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Gastropathology - Large Animal > Equine > Flashcards

Equine Flashcards

1
Q

in “choke” most obstructions occur in the _________

A

proximal esophagus

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2
Q

What are some potential causes of esophageal obstruction? (4)

A
  • hay, pellets, cubes
  • beet pulp (if not moistened prior to feeding)
  • foreign bodies (apples, potatoes)
  • rapid consumption without adequate chewing (eating too fast)
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3
Q

Clinical signs of equine esophageal obstruction (5)

A
  • distress
  • head extension
  • salivation
  • nasal discharge (food/saliva)
  • lethargy, dehydration
  • +/- abnormal lung sounds
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4
Q

Tests/signs used for diagnosis of esophageal obstruction (5)

A
  • history and CS
  • esophageal palpation
  • resistance upon passage of a nasogastric tube
  • endoscopy
  • radiography
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5
Q

treatment of esophageal obstruction (3)

A
  • sedation (xylazine or detomidine, butorphanol)
  • gentle passage of a stomach tube
  • esophageal relaxation (Buscopan, oxytocin, lidocaine)
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6
Q

How does sedation help reduce the risk of aspiration pneumonia in a choke?

A

sedating the animal appropriately will help to lower the head below the withers, gravity will cause any reflux to be more likely to drain out the nose rather than into the lungs

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7
Q

3 potential drug choices for sedating a choke

A
  • xylazine
  • detomidine
  • butorphanol
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8
Q

3 potential drug choices for esophageal relaxation (choke treatment)

A
  • Buscopan
  • oxytocin
  • lidocaine
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9
Q

Management of a choke once the obstruction has been cleared (4)

A
  • analgesia (NSAIDS)
  • slow return to normal diet (gruel, slow down bolt feeders)
  • exclusion of underlying causes (dental exam, +/- endoscopy for repeat offenders)
  • treatment/prevention of pneumonia (antibiotics)
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10
Q

Potential complications of choke (4)

A
  • laryngeal hemiplagia (impingement on the recurrent laryngeal nerve from a longstanding obstruction)
  • esophageal erosion
  • esophageal eruption
  • feed/saliva in the trachea (aspiration pneumonia)
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11
Q

What is a potential cause of esophageal obstruction that doesn’t originate from foreign material ingestion?

A

esophageal neoplasia (tumors projecting into esophageal lumen)

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12
Q

________________ is a catch all term for abdominal pain

A

colic

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13
Q

Basic mechanisms of GI pain (4)

A

distension of a viscus

  • traction on the mesentery
  • ischemia
  • inflammation
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14
Q

Primary questions for every colic evaluation

A

Can pain be controlled?

Is the problem in the SI or LI?

Is it likely strangulating or non-strangulating?

Is surgery likely indicated?

Prognosis? (Is immediated euthanasia indicated?)

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15
Q

____________ is the most common ‘quadrant’ type of colic

A

LI non-strangulating

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16
Q

2 most prevelant causes of the most common type of colic

A
  • gas/spasmodic
  • large colon impaction
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17
Q

T/F

80-85% of colics will resolve in the field with one treatment

A

T

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18
Q

Subtle clinical signs of colic (3)

A
  • anorexia
  • lying down more than usual
  • decreased fecal production
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19
Q

Moderate CS of colic (4)

A
  • pawing
  • stretching
  • flank watching
  • abdominal distension
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20
Q

Severe CS of colic (4)

A
  • rolling
  • thrashing
  • becoming cast
  • facial abrasions
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21
Q

Important characteristics of pain upon colic presentation (6)

A
  • duration
  • persistence
  • severity
  • response to analgesics
  • breed, age, and individual variability
  • severe pain replaced by depression (major concern)
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22
Q

Should temperature be taken before or after the retal exam?

A

before

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23
Q

4 characteristics you should evaluate the mucous membranes for

A
  • color
  • moisture
  • CRT
  • is a toxic line present?
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24
Q

What is the most important characteristic of gut sounds in a colic?

A

Whether or not they are present (complete absence of sounds is important)

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25
Q

What is Borborygmi?

