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Year 4 equine > Other GI Disease > Flashcards

Other GI Disease Flashcards

1
Q

What is the common name for equine dysautonomias

A

Grass sickness

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2
Q

What is the highest age of incidence for grass sickness

A

2-7 years

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3
Q

What are the 3 categories of grass sickness

A

Acute - die rapidly
Sub-acute - survive 2-7 days
Chronic - survive >7 days

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4
Q

Risk factors for grass sickness

A

Stress
Mechanical dropping removal
Good-fat bcs
Frequent worming
Cool (7-11°c) dry weather
History on premises

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5
Q

Signs of acute grass sickness

A

Severe gut paralysis (acute colic)
Difficultly swallowing
NG reflux
Drooling
Mucous coated hard faeces
Tachycardia
Muscle tremors

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6
Q

Signs of sub-acute grass sickness

A

Difficultly swallowing
Mild-mod colic
Rapid weight loss
Sweating/muscle tremors
Severely depressed
May eat small amounts

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7
Q

Signs of chronic grass sickness

A

Mild/intermittent colic
Reduced appetite
Some difficulty eating
Rapid and severe weightloss

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8
Q

Diagnostic tests for grass sickness

A

Ileal biopsy - requires laparotomy
Rectal biopsy - sensitivity lower than ileal
Phenylephrine test - topical application to one eye (positive reversal of ptosis)
Oesophageal endoscopy - linear ulcers possible

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9
Q

Treatment for grass sickness

A

Nursing care
- feeding every 30-60 mins
- hand grazing
- diazepam (appetite stimulation)
-grooming/horse access/steam therapy
Analgesia
Prokinetics
- cisapride
- neostigmine

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10
Q

Dietary causes of choke

A

Legume contamination with pizoctonia leguminicola
Oral PBTZ with clembuterol

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11
Q

Clinical signs of choke

A

Regurgitation
Ptyalism
Pysphagia
Coughing
Anxiety
Repeated extension of head an neck

Others
Distension of left jugular furrow
Crepitus
Dehydration
Abnormal respiratory pattern
Fever

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12
Q

Morphological causes of choke

A

Malformation/injury/oedema (pharynx, larynx and oesophagus)
Pharyngeal disorders (abscess, cicatrix, inflammation)
Laryngeal disorders (epiglottic cysts, RDP arch)
Palate disorders (DDSP, cleft palate)
Guttural pouch (tympany ans empyema)
Oesophageal (obstruction and diverticular)
Teeth (root abscesses, broken teeth, abnormal wear)
Glossitis (FB)
Stomatitis (ulcerative, vesicular, bacterial)
Temporohyoid OA
Temporomandibular osteopathy

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13
Q

Functional abnormalities causing choke

A

Infection (rabies, viral encephalitis, verminous encephalitis and EPM, botulism, tetanus, meningitis)
CNS (cerebral damage/oedema, brainstem haemorrhage)
CNS masses (cholesteroloma)
Toxic (lead poisoning, yellow star thistle, hepatoencephalopathy)
Other (polyneuritis, grass sickness, thosteoarthropathy, gutteral pouch disease, petrous temporal bone)

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14
Q

Diagnostics for choke

A

Palpation of neck and thoracic inlet
Oral exam
Thoracic exam
NG intubation
Clinical pathology

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15
Q

What support is needed for spontaneous resolution of choke

A

Remove feed and water
IV fluids
Analgesia
Sedation
Oxytocin (for proximal obstruction)

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16
Q

What support is needed for assisted resolution of choke

A

Oesophageal lavage and drainage
-sedate and maintain head below thoracic inlet
Aggressive oesophageal lavage
- cuffed nasotracheal/nasoeosophageal tube
- standing or GA (minimizes aspiration)

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17
Q

Oesophagostomy management of choke

A

Incision 5cm distal to lesion with indwelling tube into stomach

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18
Q

Complications of oesophagostomy

A

Laryngeal hemiplegia
Aspiration pneumonia
Oesophageal ulcer
Oesophageal stricture
Megaesophagus
Diverticula
Oesophageal rupture

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19
Q

What is SIRS

A

A self amplifying dysregulated systemic inflammatory response

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20
Q

Triggers of SIRS

A

Bacterial toxins
Staphylococcus aureus
Lipopolysaccharide derived from G-ve bacteria
Burns
Neoplasia

