15 Equine Alimentary Canal: Esophagus & Surgical Disorders

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Questions and Answers

What potential outcome is suggested by a peritoneal lactate level that is twice the systemic level in a horse undergoing colic evaluation?

A normal physiological response to abdominal pain.
A strong indicator of a surgical lesion, particularly strangulation. (correct)
An indication of improved perfusion and reduced inflammation.
A false positive due to contamination of the peritoneal fluid sample.

What is the most crucial implication of identifying rapidly progressive cervical crepitus and cellulitis in a horse?

It indicates a potential esophageal rupture requiring immediate diagnosis and intervention. (correct)
It points towards a localized muscular inflammation, treatable with rest and NSAIDs.
It suggests a resolving hematoma.
It signifies a minor allergic reaction to an environmental allergen.

In a horse diagnosed with esophageal stricture post-choke, what is the rationale behind delaying surgical intervention beyond 60 days?

To ensure complete crosslinking of collagen and remodeling of granulation tissue, potentially improving surgical outcomes. (correct)
To avoid interference with the acute inflammatory phase of healing.
To allow the stricture to spontaneously resolve.
To reduce inflammation and improve tissue perfusion, thus minimizing surgical risks.

During an equine colic examination, how does the degree of heart rate elevation correlate with the prognosis?

The degree of elevation can indicate the severity of the colic, but is not definitively predictive of the prognosis. (B) Signup and view all the answers

In managing equine choke, under what circumstance is esophagotomy considered a viable treatment option?

Specifically for obstructions located in the cervical region of the esophagus. (D) Signup and view all the answers

For a horse undergoing colic evaluation, which clinicopathological finding most strongly suggests the need for surgical intervention rather than medical management?

Serosanguinous fluid obtained during abdominocentesis, coupled with distended, hypomotile small intestine. (D) Signup and view all the answers

What specific anatomical feature of the equine esophagus contributes most significantly to the risk of esophageal obstruction?

The variable distribution of striated and smooth muscle along its length. (B) Signup and view all the answers

In the context of equine esophageal diverticulum, how does a 'traction diverticulum' differ fundamentally from a 'pulsion diverticulum'?

A traction diverticulum involves all layers of the esophagus and is often asymptomatic, whereas a pulsion diverticulum involves only the muscularis and typically requires treatment. (A) Signup and view all the answers

When performing an abdominocentesis on a horse with colic, what findings would lead you to suspect septic peritonitis?

Peritoneal glucose level significantly lower than systemic blood glucose. (D) Signup and view all the answers

What is the primary rationale for utilizing a FLASH (Fast Localized Abdominal Sonogram of Horses) protocol in evaluating a horse with colic?

To rapidly detect free fluid, assess GI motility, and identify potential sites of obstruction or bowel thickening. (B) Signup and view all the answers

In managing a horse with esophageal choke, what is the specific purpose of administering Buscopan, and where in the esophagus does this medication exert its primary effect?

To relax smooth muscle in the caudal two-thirds of the esophagus, facilitating the passage of the obstruction. (A) Signup and view all the answers

Following surgical intervention for esophageal stricture, why is it critically important to manage the surgical site by second intention healing rather than primary closure?

Primary closure can increase the risk of dehiscence and recurrence of the stricture due to compromised blood supply and continued inflammation. (D) Signup and view all the answers

When is trocarization indicated?

Only when the horse has already been deemed non-surgical. (D) Signup and view all the answers

What is the typical duration for leaving an esophagotomy tube in place when it is used as a feeding tube?

14-21 days (D) Signup and view all the answers

What percentage of horses with colic have elevated glucose levels??

50% (A) Signup and view all the answers

For what reason should a rectal exam be part of an abdominal exam for every horse with colic?

The status of the abdomen can change rapidly. (C) Signup and view all the answers

Why can't horses vomit?

They have one-way peristalsis. (B) Signup and view all the answers

When evaluating a horse for colic, what bloodwork parameter should be obtained at a minimum?

PCV/TP, occasionally Lactate (D) Signup and view all the answers

When referring a horse for colic, what is the next step in the treatment process?

Routine initial exam (C) Signup and view all the answers

When is a horse with colic unlikely to respond to treatment?

Appropriately managed after 24 hours (D) Signup and view all the answers

What findings would be indicative of immediate surgical drainage for a horse with a ruptured esophagus?

Severe cellulitis tracking to the mediastinum (A) Signup and view all the answers

Where is the most common site of obstruction for equine choke?

Mid esophagus at the thoracic inlet (A) Signup and view all the answers

What additional parameters can you use to determine the decision of a colic surgery?

Owner's financial restrictions (D) Signup and view all the answers

What does is mean if after a colic workup, the findings between parameters don't add up?

Additional procedures should be performed such as a transabdominal ultrasound and abdominocentesis. (A) Signup and view all the answers

What determines medical vs surgical management of colic?

