Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
90 Cards in this Set
- Front
- Back
|
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) |
