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50 Cards in this Set
- Front
- Back
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Slaframine is associated with what feed source?
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“Sweet clover” is associated with legume forage (Clover)
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A neonatal foal is presented with bruxism and ptyalism. What is an important differential for this foal?
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• Gastric ulceration can cause interrupted suckling, colic, dorsal recumbency, bruxism (grinding of the teeth), and salivation in foals
• May be preceded with poor growth, diarrhea, and pot-belly appearance for days-weeks |
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A horse is presented with excess salivation and feed-tinged nasal discharge. The signs developed acutely after the horse was fed. What is your most likely differential and how would you confirm it?
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Choke can cause salivation, feed-tinged nasal discharge, swelling in neck, anxiety, and “retching”
• Diagnosed via passage of NG tube or endoscope +/- Radiographs |
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A horse is presented for esophageal choke.
• What is your plan for relieving the choke? |
• Place in stall with NOTHING in stall
• Sedate with xylazine/detomidine/butorphanol • NG tube- warm fluid lavage for approximately 30 minutes, initially • Oxytocin or Buscopan • Refractory cases may require general anesthesia with ETT +/- surgery • Supportive care (NSAIDs +/- Abx) |
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What is your management plan once the choke has been relieved?
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• Return to feed SLOWLY
• Limit intake (grazing muzzle) • Encourage the horse to eat more slowly • Soak feed • Regular dental care |
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List 6 possible complications that may occur? What are the most common complications?
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• Recurrent choke (common)
• Mucosal ulcers (common) • Aspiration pneumonia (common) • Stricture • Diverticula • Esophageal rupture |
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List 6 possible predisposing factors for choke. What is the type of feed most often (but not exclusively) associated with choke?
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List 6 possible predisposing factors for choke. What is the type of feed most often (but not exclusively) associated with choke?
• Defective teeth (worn or erupting) • Greedy eaters • Pellets/Beet pulp • Bolus Rxs • Eating while sedated • Previous esophageal problem or structural abnormalities |
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A Friesian is presented for recurrent episodes of choke and excess salivation. What condition might you expect and how would you confirm it?
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• Acquired Megaesophagus
• Endoscopy may reveal esophageal obstruction/stricture |
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Owners often ask why horses colic and what they can do to prevent it. While colic cannot be reliably prevented, list 6 management recommendations that you could make to minimize the risk of colic
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• Increase fresh green pasture turnout
• Decrease concentrates and increase forage • Feed alfalfa hay (calcium may act as a buffer) • Decrease level of training (reduce stress) • Provide clean fresh water at all times • Regular appropriate dental care • Frequent feedings • Decrease access to sand |
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A horse is presented for acute colic. What parameters on your physical examination are of particular relevance in examination of horses with colic?
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7 P’s of Colic
• Pain • Pulse • Perfusion • Peristalsis • Palpation • Passage of NG tube • Paracentesis • PCV/TP |
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List 4 additional procedures that you may include in your colic exam in addition to the routine physical. Which of these would you prioritize if the horse presented with a very high heart rate?
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NG Tube
• Rectal • Paracentesis • Endoscopy |
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List 3 drugs that you might use to provide immediate pain control in an acutely colicky horse. What is the effect of these drugs on motility?
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• Xylazine: decreases GI motility
• Detomidine: decreases GI motility • Butorphanol + Xylazine: Xylazine will decrease GI motility |
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What other medications could be used to provide analgesia in horses with colic? Which is the most frequently used medication and what are the major adverse effects of this drug?
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• Flunixin meglumine: most commonly used; GI ulceration and renal papillary necrosis
• Ketoprofen: least toxic to GI tract and kidneys • Phenylbutazone: more potential for GI ulceration and renal toxicosis than Flunixin • Buscopan (spasmolytic) |
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You diagnose a pelvic flexure impaction in a horse. The horse is only mildly painful and is not clinically dehydrated at this time. List 5 things that could be used to treat the impaction. What would be your initial treatment choice.