A

gut sounds

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26
Q

4 questions you want to answer with your rectal palpation

A

Distension, yes or no?

SI or LI?

Gas, fluid, feed?

Masses?

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27
Q

___________ is one of the “few life saving things we can do” in a colic evaluation and should be performed on EVERY moderate to severely painful colic

A

nasogastric intubation

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28
Q

with a colic, >_____L net reflux is significant, and if you have >____L of net reflux you should consider leaving the tube in place

A
  • 2-3 L
  • 5L
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29
Q

When is radiography helpful in colic diagnosis?

A

When minerals are involved (sand, enteroliths)

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30
Q

3 types of imaging used in colic diagnosis

A
  • transabdominal US
  • rads
  • endoscopy
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31
Q

When should abdominocentesis not be performed on a colic?

A

When the results will not influence the course of treatment

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32
Q

What is abdominocentesis typically used for in a colic work-up?

A

to differentiate between SI strangulating and non-strangulating

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33
Q

Does normal fluid from abdominocentesis rule out strangulation?

A

no

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34
Q

What characteristics are you using to interpret abdominocentesis? (4)

A
  • gross appearance
  • odor
  • lactate levels
  • cytological examination
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35
Q

peritoneal fluid lactate levels >2x that of plasma are indicative of what?

A

strangulation

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36
Q

Abdominal fluid should not contain _________, should have WBC values between ________-_________, and should have a protein value < ____ g/dL

A
  • blood
  • WBC: 5,000-10,000 cells/uL
  • <2 g/dL
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37
Q

2 initial therapies for a colic

A
  • analgesic therapy: drugs and gastric decompression (relieve pressure)
  • fluid therapy
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38
Q

Analgesic/Sedative options for colic therapy (4)

A
  • NSAIDs
  • alpha2-agonists
  • opiods
  • Buscopan
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39
Q

2 route options for fluid therapy

A
  • enteral
  • IV
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40
Q

CS of “mild” Dehydration (4-6%)

  • CRT
  • MM
  • Skin tent
  • PCV%
  • TS (g/dL)
A
  • 1-2s
  • fair
  • 2-3s
  • 40-50
  • 6.5-7.5
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41
Q

CS of “moderate” Dehydration (7-9%)

  • CRT
  • MM
  • Skin tent
  • PCV%
  • TS (g/dL)
A
  • 2-4s
  • tacky
  • 3-5s
  • 50-60
  • 7.5-8.5
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42
Q

CS of “severe” Dehydration (>10%)

  • CRT
  • MM
  • Skin tent
  • PCV%
  • TS (g/dL)
A
  • >4s
  • dry
  • >5s
  • >65
  • >8.5
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43
Q

When are enteral fluids contraindicated in a colic?

A

when there is >2-3 L of reflux

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44
Q

Laxative options for colic (3)

A
  • psyllium
  • mineral oil
  • MgSO4
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45
Q

General protocol for enteral fluid administration?

A

6-8L every 2-6 h

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46
Q

When are IV fluids indicated for a colic? (3)

A
  • reflux
  • severe pain
  • substantial dehydration
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47
Q

EGUS stands for ____________

A

Equine Gastric Ulcer Syndrome

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48
Q

2 sub-categories of EGUS

A
  • equine squamous gastric ulcer disease
  • equine glandular gastric disease
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49
Q

Diagnosis of gastric ulcers

A
  • CS and response to treatment
  • gastroscopy (determine squamous v. glandular)
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50
Q

4 risk factors for squamous gastric ulcers

A
  • diet
  • exercise
  • environment
  • NSAIDs
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51
Q

Risk factors for glandular gastric ulcers?

A

largely unknown

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52
Q

_______ is the only thing labeled for treatment of gastric ulcer disease in the US

A

Omeprazole

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53
Q

Which is more difficult to treat, squamous or glandular gastric ulcers?

A

glandular

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54
Q

What is the difference for treatment of squamous gastric ulcers vs. glandular?

A

longer duration of therapy for glandular ulcers and typically add sucralfate

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55
Q

Which colic category has the best prognosis? Which has the worst?

