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Year 1/2 > Digestion & Metabolism 2: Medical Dz of Equine Colon > Flashcards

Digestion & Metabolism 2: Medical Dz of Equine Colon Flashcards

1
Q

ENDOTOXEMIA…
this is a typical sign for WHAT disease process?
= what causes clinical signs?
what 2 ways can it occur?
what IS the endotoxin?
5 clinical signs?

A

typical sign for horse with COLITIS

= clinical signs caused by INFLAMMATORY RESPONSE TO CIRCULATING ENDOTOXIN

2 ways?
1. GRAM-NEGATIVE BACTERIAL INFECTION in ANY TISSUE
2. GRAM NEGATIVE ENTERIC BACTERIA through COMPROMISED MUCOSAL BARRIER

LPS = THE ENDOTOXIN

5 clinical signs?
1. FEVER
2. TACHYPNEA
3. TACHYCARDIA
4. ACUTE D+/COLIC
5. PALE, HYPEREMIC, TOXIC LINE on MMs

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2
Q

INTESTINAL HYPERAMMONEMIA…
caused in ___ cases of COLITIS
= what is it?
caused by SEVERE ____ ____, 3 examples?
clinical signs tend to be ____, including 6 examples

A

caused in ACUTE cases of COLITIS

= INCREASED PRODUCTION/ABSORPTION of AMMONIA from GI tract due to COLITIS, so much that EVEN LIVER CANNOT CLEAR IT ALL

caused by SEVERE GI DZ, such as…
1. ENTERITIS
2. COLITIS
3. COLONIC TORSION

clinical signs tend to be NEUROLOGIC, including…
1. ATAXIA
2. DEPRESSION
3. DYSPHAGIA
4. CENTRAL BLINDNESS
5. NYSTAGMUS
6. SEIZURES

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3
Q

what diagnostic value CONFIRMS INTESTINAL HYPERAMMONEMIA?

this value DOES/DOES NOT correlate with SEVERITY OF ___ SIGNS

A

AMMONIA > 60 umol/L

this value DOES NOT correlate with SEVERITY OF NEUROLOGICAL SIGNS

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4
Q

TREATMENT for INTESTINAL HYPERAMMONEMIA? (4)

A
  1. TREAT UNDERLYING DZ (colitis)
  2. LACTULOSE to DECREASE ABSORPTION/PRODUCTION OF AMMONIA DIRECTLY in GI TRACT
  3. SEDATIVES to control neurologic signs
  4. SAFETY –> PADDED STALL, IV EXTENSION SETS OUTSIDE STALL
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5
Q

in ADULT HORSES with ACUTE D+, what are the BIG FOUR infectious causes?

what are 5 other causes?

A

BIG FOUR infectious causes?
1. SALMONELLOSIS
2. CLOSTRIDIUM PERFRINGENS/DIFF
3. POTOMAC HORSE FEVER
4. CORONAVIRUS

other causes?
1. ANTIBIOTIC-CAUSED
2. RIGHT DORSAL COLITIS/NSAID TOXICOSIS
3. CANTHARIDIN TOXICITY (blister beetles)
4. SAND
5. PARASITISM

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6
Q

SALMONELLA…
2 descriptors?
3 ways that disease can manifest? (4 subs for last one)
how long does the virus shed?
diagnosis? (2, one is a +/-)
treatment? (mainly one, antimicrobials?)

A

2 descriptors?
1. GRAM NEGATIVE
2. ENTEROBACTERIACAE

3 ways?
1. SUBCLINICAL CARRIERS where SALMONELLA SHED IN FECES
2. MILD clinical dz (mild fever, off-food)
3. ACUTE SEVERE DZ…
–> SEVERE D+
–> SEVERE COLIC
–> COAGULATION ABNORMALITIES
–> SIRS/SEPSIS

how long does the virus shed?
–> usually DAYS TO WEEKS, occasionally MONTHS

diagnosis?
1. SALMONELLA FECAL PCR IS MOST SENSITIVE
2. +/- CULTURE to determine TYPE of SALMONELLA for tx

treatment?
1. MAINLY SUPPORTIVE
2. NO DIRECT ANTIMICROBIAL TREATMENT unless SEPTIC or AT RISK FOR SEPSIS

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7
Q

why do we NOT want to use antimicrobials for SALMONELLA?

A

we DON’T WANT TO KILL OFF GOOD GI BACTERIA THAT COULD HELP GET RID OF SALMONELLA

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8
Q

CLOSTRIDIUM PERFRINGENS/DIFFICILE
2 descriptors?
can be associated with use of WHAT?
diagnosis? (2, + one that we NEVER do)
2 clinical signs?
treatment?