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NPO
• NG Tube • Fluid therapy • Lubricants/Cathartics • Surgery |
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What are the clinical signs of gastric ulcers in foals/adult horses?
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Foals: interrupted suckling, colic, dorsal recumbency, bruxism, salivation (sometimes preceded by poor growth, diarrhea, and pot-belly appearance for days - weeks)
• Adults: intermittent diarrhea, recurrent colic, poor condition, decreased appetite, poor performance, lethargy |
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What are potential causes of gastric ulcers in horses? Are most cases of gastric ulcers in horses related to NSAID use?
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• Idiopathic (unknown and multifactorial)
• Training: Stress and possibly ischemia with higher gastrin and lower pH • NSAIDs: may cause ulcers, but NOT a factor in many cases • Diet/Feeding practices: lowest incidence • Secondary infections with Helicobacter pylori or Candida spp. |
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How would you confirm a diagnosis of gastric ulcers in a horse? Are there reliable clinicopathologic abnormalities?
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• Clinical signs
• Endoscopy • Peritoneal tap • Response to treatment • NO reliable clinpath abnormalitites |
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What management recommendations would you make for a horse with equine gastric ulcer syndrome?
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What management recommendations would you make for a horse with equine gastric ulcer syndrome?
• Increase pasture turnout • Frequent feedings • Decrease concentrates • Feed alfalfa hay (Calcium may act as buffer) • Decrease level of training |
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List 3 drugs that are used to treat gastric ulcers in horses.
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Omeprazole (UlcerGard)
• Ranitidine (H2 antagonist) • Neigh-lox (antacid) |
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What are the clinical signs of right dorsal colitis? What diagnostic procedure can support a diagnosis of RDC?
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• Soft feces and chronic, mild colic
• Thickening of RDC on U/S |
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What clinicopathologic finding would be supportive of RDC?
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Hypoalbunemia
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What are the primary clinical signs of anterior enteritis/proximal duodenitis-jejunitis? What factors might help distinguish this syndrome from a small intestinal obstruction? (this can be difficult!) What infectious organism has been linked to some cases of proximal enteritis?
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• ACUTE ONSET of moderate – severe abdominal pain
• Tachycardia (> 60 bpm) • Ileus • Large amounts of gastric reflux (10-20 L) • Dehydration (increased PCV and TP) • Severe depression |
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How would you diagnose peritonitis in the horse? What may be a long-term complication in horses that recover from peritonitis?
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Peritoneal fluid analysis: WBC > 10,000/L and TP > 2.5 g/dL
• ADHESIONS will cause chronic complications after peritonitis |
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What are the top 3 infectious differentials for an adult horse with acute colitis?
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• Salmonellosis: 5 serial fecal cultures, because shed intermittently; primarily supportive therapy
• Potomac Horse Fever: PCR and Culture are most definitive; Supportive care and Oxytetracycline • Clostridium deficile: Toxin ID; Supportive care and Metronidazole |
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• Salmonellosis: 5 serial fecal cultures, because shed intermittently; primarily supportive therapy
• Potomac Horse Fever: PCR and Culture are most definitive; Supportive care and Oxytetracycline • Clostridium deficile: Toxin ID; Supportive care and Metronidazole List 3 other differentials for acute diarrhea in adult horses. Remember that many cases are undiagnosed! |
• Parasites
• Antibiotic associated diarrhea • Cantharidin toxicity (contaminated alfalfa) • NSAID toxicity • Sand |
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What is the typical signalment and clinical presentation for Lawsonia intracellularis? What diagnostic test would you perform? What specific therapy would you recommend?
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• Weanling age foals with poor body condition, edema, and low grade and inconsistent diarrhea
• PCR on feces • Erythromycin + Rifampin |
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In addition to diarrhea and colic, what additional clinical signs might you see in a horse with cantharidin toxicosis? What clinical pathologic abnormality can be important is distinguishing cantharidin toxicosis from other causes of diarrhea/colic? How would you confirm the diagnosis?