A
  • best: LI non-strangulating
  • worst: SI strangulating
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56
Q

Non-strangulating causes of colic (3)

A
  • intraluminal obstructions
  • large colon displacements
  • gas/spasmodic colic
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57
Q

5 examples of intraluminal impactions which may cause colic

A
  • gastric impaction (rare)
  • ileal impaction
  • cecal impaction
  • large (ascending) colon impaction
  • small colon impaction
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58
Q

What form of colic occurs almost exclusively in the southeastern US and what are its risk factors (3)?

A

Ileal impaction

  • feeding Coastal Bermuda grass hay (often after introduction of a new round bale)
  • tapeworms
  • cold weather (decreased drinking and more likely to be eating hay and not fresh grass)
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59
Q

Clinical findings of an ileal impaction

A
  • moderate, potentially severe pain
  • distended SI on rectal
  • Reflux: initially none, but may develop when fluid distends the entire SI
  • Peritoneal fluid: typically normal, may have slight/mod increase in TS, lactate similar to plasma
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60
Q

Treatment for ileal impaction

A
  • gastric decompression
  • withdrawal of feed and water
  • analgesics
  • IV fluid therapy
  • +/- deworming for tapeworms
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61
Q

When should surgical intervention be considered for an ileal impaction?

A
  • if no improvement within 24-36 hours
  • abnormal peritoneal fluid
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62
Q

Prognosis for an ileal impaction?

A

good to excellent

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63
Q

2 risk factors for a cecal impaction

A
  • broodmares near partruition
  • recent general anesthesia
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64
Q

Clinical findings of a cecal impaction

A
  • pain variable (often mild early)
  • typically no net reflux
  • peritoneal fluid typically normal
  • Rectal findings: cecal distension, feed or fluid
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65
Q

T/F:

Rupture is a common complication of a cecal impaction

A

T

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66
Q

Treatment for cecal impaction

A
  • early identification
  • withdrawal of feed
  • enteral laxatives
  • IV fluids
  • rupture is common, surgery is often required
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67
Q

Cecal impaction prognosis?

A

Guarded, likely improved with surgery

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68
Q

Most large colon impactions occur at the __________

A

pelvic flexure

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69
Q

Large colon impactions are typically caused by ________ or ________

A
  • feed
  • sand
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70
Q

Risk factors for large colon impaction (7)

A
  • inadequate water intake (often associated with change in weather)
  • ingestion of sand
  • parasite burden
  • poor dentition
  • sudden stall confinement
  • alternate source of pain (ocular/MS)
  • coarse, poor quality roughage
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71
Q

Clinical signs of large colon impaction (6)

A
  • mild to moderate pain
  • decreased to absent fecal output
  • ↓ gut sounds
  • Rectal exam: impaction, variable gas distention
  • variable reflux
  • normal abdominal fluid
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72
Q

Large colon impaction treatment (4)

A
  • withdrawal of feed
  • pain management
  • enteral fluids
    • water/electrolytes
    • lubricants/laxatives
    • psyllium (if sand)
  • IV fluids if reflux develops
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73
Q

Prognosis of large colon impaction?

A

very good

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74
Q

CS of small colon impaction (3)

A
  • colic
  • abdominal distension
  • low volume diarrhea
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75
Q

small colon colic often presents during the _____ months

A

winter

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76
Q

Diagnosis of small colon impaction

A

rectal exam (often friable)

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77
Q

Small colon impaction prognosis

A

good

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78
Q

Enteroliths are primarily made of __________

A

magnesium ammonium phosphate (struvite)

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79
Q

Risk factors for enterolith development (4)

A
  • Arabians
  • horses >5 yo
  • diet high in protein, Mg
  • high colonic luminal pH
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80
Q

Enterolith frequency is variable by region, but particularly high in ________-

A

California

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81
Q

Clinical findings for enteroliths (3)

A
  • intermittent mild-to-moderate pain
  • typically normal rectal exam
  • peritoneal fluid often normal
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82
Q

T/F: Absence of appearance on radiographs rules out the presence of an enterolith

A

False

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83
Q

What is the significance of a flat surface on an enterolith?