If the failure of response to pain management has occurred (B) Signup and view all the answers

What are risk factors for a vet to require surgery for a horse with colic?

Constant pain vs non-recurrent pain (C) Signup and view all the answers

What should be achieved with fluid therapies for horse with colic?

Rehydration and improved GI perfusion (A) Signup and view all the answers

Which of the following is a true statement about using lactate to determine course of treatment in a horse with colic?

Response to the therapy or trends can be more useful (B) Signup and view all the answers

Outside hay, what are other feedstuffs that are known to cause equine choke?

Pelleted feed, cubed hay/range cubes and apples/carrots (B) Signup and view all the answers

What can poor dentition contribute to?

Equine choke (C) Signup and view all the answers

How do you treat equine choke?

All of the above (D) Signup and view all the answers

What can be some outcomes of a horse experiencing equine choke?

All of the above (D) Signup and view all the answers

How long is the horse esophagus?

4 to 6.5 feet (C) Signup and view all the answers

What composes the walls of the esophagus?

Striated and Smooth Muscle (D) Signup and view all the answers

What does a pulse diverticulum consist of?

Defect in the muscularis (D) Signup and view all the answers

What is the goal blood lactate when evaluating colic?

Normal: 1.5 mmol/L (C) Signup and view all the answers

In a horse presenting with esophageal choke, why is it critical to confirm the obstruction is located in the cervical esophagus before considering esophagotomy?

Thoracic esophagotomies carry a significantly higher risk of mediastinitis and are generally contraindicated. (C) Signup and view all the answers

A horse is diagnosed with an esophageal stricture secondary to a choke episode 45 days prior. What is the primary rationale for recommending conservative management and delaying surgical intervention until beyond 60 days post-choke?

To permit maximal remodeling of granulation tissue and potential spontaneous widening of the stricture, possibly avoiding surgery altogether. (D) Signup and view all the answers

In cases of equine esophageal diverticulum, how does the clinical approach to a pulsion diverticulum differ from that of a traction diverticulum?

Traction diverticula, being often asymptomatic and involving all esophageal layers, are usually monitored conservatively, whereas pulsion diverticula often require surgical correction due to muscularis defects and potential enlargement. (B) Signup and view all the answers

What is the most critical diagnostic finding that necessitates immediate surgical drainage in a horse suspected of having a ruptured cervical esophagus?

Rapidly progressive cervical crepitus and cellulitis extending along the neck. (C) Signup and view all the answers

During an equine colic examination, a markedly elevated heart rate is noted. While heart rate elevation indicates severity, what is the most important limitation of using heart rate alone to predict prognosis in colic cases?

The degree of heart rate elevation does not reliably correlate with the presence or absence of intestinal strangulation or ischemia. (A) Signup and view all the answers

In managing a horse with esophageal choke, Buscopan is often administered. What is the primary pharmacological rationale for using Buscopan, and where does it exert its main effect in this context?

To induce smooth muscle relaxation in the caudal esophagus, facilitating passage of the obstruction into the stomach. (A) Signup and view all the answers

Following surgical esophagotomy for esophageal stricture, why is healing by second intention preferred over primary closure despite the potential for a prolonged recovery period?

Second intention healing minimizes the risk of suture line infection and subsequent stricture reformation, accommodating for ongoing esophageal remodeling. (A) Signup and view all the answers

When performing abdominocentesis in a horse with acute colic, which finding in the peritoneal fluid is most strongly suggestive of septic peritonitis and necessitates immediate surgical intervention?

Opaque, cloudy fluid with a markedly elevated white blood cell count composed primarily of neutrophils and the presence of intracellular bacteria. (A) Signup and view all the answers

What is the primary advantage of utilizing a FLASH (Fast Localized Abdominal Sonogram of Horses) protocol in the initial evaluation of a horse with colic compared to a comprehensive abdominal ultrasound?

FLASH allows for rapid identification of free abdominal fluid, distended bowel loops, and other critical abnormalities in a time-efficient manner. (C) Signup and view all the answers

In the context of equine colic, a peritoneal lactate level that is twice the systemic lactate level is considered a significant finding. What is the most critical implication of this discrepancy?

It strongly indicates localized tissue ischemia and anaerobic metabolism within the abdominal cavity, often associated with intestinal strangulation. (B) Signup and view all the answers

For a horse undergoing colic evaluation, which clinicopathological finding would be the most compelling indicator for immediate surgical intervention over continued medical management?

Persistent, severe abdominal pain unresponsive to analgesia, accompanied by scant manure production. (D) Signup and view all the answers

What is the underlying physiological reason why horses are unable to vomit, and how does this anatomical constraint contribute to the pathophysiology of gastric distension and rupture in equine colic?

