Weight Loss Flashcards

1
Q

What are the 4 broad mechanisms of weight loss?

A

Reduced intake
Reduced digestion, absorption or assimilation of nutrients
Increased losses
Increased requirements

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

List 3 reasons for reduced intake in a horse

A

Inappropriate feeding
Unable to obtain feed
Competition for feed
Dental issues
Dysphagia
Pain
(Gastric disease)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Which of the following isn’t a reason for reduced digestion or absorption of nutrients?
- Liver disease
- Malabsorption syndrome (e.g. intestines)
- Pregnancy
- Dental disorders

A

Pregnancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Give 2 broad reasons for increased nutritional losses

A

Protein losing enteropathy (nephropathy rare)
Loss into a body cavity (peritonitis or pleuritis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Which 2 of the following results in weight loss due to increased requirements?
- Neoplasia
- Dental disease
- Small intestinal disease
- Lactate

A

Neoplasia
Lactate

Also pregnancy, sepsis and other systemic disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Out of dental disease and malnutrition, which the most common cause of weight loss in horses?

A

Dental disease - pain or poor function
Malnutrition is rarer but could occur if owners don’t match intake with requirements (pregnancy, lactation)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Dental disease can result in horses being unable to chew long, fibrous food. What does this predisposes horses to?

A

Impactions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

A horse presents with anorexia, which you suspect is due to pain. What are your top differentials?

A

Gastric disease (severe post-prandial)
Intestinal disease
Adhesions (low grade colic)
Severe musculoskeletal pain (laminitis)
Visceral pain (pleural/peritoneal disease)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What clinical sign can be seen in chronic grass sickness, botulism and pharyngeal/laryngeal dysfunction?

A

Anorexia due to dysphagia
Also seen in toxicities, e.g. lead
Botulism now uncommon as silage rarely fed to horses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

You have diagnosed a horse with weight loss due to malabsorption or a protein losing enteropathy. What other clinical sign may you see?

A

Chronic diarrhoea, due to either:
- Primary large colon dysfunction
- Different energy substrates to flora
Need extensive pathology to see this

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

True or False?
The 3 causes of malabsorption and protein losing enteropathies are:
- Parasitic disease (cyathostominosis)
- Idiopathic
- Infiltrative bowel disease (inflammation/neoplasia)

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

You are presented with a horse with weight loss and oedema. What is the most likely cause of the oedema?

A

Hypoalbuminaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the first things that you want to rule out when presented with a horse with weight loss?

A

Diet
Parasites

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What things could you expect to find on a rectal examination of a horse with weight loss?

A

Abdominal mass
Neoplasia
Intestinal lesion
Worm larvae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What blood result areas (e.g. liver parameters) would you be most want to investigate when presented with a horse with weight loss?

A

Liver
Kidney
Inflammation (acute phase proteins)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Other than a blood test, what laboratory tests could be useful when investigating a horse with weight loss?

A

Abdominocentesis
Faecal worm egg count - remember tapeworm needs a blood test to diagnose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What could eosinophilia indicate on haematology?

A

Generalised inflammation
Parasitic infection (sometimes)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Name 2 acute inflammatory markers

A

Serum Amyloid A:
- Produced in the liver in response to cytokines
- Induces further cytokines
- Attracts neutrophils/mast cells

Fibrinogen:
- Produced in the liver in response to cytokines
- Increases 24-48 hours after stimulus
- Used in blood clots

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What should you always remember when interpreting equine anaemia?

A

Breed-specific reference ranges of red blood cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Why is it important to assess the horse’s hydration status before interpreting haematology and biochemistry results?

A

Hypovolaemia may mask total protein decreases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Which protein is normally responsible for hyperproteinaemia?

A

Globulin - hyperglobulinaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Give 4 causes of hypoalbuminaemia

A

Laboratory error (most likely)
GI loss
Renal loss (much less common than GI)
Effusions (peritoneal/pleural)
Liver disease (rare)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Give 2 causes of hypoglobulinaemia

A

GI loss
Renal loss (rare unless severe damage)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Which serum protein can be raised in chronic inflammatory disease (cyathostominosis) and neoplasia?

A

Globulin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What are 3 differentials for hyperfibrinogenaemia?

