Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Veterinary Nursing > Equine Gastrointestinal Disease > Flashcards

Equine Gastrointestinal Disease Flashcards

(88 cards)

Start Studying
1
Q

What is colic?

A

Abdominal pain.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the signs of colic?

A

Rolling
Pawing
Flank watching
Lip curling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What should we clinically examine in a suspected colic patient?

A

Cardiovascular - heart rate/rhythm, resp. rate, PCV + TP, lactate
Abdominal - auscultation (4 quadrants), distension
Rectal - distension, impaction, displacement
Stomach tubing
Ultrasound - rectal/transabdominal
Abdominoparacentesis (belly tap) - intestinal damage, haemoperitoneum, rupture, inflammatory/neoplastic cells
Oral
Gastroscopy - ulceration, outflow obstruction, impaction
Radiography

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What tests can we run on a suspected colic patient?

A

Blood - PCV, TP, lactate, haematology/biochemistry
Peritoneal fluid - gross appearance, cytology, protein
Faecal - egg count, culture
Glucose absorption test
Laparoscopy
Laparotomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Describe dental disease in horses.

A 
Eruption disorders
Dental decay
Periodontal disease
Fractured tooth
Diastema
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How can we treat dental disease in horses?

A

Filling, widening
Rasp at least 1x a year
Removal has problems - opposite tooth has nothing to grind against (long-term management)
Or risk dysphagia, impaction from not chewing properly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How can we examine a horse’s mouth?

A 
Watch horse eat
Palpate 
Sedate
Mouth gag
Wash out
Torch, mirror
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the primary/secondary causes of oesophageal obstruction (choke) in horses?

A 
Primary = bad luck, eating too fast, dry concentrate, poor dentition
Secondary = rare, oesophageal damage, mass
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the clinical signs of choke?

A

Neck extended, food/discharge from nose, cough, gag
Over time - dehydrated, acid-base imbalance, weight loss
Aspiration pneumonia
Risk acute oesophageal rupture / stricture or diverticulum long-term

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How do we diagnose choke?

A 
Auscultation
Cardiovascular parameters
Gastroscopy
Stomach tube
(Bloods, ultrasound, plain/contrast radiography)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How do we treat choke?

A

Sedate - low head carriage = reduced risk of aspiration
Stomach tube, lavage obstruction via tube
Check obstruction cleared, no damage to mucosa, no aspiration, underlying problems?
Rest from feeding, start with mash and grass
May need antibiotics and anti-inflammatories

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the causes of gastroduodenal ulceration?

A

Imbalance between inciting and protective factors
Inciting = HCl, bile acids, pepsin
Protective = mucus-bicarbonate layer, mucosal blood flow, mucosal prostaglandin E, epidermal growth factor production, gastroduodenal motility
Risk factors = empty stomach exercise, diet, stress, NSAIDs, hospitalisation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the clinical signs of gastroduodenal ulcers?

A

Range from asymptomatic

Poor appetite, recurrent colic, tooth grinding, dog sitting, diarrhoea, poor performance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How do we diagnose gastroduodenal ulcers?

A

Gastroscopy (foals difficult as too small)

Remember ulcers are common, therefore presence does not mean significance/cause of clinical signs!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How do we treat gastroduodenal ulcers?

A

Depends on cause
Management
Adult = omeprazole (or misoprostal off licence)
Foals = sulcralfate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the primary causes of gastric dilation and rupture?

A

Gastric impaction (acute/chronic colic, difficult to treat)
Grain engorgement
Etc.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the secondary causes of gastric dilation and rupture?

A

More common
Small or large intestinal obstruction
Ileus (secondary, equine grass sickness)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the clinical signs of gastric dilation and rupture?

A 
Overfilling of stomach
Acute colic
Tachycardia
Fluid from nose (right before rupture!)
Dehydration
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

How do we diagnose gastric dilation and rupture?

A

Clinical signs
Reflux
Colic work-up
Gastroscopy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

How do we treat gastric dilation and rupture?

A 
Stomach tube!!
Treat underlying cause
IV fluids
Nil per os - IV nutrition
Electrolytes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Describe anterior enteritis (SI).

A

Inflammatory condition affecting proximal small intestine
Most cases = underlying aetiology cannot be determined
Some = salmonella or clostridia cultured from gastric reflux
Recent diet change to high concentrate is a risk factor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are the clinical signs of anterior enteritis?

A

Distended small intestine and stomach
Signs same as gastric dilation
Often pyrexic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

How do we diagnose anterior enteritis?

A

Colic investigation:
Peritoneal fluid = raised protein but not serosanguinous
Reflux - culture
Often need ex-lap

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

How do we treat anterior enteritis?

