?

A

Depressed and anorexic
Dehydration
Poor thrift
Lactase deficiency

198
Q

How do you diagnose viral diarrhoea in horses?

A

Faecal antigen testing and EM

199
Q

What are common viruses that cause diarrhoea in horses?

A

Adenovirus
Coronavirus
Parvovirus

200
Q

How do you prevent transmission of rotavirus?

A

Rapid diagnosis and isolation
Effective disinfection
Minimise exposure of successive foals to diarrhoea
Subsequent vaccination in successive years

201
Q

What pathogens can cause bacterial diarrhoea?

A

E. coli
C. perfringens/difficile
Salmonella
Rhodococcus in older foals
Lawsonia intracellularis

BVMS 3 (23 decks)

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