A

Infection
Inflammation
Neoplasia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Which test would you do to investigate small intestinal malabsorption syndromes?

A

Oral Glucose Absorption Test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Describe how to do an Oral Glucose Absorption Test

A

Starve the horse overnight
Give 1g/kg glucose solution via nasogastric tube
Collect blood samples into fluoride anticoagulant immediately after and then at regular intervals
Measure blood glucose levels and plot on a graph

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

How can you differentiate between horses with no, partial or complete malabsorption on an Oral Glucose Absorption Test?

A

No malabsorption = glucose increases by 90% in first 2 hours
Partial malabsorption = glucose increases slightly
Complete malabsorption = glucose doesn’t increase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

How can you ensure the Oral Glucose Absorption Test is as accurate as possible?

A

Keep the horse calm - stress increases the insulin response
Ensure horse is properly starved - food delays and flattens the curve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

State 3 problems with the Oral Glucose Absorption Test

A

Doesn’t only assess small intestinal function - small amount of glucose absorbed in large intestine (D-xylose absorption test more reliable)
Partial malabsorption gives variable results
Delayed flat curve - from delayed gastric emptying or poorly starved horses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What are you looking at during intestinal ultrasonography?

A

Wall thickness - 0.3cm for small intestine, 3-4mm for large colon
Lumen diameter
Motility
Anatomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Which 2 regions are best to take GI biopsies from for a weight loss investigation?

A

Duodenum (transendoscopic)
Rectal mucosa (biopsy from 10am and 2pm position; needs extensive pathology to be diagnostic)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Which surgeries can you do to investigate weight loss in horses?

A

Midline exploratory celiotomy - GA
Flank laparotomy - standing sedation
Laparotomy - standing sedation

Expensive and requires significant time off (6 weeks box rest and 6 months rest)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

How far inside the rectum should you go before taking a rectal mucosal biopsy?

A

20-30cm
Give flunixin meglumine to prevent horse straining

Submit for histology

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

How frequently does a rectal mucosal biopsy result in a diagnosis for weight loss?

A

50% cases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Give 3 advantages to doing a laparotomy to investigate weight loss

A

Multiple intestinal biopsies can be obtained
Whole intestinal tract can be examined
Segmental disease, e.g. focal eosinophilic IBD, can be resected and removed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Granulomatous enteritis, eosinophilic enterocolitis and lymphocytic-plasmacytic enterocolitis are all forms of which disease?

A

Chronic Inflammatory Bowel Disease - small intestine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Other than Chronic Inflammatory Bowel Disease, name 2 other small intestinal diseases which could cause weight loss

A

Proliferative Enteropathy
Alimentary Tract Neoplasia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What causes Equine Proliferative Enteropathy?

A

Lawsonia intracellularis
Infects enterocytes, particularly in the ileum, and causes proliferation of abnormal enterocytes
Intestinal mucosa is altered and the foal can’t absorb as many nutrients

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Which cells infiltrate the lamina propria in Granulomatous Enteritis?

A

Lymphocytes
Macrophages

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

True or False?
Granulomatous Enteritis causes duodenal villous atrophy

A

False - causes ileal villous atrophy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What is the cause of Granulomatous Enteritis?

A

Unknown
Theorised inflammatory reaction to intestinal bacteria
Affects any age, sex or breed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Briefly describe the pathophysiology of Eosinophilic Enterocolitis

A

Eosinophil infiltration into the intestinal mucosa
Large numbers of eosinophils irritate and injure intestines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

What are the 3 forms of Eosinophilic Enterocolitis?

A

Multisystemic Eosinophilic Epitheliotrophic Disease (MEED):
- Other organs involved

Diffuse Eosinophilic Enterocolitis (DEE):
- Affects all small and large intestine

Idiopathic Focal Eosinophilic Enteritis/Colitis (IFEE or IFEC):
- Segmental lesions in small or large intestines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Eosinophilic enterocolitis is caused by what?

A

Unknown cause
Possibly related to nematode infestation
Parasites can induce hypersensitivity reaction, and contain endogenous factors that attract eosinophils

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Which horses are you most likely to see Eosinophilic Enterocolitis in?

A

Any age, sex or breed
Most likely in young Thoroughbreds and Standardbreds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Lymphocytic-Plasmacytic Enterocolitis involves which cells?