A

descriptors?
1. GRAM POSITIVE
2. ANAEROBES

can be associated with ANTIMICROBIAL USE

diagnosis?
1. FECAL TOXIN ELISA
2. FECAL PCR
–> we DO NOT DO CULTURE because CLOSTRIDIUM IS A PART OF NORMAL FLORA, just want to determine if STRAINS ARE PATHOGENIC

2 clinical signs?
1. COLIC
2. D+ (can be HEMORRHAGIC, has unique smell)

treatment = METRONIDAZOLE

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9
Q

POTOMAC HORSE FEVER…
caused by WHAT kinds of pathogens?
3 descriptor words?
infects what 4 types of cells?
how do horses get this? (2)
2 most IMPORTANT/COMMON clinical signs?
3 other clinical signs?

A

caused by RICKETTSIAL pathogens!

3 descriptors = OBLIGATE INTRACELLULAR PARASITE

infects…
1. MACROPHAGES
2. MONOCYTES
3. INTESTINAL EPITHELIAL CELLS
4. COLONIC MAST CELLS

how do horses get this? = horses INGEST ADULT AQUATIC HOSTS DIRECTLY

2 most imporant clinical signs?
1. SEASONALITY = MID-LATE SUMMER OR FALL
2. LAMINITIS

3 other signs?
1. FEVER
2. D+
3. SEPSIS/ENDOTOXEMIA

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10
Q

POTOMAC HORSE FEVER…
diagnosis?
treatment? when can we give it?
vaccination?
prevention? (2)

A

diagnosis? = PCR on WHOLE BLOOD & FECES

treatment? = OXYTETRACYCLINE, we can even give it BEFORE culture to HELP PREVENT LAMINITIS

vaccination OFTEN NOT EFFECTIVE because SO MANY STRAINS OF THIS DZ

prevention?
1. BARN LIGHTS OFF TO STOP ATTRACTING AQUATIC INSECTS/FLIES
2. AVOID WATER FROM NATURAL SOURCES

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11
Q

CORONAVIRUS in horses…
what TYPE of virus is this?
transmission?
what AGE of horse is likely?
what SEASON is this more likely?
4 clinical signs?
diagnosis?
treatment? (2, one main and one we don’t do)
how LONG can this virus shed?

A

RNA VIRUS

can occur in ANY AGE HORSE

occurs more in the WINTER

4 clinical signs?
1. HIGH FEVER
2. ABDOMINAL DISTENTION
3. COLIC
4. D+

treatment?
1. SUPPORTIVE
2. NO ANTIMICROBIALS

virus can shed for 3 WEEKS

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12
Q

ANTIBIOTIC-INDUCED COLITIS…
usually caused by WHAT organism? what else can cause it?

what is the PATHOPHYSIOLOGIC term for the thing that causes this?

3 commonly associated antibiotics that cause this?

what OTHER use of antibiotics can cause this?

treatment? (2)

A

usually CLOSTRIDIUM DIFFICILE, but can also be from SALMONELLA

caused by DYSBIOSIS

3 antibiotics?
1. ERYTHROMYCIN
2. TMS
3. CEFTIOFUR

MULTIPLE SWITCHES OF ANTIBIOTICS can also cause this

treatment?
1. METRONIDAZOLE if C DIFF
2. FECAL/CECAL TRANSFAUNATION if we need to reset intestinal microflora

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13
Q

____ can cause FATAL ANTIBIOTIC-INDUCED COLITIS

A

MACROLIDES

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14
Q

RIGHT DORSAL COLITIS…

can be caused by WHAT? 2 examples?

4 clinical signs?

3 lab findings? what can sometimes be the FIRST sign seen?

diagnosis? what do we see?

A

can be caused by PROLONGED or EXCESSIVE NSAID ADMINISTRATION, such as…
1. PHENYLBUTAZONE
2. FLUNIXIN MEGLUMINE

4 clinical signs?
1. D+
2. COLIC
3. TACHYCARDIA
4. VENTRAL/SHEATH EDEMA

3 lab findings?
1. HYPOPROTEINEMIA = this can be the FIRST SIGN
2. HYPOCALCEMIA
3. HYPERLACTATEMIA

diagnosis on US to see THICKENED RIGHT DORSAL COLON

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15
Q

what part of the colon is MORE SUSCEPTIBLE FOR ISCHEMIA and has a SLOWER TRANSIT TIME?

