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LA Infectious Disease > Unit 4 - Equine Enteric > Flashcards

Unit 4 - Equine Enteric Flashcards

1
Q

What are the common infectious causes of diarrhea in neonate (<2 mo) foals?

A

Rotavirus
C. perfringens A
C. difficile
Salmonella enterica (any age)

All have acute presentation which is more common

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2
Q

What are the less common infectious causes of diarrhea in the neonate (<2 mo) foal?

A

Coronavirus
Cryptosporidium

All acute presentation

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3
Q

What are the infectious causes of diarrhea in older foals?

A

R. equi
Lawsonia intracellularis
Intestinal parasites

Chronic more common

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4
Q

What are the non-infectious causes of diarrhea in foals?

A

Foal heat diarrhea (acute)
Nutritional diarrhea
Septicemic diarrhea (acute)
Gastric ulcers

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5
Q

T/F: More than 50% of foals will experience at least 1 episode of diarrhea before weaning.

A

True

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6
Q

What are the common infectious causes of diarrhea in adult horses?

A

Salmonella - acute & chronic
Neorickettsia risticii - acute
Clostridoides difficile - acute > chronic

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7
Q

What are the less common infectious causes of diarrhea in adult horses?

A

Coronavirus - acute

Intestinal parasites

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8
Q

What are the non-infectious causes of diarrhea in adult horses?

A 
Inflammatory bowel disease
Toxicities
Grain overload
Systemic diseases - heart failure, liver failure
Sand enteropathy
Gastric ulcers
Lymphosarcoma
Microbiota abnormalities
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9
Q

What is a key issue of foal diarrhea?

A

Failure of passive transfer

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10
Q

What is the level of antibody per mL that is suggestive of normal complete passive transfer? Partial failure? Complete failure?

A

Normal, complete - >800 mg/dl
Partial failure - 400-800 mg/dl
Complete failure - <400mg/dl

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11
Q

What is the gold standard for measuring passive transfer?

A

Radial immunodiffusion

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12
Q

What assays are semi-quantitative for measuring passive transfer?

A

Lateral flow/ELISA-type immunoassays

Immunoturbidometric assays

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13
Q

What does a Brix refractometer measure?

A

Total solids to estimate IgG

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14
Q

What is the gold standard for measuring colostrum quality?

A

Radial immunodiffusion

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15
Q

What factors can affect passive transfer?

A 
Maiden mares or >16 years of age
Premature lactation
Sick mares
Dystocia
Poor mothering instinct
Death of mare
Twinning
Sick foals
Congenital defects in foals
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16
Q

What factors affect foal diarrhea?

A

Transportation of the mare prior to foaling
Lack of sanitation
Too much pre-partum nutrition of the mare
Too little post-partum nutrition of the mare
Excessive oral medications to the foal

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17
Q

What is the etiologic agent of Salmonellosis?

A

Salmonella enterica subspecies enterica

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18
Q

Most salmonellosis infections are subclinical, however, what can lead to clinical disease?

A

Stressors such as concurrent infections, deworming, surgery, and transport

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19
Q

How is Salmonella transmitted?

A

Fecal-oral or fomite transmission

Highly contagious

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20
Q

T/F: Salmonellosis is zoonotic.

A

True

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21
Q

T/F: Outbreaks of salmonellosis in equine facilities have led to shut down of entire facilities for months.

A

True

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22
Q

What clinical signs are associated with acute salmonellosis?

A

Diarrhea, fever, anorexia, +/- colic, +/- tachycardia, +/- tachypnea

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23
Q

What will you see on a CBC in a patient with salmonellosis?

A

Leukopenia characterized by neutropenia +/- left shift, hemoconcentration

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24
Q

What will you see on chemistry in a patient with salmonellosis?

A

Hypoproteinemia, acidosis, and electrolyte derangements

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25
Q

How do patients with chronic salmonellosis present?

A

They are asymptomatic carriers that have chronic diarrhea

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26
Q

What is the rule of thumb when diagnosing salmonellosis?

A

A horse with diarrhea and fever or neutropenia has salmonellosis until proven otherwise

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27
Q

How is salmonellosis diagnosed antemortem?

A

Fecal PCR or culture

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28
Q

What is the gold standard for ruling out current Salmonella infection?

A

Repeat fecal samples (3-5) collected 12-24 hours apart

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29
Q

At necropsy, what should be cultured to identify Salmonella?

A

Intestinal tract or lymph nodes

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30
Q

How do you treat salmonellosis?

A

Supportive care - IV fluids, NSAIDs, polymyxin B, antibiotics, laminitis prevention

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31
Q

How is salmonellosis prevented and controlled in equine hospitals?

A

Isolate and test all clinical suspects
Routine screening of patient population
Strict attention to hygiene and disinfection

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32
Q

How is salmonellosis prevented and controlled on the farm?

A

Quarantine all horses returning from shows and other events
Sanitize feeding and cleaning equipment between animals
Vaccination

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33
Q

What is the label claim for the Salmonella vaccination?