A

It means there are multiple stones present and they need to be accounted for during surgical extraction

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84
Q

treatment/prevention for enteroliths

A
  • surgical removal
  • restrict alfalfa (<50%)
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85
Q

What type of colic is a large colon displacement?

A

LI non-strangulating

86
Q

Large colon displacement prognosis

A

good with medical or surgical therapy

87
Q

Left dorsal displacement of the colon is also known as _________________

A

nephrosplenic entrapment

88
Q

Rectal exam findings for L dorsal large colon displacement (2)

A
  • distended colon lateral to kidney
  • spleen may be displaced ventrally
89
Q

US findings with L large colon displacement (2)

A
  • gas-filled colon prevents imaging of the left kidney
  • spleen may be displaced ventrally
90
Q

treatment for L dorsal large colon displacement (3)

A
  • phenylephrine and exercise (induce splenic contraction and attempt to ‘bounce’ the colon off the spleen with jogging)
  • rolling under general anesthesia
  • surgical correction
91
Q

In a R dorsal displacement of the large colon, the ______ migrates cranially, medial or lateral to the ______

A
  • pelvic flexure
  • cecum
92
Q

Treatment for R dorsal large colon displacement (3)

A
  • fluid therapy
  • limited exercise
  • surgical correction
93
Q

All _________ colics need to go to surgery

A

SI strangulating

94
Q

LI strangulating obstructions are caused by _________

A

volvulus

95
Q

CS for SI strangulation (8)

A
  • acute, severe pain
  • significant tachycardia, often >80 bpm
  • evidence of toxemia
  • hemoconcentration (PCV >50%)
  • Rectal exam: Distended SI, often thickened and/or edematous
  • often high volume reflux, providing little to no relief
  • US: SI distention; possibly thick walled
  • peritoneal fluid: Serosanguinous, ↑ protein and WBC, ↑ lactate relative to blood
96
Q

SI strangulation treatment

A

surgical correction: resection/anastomosis

97
Q

SI strangulation prognosis is dependent upon _____ and _____

A
  • lesion location
  • quantity of SI affected (>50% indicates poor to grave prognosis)
98
Q

Potential SI strangulation lesions (5)

A
  • volvulus
  • incarceration
  • intestinal adhesions
  • intussusception
  • pedunculated lipoma
99
Q

4 types of intestinal incarceration

A
  • epiploic foramen
  • inguinal hernia
  • umbilical hernia
  • mesenteric rent
100
Q

Epiploic foramen entrapment is more common in _______

A

cribbers

101
Q

What’s the most common type of intussception?

A

jejunal-jejunal

102
Q

Large colon volvulus usually occurs at the _____ and is most common in _________

A
  • base of the large colon
  • broodmares (typically during the first 30 days post-foaling)
103
Q

Clinical findings of Large colon volvulus (5)

A
  • severe abdominal pain (usually refractory to analgesics)
  • severe tachycardia (usually >80 bpm)
  • toxemia (mucous membranes, CRT)
  • severe LC gas distension on rectal exam
  • variable amounts of reflux, typically none
104
Q

Treatment for large colon volvulus

A

Immediate surgical correction is required (replacement only or replacement and resection)

105
Q

Inflammatory GI conditions of the SI (3)

A
  • duodenitis/proximal jejunitis
  • miscellaneous inflammatory
  • proliferative enteropathy
106
Q

Inflammatory GI conditions of the colon (2)

A
  • acute diarrhea
  • chronic diarrhea
107
Q

____________: inflammation and stasis of the proximal segments of the SI

A

Duodenitis-Proximal Jejunitis (DPJ)

108
Q

3 potential causes of Duodenitis-Proximal Jejunitis

A
  • Salmonella
  • Clostridium
  • Fungal toxins
109
Q

CS of Duodenitis-Proximal Jejunitis (5)

A
  • moderate pain (typically relieved by gastric decompression)
  • low-grade fever
  • dilated SI on rectal
  • dilated +/- thick SI on US
  • ↑ TS on abdominal tap
110
Q

