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32 Cards in this Set
- Front
- Back
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what is the most common CS of esophageal dz
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ptylaism (hypersalivation)
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d/dx for ptyalism
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prehension
mastication (CN V, VII, XII) swallowing (CN V, IX, X) pharyngeal esophagus oral cavity pain FB poor dentition |
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what do you have to know about horses and how they breathe
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they are obligate nasal breathers
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what is the key to figuring out where the hell ptyalism is coming from
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oral exam
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what do you need to rule out before you consider something wrong with the esophagus?
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1. confirm good oral health (R/O fb, rule out teeth issues)
2. confirm guttural pouch health 3. confirm integrety of CN (needs to be done with endoscopy of guttural pouch) |
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examination of esophagus involves?
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palaption
plain rads contrast rads endoscopy |
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what is another name for esopheal obstruction
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choke
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whre are common sites of esophageal obstruction?
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cervical esophagus
heart base thoracic inlet terminal esophagus cats have ten tries (chtt) |
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where is there skeletal and smooth m. in the esophagus
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cr. 2/3 is skeletal
ca 1/3 is smooth |
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what are CS of choke (acute)
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frothy nasal discharge
feed from nostrils ptyalism coughing colic? |
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how do you perform a diagnostic eval for choke
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sedation of horse is key (head should be lower than point of shoulder px aspiration)
endoscopy if available passage of NG tube |
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what drugs will you use to sedate the horse and relax the esophagus?
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N-butylscopaolammoium bromide (buscopan)
xylazine oxytocin |
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when you have confimed choke what do you need to do next?
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pass NG tube until resistance if felt
pump in water while gently applying pressure to the obstruction keep horses head low (px aspiration) repeat |
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what do you do if the horse is unresponsive to the NG and water ?
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place horse in a stall, NPO, IV fluids, sedatives, relax esophagus and give it time!
it will likely resolve on its own |
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what do you do after your NG/ water and rest dont resolve the choke
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GA and cut them
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what are some meds you can give to a horse that has prolonged choke?
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broad-spectrum abx
anti-inflammatories sucralfate refeeding considerations (what you're going to feed, how often, how much) complications of choke |
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what are the complications of choke
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aspiration pneumonia
esophageal stricture esophageal rupture |
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what are you going to do for a horse that has aspiration pneumonia
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broad antibiotics
IV (K+ penicllin, procaine penicillin, gentocin) oral abx- trimethoprim sulfa |
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when there is an esophageal rupture from choke, or from a vet shoving a tube into the esophagus what is going to happen to the esophagus?
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extensive necrosis of tissues that drain due to drainage of saliva and feed material with significant subq emphysema.
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how do you treat an esophageal ruputre
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extensive debridement and lavage of tissues, broad-spectrum abx, tetanus prophalyxsis and esophageal rest. can put a esopheatomy tube in the wound, give fluids, let it heal by 2nd intention
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what is common after relieving a choke?
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reobstruction
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what do you do to px choke from reoccuring
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food modifications- soft mashed gruel (moistened pelleted feed and bran mashes_ and fresh grass when available
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what do you have to do when feed modifications are not enough to px choke from reoccuring?
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esophagostomyh
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why woudl a horse get metabolic alkalosis from choke
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because of prlonged loss of salivary Na+ and Cl-
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what results in megaesophagus
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HYPOmotlitiy
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is congenital or acquired megaesophagus more common
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acquired
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what is acquired mega esopagus a result of?
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primary or secondary esophageal obstruction
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what is primary obstruction
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when there is something inside the esophagus
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what is secondary obstruction
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when something is outside of the esophagus compressing it.
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how do you treat megaesophagus in the horse?
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target underlying cause, dietary modifications
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what is the prognosis of congenital megaesophagus?
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poor
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does megaesophagus cause mechanical or functional obstruction
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functional
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