A

RIGHT DORSAL COLON

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16
Q

TREATMENT of RIGHT DORSAL COLITIS…
medications? (2)
diet? (2)
fluids? (2)

A

medications?
1. MISOPROSTOL (PG analogue) to INCREASE MUCOSAL BLOOD FLOW & REPAIR RIGHT DORSAL COLON
2. SUCRALFATE = protects ulcers

DIETARY CHANGES RECOMMENDED
1. LOW BULK DIET TO REDUCE COLONIC LOAD
2. COMPLETE PELLETED FEED & LITTLE TO NO HAY

be CAREFUL with the USE OF FLUIDS bc…
1. HYPOPROTEINEMIA
2. can get VENTRAL EDEMA from LOW ONCOTIC PRESSURE

17
Q

CANTHARIDIN TOXICITY (blister beetles)

blister beetles feed on WHAT?

the concentration of cantharidin per beetle?

causes WHAT 1 MAIN CLINICAL SIGN? what 3 other things occur?

4 CBC findings?

what 2 diseases can occur SECONDARILY?

A

blister beetles feed on FLOWERS of ALFALFA HAY

concentration of CANTHARIDIN PER BEETLE VARIES!!

1 main clinical sign = ULCERATION THROUGHOUT GI TRACT
1. SEVERE D+
2. SWEATING
3. FEVER
4. THUMPS

4 CBC findings?
1. HYPOCALCEMIA
2. HYPOMAGNESIA
3. AZOTEMIA
4. HYPOPROTEINEMIA

2 diseases?
1. NEPHROSIS/RENAL DZ
2. MYOCARDITIS

18
Q

what is THUMPS?

what clinical finding is this usually

what DISEASE is it usually associated with?

A

THUMPS = SYNCHRONOUS DIAPHRAGMATIC FLUTTER
–> “FLUTTER” in the FLANK AREA associated with PHRENIC NERVE being STIMULATED as ATRIA DEPOLARIZE, causing a “THUMPING NOISE”

usually associated with HYPOCALCEMIA

usually associated with CANTHARIDIN TOXICITY (blister beetles)

19
Q

CANTHARIDIN TOXICITY (blister beetles)

diagnosis? (3)

treatment? (3)

mineral oil/charcoal?

A

diagnosis?
1. based on CLINICAL SIGNS
2. horse is ON ALFALFA/BLISTER BEETLES FOUND IN HAY
3. can measure CANTHARIDIN CONCENTRATION in GASTRIC/INTESTINAL contents or URINE

treatment?
1. FLUID THERAPY & ELECTROLYTE CORRECTION
2. mostly SUPPORTIVE CARE
3. ANALGESIA

MINERAL OIL/CHARCOAL = prevents ABSORPTION of the toxin

20
Q

CHRONIC D+ DDxs…
(3 main, 2 subs for first)

A
  1. INFILTRATIVE BOWEL DZ
    –> IBD
    –> NEOPLASIA (lymphoma)
  2. SAND ENTEROPATHY
  3. IDIOPATHIC
21
Q

INFILTRATIVE BOWEL DZ…

2 main diseases? 4 subs for first

typically presents with ?? signs, including 3 specific

A

2 main diseases?
1. INFLAMMATORY BOWEL DZ
–> GRANULOMATOUS
–> EOSINOPHILIC
–> LYMPHOCYTIC/PLASMACYTIC
–> MULTISYSTEMIC EOSINOPHILIC EPITHELIOTROPHIC ENTERCOLITIS (MEED)

  1. NEOPLASIA (LYMPHOMA IS THE MOST COMMON FOR GI NEOPLASIAS)

typically presents with CHRONIC signs, including 3 specific…
1. WEIGHT LOSS
2. D+
3. ANEMIA

22
Q

4 options for DIAGNOSIS of INFILTRATIVE BOWEL DZ?

A
  1. ABDOMINAL US
  2. INTESTINAL BIOPSY
  3. ORAL GLUCOSE ABSORPTION TEST
  4. PERITONEAL FLUID CYTOLOGY
23
Q

TREATMENT for INFLAMMATORY BOWEL DZ?
5 options, first and last one has 2 subs

hints: food, steroids, parasites

PROGNOSIS?

A
  1. CORTICOSTEROIDS tapered to MINIMAL EFFECTIVE DOSE
    –> DEXAMETHOSONE (better IV/IM if MALABSORPTIVE DZ)
    –> PREDNISONE
  2. ANTIHELMINTICS
    –> MOXIDECTIN
  3. ANABOLIC STEROIDS to BOOST APPETITE
  4. DIETARY MODIFICATION
    –> LOW BULK DIETS for diseased LI
    –> EASILY-DIGESTED PELLETED FEEDS for diseased SI

prognosis is VARIABLE bc hard to reach root cause

24
Q

LYMPHOMA IN HORSES…
3 types? what’s the MOST COMMON?

in the MOST COMMON TYPE…
what age horses?

where does it tend to occur?

4 clinical signs?