DPJ vs. Strangulation

A

DPJ: Strangulation

  • low grade fever (101.5-103 F): typically normothermic
  • pain, HR ↓ with gastric decompression: pain, HR not related to reflux
  • peritoneal fluid: typically normal color, PF:plasma lactate <2: serosanguinous, PF:plasma lactate >2
111
Q

Treatment for DPJ (6)

A
  • gastric decompression
  • anti-inflammatories (NSAIDs, lidocaine)
  • IV fluid therapy
  • +/- antibiotics
  • +/- parenteral nutrition
  • +/- prokinetics
112
Q

DPJ prognosis

A

good with adequate supportive care and resources

occasionally may require surgery (doesn’t alter prognosis)

113
Q

Potential complications of DPJ (4)

A
  • laminitis
  • peritonitis
  • adhesions
  • cholangiohepatitis
114
Q

CS of inflammatory bowel disease (5)

A
  • weight loss
  • recurrent colic
  • severe colic
  • eosinophilic enteritis
  • edema
115
Q

2 potential iatrogenic causes of Inflammatory Bowel Disease

A
  • corticosteroids
  • immune suppressants
116
Q

Infectious causes of acute diarrhea (7)

A
  • Salmonella species
  • Neorickettsia risticii (Potomac Horse Fever)
  • Clostridium difficile
  • Clostridium perfringens
  • larval cyathostomosis
  • coronavirus
  • other viral causes (foals)
117
Q

Non-Infectious causes of acute diarrhea (5)

A
  • diet changes (composition, quantity)
  • antibiotics (routine, ionophore)
  • NSAIDs (Right Dorsal Colitis; RDC)
  • Cantharidin (blister beetle)
  • heavy metals
118
Q

CS of acute diarrhea (7)

A
  • endotoxemia
    • fever
    • increased HR, RR
    • toxic MM
  • dehydration
  • diarrhea
    • volume, consistency variable
    • hemorrhagic rare
  • colic: can precede diarrhea
  • +/- ventral edema
  • often ↑ gut sounds (though may be ↓ initially)
  • fluid filled colon +/- cecum; variable distention
119
Q

Lab data values in acute diarrhea (6)

A
  • neutropenia with toxicity and L shift
  • metabolic or lactic acidosis
  • ↓ Na, Cl, K, and Ca
  • azotemia (often pre-renal)
  • ↓ TP (may be relative if hemoconcentrated)
  • ↑ liver enzymes (AST, GGT, SDH)
120
Q

Which cause of acute diarrhea has a blood diagnosis?

A

N. risticii PCR (Potomac Horse Fever)

121
Q

Causes of acute diarrhea diagnosed via fecal examination (5)

A
  • Salmonella (culture/PCR)
  • Clostridium toxin ELISA
  • Parasites - direct/floatation
  • sand sedimentation
  • Coronavirus PCR
122
Q

Basic treatment for acute diarrhea (4)

A
  • volume replacement, maintenance (crystalloids)
  • colloids
  • oral fluid replacement (less severe cases)
  • bind intestinal free toxin (Biosponge)
123
Q

Endotoxin related therapies for acute diarrhea (3)

A
  • NSAIDs
    • analgesic, COX-inhibition
    • Flunixin meglumine
  • Polymixin B
  • Digital hypothermia
124
Q

What’s the purpose of icing feet during endotoxic events?

A

prevention for laminitis

125
Q

Treatment of acute diarrhea (5)

A

Supportive care

  • ISOLATION!!
  • catheter maintenance
  • tail wrap
  • heavy bedding
  • perineal care
126
Q

Antibiotic therapy should be avoided in adult horses with acute diarrhea, except in the event of ________, _____, ___________, or __________

A
  • PHF
  • clostridiosis
  • substantial leukopenia (total WBC <2000/uL)
  • peritonitis
127
Q

Potential complications of acute diarrhea (6)

A
  • laminitis
  • renal failure
  • thrombophlebitis
  • cholangiohepatitis
  • peritonitis
  • fungal pneumonia
128
Q