A

Lymphocytes and plasma cells - infiltrate the lamina propria
Unknown cause - may lead to intestinal lymphoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Lawsonia intracellularis infects the cytoplasm of which cells?

A

Proliferative crypt epithelial cells in the jejunum and ileum
Obligate intracellular bacterium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Which horses are you most likely to see Proliferative Enteropathy in?

A

Weanling foals aged 3-8 months
Horses living near pigs
Individuals or outbreaks
Uncommon in yearlings and adult horses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Name 4 risk factors for Proliferative Enteropathy

A

Overcrowding
Feed changes
Antibiotic usage
Mixing and transportation
Weaning

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Give 4 differentials for large intestinal causes of weight loss

A

Parasites
Right dorsal colitis
Sand enteropathy
Eosinophilic Enteritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

True or False?
It is more common for parasites to cause colic and diarrhoea than weight loss

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Name 3 large strongyles

A

Strongylus vulgaris (bloodworm)
Strongylus edentatus
Strongylus equinus

54
Q

Describe the pathophysiology of large strongyle infections

A

4th stage larvae migrate through intestinal wall
Migrate through the lumen to the mucosa and submucosa
Larvae affect myoelectrical activity
Inflammatory cells gather
Oedema and haemorrhage through the intestines
Increased secretion and decreased absorption result

55
Q

Which larval stage of small strongyles migrate through the mucosa of the large intestine?

A

L4
Includes a period of hypobiosis before larval emergence after an unknown stimulus

56
Q

What damage occurs when small strongyle larvae emerge from the large intestine?

A

Mucosal damage
Ulceration
Inflammatory reaction

57
Q

True or False?
Cyathostomins are a group of small strongyles

A

True

58
Q

What time of year are L4 larvae from small strongyles most likely to emerge?

A

Late winter or early spring
Results in “larval cyathostominosis” - can severely damage the gut wall (diarrhoea) and cause serious colic
Mortality rate as high as 50%

59
Q

In Right Dorsal Colitis, which area of the large intestine is affected?

A

Right dorsal
Sometimes known as hindgut ulcers

60
Q

Give 3 clinical signs of Right Dorsal Colitis

A

Weight loss
Diarrhoea
Lethargy
Recurring colic

61
Q

What factors predispose a horse to getting Right Dorsal Colitis?

A

Prolonged NSAID use
(Also excessive grain intake, acidosis, stress and parasites)

62
Q

Describe how NSAIDs can result in Right Dorsal Colitis

A

NSAIDs inhibit cyclo-oxygenase (COX) -1 and -2, which produce prostaglandins
Inhibition of prostaglandin production results in:
- Reduced mucosal blood flow
- Decreased secretion of mucus, H2O and HCO3-
- Decreased mucus cell turnover and migration

Results in epithelial surface damage, which leads to ulcer formation

63
Q

Which of the following NSAIDs should you give to a horse prone to Right Dorsal Colitis?
1. Flunixin meglamine
2. Phenylbutazone
3. Ketoprofen
4. Firocoxib

A

Firocoxib - selective COX-2 inhibitor which only affects prostaglandins involved in inflammation

Phenylbutazone, Flunixin meglamine and Ketoprofen are all non-selective COX inhibitors (phenylbutazone is the worst)

64
Q

Describe the pathogenesis of Sand Enteropathy

A

Horses living in sandy areas ingest sand with their food
This builds up over time and accumulates in the sacculations of the ventral colon
Damage of the colonic mucosa occurs
Diarrhoea, weight loss and sometimes impaction

65
Q

You are presented with a horse with weight loss, which you suspect is due to hepatic disease. What are your top 4 differentials?

A

Theiler’s Disease/Serum Associated Hepatitis
Ragwort poisoning
Cholangiohepatitis
Cholelithiasis

66
Q

How much of the liver needs to be damaged before clinical signs of hepatic failure are seen?

A

Over 75%

67
Q

What are the 2 broad mechanisms behind weight loss due to hepatic disease?

A

Anorexia
Abnormal metabolism

68
Q

Other than weight loss, what clinical signs may suggest hepatic disease in a horse?

A

Colic
Diarrhoea
Ascites

Due to hepatic swelling, portal hypertension, altered microflora and abnormal bile acids

69
Q

What is hepatic encephalopathy?

