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Equine medicine > Small intestine > Flashcards

Small intestine Flashcards

1
Q

Small intestine

A

transit time - 3h
130L fluid secreted into small inetsestine/day
BV supple; jejunum, ileum

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2
Q

what are the attachements of the SI

A

mesentery
Duodenocolic ligament
hepatodudenal ligament
Ileoceal fold

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3
Q

what is the function of the Crypts of liberkuhn

A

Stem cells at base which divide & migrate up to villi tips in 3-6 days - adapted for secretion of fluid

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4
Q

what is the function of the vili

A

mature cells with absorptive function

Injury to villi disruption of absorption but secretion continues = hypersecretion

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5
Q

what are the function of SI

A

Digestion and absorption
Movement of water accross epithelium ion gradient
Ileum has specialised functiosn - absorbs bile acids & vit B12

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6
Q

what are the motility patterns of the SI

A

Peristalsis - wave of contraction = propels GIt contents aborally
Segmentation - non -propulsive, alternating contraction & relaxation of circular muscles = mixes digestive enzymes with ingesta and provides contact with epithelial cells for absorption

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7
Q

what is the neurohormonal control of the SI

A

Enteric nervous system

Enteric endocrine system

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8
Q

what are the normal parameters for a transabdominal evaluation of SI

A 
SI wall thickness - normal  <3mm 
SI diameter; normal <3cm 
motility - constant peristalsis 
SI contents - swirling fluid 
Abor normal - sedimentation/settling
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9
Q

what is a consequence of a strangulating lesion

A

obstruction lumen blockage & compromised BV blood supple of the affect intestine = intestinal ischaemia with eventually necrosis & perforation

Conditions resulting in simultaneous occlusion of intestinal lumen and blood supply
Not responsive to treatment prompt surgical intervention needed

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10
Q

Pedunculated lipoma

A

Most common cause of strangulation lesion
older horses ==> explorative laparotomy (hypomotile and distended)
mass on the end of a stalk ==> ties knot arround the intestine - occludes the blood supply
might not be the cause of colic - need to see if it actually strangulated a piece of intestine

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11
Q

Epiploic foramen entrapment

A

Displacement of segment of SI Through small hole (foramen) that separates omental bursa from the peritoneal cavity

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12
Q

where the epiploic foramen located

A

potential 4-5cm opening into the omental bursa (R cranial abdomen)
dorsal boundary - caudal VC & caudate process of the liver
Ventral boundary - portal vein, right lobe of the pancreas & hepatoduodenal ligament

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13
Q

what are the main two types of strangulating hernias / bowel entrapment

A

umbilical

Inguinal

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14
Q

intussusception

A

invagination adjacent to bowel segement (intessuscipient)
aetiology uncertain - lesion at leading edge
- small mass, Fb, parasites
Most common site = ileocaecal

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15
Q

Si volvulus

A

SI rotates > 180 degress along its mesenteric ais - initiated by change in local peristalsis
Foals - most common SI obstruction
Confirmed at surgery - twist at cranial mesenteric artery

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16
Q

intra-abdominal adhesions

A

Response to inflammation & injury - colic surgery, intraabdominal inflammation
Mostly asymptomatic - simple obstruction due to extraluminal compression, causing ‘kinking’ of SI
strangulating obstruction - incarcerates SI

==> an important complication of colic surgery

17
Q

Non strangulating lesions

A

Conditions resulting in occlusion of intestinal lumen without initially/primarily compromising blood supply
Resulting distension can affect blood supply ==> PROGRESSIVE development of compromised mural integrity

18
Q

what are the 3 types of simple obstrcution

A

MECHANICAL - ages are important

  1. intra-luminal masses (ascaric impaction + faecal)
  2. intraluminal compression - ileal hypertrophy
  3. Extraluminal compression - (intra abdominal adhesions, mass)
19
Q

Ascarid impaction

A

Paracarius equorum
WEANING FOALS UNDER TWO YEARS OF AGE (4-24)
Cs: colic following the admin of anti-helmintic, SI obtsrcution +/- dead ascarid in reflux

20
Q

how do you treat an ascarid impaction

A

surgery - enterotomy or manually evacuate ascarid into caecum
prognosis; poor to guarded

21
Q

Ileal impact what are the risk factors, what age animals are most susceptible

A

adult horses
risk factors
- feeding coastal bermuda hey or any fine hay
failing to deworm with anthelmintic against tapeworms (A. perfoliata) ( praziquantel)