Prevalence of Salmonella detection is influenced by ________, __________, and _________

A
  • diarrhea (↑)
  • method (fecal culture vs. PCR)
  • time of year (↑summer and fall)
129
Q

Risk factors for Salmonellosis induced diarrhea (7)

A

changes in microbiota

  • transportation
  • antimicrobial treatment
  • change in diet
  • surgery
  • nasogastric tubes
  • wet, dark conditions
  • GI disease
130
Q

Salmonellosis prognosis

A

good with early therapy, decreases if serious complications develop

131
Q

Horses may shed significant numbers of Salmonella for ________ (duration)

A

1-2 months

132
Q

potomac horse fever is caused by _________

A

Neorickettsia risticii

133
Q

Potomac Horse Fever is infectious, but not ______

A

contagious

134
Q

How is Potomac Horse Fever transmitted?

A

ingestion, transmitted through freshwater snails and insects

135
Q

Is Potomac Horse Fever a cause of chronic diarrhea?

A

No

136
Q

________ is a cause of diarrhea marked by biphasic clinical signs

A

Potomac Horse Fever

137
Q

Diagnosis of Potomac Horse Fever

A
  • Whole blood PCR
  • response to treatment

(can remain PCR positive up to 30 days post infection)

138
Q

CS of Potomac Horse Fever (5)

A
  • lethargy
  • anorexia
  • fever
  • +/- colic, diarrhea
139
Q

______ is a common complication of Potomac Horse Fever

A

laminitis

140
Q

___________ are the drug of choice for Potomac Horse fever

A

tetracyclines

141
Q

2 varieties of Clostridium which cause diarrhea

A
  • Clostridium difficile
  • Clostridium perfringens
142
Q

Risk factors for clostridiosis(5)

A
  • antimicrobial use (individual as well as mares of foals treated with macrolides)
  • management factors (tubes, hands)
  • hospitalization
  • age
  • geography
143
Q

Fecal test for C. perfringens

A

enterotoxin (fecal test)

144
Q

Fecal tests for C. difficile

A
  • ELISA (A +/- B)
  • PCR
145
Q

Specific therapy for Clostridiosis (2)

A
  • Metronidazole
  • BioSponge (shown to bind clostridial toxin)
146
Q

CS of Coronavirus (4)

A
  • fever
  • anorexia
  • lethargy
  • +/- diarrhea
147
Q

Diagnosis of Coronavirus

A

fecal PCR

148
Q

CS of Cantharidin toxicosis

A
  • ↑ temp, HR, RR
  • diarrhea
  • lethargy
  • colic
  • sudden death
149
Q

Lab findings associated with Cantharidin toxicosis (3)

A
  • ↓ Ca
  • ↓ Mg
  • ↓TP
150
Q

Diagnosis of Cantharidin toxicosis

A

toxin detection in serum, urine, or gastric contents

151
Q

How is ‘chronic’ diarrhea defined?

A

longer than 1 month duration

152
Q

Infectious inflammatory causes of chronic diarrhea (2)

A
  • salmonellosis
  • parasites (giardia, strongyles)
153
Q

Non-infectious inflammatory causes of chronic diarrhea (4)

A
  • inflammatory bowel disease
  • neoplasia
  • sand
  • right dorsal colitis
154
Q

diagnostic tests for chronic diarrhea (4)

A
  • bloodwork
    • CBC/Chem
  • abdominocentesis
    • may help identify IBD, neoplasia
  • rectal exam
    • check for masses and lymphadenopathy
  • rectal biopsy
    • inflammatory bowel disease, salmonellosis
155
Q

Fecal diagnostic tests (6)

A
  • gross examination for parasites
  • flotation/McMaster’s quantification
  • direct smear
  • culture
  • sand sedimentation
  • Gram stain
156
Q

Treatment of chronic diarrhea (8)

A
  • Supportive therapy
    • fluid therapy
    • NSAIDs
  • antibiotics ???
    • salmonellosis
  • Larvicidal deworming
  • withdrawal of medications
  • +/- diet modification
  • BioSponge
  • probiotics??
  • transfaunation (acid suppression first)
157
Q

