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Y4 EQ - Gastrointestinal tract > Equine Weight Loss and Chronic Colic > Flashcards

Equine Weight Loss and Chronic Colic Flashcards

(61 cards)

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1
Q

What are the 4 mechanisms of weight loss?

A
  • Reduced intake
  • Reduced digestion, absorption or assimilation of nutrients
  • Increased losses
  • Increased requirements
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2
Q

How does reduced intake occur?

A

Inappropriate feeding
Unable to obtain feed
Competition for feed
Dental disorders
Dysphagia,

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3
Q

How does weight loss occur due to increased losses?

A

Protein losing enteropathy (nephropathy, sequestration to body cavity = peritonitis or pleuritis)

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4
Q

Which increased requirements lead to weight loss

A

Pregnancy
Lactation
Sepsis
Neoplasia
Systemic disease

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5
Q

List some common causes of weight loss

A

Dental disease
Parasites
Inadequate diet
PPID
Liver disease
Malabsorption and protein losing enteropathy

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6
Q

What are the daily feed requirements for a horse?

A

2-2.5% BW

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7
Q

What is the daily requirement of a racehorse?

A

1.5% BW

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8
Q

List some less common causes of weight loss in horses

A

Chronic diarrhoea
Abdominal abscess
Renal disease
Cardiac disease
Chronic thoracic disease
Non-GI neoplasia
Grass sickness

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9
Q

Define chronic colic

A

Colic of variable intensity that last longer than 48hrs

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10
Q

Define recurrent colic

A

Shorter periods of colic pain which recur at variable intervals

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11
Q

List 4 GIT related causes of recurrent colic

A

Intermittent partial/complete obstruction
Inflammation
Motility disorder
Mesenteric traction

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12
Q

Define colic

A

Behaviour manifestation of visceral pain

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13
Q

Colic normally refers to which 4 types of intestinal pain?

A

Stretch
Inflammation
Ischaemia
Muscle spasm

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14
Q

What information needs to be gathered on the history of recurrent colic cases?

A
  • Number/ nature of previous colics / abdominal sx
  • Faecal output / diarrhoea / wgt. loss /medical conditions
  • Diet esp. recent changes
  • Worming
  • Dental problems, quidding?
  • Crib biting/windsucking?
  • Sand pastures?
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15
Q

Describe the clinical exam for recurrent colic cases

A
  • Exam as for acute colic:
  • Clinical examination
  • Nasogastric intubation (usually only during an acute episode)
  • Rectal examination
    Also observe for concurrent/associated signs:
  • Weight loss
  • Diarrhoea
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16
Q

Describe the history and initial clinical exam for chronic GIT disease

A
  • Rule out obvious simple causes e.g. recent diet change, dental disorders etc
  • Assess exposure to infectious causes e.g. worming history, environment, drug history
  • Determine if in “ACUTE” or “CHRONIC” categories
  • Diarrhoea?
  • Rule out other causes - pregnancy , heart disease, PPID, others
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17
Q

Why would you want to perform a preliminary clinical pathology for chronic GIT disease?

A

Will help to rule in or out:
- Specific organ disease: enzymes, bile acids etc.
- Inflammatory processes: WCC, fibrinogen, globulins
- Protein loss: esp. albumin into the lumen of the bowel
- Occasionally indicators of malignancy e.g hypercalcaemia
- Faecal egg count: for mature parasites

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18
Q

Why must you be cautious when interpreting clinical pathology?

A

If the first set of bloods don’t give you a diagnosis, repeating the same tests more than once more rarely will
Reference ranges are calculated to include 95% of the normal population -i.e. in any give horse, 1 in 20 results will be “abnormal”
Solution: chose specific tests and avoid extensive and expensive panels

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19
Q

Decreases in total protein may be masked by?

A

Concurrent dehydration

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20
Q

How should you interpret hypoalbuminaemia

A

GI loss more common than renal
Effusions: peritoneal/pleural
Liver disease (rare)

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21
Q

How should you interpret hypoglobinaemia

A

GI loss

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22
Q

How should you interpret hyperglobinaemia

A

Chronic inflammatory disease (including cyathostomiosis)

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23
Q

How should you interpret hyperfibrinogenaemia?

A

Infection
Inflammation
Neoplasia

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24
Q

Verminous arteritis is caused by?

A

Strongylus vulgaris - migrating to the mesenteric artery cause loss of blood supply to certain areas of the colon