A

Repeated gastric decompression (life-saving!)
Antibiotics - penicillin, gentamicin, metronidazole
IV fluids
Electrolytes
Nil per os - nutritional support
Analgesia
Ex-lap, SI decompression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What is the main clinical sign of SI malabsorption and maldigestion?
Weight loss!
26
How do we diagnose SI malabsorption and maldigestion?
Abdominoparacentesis Ultrasound Oral glucose tolerance test (not absorbed) Laparoscopic biopsy
27
How do we treat SI malabsorption and maldigestion?
Method depends on diagnosis Prognosis depends on diagnosis and response to treatment Resection? Corticosteroids? May be no treatment
28
Describe a simple SI obstruction.
Obstruction of lumen without direct obstruction of vascular flow Food material - coarse, ileal hypertrophy (secondary to tapeworm) Ascarid impaction Adhesions
29
Describe a strangulation SI obstruction.
Simultaneous occlusion of intestinal lumen and its blood supply Pedunculated lipoma, epiploic foramen entrapment, SI volvulus, mesenteric rent, inguinal/diaphragmatic hernia, intussusception Results in gastric overfilling - risk rupture Deterioration of intestinal mucosa
30
What are the clinical signs of SI obstruction?
Colic - severe as gut dies, eases when gut dead Reflux Tachycardia Hypovolaemia Rectal - distended small intestine Peritoneal fluid - serosanguinous, increased protein/lactate
31
How do we treat SI obstruction?
Surgery/euthanasia Rarely, ileal impaction can clear Act fast!
32
What are the primary/secondary causes of caecal impaction?
``` Primary = ? underlying motility disorder Secondary = usually young horses after painful orthopaedic procedures (monitor faecal output/appetite/pain level after any surgery) ```
33
What are the clinical signs of caecal impaction?
Colic | Can just rupture - signs of severe shock, death
34
How do we diagnose caecal impaction?
Clinical signs and history Rectal exam Abdominoparacentesis
35
How do we treat caecal impaction?
Medical vs surgical Oral and IV fluids Surgery = typhlotomy / caecal bypass
36
Describe caecal intussusception.
Ileo-caecal or caeco-caecal Young horses Tapeworm
37
What is the main clinical sign of caecal intussusception?
Colic - varying severity, can be chronic
38
How do we diagnose caecal intussusception?
Rectal exam Ultrasound Peritoneal fluid unreliable!
39
How do we treat caecal intussusception?
Surgery | Then treat tapeworm
40
Describe impaction of the large intestine (LI).
Usually pelvic flexure Food material Poor teeth, long fibre, motility disorder, recent box rest, sand
41
What are the clinical signs of LI impaction?
Usually mild colic, can be chronic | Reduced faecal output
42
How do we diagnose LI impaction?
Rectal exam | Abdominoparacentesis
43
How do we treat LI impaction?
``` Oral fluids and cathartics Analgesia Paraffin? IV fluids? Eventually surgery ```
44
Describe LI displacement.
Right/left dorsal displacement Nephrosplenic entrapment Can: correct itself +/- medical treatment, remain displaced and become compromised (needs surgery), torsion (emergency surgery)
45
How do we diagnose LI displacement?
Rectal exam Ultrasound - nephrosplenic entrapment Abdominoparacentesis
46
How do we treat LI displacement?
Medical if not too painful and no evidence of gut damage - fluids oral/IV, analgesia, nephrosplenic entrapment = phenylephrine and lunging Otherwise surgery, or if persistent
47
Describe LI torsion.
Strangulating lesion of LI Extreme pain, violent horse Distended abdomen Respiratory compromise
48
How do we diagnose LI torsion?
Rectal exam
49
How do we treat LI torsion?
Immediate surgery Prognosis depends on damage to LI LI resection? Risks recurrence
50
How do we diagnose LI diarrhoea?
``` Cardiovascular parameters Rectal exam Ultrasound Abdominoparacentesis Rectal biopsy Faecal egg count/cultures ```
51
How do we treat LI diarrhoea?
``` Hydration Electrolytes Anti-endotoxic Laminitis prevention Antibiotics? Plasma? Feeding Nursing care! - clean, treats, groom ```
52
Describe small colon impaction.
Quite rare Foreign body (e.g. plastic bags), salmonella Difficult to diagnose - intermittent diarrhoea and colic Can try medical treatment Many require surgery
53
Describe peritonitis.
``` Primary = pyrexia and mild colic, abdominoparacentesis, antibiotics, laparoscopy/laparotomy if persistent or recurrent Secondary = intestinal surgery contamination etc. ```
54
What colic findings would imply possibly surgical treatment?
Moderate-severe pain Persistent behavioural signs despite analgesia Absence of faeces Heart rate > 60 bpm Poor MM colour Reduced/no gut sounds on auscultation Rectal - distension +/- displacement of S/L intestine Increased PCV/TP/lactate Positive reflux with nasogastric tubing (more than 2L) Distended SI/displaced LI on ultrasound Discoloured and turbid peritoneal fluid on abdominoparacentesis