Sand enteropathy typically causes _____ diarrhea and may be accompanied by _________

A
  • mild
  • recurrent colic
158
Q

Treatment of sand enteropathy (2)

A
  • environmental adjustments
  • psyllium mucilloid
159
Q

_________ is the cause of Right Dorsal Colitis

A

long term NSAID use

160
Q

Right dorsal colitis can occur as soon as _______ of NSAID use

A

one week

161
Q

CS of R dorsal colitis (6)

A
  • colic
  • diarrhea
  • weight loss
  • inappetance
  • icterus
  • ventral edema
162
Q

_________ may preceed clinical signs of R dorsal colitis (sign to take patient of off NSAIDs)

A

drop in albumin (caused by protein loss from the GI tract)

163
Q

Diagnosis of R dorsal colitis (3)

A
  • History of NSAID use
  • hypoalbuminemia
  • US
164
Q

Treatment of R dorsal colitis (6)

A
  • avoidance of NSAIDs
  • complete pelleted diet (small, frequent, meals)
  • psyllium mucilloid
  • sucralfate?
  • metronidazole?
  • Misoprostol?
165
Q

Causes of peritonitis (5)

A
  • GI perforation (abscess)
  • iatrogenic (rectal tear, castration)
  • trauma (post foaling)
  • post-op
  • Actinobacillus equuli
166
Q

Causes of peritonitis in foals (5)

A
  • GI perforation
  • omphalitis
  • uroperitoneum
  • abscess
  • sepsis
167
Q

Diagnosis of Peritonitis (2)

A
  • Abdominal tap
    • >10,000 cells/uL
    • culture
    • intracellular bacteria
    • high lactate, low glucose
  • ultrasound (you shouldn’t see the mesentary unless there’s a bunch of fluid around it)
168
Q

Peritonitis treatment (5)

A
  • exploratory
  • antibiotics
  • lavage
  • NSAIDs
  • analgesics
169
Q

Prognosis for peritonitis (4)

A
  • GI rupture → grave
  • uterine tear → fair to good
  • A. equuli → good
  • post op → moderate
170
Q

Which cause of peritonitis has the best prognosis?

A

Actinobacillus equuli

171
Q

Specific diseases of foals

A
  • prolific enteropathy (Lawsonia intracellularis)
  • neonatal colic
  • neonatal diarrhea
172
Q

Lawsonia intracellularis typically affects ________ foals, typically _________ age

A
  • older
  • weanling
173
Q

CS of Lawsonia intracellularis infection (4)

A
  • edema
  • variable fecal consistency
  • weight loss or ill thrift
  • colic

(potential panhypoproteinemia and ↑ SI wall thickness)

174
Q

Diagnosis of Lawsonia intracellularis (2)

A
  • Fecal PCR
  • serum antibody
175
Q

Treatment of Lawsonia intracellularis (3)

A
  • macrolides
  • chloramphenicol
  • tetracyclines
176
Q

Differences in diagnostic approach for foal colic (5)

A
  • foals are drama queens
  • abdominal distension can be measured
  • limited to digital rectal exam
  • can be difficul to obtain nasogastric reflux
  • US - gastric size
177
Q

Areas of examination in a foal colic US (4)

A
  • umbilical structures
  • intestine
    • wall thickness
    • distention
    • echogenicity of contents (fluid vs. gas)
  • peritoneal fluid - character
  • specific lesions
    • intussusception
    • bladder distention
178
Q

___________ is a cause of colic specific to the foal

A

meconium retention

179
Q

___________ is the most common cause of colic in the first 1-2 days of life

A

meconium retention

180
Q

meconium retention occurs within the first ____ hours of life of the foal

A

48 h

181
Q

CS of meconium retention (3)

A
  • straining
  • colic
  • dark/tarry feces in rectum
182
Q

diagnosis of meconium retention (3)

A
  • digital rectal
  • US
  • signalment
183
Q

Treatment of meconium retention (4)

A
  • enemas
  • IV fluids
  • pain management
  • intestinal lubricants

(avoid surgery if possible)

