Treatment options for equine weight loss: focus on GI and liver

Question 1

why is body condition scoring important when treating weight loss

Answer 1

helps establish targets
help develop treatment plan

Question 2

Describe how you treat horses with inflammatory bowel disease

Answer 2

prolonged corticosteroids therapy - dexamethasone followed by prednisolone OR dexamethasone

can use chemotherapeutic agents

Resection and anastomosis- if local disease is present

Question 3

describe the dietary management in cases of inflammatory bowel disease

Answer 3

increased fibre
add vegetable oils

Question 4

describe how proliferative enteropathy is treated in horses

Answer 4

IV oxytetracyclines for 1 week followed by doxycycline
OR
macrolide + rifampin

IVFT + colloids may be needed
NSAIDs if pyrexic (avoid steroids)

Question 5

Describe how to treat right doral colitis

Answer 5

withdrawal of NSAIDs
Prostaglandin analoges: e.g. Misoprostol

Question 6

Describe how to treat chronic sand enteropathy

Answer 6

Psyllium and Magnesium sulphate daily for 5-7 days
NSAIDs
surgical emptying if medical therapy unsuccessful
high amounts of roughage
avoid feeding from ground

Question 7

Describe how to treat liver disease in horses

Answer 7

remove instigating cause if possible- plant, bacteria, virus
supportive therapy

Question 8

List 4 supportive therapies for the liver in horses

Answer 8

Vitamin E
Milk Thistle extracts
S- adenosylmethionine
N-acetylcysteine

Question 9

How does milk thistle support the liver

Answer 9

inhibits hepatic fibrosis
encourages hepatocyte regeneration
anti-oxidant

Question 10

What should we do to the diet of a horse with liver disease

Answer 10

high carbohydrate
low protein
small frequent feedings
avoid alfalfa and legume type grass (high protein)
control fats

Question 11

what do pyrrolizidine alkaloids do in the liver

Answer 11

cause irreversible damage
- is what is in ragwort

Question 12

describe how to treat Pyrrolizidine alkaloids

Answer 12

Antifibrotic agents: help to slow/ control fibrosis in these cases
- Steroids
OR
- Colchicine

Question 13

Describe how to treat Cholangiohepatitis in horses

Answer 13

Abs- broad spec (TMPS or enrofloxacin)- ideally based on C&S
2-4 weeks of therapy often needed

Question 14

Describe how to treat Cholelithiasis in horses

Answer 14

broad spectrum antibiotics - TMPS or enrofloxacin

DMSO (chemical solvent) - can help dissolve intrabulliary sludge and stones

surgery may be required

Question 15

why do we want to give inflammatory bowel disease patients frequent deworming

Answer 15

to avoid parasite triggered inflammation