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!Equine Medicine And Surgery > Gastric Disease Syndrome > Flashcards

Gastric Disease Syndrome Flashcards

(44 cards)

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1
Q

What are the causes of gastric disease syndrome?

A

Dilation
Impaction
Rupture
Equine gastric ulcer syndrome (EGUS)
Tumors (SCC)

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2
Q

General CS associated with gastric disease syndrome

A

Painful abdomen (mild to severe)
From off feed → depression and colic (laying sternal or violent rolling)
Progression → uncontrolled pain, damage/ alteration of gastric tissue, endotoxemia → death

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3
Q

Gastric dilation

A

Secondary to intestinal ileus
Backflow of gas/ fluid into stomach (reflux)
Build up of pressure not moving through GI

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4
Q

What is gastric dilation associated with?

A

CHO, feed fermentation, proximal duodenal-jejunitis
Refeeding injury or parasites (bots)

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5
Q

CS of gastric dilation

A

Anorexia, depression, or mild to moderate signs of colic

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6
Q

Gastric dilation dx

A

Endoscopy*
Rads/ US for small horses
Emptying time test

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7
Q

What can happen with prolonged gastric dilation?

A

Damage to nerves and muscle due to over stretching
Future dilations or impactions

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8
Q

Client education for gastric dilation

A

Multiple small meals, chopped/ soaked quality hay, 1-2 tbs salt, fresh water, mash of senior chow
Gradually reintroduce normal feed
Avoid lush/ spring pasture

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9
Q

Tx for gastric dilation

A

Decompress PRN
IV fluids, electrolytes replacement, analgesics, anti-inflamms

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10
Q

Gastric impaction

A

Masses of large amounts of compacted, soft to doughy or hardened material
+/- gas or fluid
Rare (1%), fast eaters, social standing, starvation

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11
Q

What is gastric impaction associated with?

A

Lack of deworming (parasites, bots, tapeworms- Anaplocephala perfoliata)
No access to water
Consumption of large amounts of feed
Eat feeds that swell (dehydrated feed)→ consumption of material that expands with water
Refeeding a starved horse

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12
Q

Primary causes of gastric impaction

A

Functional or anatomic defects:
↓ gastric emptying, acid secretion, pyloric strictures, chronic dilation

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13
Q

Secondary causes of gastric impaction

A

Poor mastication, FB, dehydration, hepatic dz, any GI disturbance resulting in ileus, refeeding injury

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14
Q

CS of gastric impaction

A

Inappetence to acute colic
Signs of shock
Duration: hours to months

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15
Q

DX of gastric impaction

A

Gastric endoscopy: finding feed after withholding food/ water for 18- 24hr*
US (smaller horses with distended stomachs)
Peritoneal tap (transudate/ exudate, fibrous matter)
Hematology (systemic inflamm)
Rectal palpation (+/-displaced spleen)

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16
Q

Tx for gastric impaction

A

Decompress PRN, IV fluids
Breakdown mass: diocytl sodium succinate
Laxatives: MgSO4 (stomach filled halfway or less)
Anti-inflamms, analgesics, abx

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17
Q

What broad spectrum abx are given if the gastric impaction ruptures?

A

Ceftiofur + gentamicin
Crystalline penicillin + gentamicin

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18
Q

Prognosis of gastric impaction

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A

Guarded to poor:
Factors: overstretched muscles/ nerves, mass too dense, altered blood flow, pressure necrosis
Euthanasia

19
Q

Client education on gastric impaction

Study These Flashcards
A

Resolves: patient goes home
Multiple small meals, mash or soaked hay, hydration
Healing: 7 days for each day sick

20
Q

What happens if gastric dilation/ impaction cannot be resolved?

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A

Shock, rupture then DEATH

21
Q

Gastric rupture

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A

Loss of serosal/ muscle integrity from gastric distention, localized infarction from impaction/ dilation impairing blood flow or severe EGUS and perforation

22
Q

Where does the rupture occur on the stomach

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A

Greater curvature

23
Q

CS of gastric rupture

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A

Moderate to severe colic
Depression, toxic line
Shock
Absent gut sounds, abnormal mm, gastric reflux, gritty serosal surface (rectal)
Sweating

24
Q

What are the signs of shock?

Study These Flashcards
A

Cold extremities, weak but rapid pulse, tachycardia, shallow breathing, low absent urine output, sudden cold sweat

25
Full thickness GR is _________
Fatal
26
Primary causes of gastric rupture
Excessive intake or fermentation of ingesta Delayed emptying (ulcers, gastroparesis) *Slow onset of symptoms*
27
Secondary causes of gastric rupture
Intestinal obstruction aboral to stomach Obstruction: FB, tapeworms/ bots, CHO Enteric: ulcerative gastritis, trauma, strictures, etc Peritoneal: ileus, peritonitis
28
When do horses go into SIRS (systemic inflammatory repsonse) if they have gastric ruptures?
If they fit 2 or more: T> 101.5, HR >60, RR >30 Fibrinogen >400 WBC >12.5 10^9 or <4.5 10^9, >10% band neutrophils
29
Gastric rupture tx
NONE with grave prog and euthanasia
30
Client education for gastric ruptures
Minimum stress Slow down greedy horse, avoid fermented feed, gradual dietary changes
31
Equine squamous gastric dz
Lesions in squamous region (↑ exposure to acid) Dx: gastroscopy
32
Tx of Equine squamous gastric dz
Gastric protectant, promote healing, ↑ roughage, fluid PRN, reduce stressors
33
Equine glandular gastric dz
Lesions in the glandular region Impaired mucosal defense Dx: gastroscopy
34
Mucus- bicarbonate layer
Mucus keeps excess acid away from mucosa Bicarb neutralizes acid near the muscosa- gradient action
35
Cellular restitution
Contributes to mucosal integrity via rapid cell turnover
36
Epidermal growth factor
Potent gastric acid inhibitors Potent stimuli of mucosal growth
37
Mucosal blood flow
Supplies mucosa with O2, nutrients and takes away metabolic waste Maintained by PG-E2
38
Prostaglandin E2
Directly cytoprotective Influences blood flow, ↑ mucus- bicarb secretion and inhibits gastric acid secretion
39
Risk factors associated with EGUS
Stress → endogenous corticosteroids
40
Other dx for EGUS
Admin fluids → positive response is ulcers Oral exam Rectal palpation/ US (rule our right dorsal colitis and thinning/ thickening of intestinal wall)
41
Gastroscopy
If no response to tx and severe CS Confirms ulcers Finds lesions in squamous, glandular region
42
Grades of ulcers
0: stomach lining intact, no reddening 1:Stomach lining intact, some reddening 2: small, single or multiple ulcers 3: large single or multiple ulcers 4: extensive ulcers
43
What happens if ulcers go untreated?
Perforate → septic peritonitis and endotoxemia and death
44
Tx of EGUS
IV fluids with electrolytes Gastric protectant: oral antacids/ sucrlafate (topical), acid inhibitors- omeprazole or ranitidine/ cimetidine (systemic) Eat good roughage

!Equine Medicine And Surgery (23 decks)

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