A

3 types?
1. MULTICENTRIC
2. CUTANEOUS
3. INTESTINAL TYPE = MOST COMMON INTESTINAL NEOPLASM IN HORSES

in INTESTINAL TYPE…
age = in YOUNG horses
location = SI > LI, but can occur in both

clinical signs?
1.CHRONIC D+
2. WEIGHT LOSS
3. PLE
4. COLIC/INTESTINAL OBSTRUCTION

25
Q

TREATMENT (2) & PROGNOSIS for INTESTINAL LYMPHOMA in HORSES?

A

treatment?
1. CORTICOSTEROIDS

  1. can do RESECTION if ONLY ONE SMALL AREA AFFECTED

prognosis?
–> survive DAYS TO YEARS depending on LOCATION, AMOUNT OF GI AFFECTED & HOW LATE IN DZ we’ve diagnosed

26
Q

SAND ENTEROPATHY…

what 2 states is it most common in?

what 3 clinical signs are most common?

2 PE findings?

diagnostics? (3)

A

found in CA and NJ where there’s A LOT OF SANDY SOIL

3 clinical signs = NON-SPECIFIC
1. COLIC
2. FEVER
3. D+

2 PE findings?
1. upon VENTRAL ABDOMEN AUSCULTATION, hear “WAVES OVER SAND, SHOOSH” sounds
2. HEAVY over VENTRAL MIDLINE

diagnostics?
1. ABDOMINAL RADS
2. US
3. FECAL SAND SEDIMENTATION

27
Q

for IDIOPATHIC diarrhea/colitis, what 4 things should we rule out?

A
  1. IBD
  2. NEOPLASIA
  3. INFECTIOUS CAUSES
  4. FUNGAL
28
Q

diagnostics for chronic D+? (7)

A
  1. ABDOMINAL US
  2. ABDOMINAL RADS
  3. GASTROSCOPY
  4. DUODENAL BIOPSIES
  5. INTESTINAL BIOPSIES
  6. ABDOMINOCENTESIS
  7. GLUCOSE ABSORPTION TEST
29
Q

are antibiotics usually used for COLITIS in ADULT HORSES?

EXCEPTIONS? (4)

A

NOT USUALLY USED, unless..

  1. < 6 months of age bc MORE PRONE TO GET SEPSIS from COLITIS
  2. CLOSTRIDIAL COLITIS SUSPECTED or DIAGNOSED –> METRONIDAZOLE
  3. POTOMAC HORSE FEVER SUSPECTED or DIAGNOSED –> OXYTETRACYCLINE
  4. SEVERE NEUTROPENIA (<1000 ug/mL) or SEVERE DEGENERATIVE LS so HIGH RISK OF SEPSIS
30
Q

3 steps for ENDOTOXEMIA treatment?

A
  1. REMOVE CAUSE/TRIGGER of COLITIS
  2. NEUTRALIZE CIRCULATING ENDOTOXIN
  3. INHIBIT ENDOTOXIN-INDUCED INFLAMMATION
31
Q

how can we NEUTRALIZE circulating endotoxin? (2)

A
  1. HYPERIMMUNE PLASMA = horses with immunity against endotoxin can provide their plasma with HELPFUL FACTORS
  2. POLYMIXIN B = broad-spectrum CYCLIC PEPTIDE ANTIBIOTIC with POTENT ENDOTOXIN-BINDING ACTIVITY
32
Q

2 ways to inhibit ENDOTOXIN-INDUCED INFLAMMATION?

A
  1. NSAIDs at a QUARTER OF REGULAR DOSE (flunixin meglumine)
  2. PENTOXIFYLLINE
33
Q

ANTICOAGULANT THERAPY can be used for WHAT disease?

A

ENDOTOXEMIA

34
Q

ANTIOXIDANTS & DMSO can be used for…..

in WHAT disease?

A

can be used to SCAVENGE REACTIVE OXYGEN SPECIES that may be present in ENDOTOXEMIA

35
Q

GASTROPROTECTANT DRUGS (4)

A
  1. SUCRALFATE (protective for GI mucosa/ulcers)
  2. MISOPROSTOL (PG analog)
  3. PSYLLIUM
  4. SACCROMYCES BOULARDII (yeast probiotic)
36
Q

what is CRYOTHERAPY used for in horses?

HOW does it work? (2)

contraindicated if…

A

used to MAINTAIN HOOF TEMPERATURE LOWER THAN 10 C to REDUCE EFFECT OF ENDOTOXEMIA ON FEET & PREVENT LAMINITIS

HOW does it work?
1. helps cause VASOCONSTRICTION to LIMIT DELIVERY FOR TRIGGERS FOR LAMINITIS
2. DECREASES tissue METABOLIC RATE to REDUCE PRODUCTION and ACTIVATION OF MMPs

contraindicated if UNDERLYING PROBLEMS WITH LEGS OR SKIN

Year 1/2 (139 decks)

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