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14 Cards in this Set
- Front
- Back
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What is the structure of endotoxin
a) what domain is responsible for toxic effects b) what domain is unique to a specific bact strain & what is the clinical relevance of this |
gram negative bacteria have endotoxin as a component in their cell wall (LPS)
a) lipid A (highly conserved, inner aspect) b) O-specific antigen (specific for each bacteria so it can be targeted) |
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defense mechanisms against endotoxin
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skin & mucosal barriers
hepatic kupffer cells specific immune system |
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pathophysiology of endotoxin
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physical barriers breached
- gram neg infection/ metritis/ etc - damage to fut wall - administration of contaminated solutions endotoxin-macrophage interaction - processing of macropahge plasma membrane arachidonic acid - TNF, IL-1beta => amplification of endotoxin signal neutrophil involvment - endothelial adhesion molecules => increased margination - cytokine induced activation of neutrophils Organ perfusion compromised - vasoconstriction => vasodilation - vascular leakage - hypotension recovery - negative feedbavck - terminates inflammatory response |
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clinical signs of endotoxemia (early)
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tachycardia/ tachypnea
blanching of mm transient hypertension pyrexia (fever) |
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clinical signs of endotoxemia (later stages (> 2 hrs))
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toxic line
congested mm/ prolonged CRT pyrexia tachycardia decreased GI motility/ diarrhea/ depression hypotension circulatory failure and disordered hemostasis - rapid/ weak pulses - cool extremities - sweating/ musc fasciculations - hypercoag/ hemorrhage - edema - laminitis |
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clin path of endotoxemia
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neutropenia / left shift**
increased PCV hyperglycemia => hypoglycemia altered hemostasis altered tissue perfusion - azotemia - increased hepatic enzymes |
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how do you treat endotoxin
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modify inflamm cascade
- NSAIDs (flunixin meglumine/ ketoprofen/ firocoxib/ phenylbutazone/ aspirin) - lidocaine - pentoxifylline - DMSO - etc. support system treat underlying dz process (ex gram neg sepsis in foals) neutralize/ bind endotoxin - polymixin B (bind) - bio sponge (bind) |
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ddx for excess salivation w/o nasal discharge
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ptyalism
- pain - FB - dental dz - mucosal ulceration - slaframine dyspahgia - pain - obstruction - neuro - muscular - oral - pharyngeal - esophageal |
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what types of disorders cause dysphagia?
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neuro
musc pain obst can be oral, pharyngeal, or esophageal |
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esophageal choke
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most often feed
predisposing factors - dental abnormalities - greedy eaters - dietary factors - bolus meds - diverticula - stricture clinical signs - ptaylism - feed-tinged nasal discharge - anxiety - swelling in neck - retching dx - passing NG tube or endoscope - radiography tx - remove food/ water (maintain hydration IV) - sedation (decrease anxiety and lower head) - lavage - oxytocin - surgery complications - mucosal ulcers - stricutre - diverticula - asp pneum - perf prevention - rocks/salt block in grain bucket |
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esophageal diverticula
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congenital
acquired clinical signs - recurrent choke - intermittent fluctuant swelling dx - endoscopy +/- contrast radiography tx - dietary mgmt if recurrent (grain/ pellet slurry/ green grass) - surgical resection |
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esophageal stricture
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recurrent esophageal feed impaction
- circumferentail ulcer from choke or reflux esophagitis - congenital - wound to neck/ external compression - lymphadenopathy - post esophageal sx dx - endoscopy +/- contrast rads tx - dietary mgmt (grain/ pellet slurry/ green grass) - non surgical: indirect bougienage - surgical intervention |
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megaesophagus
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congenital (rare)
- reflux of milk through nares - soft fluctuant swelling in lower neck - poor prognosis acquired - esophageal obstruction/ stricture - occ later in life with uncertain origin (more common in Friesians) |
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complications of esophageal disorders
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asp pneum +/- pleuritis
laryngeal paralysis horners syndrome laminitis |