184
Q

Noninfectious causes of neonatal diarrhea (4)

A
  • foal heat diarrhea
  • nutritional
  • asphyxia related gut injury (dummy foals)
  • miscellaneous
185
Q

__________ is the most common non-infectious cause of diarrea in the neonate

A

foal heat diarrhea

186
Q

Characteristics of foal heat diarrhea

A
  • non-fetid low volume, soft to watery (non-debilitating)
  • timing occurs with mare’s foal heat (5-15 days of age)

treatment not usually required

187
Q

nutritional causes of foal diarrhea (2)

A
  • milk replacers (either improper preparation or change in brand)
  • feeding bovine and goat milk (greater fat content)
188
Q

1° vs 2° lactose intolerance

A

1° → congenital lactase deficiency

2° → infectious diarrhea (Rotavirus, Clostridium)

189
Q

Treatment of lactose intolerance (2)

A
  • withdrawal of milk
  • lactase supplementation
190
Q

3 characteristics of asphyxia related gut injury

A
  • intolerant to feeding
  • severely ill foals
  • may colic
191
Q

4 categories of infectious foal diarrhea

A
  • sepsis
  • bacterial
  • viral
  • parasites
192
Q

____% of foals with diarrhea are bacteremic

A

50%

193
Q

you should assume that any sick foal <_____ of age with diarrhea is septic

A

<2 weeks

194
Q

What is the usual source of Salmonella for foals?

A

the mare

195
Q

CS of foal Salmonellosis (4)

A
  • fever
  • diarrhea
  • dehydration
  • colic
196
Q

Potential complications of foal salmonellosis (5)

A
  • osteomyelitis
  • infectious synovitis
  • uveitis
  • pneumonia
  • meningitis
197
Q

Clostridium perfringens infection in foals occurs within the first _______-

A

48 hours

198
Q

Characteristics of Type A Clostridium perfringens (5)

A
  • alpha toxin, enterotoxin
  • transient bloody stool
  • colic
  • fever
  • lower mortality (<30%)
199
Q

Characteristics of type C Clostridium perfringens (6)

A
  • alpha, beta toxin
  • hemmorrhagic diarrhea
  • colic
  • abdominal distention
  • shock
  • high mortality (>75%)
200
Q

Which is the more dangerous strain of Clostridium perfringens to the foal, Type A or Type C?

A

Type C

201
Q

CS of Clostridium difficile in the foal (2)

A
  • enteritis
  • +/- hemorrhagic diarrhea
202
Q

Clostridium prevention of the foal (4)

A
  • vaccination of pregnant mare (type C and D toxoid)
  • management (reduce grain, clean environment)
  • medication (anti-toxin?)
  • probiotics?
203
Q

________ is the most common infectious cause of diarrhea in the foal

A

Rotavirus

204
Q

How is Rotavirus transmitted?

A

fecal-oral

205
Q

_________ is the most common strain of Rotavirus

A

Group A

206
Q

Rotavirus infections in foals generally occur between ____-____ d of age (up to ______ d)

A
  • 5-35d
  • 60d
207
Q

What is the pathophysiology of Rotavirus infection

A
  • affects the SI, blunting the villous tips
  • this results in brush border enzyme (lactase) deficiency - inadequate digestion
  • leads to osmotic diarrhea in the colon
208
Q

Rotavirus diagnosis (4)

A
  • farm history
  • numbers affected
  • physical exam findings
  • fecal antigen tests
209
Q

treatment and management of Rotavirus (4)

A
  • supportive care (IV or oral fluids)
  • +/- antibiotics (depending on age)
  • maternal vaccine
  • isolation
210
Q

Rotavirus foals typically shed for about _____ days

A

10d

211
Q

4 uncommon infectious causes of diarrhea in foals

A
  • coronavirus
  • Cryptosporidium parvum
  • Giardia
  • Strongyloides westeri
212
Q

Adult Equine TPR

A

T: 99-101.5

HR: 32-44

RR: 12-25

Gastropathology - Large Animal (3 decks)

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