A

Syndrome of neurologic problems due to poor liver function resulting in increased blood toxin levels

70
Q

What clinical signs would make you suspect hepatic encephalopathy?

A

Depression
Lethargy
Head pressing
Circling
Aimless walking
Ataxia
Dysphagia
Pica
Behavioural changes
Stupor/Seizures/Coma

71
Q

Name one GI-derived neurotoxin

A

NH3 (ammonia)

72
Q

True or False?
Increased cytokines, increased BBB permeability and altered benzodiazepine synthesis are all involved in hepatic encephalopathy?

A

True
Also increased neurosteroid synthesis and manganese

73
Q

You have a horse with Theiler’s Disease (hepatitis). What are the 3 most likely causes?

A

History of being given an equine blood production (transfusion) - most likely
Equine parvovirus-hepatitis - association
Equine hepacivirus - can’t be ruled out as causative

74
Q

Give 3 clinical signs of Theiler’s disease (hepatitis)

A

Lethargy
Anorexia
Jaundice
Hepatic encephalopathy

75
Q

Which alkaloid is involved in ragwort poisoning?

A

Pyrrolizidine alkaloid toxicity

76
Q

A horse presents with lethargy, jaundice, photosensitisation, diarrhoea and weight loss. The owner mentions that the horse was accidentally given access to hay containing ragwort 12 months ago. Could this be the cause of this horse’s clinical signs?

A

Yes - technically clinical signs can occur after 1-12 months after ingestion

77
Q

What is the most common source of ragwort poisoning in horses?

A

Contaminated feed, especially pellets

78
Q

Which organisms are frequently involved in Cholangiohepatitis?

A

Salmonella spp.
Klebsiella spp.
E. coli
Ascending bacterial infection likely from the intestines
Can also be as part of sepsis from systemic spread

79
Q

Are you more likely to see weight loss in horses with acute or chronic Cholangiohepatitis?

A

Chronic disease results in:
- Liver fibrosis = weight loss

Acute disease results in:
- Inflammation/infection = fever
- Biliary obstruction/hepatic enlargement = colic
- Biliary obstruction = jaundice + photosensitivity

80
Q

What is the name given to stone formation in the biliary ducts of the liver?

A

Cholelithiasis
Unknown cause, but bacterial infection likely involved

81
Q

You have a horse with inflammatory bowel disease. What 3 treatment options are available?

A

Prolonged corticosteroid therapy:
- Dexamethasone +/- prednisolone for 3-5 weeks, then taper

Chemotherapeutic agents:
- Azathioprine, vincristine, etc. (lymphosarcoma)

Resection and anastomosis:
- If localised idiopathic eosinophilic enteritis

82
Q

Why might you treat a horse with inflammatory bowel disease with IM dexamethasone before oral prednisolone?

A

Bypasses intestinal malabsorption

83
Q

What dietary modifications can you recommend for a horse with inflammatory bowel disease?

A

Increase fibre intake to minimise small intestine function
Add vegetable oils into diet (reduce VFAs)
Avoid/Minimise commercial feeds to try and reduce antigens

84
Q

A horse with inflammatory bowel disease is being treated with dexamethasone and dietary modifications. What else can you do to reduce the likelihood of recurrence?

A

Frequent deworming - parasites which don’t normally trigger inflammation can do if the bowel isn’t normal

85
Q

You have a horse with proliferative enteropathy. Which antibiotic will you choose to treat her?

A

Tetracyclines - IV oxytetracycline BID for 1 week, then oral doxycycline BID

Macrolide and rifampin SID

86
Q

The owner of a horse with proliferative enteropathy has asked you to give steroids to reduce pyrexia as part of the treatment plan. What do you respond?

A

Don’t give steroids - bacterial infection
NSAIDs if pyrexia

87
Q

A horse you are treating for proliferative enteropathy has profuse diarrhoea and severe hypoalbuminaemia. What additional treatment can you provide?

A

IV fluids
Plasma/Colloids

88
Q

You have diagnosed a horse with Right Dorsal Colitis. How are you going to treat him?

