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RUSVM LAM1 > Specific Gastro- Intestinal Diseases > Flashcards

Specific Gastro- Intestinal Diseases Flashcards

1
Q

What conditions are most frequently seen in the stomach?

A

Gastric dilation and impaction — highly fermentable feeds

Equine gastric ulcer syndrome —> can progress to stenosis

Neoplasia —SCC

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2
Q

T/F: the small intestine usually presents with strangulating disease

A

True

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3
Q

What are the non-strangulating small intestinal obstructions?

A

Ascarid inactions (often appear strangulating)
Small intestinal feed or foreign body impaction
Muscular hypertrophy
Abscess
Adhesions
Neoplasia

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4
Q

What is the signalment usually seen with ascarid impaction?

A

Young horses : weanlings/yearlings

Recent administration of very effective antheminitics

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5
Q

Clinical signs associated with small intestinal ascarid impaction?

A

Looks strangulating —> severe necrosis and inflammation by death of the worms

Toxic, shocky, moderate to severe colic

Can see worms on gastric reflux

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6
Q

What is the treatment for ascarid impaction?

A

Might required surgical intervention if complete obstruction
Severe necrosis of the small intestine is the normal

Conservative : laxatives (mineral oil) and IV fluids
Prevention: slow deworming

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7
Q

Where do small intestinal feed impactions usually occur?

A

Ileal

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8
Q

What feed is usually associated with feed impactions?

A

Bermuda gras

Fine hay particles

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9
Q

Clinical signs seen with SI feed or FB impactions?

A

Intermittent, partial, or complete obstrucion

Rectal : SI distention and can palpate impaction dorsally on the right just cranial to the cecum. As impaction progresses, it gets pulled out of reach

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10
Q

Treatment for SI feed/ FB impactions?

A

Conservative : laxatives (mineral oil), IV fluids, and analgesics

Surgical correction — post op ileus seen

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11
Q

What is the prognosis for SI feed/FB impactions?

A

Duration < 17hrs : likely to survive

Duration > 17hrs : usually die

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12
Q

What are causes of muscular hypertrophy of the SI ?

A

Primary (idiopathic)

Secondary - proximal hypertrophy associated with a distal stenosis

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13
Q

Risk factors for SI muscular hypertrophy?

A

Ileal impactions

Can be associated with tapeworms

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14
Q

Clinical signs of SI muscular hypertrophy?

A

Intermittent colic with mild to moderate pain after eating

Anorexia and weight loss

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15
Q

Treatment of SI muscular hypertrophy ?

A

If associate with tapeworms — pyrantel pamoate

Ileomyotomy
Side-to side ileocecal anastomosis (without resection)
Side-to-side jejunocecal anastomosis

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16
Q

How do abscesses cause SI obstructions?

A

Direct compression or stricture due to the abscesses or mass itself OR due to adhesions which result from the local inflammation

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17
Q

Signalment associated with abscesses resulting in SI obstructions?

A

Less than 5yrs

History of weight loss and/or unthriftiness

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18
Q

Clinical signs associated with abscesses causing SI obstrucion??

A

Depressed, anorexic, and febrile

Neutropenia with a left shift and hyperfibrogenemia

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19
Q

What do you usually see on an abdominocentesis of a horse with abscesses ?

A

Elevated protein and WBC count
Intracellular or fee of bacteria occur only rarely

Usually — strep zooepidemicus, strep equi, rhodococcus equi, and cornybacterium pseudotuberculosis

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20
Q

Treatment for abdominal abscessation?

A

Conservative : long term antibiotics are the treatment of choice — has guarded prognosis

Surgical
— removal of abscess and/or affected bowel
— marsupilaization of abscess
— by-pass affected bowel

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21
Q

T/F: adhesions can occur in either the LI or SI, but are of more significance in the SI?

A

True

SI has many hair-pin curves and tight adhesions are more likely to cause significant obstruction

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22
Q

What causes of inflammation can lead to adhesions ?

A

Infection
Foreign body
Vascular insufficiency

Peritonitis — usually resulting from microbial contamination of abdomen

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23
Q

What can peritonitis be caused by?

A

Previous abdominal surgery
Parasitic larval migration
Abdominal abscessation
Interstitial ischemia

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24
Q

Clinical signs associated with a intestinal obstruction caused by adhesions?

A

History of recurrent episodes of colic

Usually responsive to medical therapy until severe obstruction
Can have severe unresponsive pain

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25
Q

Treatment for intestinal obstrucion caused by adhesions?

A

Reception of adhesions and involved bowl
By-pass

Guarded to poor prognosis, recurrence is a major problem

26
Q

What are the two most important neoplasms of the equine abdomen?

A

Squamous cell carcinoma a

Lymphosarcoma

27
Q

What are causes of a strangulating SI obstructions?

A 
Volvulus 
Strangulating lipoma 
Internal hernia 
- epiploic foramen 
- gastrospelnic ligament 
- mesenteric defect 
External hernia 
-inguinal 
-umbilical 
-diaphragmatic 
Intussusception
28
Q

Signalment associated with SI volvulus?

A

<3yrs

If <1yr, associated with change in diet or ascarid infection

29
Q

SI volvulus may be secondary to other conditions that result in a fulcrum. What are some of these conditons>?

A

Mesodiverticuar bands (embryonic remnant of vitelline circulation)

Meckel’s diverticulum (embryonic remnant of omphalomesenteric duct)
Adhesions
Hernias— inguinal, mesenteric

30
Q

Signalment associated with strangulating lipoma?

