Equine Small Intestine

What is Anterior Enteritis?

Inflammation or infection of the duodenum and proximal jejunum

What is Anterior Enteritis characterized by?

Voluminous SI secretions

Functional ileus (functional Inappropriate movement)

Copious GI reflux (back up into stomach)

How does Clostridium Difficiles cause Anterior Enteritis?

Ingested -> reach duodenum -> spores interact w/ bile rich environment and geminate and produce toxins and cause epithelial damage and inflammation

What is the is the primary differential diagnosis of Anterior Enteritis?

Strangulating SI lesion

How do you tx Anterior Enteritis?

Remove excess GI secretions (NG tube)

Restore motility

Ensure hydration and electrolyte balance (NPO iv fluids)

Maintain colloid osmotic pressure (Leaky vessels)

Prevent laminitis

Maintain Positive Energy Balance

Address inflammation/ endotoxemia

What does Lawsonia intracellularis cause?

Equine Proliferative Enteropathy (weanlings dz)

What are clinical signs of Equine Proliferative Enteropathy?

Wt loss

Unthriftiness

Edema (low protein)

Depression

Fever

Hypoprotieniemia - thick SI

What are tx goals of Equine Proliferative Enteropathy?

-Eliminate organism

-Restore protein levels and hydrate

-Restore nutrition

-Tx any co-morbidities

-biosecurity

How dose IBD present?

Wt loss w/ good appetite

+/- colic

+/- diarrhea (malabsorption)

What is Eosinophilic enterocolitis?

Infiltration of eosinophils/ lymphocytes into mucosa of large intestine

What is Idiopathaic focal eosinophilic enteritis

Intramural mass/ bands w/in small intestines (does okay w/ sx)

What is multi-systemic eosinophilic epitheliotropic dz (MEED) ?

INFILTRATION OF EOSINOPHILS INTO OTHER TISSUES LIKE SKIN LIVER LUNGS and GI (poor prognosis)

What is Granulmatous enteritis?

Infiltration of lymph and macrophages into ilium (can go to liver and lungs)

Lymphocytic-plasmacitic enterocolitis is due to what?

Infiltration of lymphocytes and plasma cells w/out macrophages

Pts with AE will have ___ heart rates due to pain?

`High (above 40)

____ Will distinguish AE from other colics?

Temperature (fever 103-104)

What are complications of AE?

Laminates

Arhythmisas,

Hepatic/pancratitis,

Peritonitis

How can you tx IBD?

Steroids (careful of laminitis),

Sx excision

Parasite control

Diet

Why might total protein be elevated in a pt w/ AE?

Dehydration or Antibodies

Total and indirect bilirubin are usually indicative of what?

Not eating well

You should not exceed what daily dose of potassium?

0.5mEq/kg/hr

We will typically treat AE with what kind of antibiotics?

Broad spectrum trying to hit everything

How does EPE usually present?

Ventral pitting edema

Pot-bellied appearance

skinny quiet foals

Cow pie manure

What antibiotics are typically used to tx L. intracellularis

Macrolide + rifampin