A

Remove NSAIDs
Prostaglandin analogues, e.g. Misoprostol BID

89
Q

Which of the following isn’t a good treatment option for a horse with Chronic Sand Enteropathy?
1. Dexamethasone BID for 2 weeks
2. Psyllium and MgSO4 by NG tube
3. Surgical emptying
4. Hay, haylage or alfalfa mix

A

Dexamethasone - should give NSAIDs BID instead

Also prevent horse from eating on the ground - rubber mats, feeders, hay nets

90
Q

You have a horse with liver disease. Which of the following isn’t used to support the liver?
1. Milk thistle extracts (silymarin)
2. Vitamin A
3. N-acetylcysteine
4. S-adenosylmethionine

A

Vitamin A

Should use vitamin E instead

91
Q

How does Silymarin in milk thistle support the liver?

A

Inhibits hepatic fibrosis
Encourages hepatocyte regeneration
Anti-oxidant

92
Q

True or False?
Increasing levels of fat and protein in the diet supports the liver by reducing the level of metabolic work it has

A

False - decreasing levels of dietary fat and protein does this

93
Q

How does Vitamin E support the liver?

A

Reduces blood glucagon levels (so increases insulin levels)
Helps detoxification pathways

94
Q

Are diets high in alfalfa, legumes and carbohydrates good for horses with liver disease?

A

High levels of carbohydrates are helpful, but care if obese
High levels of alfalfa and legumes are bad as contain heaps of protein

Should include low protein foods, e.g. beet pulp, cracked corn, bran (care hyperphosphataemia)

95
Q

An injection of which vitamin can help support the diseased liver?

A

Vitamin B, especially in acute disease

96
Q

Pyrrolizidine alkaloid toxicity causes irreversible liver damage. Which diagnostic test can you do to establish long term prognosis?

A

Liver biopsy

97
Q

Which 2 antifibrotic agents can you use to treat a horse with pyrrolizidine alkaloid toxicity?

A

Steroids - dexamethasone or prednisolone for several weeks and then tapered off
Colchicine - disrupts tubulin, which downregulates the innate immune system; extremely toxic if overdosed

98
Q

Which antibiotics could you use in a horse with cholangiohepatitis?

A

Broad spectrum with good gram -ve cover and anaerobes
Potentiated sulphonamides
Fluoroquinolones - enrofloxacin
Cephalosporins
+/- Metronidazole

99
Q

Which sample would you take to do an antibiotic culture and sensitivity test for a horse with cholangiohepatitis?

A

Liver biopsy

100
Q

How long should you give antibiotics to a horse with cholangiohepatitis?

A

Until 2-4 weeks after liver enzymes have returned to normal and no pyrexia present

101
Q

Which antibiotics should you give a horse with cholelithiasis?

A

Broad spectrum with good gram -ve cover and anaerobes
Potentiated sulphonamides
Fluoroquinolones - enrofloxacin
Cephalosporins
+/- Metronidazole
Dimethyl sulphoxide - may help dissolve sludge and stones

102
Q

Which history questions are important when investigating a horse with weight loss?

A

Age and activity
Perceived length of weight loss
Diet - amount and frequency
Worming history
Dental care
Episodes of diarrhoea, soft manure, inappetence, colic, etc.
Type of pasture - size, vegetation species
Sharing pasture with other horses or species

103
Q

In which body areas is muscle wastage most notable?

A

Head muscles
Cervical muscles
Epaxial muscles (around the spine)

104
Q

Other than muscle wastage, what things will you specifically look for on clinical exam of a horse with weight loss?

A

Oedema - ventrally or distal limbs
Faecal staining on hindquarters - type and quality of faeces, sand, gravel, long fibre, parasites
Heart rate
Abnormal lung sounds
GI motility
Dental exam

105
Q

What is the ideal body condition score for the pet horse, breeding mare and breeding stallion on the 1-9 scale?

A

Pet horse: 4-6
Breeding mare: 6-7
Breeding stallion: 5-6

Performance horses are normally 4-5

106
Q

What are you analysing when doing a liver ultrasound?

A

Sharpness of edges
Echogenicity
Masses
Gas-shadowing structures

Right and left lobes

107
Q

Where can you find the small and large intestines when doing ultrasonography?

A

Small intestine: inguinal area in the cranioventral abdomen
Large intestine: left ventral abdomen

108
Q

How much of the small and large intestine will you be able to see on ultrasound?

