Acute Diarrhea in Horses Therapy
Eight principles were outlined in the treatment of acute diarrhea in horses, name four
1. Prevent spread to other horses
2. Fluid and electrolyte therapy
3. treatment of endotoxaemia
4. intestinal binding agents
5. re-establish normal GI flora
6. nutrition
7. prevent complications
8. specific treatments
Fill in the blank:
When refining the problem of weight loss, it's important to determine if it's associated with (1) or (2). If it's due to (1), you must refine whether the animal can't (3) or won't (3).
(38 second time limit from the time I remember to set it)
1) decreased appetite
2) normal or increased appetite
3) eat
Malassimilation is a combination of what?
maldigestion and malabsorption
Chronic GIT in horses can be divided into what three groups
Weight loss
Chronic diarrhea
Recurrent colic
How many adult incisors do these sheep have?
- under 1 year
- 1-2 years
- 2-3 years
- 3-4 years
- 4+ years
lamb = all deciduous
1-2 = 2 (1 pair)
2-3 = 4 (2 pair)
3-4 = 6 (3 pair)
4+ = 8 (4 pairs)
List 6 clinical signs of dehydration
- Pale/Tachy MM
- Changes in mentation
-Decreased skin turgor
-Tachycardia
-Increased CRT
-Increased jugular refill time
-Weak pulses
-Cool extremities
-Decreased urine output
Weight loss with a normal or increased appetite can involve what three factors
Maldigestion
Malabsorption
Malutilisation
What two products does the exocrine pancreas produce
Enzymes to digest all major types of food
Bicarbonate to neutralize HCl (provides the right environment for enzymes to work)
List 5 causes of weight loss in horses
dental disease
larval cyathostominosis
inflammatory bowel disease
GI neoplasia
Chronic grass sickness
Liver failure
PPID
Chronic renal failure
Name 2 diseases that may result in swelling in the region of the mandible in adult cows, and which one can result in bony changes
Wooden tongue
Lumpy jaw - bony changes
What factors do you need to address with a fluid plan?
Fluid deficit
Maintenance
Ongoing losses
Anorexia is a very non-specific sign, and because of this physical exam is very important for narrowing it down. Give me 4 things you might find on a PE that are informative in the context of anorexia
Pyrexia
massess
severe constipation
severe heart disease
anemia
icterus
How does the pancreas affect cobalamin absorption
Pancreas synthesizes intrinsic factor that's essential for B12 absorption
List 5 common causes of chronic diarrhea in horses
larval cyathostominosis
dietary (lush pasture/excessive grain intake)
inflammatory bowel disease
sand enteropathy
proliferative enteropathy
NSAID induces ulcerative right colitis
GI neoplasia
Define Vagal Indigestion and what species it affects
chronic dysfunction of the reticulorumen and/or abomasum resulting in delayed emptying of one or both, leading to abdominal distention
Occurs in Cattle, sheep and goats
Diagnosis of endotoxaemia is based on human SIRS criteria (tachypnoea, fever, tachycardia, leukopenia, neutropenia due to neutrophil margination and degenerative left shift.
What are the 4 main points of TREATING endotoxaemia
-neutralizing circulating LPS
-Inhibition of LPS-induced inflammation
-modulation of coagulation system
-circulatory support
Name a secondary cause of malabsorption in small animals and in horses
Small animal: Hepatic disease, right sided cardiac disease, hyperthyroidism
Horse: intestinal dysmotility (chronic grass sickness)
What's the most common cause of EPI in cats?
chronic pancreatitis
In an oral glucose absorption test, what result would indicate partial malabsorption
Normal = >85% increase in BG at 120 min
Partial Malabsorption = 15-85% increase at 120min
Complete malabsorption = <15% increase at 120 min
Liver abscesses can be caused by what chronic GI issue? How can they lead to death?
rumen acidosis and sub acute rumenal acidosis
Lead to Vena cava syndrome or thrombosis of caudal vena cava
Treating endotoxaemia involves 4 factors. Give me one treatment for each area. All or nothing points.
1. Neutralize circulating LPS: Polymixin B (binds LPS) or hyperimmune plasma (prevent cytokine release)
2. Inhibit LPS induced inflammation: NSAIDs, glucocorticoids (inhibit cytokine gene expression), pentoxifylline (PDE inhibitor)
3. Modulate coagulation system: Low molecular weight heparin (only works when still in hypercoagulable state bc once in DIC REAL BAD)
4. Circulatory support: IVF, plasma (has clotting factors and colloid properties)
Of the seven causes of malutilisation-driven weight loss in small animals, what three are associates with increased appetite?
Diabetes mellitus
Neoplasia (occasionally)
Hyperthyroidism
Liver disease (occasionally)
There are three phases of absorption: luminal, mucosal and transport. List two pathologies affecting the transport phase
Lymphatic obstruction: primary or secondary lymphangiectasia (secondary most common, due to neoplasia, infection or inflammation)
Vascular compromise: vasculitis (infection, immune mediated), portal hypertension (hepatopathy, right sided heart failure)
Proliferative enteropathy is caused by what?
Lawsonia intracellularis bacterium
Blacks disease is caused by the combination of a liver fluke and a toxin-producing bacterium. What is that bacterium?
For a daily double: what bacterium has a very similar pathophysiology and causes bacillary hemoglobinuria
Clostridium novyi type B
DD: clostridium haemolycticum AKA clostridium novyi type D