55
What practicalities of surgery need to be considered?
Cost - unsuccessful cases likely to end in dead horse + big bill Transport of horse to surgery Prognosis - hard to be sure pre-surgery Complications many/common - owner awareness from outset
56
How do we prep a horse for colic surgery?
Jugular IV catheter placement Decompress stomach with nasogastric tube ('refluxing') Administration of analgesia/antimicrobials IV fluids to support circulation Clip abdomen? Shoe removal/tape feet Wash out mouth
57
How can we carry out refluxing with nasogastric tubing?
Horse restrained - stock/twitch/sedation (xylazine)? Tube passed into ventral nasal meatus Head flexed to encourage passage into oesophagus not trachea Horse swallows as tube advanced Observe left-hand side of neck for end of tube advancing into oesophagus to confirm correct placement (critical!) Pass down into stomach - if no spontaneous reflux establish syphon by attaching funnel to end of tube and pouring in measured amount of water from jug and then lowering end of tube into bucket, collect and measure what comes out
58
How do we prep a horse for laparotomy?
After induction Move to table from recovery box - place in dorsal recumbency for ventral midline incision Urinary catheter (suture prepuce in males) Clip abdomen plus second fine clip Cover legs and feet Drape Sterile skin prep Surgical colic kit - different surgeons have different instrument preferences
59
Describe simple intestinal obstructions.
Lumen only obstructed (e.g. food), vasculature minimally compromised Prognosis usually good E.g. pelvic flexure impaction
60
Describe functional intestinal obstructions.
Peristalsis fails to propels ingesta (i.e. ileus) leading to distension E.g. grass sickness/post-operative ileus secondary to distension
61
Describe strangulating intestinal onstructions.
Compromise of vasculature resulting in ischaemia of intestine E.g. pedunculated lipoma/large colon volvulus Veins obstructed first, causing oedematous thickening of gut wall Release of endotoxins into circulation (endotoxaemia) - systemic compromise/shock Prognosis increasingly poor after 6-8hrs Later secondary problems e.g. laminitis - further worsen prognosis
62
Describe SI strangulating obstructions.
Strangulated section goes maroon/purple/black as blood supply compromised Mucosa becomes permeable to endotoxins which leak into peritoneal cavity/circulation Proximal = 'simple obstruction' with just distension as gas/fluid cannot pass obstruction Distension will however cause ileus if protracted which can be hard to reverse Distal = intestine appears relatively normal
63
Which specific conditions cause a SI strangulating obstruction?
Pedunculated lipomas Herniation - epiploic foramen/inguinal/mesenteric defects Intussusceptions
64
How do we resect and anastomose SI to treat a strangulating obstruction?
Isolate affected segment with bowel clamps Ligate blood vessels supplying affected segment Resect affected segment Anastomose intestine with sutures/staples Close defect in mesentery to prevent herniation Check patency of lumen, integrity of anastomosis (no leaks) and mesentery (no holes) Lavage and remove packing Decompress remaining bowel Replace bowel in abdomen
65
Describe SI simple/functional obstructions.
E.g. ileal impaction/enteritis Decompression of SI +/- enterotomy to remove obstruction Non-strangulating so blood supply not compromised No resection or anastomosis required
66
What are the common LI obstructions?
Displacements (left dorsal/nephrosplenic entrapment, right dorsal) Large colon torsion Enteroliths (not common in UK)
67
How do we surgically manage colonic displacements?
Recognising nature of displacement Decompression of distended bowel (needle/suction for gas) Evacuation of colon via pelvic flexure enterotomy may be necessary if distension is with food/fluid Correction of displacement Resections rarely necessary and technically challenging Colopexy (anchoring colon by suturing e.g. to body wall) occasionally performed in non-athletes to prevent recurrence of displacement
68
Describe large colon volvulus.
Commonly a strangulating obstruction with ischaemia of huge section of GI tract May occur at sternal flexure or close to attachment of right ventral colon to cecum Results in great deal of gas distension of affected colon Usually affects larger horses and particularly seen in brood mares ~90 days after foaling
69
What are the clinical signs of large colon volvulus?
Sudden and sever abdominal pain Colon extremely enlarged, very evident on rectal exam Mucosal ischaemia leads to endotoxinaemia and systemic status deteriorates rapidly High heart rate, poor peripheral perfusion
