Lecture 2: Esophageal Obstruction and Equine Gastric Ulcer Syndrome Flashcards
(48 cards)
what is the most common cause of choke/esophageal obstruction
Inadequately soaked beet pulp
Describe the anatomy of the esophagus
2 muscle layers:
1. Muscularis mucosa: in cranial esophagus, becomes more substantial as it approaches cardia- composed of smooth muscle, longitudinal orientation
- Muscularis externa: present along entire length of esophagus. Composed of striated muscle in midthoracic region and smooth muscle in caudal 1/3
What are the 4 most common sites for choke
- Cervical esophagus
- Thoracic inlet
- Base of heart
- Cardia/terminal esophagus
What are the sedation options for treatment of choke and what do they do
- Xylazine: alpha 2 agonist with sedative and pain relieving properties ~10 minutes
- Butorphanol- partial kappa/sigma agonist opioid with pain relieving properties. Stops coughing and gagging (antitussive)
- Acepromazine: muscle relaxant and anti-anxiety, no pain relief
What muscle relaxants are used to tx choke and what do they do
- Buscopan/N-butylscopolammonium: anti-cholinergic, antispasmatic, smooth muscle relaxant
- Acepromazine
What is a side effect of Buscopan/ N-butylscopolammonium
Tachycardia! Important to check heart rate prior to use because can cause V-fib
What is a common NSAID used to tx choke
Banamine
What antibiotic is commonly used for choke
Excede- broad spectrum antibiotic- not administered orally
What mucosal protectant is commonly used to tx choke
Sucralfate
When passing an NG what two things should you do to prevent aspiration pneumonia
- Nastrotracheal tube with cuff
- Heavy sedation with head down
Once NG is passed what do you want to give
6-8 liters of water and electrolytes
T of F: you can feed a horse right after tx choke
F: hold off feed for 12 hours and slowly reintroduce wet, soft feed
What do you do if you are unsuccessful in relieving the choke
- Supportive care: night of IV fluids and muscle relaxants
- Refer to scope
- GA
What are some common life threatening complications of choke and which is the most common
- Aspiration pneumonia- most common
- Acid base and electrolyte abnormalities
- Dehydration
- Esophageal mucosal irritation
What is the MOST common life threatening complication of choke
Aspiration pneumonia
What are some less common life threatening complications of choke
- Stricture formation
- Esophageal perforation
- Pleuritis
- Laminitis
- Laryngeal paralysis
- Horners syndrome
What are some ways to prevent choke
- Dental care
- Slow feeders
- Elevated feeders
What are some signs of gastric ulcers
Poor appetite, dullness, attitude change, decreased performance, reluctance to train, poor body condition, mild colic, salivation when tacking, poor hair coat, weight loss, sour disposition, avoidining hard feed, prefer hay, bruxism, cribbing
What is wrong here
Multifiocal, diffuse, gastric ulcers near the pylorus. Grade 3-4
What is the pathophysiology of ESGD
Increased exposure of squamous mucosa to acid
What is the pathophysiology of EGGD
Breakdown of normal defense mechanisms that protect the mucosa from acidic gastric contents
What are some predispositions to ESGD
Racehorses, increase intensity and duration of exercise, high fiber, >6 hours between meals, feeding grain at 1% body weight
What are some predispositions to EGGD
Warmbloods, exercised more than 5 days a week, stress
Access to pasture may be protective in what gastric ulcer syndrome
EGGD