A

Older horse > 9-10yrs

Peducutated - fat masses on the end of a fibrovascular stock

31
Q

What are the boundaries of the epiploic foramen?

A

Dorsal: caudate lobe of the liver and vena cava

Ventral: right lobe of the pancreas, gastropancreatic fold and portal vein

Cranial: hepatoduodenal ligament

Caudal : intersection of the pancreas and mesodudodenum

32
Q

What are two mechanisms that epiploic foramen entrapment can occur?

A

Right to left passage of intestine from right of midline through foramen into the omental bursa

Left to right passage of bowel ruptures the omentum and pushes through the foramen

33
Q

What are risk factors for epiploic foramen entrapment?

A

Older horse: reduction in size of liver results in enlargement of space

Cribbing

34
Q

Clinical signs of epiploic foramen entrapment?

A

Rectal exam
SI distention with fewer loops than you would expect

Peritoneal fluid can be misleading — only abnormal isn 56% of cases

35
Q

What is the treatment for epiploic foramen entrapment?

A

Surgical correction

But can result in immediate death of the horse (particular complicating factor for this surgery) —> due to inflammation, local damage, and necrosis you can have rupture of the caudal cava or portal vein

36
Q

Where is the gastrosplenic ligament located?

A

From left part of greater curvature of the stomach t the hilus of the spleen

37
Q

With gastrosplenic ligament entrapment, which part of the SI is usually trapped?

A

Distal jejunum and ileum

38
Q

What is the signalment fo inguinal hernias?

A

Newborn colts

Breeding stallions: usually after breeding or significant physical exertion

Standardbreds, saddlebreds, and Tennessee walkers

39
Q

Clinical signs of inguinal hernia?

A

Usually unilateral and indirect in stallions (within vaginal tunic)

Newborns
Indirect — reducible, non-painful
Direct (outside the vaginal tunic, in SQ tissue, passing through rent in peritoneum or fascia)
Acute and painful

Rectal palpation— intestine through vaginal ring

40
Q

What are predisposing factors for umbilical hernias?

A

Manual breaking of the umbilical cord
Umbilical infection
Excessive straining
Ligation of cord

41
Q

When are umbilical hernias in need of surgical correction?

A

If there is increase in size of hernia
If presence of firmness, warmth, edema
If presence of pain on palpation of the area

42
Q

What are causes of diaphragmatic hernias ?

A

Congenital

Trauma

Increased intraabomdinal pressure: blow, parturition, severe GI distention or strenuous exercises

43
Q

T/F: horses usually present only with GI signs with diaphragmatic hernias, respiratory dysfunction is not commonly seen

A

True

44
Q

What are predisposing causes to intussusception?

A 
Dietary change
Heavy ascarid infection 
Enteritis 
Previous SI surgery 
Anthelmitic administration 
Tapeworm infestation 
Intramural tumors 
Obstruction secondary to foreign body— luminal polyp
45
Q

T/F: intussusception is more common in older horses

A

False usually <3yrs

46
Q

What portion of the intestine is most frequently involved in intussusception?

A

Ileum and ileocecal junction

47
Q

The subacute form of intussusception is associated with what clinical sign in foals?

A

Diarrhea

48
Q

Why would peritoneal fluid changes not reflect the degree of necrosis caused by intussusception ?

A

Because the “dead” bowl is inside another piece of bowel and isolated from peritoneal cavity

49
Q

What inflammatory disease is a major differential for what appears to be a strangulating lesion of the SI?

A

Dudodenitis proximal jejunitis (DPJ)

50
Q

What are the disease characteristics of duodentitis proximal jejunitis (DPJ) ?

A

Inflammation and edema of the duodenum and variably the stomach and jejunum

51
Q

Signalment associated with DPJ?

A

Mostly adults especially those on a high plain of nutrition

52
Q

What bacteria is thought to be involved with DPJ?

A

Salmonella and or clostridia (c.difficile)

53
Q

Clinical signs seen with DPJ?

A

Moderate to severe pain with copious amounts of NG reflux, often with orange-brown fetid odor

Initial volumes may reach 12-16L

Pain usually subsides after decompression but most horses remain depressed

54
Q

Abdominocentesis results that could indicate DPJ?

A

Increased TP
Mild to moderate WBC

Fluid yellow-turbid, in severe cases RBC might be present

55
Q

What are the two major components of therapy for DPJ?

A

Gastric decompression — every 1-2hrs

Fluid administration — CV support

56
Q

You want to give your DPJ horse something to treat endotoxemia .. what can you administer?

A

Polymixin B or endoserum
Lidocaine
DMSO

NSAIDS — flunixin

57
Q

T/F: we give DPJ horse antibiotics as part of their therapy to treat the enteritis

A

False

—given to cover systemic effects of altered mucosa
Use penicillin due to possible association of clostridum

58
Q

T/F: motility drugs are used in cases of DPJ?

A

True
In cases of persistent reflux
IV lidocaine

59
Q

Common complications assoicated with DPJ ?

A 
Peritonitis 
Myocardial and renal infarction 
Aspiration pneumonia 
Adhesions of small intestine 
Laminitis
60
Q

What is usually responsible for thromboembolic injury resulting in necrotic, comprised bowel segments ?

A

Large strongly —> cranial mesenteric arteries

Vasculitis, purpura and DIC can also result in thrombosis

RUSVM LAM1 (17 decks)

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