Diarrhoea in Horses and Foals Flashcards Preview

Alimentary > Diarrhoea in Horses and Foals > Flashcards

Flashcards in Diarrhoea in Horses and Foals Deck (21):
1

adult vs foal - large vs small intestine

adult - LI only
foal - can be both

2

DDx - neonates

Foal heat diarrhoea
Viral especially Rotavirus
Salmonella
Clostridia
Necrotizing enterocolitis
Sepsis
Nutritional diarrhoea
Parasitic diarrhoea – Strongyloides westeri
Gastroduodenal ulceration

3

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

4

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

5

what is acute diarrhoea

Acute onset febrile diarrhoea
Clinical signs of hypovolaemia, endotoxaemia

6

acute diarrhoea - causes

Salmonellosis
Parasitism (Larval cyathostominosis,strongylosis)
Clostridiosis
antimicrobial-associated diarrhoea
NSAID toxicity (right dorsal colitis)
Sand enteropathy
Carbohydrate overload

7

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

8

why try to make definitive diagnosis?

specific treatment
contagious +/- zoonosis

9

principles of therapy

address fluid loss
Address inflammation and endotoxaemia
Address specific cause

10

fluid therapy

check deficit
maintenance of fluid levels
ongoing losses need to be factored in

11

what is endotoxin

Part of the outer membrane of gram negative bacteria Released during cell death or rapid growth

12

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

13

effects of endotoxaemia

Interacts with cells eg macrophages
Initiates systemic inflammation
Clinical signs of endotoxaemia
CV and GI dysfunction, shock, organ failure, death

14

endotoxaemia - clinical signs

Depression
tachycardia
Tachypnoea
fever
Colic
Diarrhoea
Hyperaemic ‘toxic’ mucous membranes

15

endotoxaemia - diagnosis

clinical signs
low white cell count
low neutrophil count
immature band neutrophils

16

endotoxaemia - treatment

1. Prevent movement of endotoxin into the circulation
2. Neutralize endotoxin before it interacts with inflammatory cells
3. Prevent synthesis, release or action of inflammatory mediators
4. Prevent endotoxin-induced cellular activation

17

endotoxaemia - prevent access to circulation

remove dead tissue with exposed mucosa

18

endotoxaemia - drugs

Polymixin B
Hyperimmune plasma
Pentoxyfilline
Flunixin

19

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

20

foals on fluids

smaller volumes
intermittent, freq boluses or seperate mare + foal for continuous fluids
labour intensive

21

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