GI Tract General Disease States

Ileus

Lack of progressive intestinal motility

Ileus

When the intestine stops moving food even though there is no blockage

Intestinal distension, endotoxemia, electrolyte imbalances. meds

What causes ileus?

Xylazine, butorphanol, anesthetic agents

What drugs can cause ileus?

Decreased/no intestinal sounds, nasogastric reflux, decreased fecal output, bloating, pain

Clinical signs of ileus

Decompression of fluid and gas w nasogastric tube, pain control, promotility drugs

Therapies of ileus

With - ileus will be transitory and resolve in 2 to 6 days, without - severe endotoxemia with or without gastric rupture

Prognosis of Ileus if treated and not

Bethanecol and Acepromazine

What two drugs are most commonly used with ileus?

Bethanecol

Drug that can help with certain GI motility dysfunctions such as POI and cecal impacting

Acepromazine

Drug thatt may reduce severity of POI in horses with small inestinal lesions, keep horse hydrated because can produce hypotension → shock

Endotoxemia

Increase in gram neg. bacteria that gets into intestinal wall and infects, causing shock and organ failure

Fever, inadequate vital organ perfusion, ischemia, systemic shock, sepsis, hypercoagulation, interference with liver metabolism

Clinical signs of Endotoxemia

Colic, retained placenta, laminitis, intestinal disease

What are some things that can cause endotoxemia?

Prevent or correct shock, control or eliminate cause, restore circulating blood volume

Goals of Endotoxemia therapy?

Reperfusion Injury

Occurs post-operatively, surgical correction of GI abnormality causes blood supply to return and built-up toxins are now flushed into circulation throughout the body

Reduce endotoxin buildup, give polymixin B to neutralize endotoxins, give flunixin meglumine in low doeses to prevent release of inflammatory mediators

Prevention of Reperfusion Injury

Strangulating Obstruction

Physical blockage in lumen that blocks blood supply

Simple Obstruction

Obstruction is lodged in lumen of large intestine and compressing from inside out, causing poor venous outflow even though we still have arterial inflow, which causes increased pressure in vessels