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21
Q

Difference between sepsis, severe sepsis and septic shock

A

Sepsis = SIRS plus culture proven infection
Severe sepsis = sepsis with organ hypoperfusion or dysfunction
Septic shock = severe sepsis with systemic hypotension

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22
Q

What is Multi-organ dysfunction syndrome

A

Altered organ function in an actually ill animal, hemostasis is not maintained without intervention.
Primary = caused by a well defined insult
Secondary= organ failure as a consequence of host response

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23
Q

Definition of DIC

A

Disseminated intravascular coagulopathy

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24
Q

DIC pathology

A

Activation of coagulation with microvascular clotting, haemorrhagic diathesis and procoagulant consumption

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25
Clinical signs of DIC
In large usually thrombosis Also petechial haemorrhage Bleeding following trauma
26
Diagnosis for DIC?? (3 out of 5 of)
Thrombocytopenia Prolonged prothrombin time Prolonged activated partial thromboplastin time Increased fibrin degradation products Decreased antithrombin 3
27
Common name for Gasterophilus spp
Bot fly
28
What is the lifecycle of Parascaris quorum nearly identical to
That if ascaris suum
29
At what age do ascarids cause disease
Under 2 years
30
Prevalence of Parascaris equorum
10-50%
31
Diagnosis of Parascaris equorum
Coughing and nasal discharge Poor coat, weight gain, dull, anorexic Occasionally colic Disorders of bone and tendon
32
Treatment of Parascaris equorum
Avermectins Pyrantel (Can survive 10 years on pasture)
33
Test for oxyuris equi
Sellotape test on anus
34
Treatment of oxyuris equi
All anthelmintics effective Topical or systemic anti-inflammatories for pruritis Keep clean
35
Most important equine parasite
Cyathostomiasis
36
Diagnosis of strongylus vulgaris
Thrombi on rectal palpation Faecal analysis (not always able to tell from other strongyles)
37
Treatment for strongylus vulgaris
Benzimidazoles and avermectins Faeces removal Avoid overgrazing
38
What type of strongyle is S edentatus
Hepatoperitoneal
39
What type of strongyle is S equinus
Hepatopancreatic (do not enter blood vessels like others)
40
Risk factors for gastric disease
Lack of water Lack of forage High carbohydrate diets High stress Pain focuses
41
Clinical signs of gastric disease
Colic signs Weight loss Bucking/rearing under saddle Resentment of girthing and leg aids Poor performance Temperament changes
42
Preparation for scoping
Withhold food 12 hours and water 4 Sedate - Dom/torb, nose twitch can be useful in addition 3 people - hold horse, pass endoscope, control endoscope
43
Descriptions of gastric lesions
0 - epithelium intact with no hyperkeratosis 1 - mucosa intact but areas of hyperkeratosis 2 - small single/multifocal lesions 3 - large single or extensive superficial lesions 4 - extensive lesions with areas of deep ulceration
44
Treatment for squamous gastric ulceration
Oral Omeprazole 4mg/kg +/- oral sucralfate (10-40mg/kg/
45
Treatment for glandular ulceration
Oral misoprostal 5mcg/kg +/- oral sucralfate (10-40mg/kg)
46
Optional treatment for squamous/glandular ulceration
Long acting injectable Omeprazole 4mg/kg once a week IM
47
Management of horses with gastric disease
Forage ad lib Reduce stress Eliminate carbohydrates Supplements - limited evidence (pectin and lecithin growing in evidence) Oral Omeprazole 1mg/kg can be used long term and is fei but not bha legal
48
Types of liver disease
Colangiohepatitis Toxic hepatitis Viral hepatitis Choleliths
49
Common blood work findings for intestinal/liver disease
WBC - normally low Anaemia Proteins - hyperglobulinemia, hypoalbuminemia Fibrinogen, SAA, globulins Liver values - SDH, GGT, AST, bile acids Creatinine, Na, K, Ca +/- phosphorus
50
Common ultrasonographic findings with intestinal/liver enteropathy
SI wall thickness - reduced absorptive capacity >4mm LI wall thickness - abnormal >6mm Liver - sharpness of edges, echogenicity, masses, gas shadowing Peritoneal fluid - anechoic viscous Masses - round, lobulated with varying echogenicity