70
How do we treat large colon volvulus?
Surgery to correct the problem and remove ischaemic colon if necessary
71
What is the prognosis for large colon volvulus patients?
Directly related to time that elapses between onset of condition and surgery As a result, survival rates much higher for veterinary facilities located near e.g. brood mare farms
72
What post-op care can we provide for equine GI patients?
``` 'Colic check' every 2-4hrs Analgesia Antimicrobials IV fluid therapy Belly bandage Monitoring for complications Regular blood sampling - PCV, TP, lactate Nasogastric intubation ```
73
What are the potential post-op complications?
``` Endotoxinaemia Ileus Jugular thrombophlebitis Incisional infection Further obstruction Anastomosis leakage Peritonitis Adhesions ```
74
What should we be monitoring post-operatively?
Pain - behavioural signs, HR, specific e.g. peritoneal/incisional/MSK Pyrexia (rectal temp.) GI system - reflux through NG tube, faecal output, gut sounds, appetite Cardiovascular - HR, MM colour/CRT, PCV/TP/lactate/electrolytes Incision - swelling, pain, discharge Catheter - swelling, pain, jugular patency Feet - mobility, digital pulses, heat Respiratory - auscultation, rate, nasal discharge/cough
75
How do we provide post-op feeding?
If significant reflux on passing NG tube - nil by mouth, IV fluid therapy, muzzle to prevent horse eating bedding Once reflux ceased/parameters improving, start with 5cm depth water in bucket (gradually increase) Grass = good first solid food Small wet mashes of concentrates, less appetising Hay reintroduced in handfuls, gradually increased Return to normal volumes over ~3 days
76
What post-op exercise is allowed?
Initially box rest for 6 weeks, maybe very short walks in hand to allow grazing/promote GI motility Check no incisional problems (e.g. breakdown of underlying abdominal wall) - may require prolonged restriction At 6 weeks can turn out into small paddock for further convalescence Ridden exercise may resume after 3 months if abdominal repair sound
77
What are the potential post-op complications?
``` Immediate = endotoxaemia, ileus Short-term = laminitis, jugular thrombophlebitis, peritonitis, colitis, incisional infection Longer-term = adhesions ```
78
What are the clinical signs of endotoxaemia?
Tachycardia, tachypnoea Pyrexia leading to hypothermia Hyperaemic MMs leading to dark purple/brown Colic signs, dullness
79
How do we treat endotoxaemia?
IV fluid therapy Flunixin Polymixin B Hyperimmune plasma
80
How do we treat ileus?
Nasogastric intubation, refluxing - gastric decompression to relieve gastric distension Fluid IV - maintenance + dehydration correction + 80% net reflux losses Supplement electrolytes if needed Prokinetics? - lidocaine infusion/erythrocytes/metoclopramide
81
Describe laminitis.
Inflammation of laminae Endotoxic horses at greatest risk Prevention attempted - ice boots on at-risk patients Clinical signs = increased/bounding digital pulses, heat, foot pain Treatment = frog support/deep bedding, analgesia
82
How do we treat jugular thrombophlebitis?
Remove catheter Local anti-inflammatory treatment Can consider thrombolytics such as aspirin Antibiotics? Catheter not placed in other jugular - alternative site if IV access still required
83
Describe signs and treatment of peritonitis.
Clinical signs = colic, inappetence, pyrexia Antibiotics (broad spectrum, often penicillin/gentamycin/metronidazole) Abdominal drainage/lavage?
84
What are the clinical signs of colitis?
Clinical signs = pyrexia, colic, diarrhoea After colon torsion/displacement, where colon has been compromised From antibiotics and NSAID usage plus sudden change in management
85
How do we treat colitis?
``` Can require intensive nursing IV fluid therapy Analgesia - may need to avoid NSAIDs Misoprostal and sucralfate may help Probiotics? ```
86
Describe incisional infection.
Occurs in 10-15% of cases, more common after 2nd laparotomy Local oedema around incision is normal Palpate for focus of pain Look for drainage of purulent material
87
How do we treat an incisional infection?
Antibiotics if horse systemically affected, e.g. pyrexia Culture for sensitivity Encourage drainage Tends to persist until suture material resorbs (~6 weeks)
88
Describe adhesions.
Consequent on surgery/general handling of intestines at surgery May result in further obstruction and colic Recurrence of significant colic often ends in euthanasia, as owners reluctant to put horse through further surgery for which prognosis likely to be guarded at best

Veterinary Nursing (65 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions