Equine Acute Abdomen PDF
Preview Equine Acute Abdomen
EAA_Guts:EAA 7/8/09 9:46 AM Page i The Equine Acute Abdomen TThhiiss ppaaggee iinntteennttiioonnaallllyy lleefftt bbllaannkk EAA_Guts:EAA 7/8/09 9:46 AM Page iii The Equine Acute Abdomen Nathaniel A. White, DVM, MS James N. Moore, DVM, PhD Tim S. Mair, BVSc, MRCVS, PhD Teton NewMedia Teton NewMedia 90 East Simpson, Suite 110 Jackson, WY 83001 © 2009 by Tenton NewMedia Exclusive worldwide distribution by CRC Press an imprint of Taylor & Francis Group, an Informa business Version Date: 20140205 International Standard Book Number-13: 978-1-4822-4114-3 (eBook - PDF) This book contains information obtained from authentic and highly regarded sources. While all reasonable efforts have been made to publish reliable data and information, neither the author[s] nor the publisher can accept any legal responsibility or liability for any errors or omissions that may be made. 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For permission to photocopy or use material electronically from this work, please access www.copyright.com (http://www.copyright.com/) or contact the Copyright Clearance Center, Inc. (CCC), 222 Rosewood Drive, Danvers, MA 01923, 978-750-8400. CCC is a not-for-profit organization that provides licenses and registration for a variety of users. For organizations that have been granted a photocopy license by the CCC, a separate system of payment has been arranged. Trademark Notice: Product or corporate names may be trademarks or registered trademarks, and are used only for identification and explanation without intent to infringe. Visit the Taylor & Francis Web site at http://www.taylorandfrancis.com and the CRC Press Web site at http://www.crcpress.com and the Teton NewMedia Web site at www.tetonnewmedia.com EAA_Guts:EAA 7/8/09 9:46 AM Page v Contributing Authors James K. BelknapDVM,PhD Ray J. GeorBVSc,MVSc,PhD Diplomate,ACVS DiplomateACVIM 601VernonL.TharpSt. ProfessorandChair Dept.ofVeterinaryClinicalSciences LargeAniamalClinicalSciences CollegeofVeterinaryMedicine D202VetMedicalCenter OhioStateUniversity CollegeofVeterinaryMedicine Columbus,Ohio43210 MichiganStateUniversity EastLansing,MI48824-1314 Anthony BlikslagerDVM,PhD Diplmate,ACVS Gayle D. HallowellMAVetMBCertVAMRCVS CollegeofVeterinaryMedicine DiplomateACVIM 4700HillsboroughStreet 14,ThreadcuttersWay, RaleighNC27606 Shepshed,Leicestershire,UK Clare BryantBScVetedPhDCertVA Joanne HardyDVM,PhD DiplomateECVPT DiplomateACVSandACVECC SeniorLecturerinClinicalPharmacology, DepartmentofLargeAnimalMedicineandSurgery CentreforVeterinaryScience, CollegeofVeterinaryMedicine DepartmentofVeterinaryMedicine, TexasA&MUniversity UniversityofCambridge, 4475-TAMU MadingleyRoad,Cambridge,CB30ES CollegeStation,Texas77843-4475 Noah D. CohenVMD,MPH,PhD Carla L. JarrettDVM,MS Diplomate,ACVIM Histotechnologist(HTL),ASCP DepartmentofLargeAnimalClinicalSciences DepartmentofAnatomyandRadiology CollegeofVeterinaryMedicineandBiomedicalSciences CollegeofVeterinaryMedicine TexasA&MUniversity UniversityofGeorgia CollegeStation,Texas77843-4475 Athens,GA30602 Kevin CorleyBVM&SPhD Thomas M. KrunkoskyMS,DVM,PhD DECEIMDACVIMDACVECCMRCVS DepartmentofAnatomyandRadiology Specialist(InternalMedicineandCriticalCare) CollegeofVeterinaryMedicine AngleseyLodgeEquineHospital UniversityofGeorgia TheCurraghCo.Kildare,Ireland Athens,GA30602 Thomas J. DiversDVM Marco A F LopesMV,MS,PhD DiplomateACVIMandACVECC DepartmentofLargeAnimalMedicine DepartmentofClinicalSciences, CollegeofVeterinaryMedicine CollegeofVeterinaryMedicine, TheUniversityofGeorgia CornellUniversity, Athens,Georgia30602 Ithaca,NewYork14853 Tim S. MairBVScPhDDESTSDEIMMRCVS David E. FreemanMVB,PhD DiplomateECEIM DiplomateACVS BellEquineVeterinaryClinic ProfessorandAssociateChiefofStaff Mereworth UniversityofFlorida Maidstone,KentME185GS CollegeofVeterinaryMedicine UnitedKingdom DepartmentofLargeAnimalClinicalSciences Box100136 Dr. Harold C. McKenzie III DVM,MS Gainesville,Fl32610-0136 DiplomateACVIM MarionduPontScottEquineMedicalCenter Martin O. FurrDVM,PhD VMRCVM-VirginiaTech DiplomateACVIM P.O.Box1938 MarionduPontScottEquineMedicalCenter Leesburg,VA20177 VMRCVM-VirginiaTech P.O.Box1938 James N. MooreDVM,PhD Leesburg,VA20177 DepartmentofLargeAnimalMedicine CollegeofVeterinaryMedicine UniversityofGeorgia Athens,GA30602 EAA_Guts:EAA 7/8/09 9:46 AM Page vi P.O. Eric MuellerDVM,PhD Cynthia M. TrimBVSc,MRCVS DiplomateACVS DiplomateACVAandECVA ProfessorofSurgery DepartmentofLargeAnimalMedicine ChiefofService,LargeAnimalHospital CollegeofVeterinaryMedicine DepartmentofLargeAnimalMedicine UniversityofGeorgia CollegeofVeterinaryMedicine Athens,GA30602 UniversityofGeorgia Athens,Georgia30602-7385 Nathaniel A. WhiteDVMMS DiplomateACVS Michael J. MurrayDVM,MS MarionduPontScottEquineMedicalCenter DiplomateACVIM VMRCVM-VirginiaTech Merial,Limited P.O.Box1938 3239SatelliteBlvd. Leesburg,VA20177 Duluth,GA30096 Andrew H. Parks MA,VetMB,MRCVS DiplomateACVS DepartmentofLargeAnimalMedicine CollegeofVeterinaryMedicine UniversityofGeorgia Athens,GA30602 John F. PeroniDVMMS DiplomateACVS AssociateProfessorofSurgery DepartmentofLargeAnimalMedicine CollegeofVeterinaryMedicine UniversityofGeorgia Athens,Georgia30602-7385 ChristopherJ.ProudmanMA,VetMB,PhD,CertEO,FRCVS RCVSSpecialistinEquineGastroenterology DepartmentofClinicalVeterinaryScience UniversityofLiverpool EquineDivision Leahurst,Neston, WirralCH647TE UnitedKingdom Dr. Peter RakestrawDVMPhD DiplomateACVS TexasA&MUniversity CollegeofVeterinaryMedicine DepartmentofLargeAnimalMedicineandSurgery CollegeStation,TX77843-4475 Emma RoweBVScMS