weightloss treatment Flashcards
what is the core therapy for inflammatory bowel disease in horses?
Prolonged corticosteroid therapy
* Dexamethasone 0.05 mg/kg IM daily for 2 weeks, then
* Prednisolone 0.5-1mg/kg for 3 weeks oral
Or
* Dexamethasone 0.03mg/kg for 3 weeks oral
Followed by tapering dose another 6 weeks (half the dose and every other day dosing)
what is the treatment for inflamatory bowel disease in horses caused by localised idiopathic eosinophilic enteritis?
resection and anastomosis
what are the chemotherapeutic agens used for lyphosarcomas in horses that are causing weight loss?
azathioprine, vincristine
what are the dietatry reccomendatino for weight loss caused by inflammatroy bowel diseae?
- A highly digestible and well-balanced feed providing a small feeds during the day to optimise the limited absorptive capacity of the small intestine.
◦ fibre diets with vegetable oils should maximise the production of volatile fatty acids in the large intestine and reduce the workload of the small intestine for its absorptive functions.
‣ Add vegetable oils to diet: corn/sunflower/flaxseed
◦ Prioritize monodiet with fibre (avoid commertial feeds): decrease inciting antigens??
what is the treatment for weight loss caused by proliferative enteropathy?
Antibiotics: Tetracyclines
* Intravenous oxytetracycline (6.6 mg/kg every 12 hours) for 1 week followed by doxycycline (10 mg/kg every 12 hours PO)
OR
* Macrolide and rifampin (5–10 mg/kg every 24 hours PO)
Antibiotic therapy 2-3 weeks»but rapid response to treatment clinically: 82-93% resolved
* No steroids - use NSAIDs if pyrexia
* IV fluids and plasma/ colloids if profuse diarrhoea & severe hypoalbuminemia
what is the treatment for largintestinal causes of weight loss in horses?
Treat diarrhoea if present: supportive fluids, plasma/colloids, +/- NSAIDs
what is the treatment for weight loss cuased my right dorsal colitis?
withdrawl of NSIADS
prostaglandin analoges: misoprostol (2-5ug/kg BID orally)
what is the treatment for weight loss caused by chronic sand enteropathy in horses?
- Psyllium and MgSO4 (both 1g/kg by nasogastric tube ): daily for 5-7 days (then can be continued orally)
- NSAIDs (flunixin 1.1mg/kg BID)
- Surgical emptying if refractory to medical therapy (14-31%)
- Enough roughage: hay/haylage or alfalfa mix
- Do not feed on the ground: rubber mats, feeders, hay nets…
what are the supportive care treatments for weight loss caused by hepatic disease?
- Vitamin E: 20IU/kg
- Milk Thistle extracts (Silymarin):
- S-adenosylmethionine: 24mg/kg PO q 24h
- N-acetylcysteine: (70-80mg/kg IV q8h)
what is the mechanism of milk thistle extract for the treatemtn of weight loss caused by hepatic disease?
◦ inhibits hepatic fibrosis
◦ encourages hepatocyte regeneration
◦ anti-oxidant
what is the mechanism of S-adenosylmethionine fo rthe treatment of weightloss caused by hepatic disease?
◦ increases glutathione synthase in hepatocytes
◦ stabilises
what is the mechanism of N-acetylcysteine for the treatment of weightloss caused by hepatic disease?
◦ Cytoprotective (through cysteine pathway
◦ increase microcirculation and O2 delivery
what diet should be used for horses suffering from weight loss due to hepatic causes?
- High carbohydrate (be careful in obese horses)
- Low protein (high branch aa/aromatic aa ratio)
◦ Beet-pulp
◦ Cracked corn
◦ Milo/Sorgum/bran - Be careful with hyperphosphatemia - NUTRITIONAL SECONDARY HYPERPARATHYROIDISM = OSTEODYSTROPHIA FIBROSA - if used as sole diet of the horse - Small frequent feedings: reduce glucogenic load
- Avoid alfalfa and legume type grasses (high protein)
- Control fats (poor metabolic capacity of liver)
- Vitamin B complex: injectable particularly in acute disease
what is the prognosis and treatment of weight loss caused by pyrrolizidine alkaloids?
- Irreversible damage: liver biopsy will aid to establish long term prognosis
Use antioxidants and diet and: - Antifibrotic agents
◦ Steroids: dexamethasone (0.05-0.1mg/kg q 24h IM/oral) or prednisolone (1mg/kg PO q24h) several weeks, followed by tapering dose
◦ Colchicine: (0.01-0.03mg/kg PO q )
what is the treatment for weight loss caused by cholangiohepatitis ?
- Antibiotics: broad-spectrum (+++Gram Neg +/- anaerobs)
◦ Potentiated sulphonamides»_space;»enterohepatic circulation
◦ 25mg/kg PO q 12h
◦ Fluoroquinolones: Enrofloxacin 7.5mg/kg PO q 24h
◦ Cephalosporins: 2-5mg/kg q IV/IM12h
◦ +/- Metronidazole: 15-20mg/kg PO q8h - Ideally based on liver biopsy culture sensitivity
- Therapy should be continued until 2-4 weeks with normal liver enzymes and no fever
