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Equine Medicine > Unit 2 - GI Lesions > Flashcards

Unit 2 - GI Lesions Flashcards

1
Q

What are the clinical signs of peritonitis?

A

fever, anorexia, ileus, endotoxemia, and mild colic

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2
Q

How is peritonitis diagnosed?

A

via abdominocentesis - fluid abnormalities and culture

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3
Q

How is peritonitis treated?

A

Broad spectrum antimicrobials, abdominal lavage, manage endotoxemia, and exploratory celiotomy

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4
Q

What gastric lesions can horses get?

A

Gastric impaction, gastric dilation and rupture, pyloric stenosis and outflow obstructions, and Equine gastric ulcer syndrome (EGUS)

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5
Q

What are the two types of gastric impaction?

A

primary or secondary

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6
Q

What can cause gastric impaction?

A

overfeeding/overeating - grain overload and leaves

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7
Q

How is gastric impaction treated?

A

Gastric lavage via NG tube, coke

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8
Q

What is the prognosis for gastric impaction?

A

good

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9
Q

At what volume can the adult equine stomach rupture?

A

5 gallons (19L)

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10
Q

What ‘tool’ is very important to prevent gastric rupture?

A

an NG tube

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11
Q

What can cause gastric rupture?

A

Dilation with gas or solids - causes pressure necrosis

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12
Q

What privides pain relief in gastric rupture cases?

A

relief of pressure

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13
Q

Over time, what can happen if a gastric rupture is not caught?

A

endotoxemia and death

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14
Q

How is gastric rupture diagnosed?

A

abdominocentesis

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15
Q

What is the prognosis for gastric rupture?

A

grave

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16
Q

What are some non-strangulating lesions of the small intestine?

A

Spasmodic (gas), ileal impaction, duodenitis-proximal jejunitis, ascarid impaction, muscular hypertrophy of the ileum, gastroduodenal obstruction, intestinal inflammation and fibrosis, and neoplasia

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17
Q

What are some strangulating lesions of the small intestine?

A

Pedunculated lipoma, volvulus, epiploid foramen entrapment, gastrosplenic ligament entrapment, intussussception, mesenteric rents, inguinal/umbilical/diaphragmatic hernia, intussussception, viteline anomalies

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18
Q

What is the most common cause of colic?

A

gas/spasmodic colic

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19
Q

Where does gas/spasmodic colic localize?

A

it can be in any part of the intestine

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20
Q

What clinical signs are associated with gas/spasmodic colic?

A

mild to moderate signs of colic with few abnormalities on physical or colic examination

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21
Q

How is gas/spasmodic colic treated?

A

pain control, hand walking

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22
Q

What is the prognosis for gas/spasmodic colic?

A

good to excellent

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23
Q

How will a small intestinal obstruction feel on palpation?

A

Turgid, distended small intestine - the small intesine will also be in abnormal areas

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24
Q

How will small intestinal obstruction look on ultrasound?

A

No motility, anechoic or stratified ingesta, some normal small intestine may be visible, and intestinal wall thickness may be normal in acute cases and increase with time

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25
Q

What is the etiollogic cause of ileal impaction?

A

Coastal Bermuda grass hay

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26
Q

Where is Coastal Bermuda grass hay a risk factor?

A

in the southern US

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27
Q

What signs are associated with ileal impaction?

A

Mild to severe abdominal pain, elevated HR, decreased borborygmi, dehydreation, gastric reflux

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28
Q

What will ileal impaction feel like on rectal palpation?

A

distended SI, palpable impaction

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29
Q

What will the peritoneal fluid be like in cases of ileal impaction?

A

Normal color, normal or elevated protein

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30
Q

How is ileal impaction treated?

A

Analgesics, IV fluids, mineral oil, surgical correction may be required

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31
Q

What is the prognosis of ileal impaction?

A

guarded to good

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32
Q

What is duodenitis-proximal jejunitis(DPJ) also known as?

A

proximal enteritis or anterior enteritis

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33
Q

What is DPJ?

A

hemorrhagic necrotizing duodenitis and proximal jejunitis

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34
Q

What is the etiology of DPJ?

A

Unknown - salmonellosis, clostridia, sudden feed changes

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35
Q

Where is DPJ a risk factor?

A

Southeast, Ohio River Valley, and East Coast of the US

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36
Q

What are the clinical signs associated with DPJ?

A

Mild to severe colic, depression, blood-tinged gastric reflux, febrile, inflammatory leukogram

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37
Q

What will the SI feel like on rectal palpation?

A

mild to moderate distension of the SI

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38
Q

What will the peritoneal fluid be like in cases of DPJ?