The angle at which the esophagus enters the stomach in horses creates a functional one-way valve, preventing retrograde movement of gastric contents and increasing risk of gastric rupture with over distension. (B) Signup and view all the answers

When evaluating a horse with colic, a rectal examination is considered a crucial component of the abdominal assessment. What is the most significant limitation of rectal palpation in horses, impacting its diagnostic sensitivity?

The anatomical reach of rectal palpation in adult horses is limited to the caudal abdomen and a portion of the pelvic flexure, thus missing cranial abdominal structures. (D) Signup and view all the answers

In managing equine choke, nasogastric intubation is a primary therapeutic step. What is the most critical precaution to observe when lavaging an esophageal obstruction via a nasogastric tube, especially in cases of prolonged choke?

Avoiding excessive fluid volume and pressure during lavage to minimize the risk of esophageal rupture, particularly if mucosal damage is present. (B) Signup and view all the answers

When considering trocarization for a horse with severe gaseous distension of the bowel, what is the primary risk associated with this procedure that warrants careful consideration and typically limits its routine use?

Induction of peritonitis due to fecal contamination of the abdominal cavity during trocar insertion. (A) Signup and view all the answers

What is the most significant factor that differentiates medical management from surgical intervention in equine colic cases, considering the dynamic and often unpredictable nature of abdominal disease?

The progressive deterioration despite appropriate medical therapy, suggesting a lesion requiring surgical correction. (B) Signup and view all the answers

In the decision-making process for referral or critical care in equine colic, certain clinical parameters increase the likelihood of a critical case. Which combination of findings most strongly suggests an increased risk?

CRT > 2.5 seconds, weak peripheral pulse, and absence of gastrointestinal sounds. (D) Signup and view all the answers

When initiating fluid therapy in a horse with colic, what is the primary physiological goal regarding gastrointestinal perfusion, and how is this goal best achieved through fluid administration?

To restore circulating blood volume and improve blood flow to the intestinal tissues, counteracting hypovolemia and dehydration. (C) Signup and view all the answers

What is the significance of glucose levels in peritoneal fluid compared to systemic glucose levels when evaluating a horse for colic, particularly in the context of septic peritonitis?

A peritoneal glucose level significantly lower (e.g., <30-50 mg/dL lower) than systemic glucose is highly suggestive of septic peritonitis due to glucose consumption by bacteria and inflammatory cells. (D) Signup and view all the answers

In the context of surgical disorders of the equine alimentary canal, what is the most critical implication of 'findings not adding up' during a colic workup, and how should this scenario guide clinical decision-making?

It implies a complex or atypical colic presentation, potentially masking a serious underlying surgical lesion that requires further investigation and possibly referral. (D) Signup and view all the answers

What is the primary reason for routinely performing a rectal examination as part of the abdominal exam in every horse presenting with colic, despite the inherent risk of rectal tears?

To palpate for impactions, displacements, and distension of the large intestine, as well as to detect masses or thickening, providing crucial diagnostic information unobtainable by other means. (B) Signup and view all the answers

Which statement accurately describes the typical duration for leaving an esophagotomy tube in place when utilized as a feeding tube in equine patients, and what biological process dictates this timeframe?

Esophagotomy tubes are generally maintained for 14-21 days, allowing for the formation of a granulation tissue stoma around the tube, which prevents subcutaneous tracking of feed and saliva. (B) Signup and view all the answers

What percentage range of horses presenting with colic are typically found to have elevated glucose levels (>135 mg/dL), and what is the clinical significance of this finding in the context of colic severity and prognosis?

Roughly 50% of horses with colic show elevated glucose levels, reflecting stress and pain, but extreme elevations (>180 mg/dL) may indicate a poorer prognosis, particularly in surgical cases and strangulating lesions. (C) Signup and view all the answers

Outside of hay, which category of feedstuffs is most frequently implicated in causing esophageal choke in horses, particularly in those with predisposing factors like poor dentition or bolting feed?

Pelleted feed and cubed hay/range cubes, which can swell significantly when moistened in the esophagus. (A) Signup and view all the answers

What is the most significant contribution of poor dentition to the development of equine choke, particularly in older horses or those with dental neglect?

Malocclusion and missing teeth impair the horse's ability to grind feed effectively, leading to ingestion of larger particles that are more likely to cause obstruction. (A) Signup and view all the answers

In the initial management of equine choke, heavy sedation is often employed. What is the primary objective of heavy sedation beyond analgesia in this clinical scenario?

To lower the horse's head position, encouraging gravity to assist in the passage of the esophageal obstruction. (A) Signup and view all the answers

Which anatomical feature of the equine esophagus renders it particularly susceptible to obstruction, especially at common sites like the cervical esophagus or thoracic inlet?

The relatively narrow diameter of the esophagus compared to the size of feed boluses horses typically ingest. (D) Signup and view all the answers

Flashcards

Equine Choke

Blockage of the esophagus in horses, often due to food impaction.

Equine Esophagus

4 to 6.5 feet long; delivers food to the stomach.