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25
Following clinical pathology tests, what is the next step in diagnosing chronic GIT disease?
Monitor temperature several times a day over several days - consider abscess and neoplasia if intermittently febrile Perform peritoneal fluid analysis
26
How should normal peritoneal fluid appear
Clear and light yellow
27
Cloudy peritoneal fluid = ...?
Increased protein and WBCs
28
Red peritoneal fluid = ... ?
RBCs - may indicate a strangulating colic
29
Name the 3 types of ultrasound that can be used to diagnosed chronic GIT disease
Transabdominal Transrectal Intestinal
30
What does an increased in intestinal wall thickness on US indicate?
Inflammation
31
What does an increase in intestinal lumen diameter indicate on US?
Obstruction
32
What are the visible structures on the right side of a horse?
Liver Duodenum Caecum RDC
33
What are the visible structures on the left side of a horse?
Stomach Spleen Left ventral colon Pelvic flexure Small colon Small intestine
34
Where does the stomach lie in the horse
8th - 13th ICS Medial to spleen Visible over ≥ 5 rib spaces = distension
35
Describe nephrosplenic entrapment
Colon migrates through the body wall of the spleen – hooks into the space between the kidney and the spleen
36
Which 3 tests are used when there is weight loss
Oral glucose absorption test Rectal Biopsy Duodenal biopsy
37
What is the oral glucose absorption test?
Absorption test vs. tolerance Small intestinal only Fast overnight 1 gm/kg in a 20% solution administered by nasogastric tube Keep horse calm (do not sedate with alpha 2’s)
38
Describe a normal result following a normal oral glucose absorption test
NORMAL: >85% increase in blood glucose concentration at two hours
39
Describe the two abnormal results following a normal oral glucose absorption test
PARTIAL: 15 - 85% increase in blood glucose concentration at two hours COMPLETE: < 15% increase in blood glucose concentration at two hours = small intestinal disease
40
Describe how to perform a rectal biopsy
- Easy to perform - 20 - 30 cm inside rectum - Small piece of mucosa from floor at around 4 or 8 o’clock - Submit for histology (in formalin) and culture - Antibiotics and tetanus prophylaxis
41
Name 3 inflammatory/infiltrative bowel diseases
- Granulomatous enteritis - Lymphocytic-plasmacytic enteritis - Eosinophilic enteritis -> Presence of inflammatory cells in intestinal wall leading to malabsorption and protein-loss
42
List the DDx of inflammatory bowel disease
Cyathostomosis Mixed strongyle infection Idiopathic Infiltrative bowel diseases Neoplasia Lawsonia (foals 3- 11 months)
43
Multisystemic eosinophilic epitheliotropic disease often involves which parts of the body?
GIT, skin, particularly around coronary bands, pancreas, liver
44
How is Multisystemic eosinophilic epitheliotropic disease treated?
Dexamethasone
45
What are the clinical clues/signs that indicate lymphoma or other forms of disseminated neoplasia
Fever Weight loss Peritonitis Pleural effusion Abdominal distension Intra-abdominal mass palpable per rectum Hypercalcaemia/haemolysis/cachexia of malignancy
46
Other than lymphoma, name 4 other intestinal neoplasias
Leiomyoma Myxosarcoma Gastric or Adenocarcinoma Melanoma
47
Describe how to treat inflammatory bowel disease
Non-specific Prednisolone Dexamethosone Anthelmintics
48
Name 2 common causes of chronic GIT bacterial infections
S.equi R.equi
49
How are chronic bacterial infections diagnosed?
Inflammatory haemogram - Neutrophillia, hyperfibrinogenaemia, anaemia
50
What are the two main GIT consequences of large strongyles?
- Verminous arteritis - Thromboembolic colic
51
What is the main GIT consequences of small Strongyles?
Submucosal infection
52
Describe the haematological changes for parasitism in horses
Neutrophilia, hypoalbuminaemia, and hyperglobulinaemia, NOT eosinophillia
53
Describe equine gastric ulcer syndrome
- Common and widespread problem in horses in training (70%) - Potential cause of poor athletic performance
54
Equine gastric ulcer syndrome is divided into which 2 conditions?
Equine glandular gastric disease Equine squamous gastric disease
55
What are the important implications for risk factors and treatment in the two conditions of equine gastric ulcer syndrome?
Equine glandular gastric disease: risk factors not well known - possibly stress, NSAIDS Equine squamous gastric disease: risk factors related to acid injury
56
What are the clinical signs of equine gastric ulcer syndrome?
Vague e.g. weight loss, poor performance Selective appetite, slow eating, eat roughage in preference for grain Bad/cranky behaviour
57
Why are horses so susceptible to equine gastric ulcer syndrome?
Horses are herbivores evolved to: - Digest fibre, - Graze continuously and maintain a full stomach Stomach anatomy - Poor mixing - Grain portion rapidly fermentable - Production of acids
58
Which portion of the stomach is prime to acid injury?
Squamous portion - pH 5.4
59
List the predisposing factors for acid injury in horses
- Intermittent feeding vs trickle feeding over 18+ hours - High concentrate diets: VFAs, low fibre concs -> reduced saliva production (buffer) - Exercise: gastrin production - Stress: transport, confinement, stabling
60
How is equine gastric ulcer syndrome diagnosed?
Gastroscopy: ≥3 m endoscope Faecal occult blood is not reliable
61
How is equine gastric ulcer syndrome treated?
- Proton pump inhibitor omeprazole - ESGD more responsive clinically at lower doses e.g. 2 mg/kg daily for 3 – 4 weeks - EGGD less responsive and requires higher doses e.g. 4 mg/kg daily for 4 – 6 weeks - Reduce exposure to risk factors: diet, exercise, stress (modern management) - Long term dietary supplements may help

Y4 EQ - Gastrointestinal tract (9 decks)

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