A

elevated protein, normal WBC

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39
Q

What is the reatment for DPJ?

A

medical therapy, gastric decompression, IV fluids, analgesics, Flunixin, prokinetics, +/- antibiotics

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40
Q

What is the prognosis for DPJ?

A

guarded

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41
Q

What secondary complications are associated with DPJ?

A

Laminitis, septic jugular phlebitis, nephritis and renal failure, DIC

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42
Q

What ascarid causes impaction?

A

Parascaris equorom

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43
Q

What population of horses have a higher risk of getting ascarid impaction?

A

young horses

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44
Q

What clinical signs are associated with ascarid impaction?

A

variable amounts of pain, gastric reflux, and normal peritoneal fluid

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45
Q

How is ascarid impaction treated?

A

Medical therapy if possible - low efficacy anthelmintics to kill off slowly, intestinal lubricants and analgesics, and surgical correction via enterotomy

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46
Q

What is the prognosis of ascarid impaction?

A

guarded if surgery is necessary

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47
Q

What signs are associated with strangulated small intestine?

A

Acute and severe pain, shock, elevated HR and CRT, weak pulse, injected mm, hemoconcentration, gastric reflux, distended loops of SI

48
Q

What will the peritoneal fluid look like in patients with strangulated small intestine?

A

Serosanguinous, elevated WBC and protein, and elevated lactate

49
Q

What is a pedunculated lipoma?

A

a solid lipoma suspended on a mesenteric pedicle - in older horses

50
Q

How does small intestinal volvulus affect the SI?

A

It causes alterations in peristalsis

51
Q

In what scenario does sequestration happen as a result of a strangulated small intestine?

A

There is epiploic foramen entrapment and intussusception

52
Q

What lesions commonly happen in the cecum?

A

Cecal impaction, cecal motility disorders, cecal torsion, cecal infarct, cecocecal/cecocolic intussusception, and intussusception of the ileum into the cecum

53
Q

What is the number one lesion to be aware of in the cecum?

A

cecal impaction

54
Q

What are the risk factors for cecal impaction?

A

Orthopedic surgery, anesthesia, NSAIDs

55
Q

What are the clinical signs of cecal impaction?

A

Mild colic, ADR, decreased amount of fecal passage - may rupture before you see clinical signs

56
Q

How is cecal impaction diagnosed?

A

rectal examination

57
Q

How is cecal impaction treated?

A

medically (fluids, laxatives, pain medication, and psyllium) and surgical

58
Q

What is the prognosis of cecal impaction?

A

guarded to good

59
Q

What lesions can occur in the large intestine?

A

Impaction, enteroliths, displacements, torsion/volvulus, sand colic, thromboembolism, right dorsal colitis, and colitis

60
Q

What is the etiology of large colon impaction?

A

coarse feed, poor dentition, abnormal motility, decreased water intake, and sand

61
Q

What are the risk factors for large colon impaction?

A

aged horses with poor dentition, cold weather

62
Q

What are the clinical signs associated with large colon impaction?

A

Intermittent mild colic that gradually worsens, mild to moderate dehydration, normal or elevated heart rate, normal peritoneal fluid, and mass or gas distension on rectal palpation

63
Q

Where are the common locations of large colon impaction?

A

pelvic flexure, dorsal colon

64
Q

How is large colon impaction treated?

A

Intravenous +/- oral fluids, oral laxitives, analgesics, and surgical intervention

65
Q

What is the prognosis for large colon impaction?

A

good

66
Q

What is the etiology of enteroliths?

A

Precipitation of magnesium ammonium phosphate salts around a nidus

67
Q

What are the risk factors for enteroliths?

A

Geography (California), Breed (Arabian), and Diet (alfalfa)

68
Q

What clinical signs are associated with enteroliths?

A

Intermittent colic, gas distension of the large colon on rectal exam

69
Q

How are enteroliths treated?

A

Surgical removal by enterotomy

70
Q

What does triangular sape of enteroliths indicate?

A

there are multiple stones

71
Q

What is the prognosis for enteroliths?

A

good unless there is bowel necrosis

72
Q

What is left dorsal displacement (nephrosplenic)?

A

The colon is stuck over the nephrosplenic ligament

73
Q

What are the risk factors for left dorsal displacement?

A

large breed horses

74
Q

What are the signs associated with left dorsal displacement?

A

Variable amounts of pain, +/- gastric reflux, rectal palpation of the entrapment/spleen medial, ultrasound examination, abdominocentesis

75
Q

How Is left dorsal displacement treated?

A

Medical, phenylephrine, surgical correction via midline celiotomy, and rolling under general anesthesia

76
Q

What is the prognosis for left dorsal displacement?