DiplomateACVS EncounterBay SouthAustralia5211 Australia Elizabeth M. SantschiDVM DiplomateACVS DepartmentofVeterinaryClinicalSciences CollegeofVeterinaryMedicine TheOhioStateUniversity 601VernonTharpStreet Columbus,Ohio43210 EAA_Guts:EAA 7/8/09 9:46 AM Page vii Contents Part 1. Normal Anatomy and Physiology Chapter 1 Gross and Microscopic Anatomy of the Equine Gastrointestinal Tract Thomas M. Krunkosky, Carla Jarrett, and James N. Moore Esophagus ...................................................................5 Esophagus-Stomach Junction ......................................................7 Stomach .....................................................................7 Stomach-Small Intestine Junction ..................................................11 Small Intestine ...............................................................11 Large Intestine ...............................................................14 Liver .......................................................................17 Spleen .....................................................................18 Pancreas ...................................................................19 Chapter 2 Physiology of the Digestive Tract Gastric Secretory Function – Michael J. Murray ........................................22 Small Intestine Function – David E. Freeman ..........................................25 Digestive Physiology – Anatomy ................................................25 Intraluminal Digestion .......................................................28 Absorption of Ions and Water ..................................................29 Absorption of Carbohydrate, Protein and Fat .......................................32 Iron Absorption ............................................................33 Calcium and Magnesium Absorption .............................................34 Intestinal Secretion .........................................................35 Motility ..................................................................36 Control of Motility ..........................................................37 Function of the Ileum ........................................................38 Large Bowel Function – Marco A.F. Lopes ...........................................41 Motility Patterns and Transit of Contents ..........................................41 Microbial Activity and Fermentation .............................................42 Secretion and Absorption ....................................................45 Liver Function – Tim S. Mair......................................................54 Bile Acid Metabolism and Excretion of Bile ........................................54 Protein Metabolism .........................................................54 Carbohydrate Metabolism ....................................................55 Lipid Metabolism ...........................................................55 Detoxification and Drug Metabolism .............................................56 Storage .................................................................56 Chapter 3 Effects of Feeding on Equine Gastrointestinal Function or Physiology Marco A.F. Lopes Feeding Grain ................................................................58 Feeding Lush Grass ............................................................62 Replacing Grain With Fat ........................................................62 Feeding Mature Grass and Poor Quality Hay ..........................................62 Feeding Large Meals Intermittently and Fasting ........................................62 Chapter 4 Intestinal Motility and Transit Peter C. Rakestraw Physiology of Normal Motility .....................................................68 Pathophysiology of Ileus ........................................................80 Treatment of Motility Disorders in the Horse ..........................................82 EAA_Guts:EAA 7/8/09 9:46 AM Page viii Part 2 Pathophysiology of Gastrointestinal Diseases Chapter 5 Pathophysiology of Gastric Ulcer Disease Michael J. Murray Gastric Ulcer Disease ..........................................................96 Chapter 6 Pathophysiology of Gastrointestinal Disease: Obstruction and Strangulation Anthony T. Blikslager Simple Obstruction ...........................................................100 Strangulating Obstruction.......................................................101 Intestinal Reparative Mechanisms .................................................107 Chapter 7 Prevention and Treatment of Postoperative Intraabdominal Adhesions in Horses P.O. Eric Mueller Current Concepts in Pathophysiology of Adhesion Formation .............................119 Diagnosis of Intraabdominal Adhesions .............................................120 Current Concepts in Prevention of Adhesion Formation .................................121 Separation of Adhesiogenic Surfaces ..............................................122 Treatment of Intraabdominal Adhesions .............................................125 Adhesion Prevention Strategies ..................................................125 Chapter 8 Pathophysiology of Peritonitis John F. Peroni Anatomy and Physiology of the Peritoneum ..........................................130 Etiology of Peritonitis ..........................................................131 Clinical Presentation ..........................................................131 Diagnostic Approach ..........................................................132 Chapter 9 Pathophysiology of