L02: Equine Gastro 2 Pt.1 (Sanchez)

Question 1

Duodenitis-Proximal Jejunitis (DPJ)

Answer 1

• inflamm. and stasis of the proximal segments of the small intestine
• may be due to salmonella, clostridium, or fungal toxins
• uncommon

Question 2

CS of DPJ

Answer 2

• mod. pain which is typically relievedby gastric decompression
• low-grade fever
• dilated SI on rectal/ultrasound
• inc. TS on Ab tap

Question 3

DPJ vs. strangulation

Answer 3

• DPJ has fever, strangulation usually doesn’t
• pain/HR decreases with gastric decompressionin DPJ
• peritoneal fluid: inc. protein in DPJ, serosanguinous in strang.

Question 4

Tx of DPJ

Answer 4

-gastric decompression
-anti-inflammatories (NSAIDs, lidocaine)
-IV fluids
+/-abx, parenteral nutrition, prokinetics

Question 5

Prognosis of DPJ

Answer 5

• good with supportive care
• may require sx, which doesn’t alter prog.
• complications: laminitis**, peritonitis, adhesions, cholangiohepatitis

Question 6

most common types of Inflammatory bowel disease

Answer 6

lymphocytic-plasmocyticenterocolitis

eosinophilic, basophilic enterocolitis

Question 7

CS of inflammatory bowel disease

Answer 7

weight loss
recurrent colic
severe colic (with eosinophilic enteritis)
edema

Question 8

pathophysiology of IBD

Answer 8

interaction of multiple immune functions (possible lack of immunity to normal flora?)

Question 9

Tx of IBD

Answer 9

steroids
immune suppressants
surgery for eosinophilic enterocolitis with obstruction

Question 10

Infectious causes of ACUTE diarrhea in adult horses

Answer 10

Salmonella (most common!)
Neorickettsia risticii(Potomac Horse Fever)
Clostridium difficile
Clostridium perfringens
Larval cyathostomosis
Coronavirus

Question 11

Non-infectious causes of ACUTE d in adult horses

Answer 11

diet change*
Abx*
NSAIDs*
blister beetle (less common)
heavy metals (less common)

Question 12

colitis aka

Answer 12

diarrhea

Question 13

CS of colitis

Answer 13

-endotoxemia (–> fever, inc. HR/RR, toxic mm)
-dehyd.
-diarrhea (rarely hemorrhagic)
+/- colic, ventral edema
-inc. borborygmi
-recal exam: fluid-filled colon +/- cecum with variable distention

Question 14

lab data assoc. with colitis

Answer 14

• neutropenia w/ L shift
• metabolic or lactic acidosis
• dec. Na/Cl/K/Ca
• azotemia
• dec. TP
• inc. liver enzymes

Question 15

how do you test for N. risticii

Answer 15

whole blood PCR

Question 16

how test for salmonella?

Answer 16

culture, PCR

Question 17

how test for Clostridium Toxin?

Answer 17

ELISA

Question 18

how test for Coronavirus?

Answer 18

PCR

Question 19

basic tx of colitis

Answer 19

• crystalloid fluids for replacement + maintenance
• colloids
• oral fluid replacement for less severe cases
• bind intestinal free toxin
• ABX HAVE NO SIGNIFICANT EFFECT ON COLITIS!

Question 20

endotoxin-related tx of colitis

Answer 20

NSAIDs (ie flunixin)
Polymixin B (binds circulating free endotoxin)
Digital hypothermia (preventative for laminitis!)

Question 21

supportive care of colitis

Answer 21

ISOLATION
maintain catheter
wrap tail
perineal care

Question 22

Exceptions for abx use (when to maybe use)

Answer 22

PHF
Clostridiosis
substantial leukopenia
peritonitis

Question 23

potential sequelae from colitis

Answer 23

laminitis
renal failure (from long term hypovolemia)
thrombophlebitis
cholangiohepatitis
peritonitis
fungal pneumonia

Question 24

prevalence of salmonellosis detection influenced by:

Answer 24

amt. of diarrhea
method (fecal culture vs. PCR)
time of year (inc. summer and fall)

Question 25

risk factors for salmonellosis

Answer 25

``` stress abx therapy change in diet sx nasogastric tubes wet/darkness GITdz ```

Question 26

how long is salmonella shed?

Answer 26

1-2 months

Question 27

salmonellosis prog.

Answer 27

good w/ earlytherapy

Question 28

Neorickettsia risticii

Answer 28

- cause of Potomac Horse Fever - infectious, NOTcontagious - seasonal - transmitted by fresh water snails and insects

Question 29

CS of N. risticii

Answer 29

biphasic lethargy/anorexia/fever +/- colic, diarrhea - can progress rapidly - NOT a cause of chronic d

Question 30

Dx of N. risticii

Answer 30

- whole blood PCR | - response to tx

Question 31

Tx of N. risticii

Answer 31

Tetracyclines Vax (questionable) Prognosis good with early tx *laminitis common complication*

Question 32

what bacteria assoc. with antimicrobial-associated diarrhea?

Answer 32

Clostridium difficile

Question 33

Clostridium perfringens affects young or adult horses?

Answer 33

foals

Question 34

risk factors of Clostridiosis

Answer 34

- Abx - Tubes, handling - hospitalization - age - geography

Question 35

Dx of Clostridiosis

Answer 35

Fecal toxin tests (enterotoxin, ELISA, PCR) | Fecal gram stain

Question 36

Tx for Clostridiosis

Answer 36

Metronidazole | BioSponge (DTO-smectite) to bind toxin

Question 37

Coronavirus CS

Answer 37

fever/anorexia/lethargy/+/- diarrhea (usually in colder months and short-lived)

Question 38

trans. of coronavirus

Answer 38

fecal/oral | -outbreaks common

Question 39

Dx/Tx of coronavirus

Answer 39

fecal PCR (tx = supportive)

Question 40

Cantharidin CS

Answer 40

inc. TPR | D/lethargy/colic/sudden death

Question 41

Lab data for Cantharidin

Answer 41

Dec. Ca** | Dec. Mg/TP

Question 42

Dx of Cantharidin

Answer 42

detect toxin in serum, urine, or gastric contents

Question 43

Infectious causes of CHRONIC diarrhea in adult horses

Answer 43

Salmonella | Parasites (giardia, strongyles)

Question 44

Non-infectious causes of CHRONIC diarrhea in adult horses

Answer 44

IBD neoplasia sand right dorsal colitis

Question 45

fecal diagnostics for chronic diarrhea

Answer 45

- gross exam for parasites - flotation/McMaster's quantification - direct smear - culture - sand sedimentation - Gram stain

Question 46

Tx of chronic diarrhea

Answer 46

-supportive: fluids, NSAIDs +/- Abx for salmonella -llarvicidal deworming -withdraw meds