A

Aid in prevention of endotoxin-mediated disease

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34
Q

What is the etiologic agent of Potomac Horse Fever?

A

Neorickettsia risticii

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35
Q

When is the highest incidence of PHF?

A

In late summer and early fall

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36
Q

What intermediate hosts are associated with PHF?

A

Trematodes, freshwater snails, and aquatic insects

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37
Q

How is PHF transmitted?

A

Ingestion of feed or water contaminated with aquatic insects especially mayflies and caddis flies

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38
Q

What does Neorickettsia risticii infect?

A

Circulating macrophages

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39
Q

What clinical signs are associated with acute cases of PHF?

A

Fever, anorexia, depression, ileus, injected mucous membranes, +/- colic
Diarrhea 24-72hrs after clinical signs

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40
Q

What abnormalities will be on CBC in a patient with PHF?

A

Leukopenia, neutropenia +/- left shift, hemoconcentration

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41
Q

What abnormalities will be on chemistry in a patient with PHF?

A

Hypoproteinemia, acidosis, electrolyte derangements

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42
Q

What clinical signs are associated with chronic PHF?

A

Laminitis and abortion

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43
Q

T/F: PHF is not fatal.

A

False - it can be due to endotoxemia and laminitis

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44
Q

How is PHF diagnosed?

A

Seasonal timing and geography is highly suggestive
Often initiate treatment prior to receiving test results

PCR
Paired serology

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45
Q

What is the preferred method of PHF diagnosis?

A

PCR with feces and/or whole blood

46
Q

What increase in titers is indicative of PHF?

A

4-fold increase

47
Q

How is PHF treated?

A

Supportive care - IV fluids, NSAIDs, laminitis

Antibiotics - oxytetracycline (response in 1-3 days)

48
Q

How is PHF prevented and controlled?

A

Vaccination

Insect control

49
Q

T/F: Vaccinated individuals against PHF can still develop disease.

A

True - the vaccine is just thought to lessen the severity of disease

50
Q

What is the administration protocol for the PHF vaccine?

A

Initial 2 dose series - 3-4 weeks apart

Booster yearly or every 3-4 months prior to high risk period

51
Q

What is the etiologic agent of Rotavirus?

A

Rotavirus A

52
Q

T/F: Tramission of Rotavirus can cross species.

A

True

53
Q

T/F: Almost all horses are exposed to Rotavirus in early life.

A

True

54
Q

When do most clinical infections of Rotavirus occur?

A

In foals that are < 2 months

55
Q

How is Rotavirus transmitted?

A

Fecal-oral

56
Q

Rotavirus is a ____ dependent disease.

A

Dose

57
Q

What clinical signs are associated with rotavirus infection?

A

Diarrhea

58
Q

What types of diarrhea can Rotavirus cause?

A

Osmotic or secretory diarrhea

59
Q

How does Rotavirus cause osmotic diarrhea?

A

The virus destroys small intestinal villi resulting in malabsorption and thus osmotic diarrhea

60
Q

How does Rotavirus cause secretory diarrhea?

A

The enterotoxin causes chloride secretion which in turn results in secretory diarrhea

61
Q

How is Rotavirus diagnosed?

A

PCR, ELISA, and Latex agglutination

62
Q

How is Rotavirus treated?

A

Supportive care - IV fluids, NSAIDs, +/- broad spectrum abx

63
Q

How is Rotavirus prevented and controlled?

A

General sanitation and biosecurity principles

Vaccination

64
Q

What is the administration protocol for the Rotavirus vaccination?

A

Immunize mares 3x late in each gestation (8, 9, 10 months)

65
Q

What is the etiologic agent of Coronavirus?

A

Equine coronavirus (ECoV) - beta coronavirus

66
Q

Coronavirus has been recently identified as a primary causative agent of _____ diarrhea.

A

Adult

67
Q

There is a high seroprevalence of Coronavirus in _____ breeds.

A

Draft

68
Q

How is Coronavirus transmitted?

A

Fecal-oral transmission, fomites

69
Q

What clinical signs are associated with coronavirus?

A

Acute necrotizing enteritis (small > large intestines)

Acute onset - fever, anorexia, lethargy, soft formed to diarrhea to scant feces to colic, +/- encephalopathy

70
Q

What CBC abnormalities are associated with a coronavirus infection?

A

Leukopenia and neutropenia

71
Q

How is coronavirus diagnosed?

A

PCR on feces - best time is 3-4 days after onset of clinical signs

72
Q

How is coronavirus treated?

A

Supportive care only - fluids, electrolytes, NSAIDs

73
Q

T/F: Vaccination for coronavirus provides life-long protection.

A

False - there is no vaccine

74
Q

How is coronavirus prevented and controlled?

A

General sanitation and biosecurity principles

Known positive animals should be isolated for 3 weeks

75
Q

What is the etiologic agent of clostridial enteritis?

