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;
26 Cards in this Set
- Front
- Back
equine gastric ulcer dz
|
2 forms: squamous disease (EGUS), glandular dz, may coexist
|
|
gastric ulcder dz pathophysiology
|
chemical damage by acid and bile salts: protective factors (saliva, roughage mat-buffer, mucus epithelial integrity-PGs, gastric emptying), harmful factors (disruptors of the roughage mat, NSAIDs, mucosal ischemia, pooling of acid or bile salts)
|
|
risk factors for squamous dz
|
occupation/training (90% racehorses in training, 50% of show horses), intermittent feeding (anorexia/withholding food), stress (change in environment, hauling, stall confinement)
|
|
risk factors for glandular dz
|
illness (90% foals in ICU, post-op colic), gastric outflow obstruction, NSAID toxicity, heliobacter infection
|
|
clinical signs in adults gastric ulcers
|
colic (chronic, intermittent, after a meal), occasional hypersalivation, occasional bruxism, reluctance to eat
|
|
clinical signs in foals gastric ulcers
|
colic signs more common and often more severe than adults, hypersalivation, bruxism, mild non-hemorrhagic diarrhaea
|
|
diagnosis gastric ulcers
|
gastric endoscopy, response to therapy
|
|
specific therapy gastric ulcers
|
proton pump blocker omeprazole-high dose 4mg/kg PO daily, H2 antagonist ranitidine, promote healing (sucralfate-glandular), 2-4wks of therapy
|
|
compounded omeprazole
|
legal issues, clinical trial comparing gastroguard and compounded omeprezole found compounded formulation ineffective
|
|
management/diet gastric ulcers
|
reduce stall confinement, frequent feeding-grazing, less grain more roughage, alfalfa hay appears to be the best roughage buffer, corn oil (increase APGE2), high fat diets, modify training
|
|
prevention gastric ulcers
|
good dietary and occupational management, low dose omeprazole (continuos during training/racing, intermittent at times of highest risk-3d prior to and during a show, misoprostol if high risk and on an NSAID)
|
|
esophageal obstruction is known as
|
choke
|
|
causes of esophageal obstruction
|
poor quality feed-impaction, poor mastication, dehydration/lack of saliva, greedy eaters, corn cobb/apple/foreign body, stricture, diverticulum, neoplasia, abscess or granuloma, inclusion cysts, vascular ring anomaly, motility dysfunction-megaesophagus
|
|
pathophysiology of esophageal obstruction
|
functional/mechanical obstruction, reflux of saliva and food material, dehydration and electrolyte abnormaltities if prolonged, mucosal injury, possible tissue injury (mucosal ulceration, stretching of the wall, rupture)
|
|
clincal signs of esophageal obstruction
|
anxious, hypersalivation, nasal discharge (food material, saliva, water), cough, gag (extend neck when eating), swelling cervical region, dehydration
|
|
lab finding of esophageal obstruction
|
elevated PCV/TP, electrolyte and acid/base imbalances (hyponatremia, hypokalemia, metabolic cidosis), mild azotemia
|
|
diagnosis of esophageal obstruction
|
establish obstruction (clinical signs, NG tube, endoscopy, ultrasonography, radiography), look for underlying cause
|
|
radiography of esophageal obstruction
|
use contrast agents, pattern affected by prior passage of an NG tube, spasmolytic drugs (local dilations), combination of NG tube passage and detomidine
|
|
relief of esophageal obstruction
|
lavage (single NG tube while standing using detomidine for sedation, or couble NG tubes with general anesthesia; place an endotracheal tube, ingress and egress tube), surgery in rare cases of foreign body, strictures, ruptures, masses
|
|
enteral diet for esophageal obstruction
|
hi fat complete pelleted food (12% protein), 2-3% of body weight per day divided into 6 feedings (gradually increase over week after Sx), supplement w/1 cup of corn oil BID, 1 Tbsp of salt in each feeding, can deliver 23 Mcal of digestible energy per day (1.5 times maintenance)
|
|
hydration for esophageal obstruction
|
soften impaction, replace fluid deficits (>48h duration), correct electrolyte or acid/base imbalances (0.9% saline with bicarb added as needed is fluid of choice), intravenous or rectal administration
|
|
pharmacology for esophageal motility
|
acepromazine, X/T, and detomidine (detomidine decreases waveform duration and increases transit time, distension and reduced primary peristalsis in proximal esophagus, decreased swallows, mostly use detomidine), oxytocin (reduce esophageal pressure in the proximal esophagus in a distension model-modest increase)
|
|
diet for esophageal obstruction
|
bran mashes, pelletted food slurry, avoid hay or grass until function is normal, supplement with salt if salivary loss continues
|
|
complications of esophageal obstruction
|
rupture, aspiration pneumonia
|
|
sequela of esophageal obstruction
|
stricture, diverticulum
|
|
follow up for esophageal obstruction
|
rescope after relieving obstruction (R/O injury to mucosa or underlying dz), if ulcerated (NSAID's to prevent stricture?, sucralfate), rescope in 14 & 30d if injury to the mucosa has occurred
|