Diarrhoea in Horses and Foals Flashcards
(21 cards)
adult vs foal - large vs small intestine
adult - LI only
foal - can be both
DDx - neonates
Foal heat diarrhoea Viral especially Rotavirus Salmonella Clostridia Necrotizing enterocolitis Sepsis Nutritional diarrhoea Parasitic diarrhoea – Strongyloides westeri Gastroduodenal ulceration
DDx - older foals (10-12 months)
Cryptosporidiosis
Parasitic diarrhoea – Strongylus vulgaris, cyathostomins
Proliferative enteropathy - Lawsonia intracellularis
Rhodococcus equi colitis
Viral, especially Rotavirus
Salmonella
Clostridia
Sepsis
Nutritional diarrhoea
Gastroduodenal ulceration
Parasitic diarrhoea – Strongyloides westeri
DDx - adults
Salmonellosis Clostridiosis Parasitism (Larval cyathostominosis, strongylosis) Antimicrobial-associated diarrhoea NSAID toxicity (right dorsal colitis) Sand enteropathy Carbohydrate overload Inflammatory or infiltrative disorders – IBD Dietary: abnormal fermentation Neoplasia – Lymphoma Peritonitis, Abdominal abscessation undiagnosed
what is acute diarrhoea
Acute onset febrile diarrhoea
Clinical signs of hypovolaemia, endotoxaemia
acute diarrhoea - causes
Salmonellosis Parasitism (Larval cyathostominosis,strongylosis) Clostridiosis antimicrobial-associated diarrhoea NSAID toxicity (right dorsal colitis) Sand enteropathy Carbohydrate overload
chronic diarrhoea - causes
Salmonellosis
Parasitism (Larval cyathostominosis, strongylosis)
Sand enteropathy
NSAID toxicity (Right dorsal colitis)
Inflammatory of infiltrative disorders – IBD
Dietary: abnormal fermentation
Neoplasia – Lymphoma, Peritonitis, Abdominal abscessation
why try to make definitive diagnosis?
specific treatment
contagious +/- zoonosis
principles of therapy
address fluid loss
Address inflammation and endotoxaemia
Address specific cause
fluid therapy
check deficit
maintenance of fluid levels
ongoing losses need to be factored in
what is endotoxin
Part of the outer membrane of gram negative bacteria Released during cell death or rapid growth
where does endotoxin come from
Horse GIT normally has large numbers of G-ve bacteria in lumen - fermentation/digestion
Normal mucosal barrier prevents access to circulation
mucosal barrier breakdown = endotoxaemia
effects of endotoxaemia
Interacts with cells eg macrophages
Initiates systemic inflammation
Clinical signs of endotoxaemia
CV and GI dysfunction, shock, organ failure, death
endotoxaemia - clinical signs
Depression tachycardia Tachypnoea fever Colic Diarrhoea Hyperaemic ‘toxic’ mucous membranes
endotoxaemia - diagnosis
clinical signs
low white cell count
low neutrophil count
immature band neutrophils
endotoxaemia - treatment
- Prevent movement of endotoxin into the circulation
- Neutralize endotoxin before it interacts with inflammatory cells
- Prevent synthesis, release or action of inflammatory mediators
- Prevent endotoxin-induced cellular activation
endotoxaemia - prevent access to circulation
remove dead tissue with exposed mucosa
endotoxaemia - drugs
Polymixin B
Hyperimmune plasma
Pentoxyfilline
Flunixin
foals and endotoxaemia
Similar effects as in adult horses
Usually associated with bacteraemia/sepsis
Large colon less well developed
gram negative bacteria population smaller?
Concern regarding nephrotoxicity - polymixin B, flunixin
Treatments - plasma, antibiotics
foals on fluids
smaller volumes
intermittent, freq boluses or seperate mare + foal for continuous fluids
labour intensive
treat vs refer
If horse/foal can keep up with fluid requirements by drinking, then probably OK to treat at home
Best to be over cautious with foals as they can deteriorate very rapidly
Contagious?
Isolation facilities can be provided at a hospital