A

C. perfringens A and C in foals

C. difficile in foals and adults

76
Q

How is clostridial enteritis transmitted?

A

Fecal/oral, fomites

77
Q

What clinical signs are associated with C. perfringens clostridial enteritis?

A

Acute onset - hemorrhagic diarrhea with sepsis, colic, dehydration, shock
Can progrss to necrotizing colitis and typhlitis

78
Q

What clinical signs are associated with C. difficile clostridial enteritis?

A

Acute onset of diarrhea with sepsis

79
Q

What history is often associated with C. difficile clostridial enteritis?

A

A history of antibiotics or hospitalization

80
Q

How is clostridial enteritis diagnosed?

A

Demonstrate large numbers of gram positive rods in feces or from affected areas of the intestines
PCR
Culture and genotyping
Commercial ELISA for C. difficile

81
Q

How is clostridial enteritis treated?

A

Aggressive supportive care - IV fluids, electrolytes, biosponge, antitoxin (extralabel)
Antibiotics - Metro and/or penicillin in foals with C. perfringens, metro in adults with C. diff

82
Q

How is clostridial enteritis prevented and controlled?

A

Vaccination - extralabel
General sanitation and biosecurity principles
Hyperimmune plasma
Probiotics

83
Q

What is the etiologic agent of proliferative enteropathy?

A

Lawsonia intracellularis

84
Q

T/F: Lawsonia intracellularis is an obligate intracellular pathogen.

A

True

85
Q

How is L. intracellularis transmitted?

A

Fecal-oral

86
Q

What cells does L. intracellularis infect?

A

Crypt epithelial cells in the ileum

87
Q

What age group is most commonly affected by proliferative enteropathy
?

A

Foals 3-4 months to 7-9 months of age

88
Q

What clinical signs are associated with proliferative enteropathy?

A

Ventral edema, diarrhea, weight loss (all due to protein losing enteropathy)
Fever, lethargy, anroexia
Poor doer - rough hair coat, pot bellied appearance, concurrent infections
Acute necrotizing colitis

89
Q

What lesion can lead to perforation and death associated with proliferative enteropathy?

A

Erosion and ulceration of intestine

90
Q

What CBC abnormalities are consistent with a patient with proliferative enteropathy?

A

Anemia and leukocytosis

91
Q

What chemistry abnormalities are consistent with a patient with proliferative enteropathy?

A

Hypoproteinemia, increased CK

92
Q

How is proliferative enteropathy presumptively diagnosed?

A

Based on signalment, clinical signs, hypoproteinemia, and thickened small intestines and abdominal ultrasound

93
Q

How is proliferative enteropathy confirmed?

A

PCR on feces

Serology (Immunoperoxidase monolayer assay

94
Q

How is proliferative enteropathy diagnosed at necropsy?

A

IHC staining

95
Q

How is proliferative enteropathy treated?

A

Early treatment is key!

Antibiotics and supportive care (colloids)

96
Q

How is proliferative enteropathy prevented and controlled?

A

Extra-label vaccination

Monitoring - 1-2x monthly serum TP and serologic status testing

97
Q

Colibacillosis is not usually considered a primary pathogen in foal _____ disease.

A

enteric

98
Q

What does colibacillosis cause in neonates?

A

Joint infections, omphalophlebitis, and septicemia

99
Q

What is the primary disease process that Rhodococcus equi causes?

A

Pyogranulomatous pneumonia

100
Q

What non-respiratory disease can R. equi cause in horses and what age group?

A

May cause enteric disease in 2-6 mo foals

101
Q

T/F: Extrapulmonary infections due to R. equi are associated with increased mortality.

A

True

102
Q

How do you treat R. equi enteric infections?

A

The same as with respiratory infections - macrolide + rifampin

103
Q

What is the etiologic agent of Actinobacillosis?

A

Actinobacillus equuli

104
Q

Actinobacillosis is also known as what?

A

Sleepy foal disease

105
Q

T/F: A. equuli is a common organism found in the intestinal tracts of many horses

A

True - mares may also carry it in their genital tracts

106
Q

What are the clinical signs of actinobacillosis in neonates?

A

Early septicemia (1-4 days of age) - lethargy, anorexia, diarrhea, joint infections, abscesses in multiple organs, sudden death

107
Q

What does actinobacillosis cause in adults?

A

Peritonitis, endometritis, endocarditis

108
Q

How is actinobacillosis diagnosed?

A

Culture

109
Q

What antemortem samples should be used for diagnosis of actinobacillosis?

A

Blood, joint

110
Q

What post mortem samples should be used for diagnosis of actinobacillosis?

A

Kidney, lung, liver

111
Q

How is actinobacillosis treated?

A

Antibiotics - gram negative septicemic coverage

112
Q

How is actinobacillosis prevented and controlled?

A

Adequate passive transfer

Good sanitation at foaling

LA Infectious Disease (33 decks)

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