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90 Cards in this Set

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when intestines are obstructed what happens to the blood supply?
nothing, there is not an interupption to blood flow
does obstruction or strangulation cause mechanical obstruction
both
where does occlusion occur with strangulation of SI
occlusion from serosal surface
where does obstruction occur with obstruction to the SI
luminal obstruction, impedes flow of ingesta, dilation of the prox bowel
is the blood supply of SI strangulation disturbed?
yes, both the lumen and blood supply are interuppted
causes- devitalized bowel- endotoxemia, hemoconcentration and dehydration
what are the CS of obstruction of the SI
mild/moderate pain
good response to analgesia
minimal CV compromise
periotoneal fluid WNL
+/- gastric reflux
+/- surgery
what are CS of SI
mild, mod, severe pain
only brief response to analgesia
CV deterioration- endotoxemia, hemoconcentration, dehydration.
peritoneal fluid abnormal
+/- gastric reflux
SURGICAL EMERGENCY
when only the lumen is occlued in the SI will you see cardiovascular side effects
no
intussusectoino
oral segement of bowel telescopes up into the aboral segment. obstructs flow of ingesta
who is intessuseption most common in
young horses
what parasite can cause intussesection
tapeworms
what part of the SI is most commonly effected by intussusception
ileoceceal
where will tapeworms cause an intussusception
ileocecal
where will ascarids cause intusseceptoin
in the jejuno-jejunal intus
what can cause intuss?
deworming
abrupt dietary changes (weaning)
GI parasites
acute intus
acute colic
rare cases- intermittient colic
if the foal is big enough, and you do a rectal what will you feel if they have intus
dilated small int on rectal exam
what can you see on US with intuss
bullseye lesion
what will peritoneal fluid be like in intuss
abnormal youve got strangulation
how do you treat intuss?
surgical intervention is required
devitalized bowel- resection/ anastomosis
prog of intuss?
simple- good
ileocecal intuss- guarded
what do you do to treat an ileocecal intuss?
you have to perform a jejunocecostomy
what are the equine tapeworms
anoplocephala perfoliata
they do not have proglottids
there is an intermediate host -cribitid mite
prepatency period for tapes
6-8 weeks
when should you deworm for tapes
if you deworm them right after the first frost after all the mites have been killed off you have a better chance of deworming
how do you prevent ileocecal/cecocolic intuss?
praziquantel for tapes
small intestinal volvulus
strangulating obstruction of SI tract
where does the SI twist on
around the root of the mesentery. causes complete interupption of the intestinal blood supply
is small intestinal volvulus sequellae reversible?
no the affected portion of the intestine suffers irreversible ishchemia
CS of SI volvulus
consistent with strangulating obstruction
colic, gastric reflux, poor tissue perfusion, endotoxemia, absent borborygmi, distended SI on rectal exam, serosanguinous peritoneal fluid (inc. WBC and protein_
metabolic acidosis-> lactate
SI volvulus tx
sx intervetion if necessary
resection of affected portion of SI is typically necessary
half can be resected half will have issues (short bowel sydrome)
incarceration of SI within the abdomen
bowel may pass through a mesenteric rent, an inguinal ring, the gastrosplenic ligament or epiploic foramen
who are inguinal hernias more common in
tennessee walking horses
indirect scrotal hernia
in older horses
direct scrotal hernia
when bowel rupture through the inguinal ring in FOALS
what will a scrotal hernia look like
one side of hte scrotum is enlarged and cool
what are the landmarks of the epiploic foramen and can you see it during surgery?
you cannot see it during surgery you have to imagine this.
right craniodorsal abdomen
landmarks- caudate lobe of liver, caudal vena cava, portal v, pancreas
what portion of the intestine is involved in epipolic foramen SI incarceration
ileum.
what must you do if the ileum is invovled in the epiploic foramen incarceration
you have to do a jejunocecostomy for repair
where is the occlusion of the bowel in SI incarceration
occlusion of bowel lumen from serosal surface (not luminal space)
prognosis of SI incarceration
fair for most conditions
higher survival rates coincide with early prompt sx intervention
what are post op complications of any SI sx
post op Ileus will mimic DPJ
adhesions
pedunculated lipoma
strangulating lipoma
who gets strangulating lipoma
old horses
arbians (overrepresented) and ponies
~ 9 yo
late teens/ early twenties
geldings overrepresented
strangulating lipoma
grow on the mesentery keep gorwing with pendulous stalk, surrounds loop of bowel, causes strangulation
CS of strangulting lipoma
colic
tx for stangulating lipoma
surgery to free the lipoma
resection and anastomosis
prog of strangulating lipoma
good
what can be misinterpreted as a strangulating lipoma
dessicated feed may be palpated in the lg. colon. this is not a typical feed impaction
should a SI impaction cause inc. heart rate
no not normally it means you have something more complicated going on.