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• Salivation, oral ulcerations, colic, diarrhea, depression, cardiovascular collapse, tachycardia
• PROFOUND hypocalcemia (4-6 mg/dL) • ID beetles in hay, Urine cantharidin levels, or Gastric content analysis |
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What infectious agent is a common cause of diarrhea in neonatal foals that is not seen in adult horses?
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Cryptosporidia
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What are the major differentials for chronic diarrhea?
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• Diet
• Chronic Salmanellosis • Parasitism • Rhodococcus equi (foals) • Gastric ulcers (foals) • Lawsonia intracellularis (foals) • NSAID toxicity • IBD • Neoplasia • Sand • Non-inflammatory chronic diarrhea • Non-GIT causes |
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What diagnostic test would you recommend for the diagnosis of inflammatory bowel disease? What treatment would you recommend?
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Histopathology or Absorption tests (flat-line = IBD)
• Prednisolone or Dexamethasone |
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What is the most common neoplasia associated with the gastrointestinal tract of the horse?
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Lymphosarcoma (multiple locations)
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What is the role of the liver in metabolism of ammonia derived from protein?
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Biotransformation of ammonia to urea via oxidases of the cytochrome P-450 enzyme
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Why are hepatic enzymes often elevated in horses with endotoxemia or abdominal inflammation?
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AST and GGT
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Which hepatic enzyme is most specific for equine hepatocellular disease?
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SDH
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What disorders may cause increased AST?
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• Liver or Muscle damage (leakage enzyme)
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• Which hepatic enzyme is most specific for equine biliary tract disease?
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• GGT
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• What disorders may cause increased ALP?
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• Liver, GI, Bone, or Placental pathologies
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• What are the most common signs of hepatic disease in horses?
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• Depression
• Anorexia • Colic • Hepatic encephalopathy (accumulation of ammonia -> cerebral edema-Central Dz) • Weight loss • Icterus • Often presents as Acute-on-Chronic • May also see diarrhea, photosensitization, unexplained bleeding, fever, and hemolysis |
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• What is the normal ratio of unconjugated to conjugated bilirubin in horses?
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Direct:Total < 0.3
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What laboratory tests provide information regarding hepatic function in horses?
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• Glucose
• TP • Fibrinogen • BUN • Ammonia • Bilirubin • Bile acids (most sensitive for abnormal hepatic function) • Coagulation parameters |
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What triad of clinical signs is associated with bacterial cholangitis/cholelithiasis?
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• Fever
• Icterus • Abdominal pain |
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What are the ultrasound characteristics of cholelithiasis/cholangitis in horses?
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Dilated bile ducts with stones
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How do you treat cholelithiasis/cholangitis? What is the prognosis?
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4-6 wk TMS or Sx
• Prognosis is fair to good with early, appropriate diagnosis and medical/surgical intervention |
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What causes Theiler’s disease? What is the prognosis?
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Tetanus antitoxin
• Prognosis is usually poor |
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Tetanus antitoxin
• Prognosis is usually poor |
Central Dz, so neurologic signs
• Treat with Thiamine ? |
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What clinical pathologic and/or exam factors are associated with a poor prognosis for horses with liver disease?
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• Most clinical signs are usually nonspecific and highly variable
• Most commonly associated = Depression, Anorexia, Colic, Hepatic encephalopathy, Weight loss, and Icterus • Clin Path: Hypoalbuminemia +/- Hyperglobulinemia, decreased BUN • Liver biopsy: loss of parenchyma and fibrosis |
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What is Tyzzer’s disease and what is the most common signalment for affected horses?
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• Acute liver failure caused by infection with Clostridium piliformis
• Common in foals b/w 7-42 days of age |
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What plant toxin is most commonly implicated in horses with toxic hepatopathy in the United States? Which plants contain this toxin?
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• Pyrrolizidine alkaloid
• Senecio and Crotolaria spp. |
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What other plants are associated with hepatotoxicity in horses?
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• Alsike Clover Toxicity
• Kleingrass • Xanthium |
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What is the most common signalment for horses with hyperlipemia/hepatic lipidosis?
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Primarily in ponies and miniature horses
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