A

good

77
Q

What is right dorsal displacement?

A

malposition of the colon between the body wall and the cecum

78
Q

What is the etiology of right dorsal displacement?

A

abnormal motility with gas distension

79
Q

What are the risk factors for right dorsal displacement?

A

large breed horses

80
Q

What are the signs associated with right dorsal displacement?

A

variable amounts of pain, +/- gastric reflux, bands of large colon palpated in transverse orientation, normal peritoneal fluid, and elevated GGT

81
Q

What is the treatment for right dorsal displacement?

A

Medical if not tightly distended and surgical if it does not resolve

82
Q

What is the prognosis for right doesal displacement?

A

good

83
Q

What are the risk factors for large colon torsion?

A

Broodmare just after parturition

84
Q

What are the clinical signs of large colon torsion?

A

Acute onset of severe pain, rapid deterioration of systemic signs, shock, gas distension, abdominal distension, normal peritoneal fluid

85
Q

What is the treatment for large colon torsion?

A

Medical treatment unsuccessful, immediate surgical correction, and fluid, anti-endotoxic therapy post op

86
Q

What is the prognosis for large colon torsion?

A

Good if treatment within 4 hours, poor if delayed

87
Q

What is the etiology of sand colic?

A

short pasture, insufficient roughage, and sandy soil

88
Q

What are the risk factors of sand colic?

A

sandy soil, feeding on the ground, and poor grass cover

89
Q

What clinical signs are associated with sand colic?

A

Intermittent colic, diarrhea, ventral auscultation of abdomen, rectal palpation often normal, sand present in the feces

90
Q

How is sand colic treated?

A

medically with fluids and laxatives and surgical

91
Q

How is sand colic prevented?

A

Feed off the ground, maintain in a lush pasture, feed hay if the grass is short, and chronic psyllium administration

92
Q

What is the prognosis for sand colic?

A

good

93
Q

What is the etiology of thromboembolic colic?

A

verminous arteritis

94
Q

What are the risk factors for thromboembolic colic?

A

young horses and horses not on a parasite control program

95
Q

What are the signs of thromboembolic colic?

A

Depression, variable amounts of pain, inflammatory changes in the peritoneal fluid, endotoxemia if large or severe

96
Q

What regions of the GI tract are commonly affected by thromboembolic colic?

A

the cecum and colon

97
Q

What lesions can occur in the small colon?

A

impaction, infarc, strangulating lipoma, enterolith, fecalith, meconium impaction, atresia ani/coli, rectal tears, rectal prolapse

98
Q

What animals are commonly affected with small colon impactions?

A

miniature horses and ponies

99
Q

What pathogen are small colon impactions associated with?

A

Salmonella

100
Q

How do you treat small colon impactions?

A

treat like other impactions

101
Q

What is the prognosis for small colon impactions?

A

good prognosis

102
Q

What is the etiology of rectal tears?

A

Iatrogenic, breeding injury, or spontaneous

103
Q

How are rectal tears classified?

A

Depth, distance, and circumferential location

104
Q

How are rectal tears diagnosed?

A

Loss of resistance, fresh blood on the sleeve, sedation, epidural, careful palpation, endoscopy

105
Q

What is a grade 1 rectal tear?

A

flap of mucosa

106
Q

What is a grade 2 rectal tear?

A

cavity/depression with mucosal lining

107
Q

What is a grade 3 rectal tear?

A

recess with firm ring

108
Q

What is a grade 4 rectal tear?

A

tear to the abdominal cavity

109
Q

Where is the rectal tear the most common?

A

25-30 cm from the anus at the junction of the rectum and small colon on the dorsal aspect

110
Q

What is the medical management for grade 1 and 2 tears?

A

laxative diet, decreased fecal volume, mineral oil, and systemic antibiotics

111
Q

What is the prognosis of a grade 1 rectal tear?

A

good prognosis, usually heal in a week, no rectal palpation for 8 weeks

112
Q

What is the prognosis of a grade 2 rectal tear?

A

Usually inconsequential, occasionally resultes in recurrent impaciton, no palpation for 8 weeks

113
Q

What is the prognosis of a grade 3 rectal tear?

A

guarded, often progress to a grade 4

114
Q

What is the prognosis of a grade 4 rectal tear?

A

poor, septic peritonitis, euthanasia

115
Q

What is the ‘first aid’ for rectal tears?

A

Client communication, sedation, spasmolytics, caudal epidural, fecal evacuation and rectal packing, fecal softening, antimicrobials, tetanus toxoid, and flunixin meglumine

Equine Medicine (27 decks)

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