mechanical obstruction
means something is in the middle of the lumen impeding flow of ingesta will cause a dilation of the prox. bowel
if you have an obstruction will you have an interupption to vascular flow
no, and there shouldnt be any cardiovascular distrubances
what will happen to strangulated intestine
it will die
which dz will horses respond better to analgesics, obstruction or strangulation
obstruction
how bad is the pain of SI obstruction
mild to moderate
how bad is the pain for SI strangulation
mild, mod, to severe
what is the only way to make the pain go away for SI stangulation
sx
will peritoneal fluid be abnormal in obstruction or stangulation of SI
stangulation will be serosanguinous
will horses with obstruction or stangulation have cardiovascular deterioration
strangulation, endotoxemia, hemoconcentration, dehydration
what is the big deal with strangulation
its a surgical emergency
how do you know if you should do sx or not on the SI obstruction/ strangulation?
PE parameters
historical factors
dx eval
degree of pain
what can cause SI obstruction
ascarid impaction
ileal impaction
what causes strangulatoin
intussusception
SI volvulus
abdominal incarceration
pedunculated lipoma
what type of ascarids do horses get
parascaris equorum
equine roundworm
signalment of p. equorum
foals/weanlings
typically < 1 yo
resistance 18-24 months
affects foals with poor deworming hx
when should a foal first be dewormed
8-12 weeks is the ppp for p. equorum so deworm before 2 months old
what is the prepatency period of p. equorum
travel through liver and bust through the lungs, trhough the lungs to the trachea and they are coughed up swallowed to SI where larvae become adults
what can happen if you deworm after ppp of p. equorum
they die and clog up the lumen of the SI
what happens when the adults p. equorum worms die
they release toxins that can cause damage to the bowel. this causes an inflammatory response-> endotoxemia
CS of roundworms after being dewormed or after a resp. infection
colic
depression
endotoxemia
tachycardia
tachypnea
fever
gastric reflux of worms
dx of roundworms
history (recent deworming, recent resp. infection)
signalment
abdominal US
nasogastric fluid
periotoneal fluid
fec 10 x 10^6 very very high
roundworms tx
gastric decompression/ lavage (pass stomach tube try to get them out this way)
anti-inflammatory therapy
worms are toxin/ damage wall of SI
(necrosis/bowel rupture not uncommon)
+/- surgery
what is great about being a foal with endotoxemia
they dont founder doesnt mean they cant but its rare
prog of roundworms
guarded due to severe inflammatory response triggered by the death of the adult worms
what is better for getting rid of roundworms, medicine or sx
medicine, < 10% of surgical cases survive
px of roundworms
proper deworming protocols
begin about 60 days and repeat 2-4 mo after
what have roundworms been reported to be resistant to
ivermectin
what are the two best dewomers right now for roundworms
benzimadazoles/ fenbendazole
best choice is based on the farm sensitivities and FEC
when will you use a less effective anthelcide?
when you have a ton of worms and you dont want to obstuct their GIT so you do a slow kill
Ileal impaction
non-strangulating
where is ileal impaction common
SE US probably coastal bermuda grass
very coarse fibers and very finely ground
CS of ileal impaction
assoc. with obstruction and bowel lumen
should NOT have CV impairement
what will you feel on rectal palaption with a horse with ileal impaction
can feel the back of the cecum, and can palpate the ileum- very acute if you're later than that then more fluid will distend the prox bowel. you will reach and and only feel small intestine
will you have gastric reflux with ileal impaction
maybe
will peritoneal fluid be normal with ileal impaction
yes its obstruction not strangulation
tx of ileal impaction
natural motiliy may resolve the impaction, give them some mineral oil and some analgesics/ IV fluid
early tx of ileal impaction
analgesia/iv fluid/ mineral oil
monitor vital signs closely
monitor pain
late tx of ileal impaction
+/- surgery
pain
deteriotation in peritoneal fluid
prog of ileal impaction
good. post op ileus is a risk
px of ileal impaction
avoid coarse bermuda grass hay
proper deworming (tapes known to perturb ileal motility)