22
Q

where does a functional obstruction occur

A

Ileus
Disruption of normal propulsive GI motor activity from non-mechanical mechanism
causes/mechanism
- primary - inflammatory SI disease, ishcaemic injury
- secondary - electrolyte disorders, pain, systemic disease

23
Q

Anterior enteritis clinical syndrome

A

Inflammation & oedema of duodenum & proximal jejenum
Excess fluid & electrolyte secretion of SI
Intestinal hypersecretion & impaired motility = large volume of enterogastric reflux

24
Q

what are the main Cs associated with anterior enteritis

A

mod to severe pain oftem relieed with gastric decompression
tachycardia, tachypnoea
low grade fever
dilated SI+/- intestinal wall thicknes

25
Q

what does a peritoneal fluid analysis show in anterior enteritis

A

colour: yellow, turbid (incrrase protein and cell count) serosanguineous if severe
mild/ mod > total nucelated cell count with moderate/marked > TP conc
Higher the total protein the worst the prognosis

26
Q

what does the clinical path show in anterior enteritis

A

increased PCV/TP
normal or increased or decrease WCC
electrolyte and acid base inbalances common
secondary hepatopathy (increase liver enzymes)
SIRS (systemic inflammatory respinse syndrome

27
Q

what is the tx for anterior enteritis

A

Frequent gastric decompression
fluid/electrolyte replacement
Ab therapy - typically not recommended unless treating endotoxaemia, aspiration pneumonia or immunocomprimisedd
Anti-endotoxic therapy
Prognosis will be good with adequate supportive care

28
Q

Equine proliferative enteropathy - Lawsonia intracellularis - aetiology

A 
obligate intraccellula bacteria in cytoplasm crypt epithelial cells of jejunum and ileum 
Older foals (3-8 months) - weaning (risk factors)
29
Q

What are the clinical signs associated with equine proliferative enteropathy

A

colic, weight loss, oedema, variable faecal consitency
panhypoproteinaemia
increase SI mural thickness

30
Q

How do you diagnose equine proliferative enteropathy

A

faecal PCR - highly specific (lacks sensitivity)
ileal PCR
serum Ab
Silver staining tissue

31
Q

Inflammatory bowel disease what are the specific types

A

Granulomatous enteritis
Lymphocytic-plasmacytic enterocolitis
Mutli-systemic, esonophilic
Eosinophilic enterocolitis

32
Q

CS of Inflammatory bowel disease

A

weight loss, recureent/severe colic, oedema
+/- diarrhoea
+/- dermatitis
pathophysiolgy - interaction of multiple immune functions, lack of immunity to normal flora

33
Q

How do you treat inflammatory bowel disease

A

corticosteroid
Immune suppressants
exploratory laporotomy

34
Q

How do you diagnose inflammatory bowel disease

A

biopsy

Carbohydrate absortion test - oral glucose tolerance test (OGTT)

35
Q

Alimentary lymphosarcoma

A

neoplasia of GALT
+ progressive involvement of SI & associated LNs
minimal LI or systemic involvement
young horses (2-4 years)

36
Q

what is the clinical pathology associated with alimentary lymphosarcoma

A

Anaemia
neutrophila or neutropaenia
lymphocytosis = rare
Hypoalbuminaemia + hyperglobulinaemia

37
Q

You are presented with a weanling foal 6 months of age who has colic 3 days after the administration of an anthelmintic. The weanling has a poor deworming history
What is the most likely cause, how would you come to a diagnosis
what are your treatment options

A

Paracaris equrum impaction
dx: US
Txm - surgery ==> enterotomy or manually evacutae ascarids from caecum

38
Q

You are presented with a 7 month old foals that has just been weaned who is showing signs of colic, wieght loss, oedema and variable faecal consitency, Panhypoprotaeineam and increase SI mural thickness

What disease are you suspicous off?
what steps would you take to diagnose

A

Equine proliferative enteropathy - lawsonia intracellularis
Faecal PCR
Ileal PCR
silver staining tissue

39
Q

How would you treat a weanling with Equine proliferative enteropathy

A

A/B 2-4 weeks erythromycin, Rifampicin, chlorampenicol

supportive therapy - colloids, supportive Iv fluid therapy good nutrition

Equine medicine (9 decks)

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