Enteritis and Colitis Harold C. McKenzie Inflammation ................................................................136 Pain .....................................................................137 Ileus ......................................................................137 Hypermotility ................................................................137 Hypersecretion ..............................................................138 Osmotic Diarrhea ............................................................138 Decreased Absorption .........................................................138 Endothelial Dysfunction ........................................................138 Specific Diseases ............................................................138 Chapter 10 Malabsorption Syndromes Tim S. Mair and Thomas J. Divers Causes of Malabsorption Syndrome ...............................................148 Clinical Signs ...............................................................155 Diagnosis ..................................................................156 Treatment ..................................................................158 Chapter 11 Liver Diseases and Liver Failure Tim S. Mair and Thomas J. Divers Causes of Liver Disease .......................................................162 Diagnosis of Liver Disease ......................................................165 Hyperlipemia ................................................................167 Theiler’s Disease (Serum Hepatitis) ................................................174 Other Causes of Acute Hepatic Disease and Failure in Adult Horses ........................178 EAA_Guts:EAA 7/8/09 9:46 AM Page ix Pyrrolizidine Alkaloid Intoxication .................................................178 Cholangiohepatitis and Choledocholithiasis ..........................................182 Other Biliary Conditions ........................................................185 Chronic Active Hepatitis ........................................................185 Klein Grass (Panicium Coloratum) Toxicity ...........................................186 Alsike Clover Toxicity ..........................................................186 Hepatic Neoplasia ............................................................187 Hepatic Amyloidosis ..........................................................187 Iron Overload, Hemochromatosis .................................................187 Right Hepatic Lobe Atrophy .....................................................188 Chapter 12 Systemic Inflammatory Response Syndrome: Endotoxemia Reconsidered Clare E. Bryant and James N. Moore Responses to Pathogen-Associated Molecular Patterns .................................192 Receptors for Gram-Negative Bacteria and Bacterial Ligands .............................193 Receptors for Gram-Positive Bacteria and Bacterial Ligands ..............................195 Systemic Inflammatory Response Syndrome .........................................196 Inflammatory Mediators and Their Source in the Horse .................................197 Part 3. Intestinal Parasitism Chapter 13 Intestinal Parasitism Christopher J. Proudman Principles of Iintestinal Parasitism .................................................204 Strongylus Vulgaris ...........................................................204 Cyathostomins ..............................................................207 Tapeworms .................................................................208 Parascaris Equorum ..........................................................210 Other Intestinal Parasites .......................................................211 Prevention .................................................................211 Part 4. Epidemiology Chapter 14 Epidemiology of Colic Noah D. Cohen General Epidemiologic Considerations .............................................218 Incidence of Colic ............................................................222 Factors that Predispose to Colic .................................................222 Factors Indicating the Need for Surgical Management of Colic ............................225 Frequency of and Factors Associated with Survival from Colic and Colic Surgery ...............226 Study of Colic Problems in Individuals and Herds ......................................228 Part 5. Diagnosis Chapter 15 Diagnosis of Gastrointestinal Disease Emma L. Rowe and Nathaniel A.White Signalment .................................................................236 History ....................................................................237 Physical Examination ..........................................................238 Hematology, Blood Gases, and Serum Biochemistry ...................................270 Ultrasonography .............................................................271 Radiographs ................................................................276 Endoscopy .................................................................278 Laparoscopy ................................................................280 Fecal Examination ............................................................280 Transit Time ................................................................281 Exploratory Laparotomy ........................................................281 False Colic .................................................................281 Decision for Surgery ..........................................................282
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