A

30% of small intestine
50% of large intestine

109
Q

What is the aim of doing a rectal examination for a horse with weight loss?

A

Find masses, impactions, strictures and mesenteric lymphadenopathies
Take faecal samples

110
Q

What is the normal gross appearance of peritoneal fluid collected via abdominocentesis?

A

Turbid
Serosanguinous
Green-dark

111
Q

How can you measure protein levels in peritoneal fluid? What are the normal values?

A

Use a refractometer
Abnormal if >30g/L, which would indicate inflammation or infection

112
Q

Peritoneal fluid normal lactate levels are <2.5mmol/L. What might cause them to rise?

A

Intestinal ischaemia - peritoneal lactate levels are double systemic
Bacterial infection

113
Q

<5000 white blood cells/ul in peritoneal fluid is normal. What might you see if there was a bacterial infection?

A

Likely infection if >10000 cells/ul
>90% neutrophils
Degenerative neutrophils due to bacterial toxins (large, swollen nucleus, vacuolated cytoplasm)
Intra and extracellular bacteria
Abdominal glucose >2.8mmol/L

114
Q

What is the most common abdominal neoplasia in the horse?

A

Intestinal lymphoma/lymphosarcoma

115
Q

Which organisms involved in weight loss can be found on histopathology and culture/PCR of an intestinal biopsy?

A

Lawsonia intracellularis
Salmonella

116
Q

Out of Multisystemic Eosinophilic Disease, Granulomatous Enteritis and Lymphocytic-Plasmacytic Enterocolitis, which 2 are most likely to be found on a rectal biopsy?

A

Granulomatous Enteritis
Multisystemic Eosinophilic Disease
Still only find 50% cases

117
Q

Which area of the large intestine would you biopsy to look for Lymphocytic-Plasmacytic Enterocolitis and Eosinophilic Enteritis?

A

Duodenum
Finds only 20% of cases

118
Q

Full thickness intestinal biopsies are used to find which causes of equine weight loss?

A

Eosinophilic Enteritis
Lymphoma
Grass sickness (ileum)

119
Q

Which of the following causes of inflammatory bowel disease would have a normal Oral Glucose Absorption Test?
1. Multisystemic Eosinophilic Epitheliotropic Disease
2. Granulomatous Enteritis
3. Intestinal Lymphoma
4. Lymphocytic Enterocolitis

A

Multisystemic Eosinophilic Disease
Focal Eosinophilic Enteritis can have a normal or abnormal Oral Glucose Absorption Test

120
Q

Which 2 of the following would you see anaemia on haematology and biochemistry?
1. Lymphocytic enterocolitis
2. Intestinal lymphoma
3. Granulomatous enteritis
4. Focal eosinophilic enteritis

A

Granulomatous enteritis
Intestinal lymphoma

Will also see anaemia in Multisystemic Eosinophilic Epitheliotropic Disease

121
Q

What diagnostic test could you do to help determine Ascarid burden in weaning and yearling horses?

A

Ultrasound

122
Q

How can you diagnose Proliferative Enteropathy?

A

Faecal PCR for Lawsonia intracellularis

123
Q

How could you diagnose Salmonella in a horse with weight loss?

A

PCR and enriched culture from a faecal sample

124
Q

What is the best diagnostic test for sand enteropathy?

A

Radiography

Also ultrasound and a sedimentation test, but that has low sensitivity

125
Q

Where are AST and ALT enzymes found in the liver?

A

AST is hepatocellular (lots produced in muscles, as well as red blood cells and kidneys)
ALP is in the biliary ducts (20% produced from bone)

126
Q

What is the main cause of increased bilirubin on biochemistry analysis?

A

Anorexia

127
Q

True or False?
Bile acids are liver specific

A

True

128
Q

Which intercostal spaces would you use to find the liver on ultrasound?

A

Left: 7-9th intercostal space
Right: 6-17th intercostal space

129
Q

Other than pyrrolizidine, what 2 main toxins cause liver damage?

A

Mycotoxins - severe hepatic necrosis
Iron supplements - hepatic necrosis, haemochromatosis

130
Q

True or False?
A bacterial culture can be done on liver biopsies to test for Clostridium piliforme, which causes cholangiohepatitis

A

True - foals 1 week - 2 months
Also virus PCR can be done for Equine Parvovirus-Hepatitis