51
Common findings on abdominocentesis
Colour - turbid, serosanguinous, green/dark Protein - abnormal >30g/L (inflammation/infection) Lactate - abnormal >2.5mmol/L - intestinal ischemia >double systemic Abdominal glucose >2.8mmol/L
52
Intestinal function test
Glucose absorption Serial blood tests after nasogastric infiltration of sugar Elevation in 90-120 mins should be >85% normal
53
Granulomatous enteritis LEARN
Cs - weight loss, anorexia, skin lesions on coronet Low albumin Anaemia Abnormal glucose absorption Good correlation with rectal biopsy
54
Lymphocytic enterocolitis LEARN
Cs - weightloss +/- low albumin Normal blood Abnormal glucose absorption Unreliable on biopsy
55
Foal eosinophilic enteritis LEARN
Cs - colic, weightloss (rare) Normal albumin Normal blood work Glucose absorption+/- Focal full thickness biopsy, no rectal
56
MEED - LEARN
Cs - weightloss, skin lesions, liver disease Albumin - normal initially, low in advanced Blood - normal, anaemia, high GGT Glucose absorption - LI>SI 50% biopsies on rectal
57
Intestinal lymphoma LEARN
Cs- weight loss, mild colic, diarrhoea Low albumin Anaemia Generally abnormal glucose absorption Full thickness rectal or duodenal biopsy
58
How to diagnose proliferative enteropathy
Faecal PCR for L. intracellularis Chronic - biopsy, PCR and histo with silver staining
59
How to diagnose chronic salmonella
PCR and enriched culture
60
How to diagnose sand enteropathy
Sedimentation test - low sensitivity
61
What does SDH (sorbitol DH) measure
Liver specific hepatocellular enzyme Low stability >4 hours
62
What does AST show
Hepatocellular enzyme marking muscle +++ RBCs and kidney Need to interpret with muscle and liver enzymes
63
What does GGT show
Biliary duct enzymes with reproductive, urinary, pancreas - local elevation but not systemic Takes longer to reduce after insult
64
What is ALP
Biliary duct enzyme 80% liver, 20% bone Non specific Elevation in growing foals and horses with fractures
65
Bile acids use
Liver specific function test higher in hepatobiliary than hepatocellular - moderate to severe dysfunction needed to elevate
66
Use of bilirubin
Liver specific function test - total of little value, anorexia, haemolysis, liver disease. Driven in acute masses >170umol/L. Chronic = mild elevation
67
Where is a liver biopsy taken
14-15 ics right side
68
Likely findings on liver histopathology
Toxins -pyrrolizidine causes megalocytosis, hyperplasia and fibrosis - mycotoxins, severe hepatic necrosis - iron supplements, hepatic necrosis, haemochromatosis
69
Likely bacterial and viral culture from liver biopsy
Clostridium piliforme (foal 1w-2m) Klebsiella, E.coli, salmonella in ascending cholangiohepatitis Viral - equine parvovirus-hepatitis virus (EaPV-H)
70
What types of worm are anoplocephala perfoliate/magna
Equine tapeworm
71
Clinical signs of anoplocephala perfoliate/ magna
Colic (various types) Diarrhoea
72
Diagnosis of anoplocephala perfoliate/ magna
Blood test Saliva test Elisa - for groups only
73
Treatment/prevention of anoplocephala perfoliate/manga
High dose Pyrantel and praziquantal - treat in autumn/winter
74
What dose strongylus vulgaris cause
Large strongyle causing verminous arteritis due to travel through mesenteric arteries
75
Clinical signs of strongylus vulgaris
Colic Diarrhoea Anorexia thrombi at aorto-illiac junction Ischaemic
76
Diagnosis of cyathostomiasis
Difficult as PPP disease, history and clinical signs important (young/poor worming history) Larvae on glove after rectal IgG Elisa
77
Disease of cyathostomiasis
Acute larval cyathostomiasis seen in spring - mucosal damage - colic - weight loss - diarrhoea acute/chronic - wasting/death Autumn - larva entering intestinal wall - colic - diarrhoea (due to inflammation)
78
Treatment of clinical parasite cases
Moxidectin for larval cyathostomiasis Pyrantel for high Parascaris burden Praziquantal or double Pyrantel for anaplocephala
79
How to avoid larval cyathostomiasis
Strategic anthelmintic use Pasture management - faecal collection Pasture rotation Grazing with ruminants Dung heap away from grazing area

Year 4 equine (20 decks)

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