Page 6 - Clinical Connections- Autumn 2021

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Page 6 - Clinical Connections- Autumn 2021
P. 6

RVC RESEARCH    STUDY    VETERINARY SERVICES       RVC.AC.UK
         Equine
        UPDATE ON GASTROINTESTINAL DISEASES

        IN HORSES


        Bettina Dunkel, Associate Professor in Equine Medicine
             he most commonly described     unreliable.                         operative pain and development of reflux
             intestinal disease in horses is   The mainstay of successful treatment for   are recorded. This important investigation
        T probably gastric ulcers and colic   colic remains rapid recognition, immediate   will contribute to answering the important
        but other diseases such as colitis and   assessment and, in cases with a high   clinical question on best use of lidocaine in
        inflammatory bowel disease also play   likelihood of a strangulating lesion, timely   post-operative colic care.
        an important role. The article describes   exploratory surgery. For horses undergoing   Inflammatory bowel disease (IBD) is
        selected recent developments in aetiology,   exploratory laparotomy, post-operative   increasingly recognised as a cause of
        diagnosis and treatment of equine   reflux remains a serious and potentially   weight loss and hypoproteinaemia. Less
        gastrointestinal diseases.          life-threatening complication. During the   well recognised presentations might include
          Gastric ulcers remain a very common   last two decades, a continuous intravenous   poor weight gain and recurrent colic. IBD
        condition in horses and knowledge about   infusion of lidocaine has become a routine   is an umbrella term for a variety of often
        different types of ulcers and different   treatment for horses recovering from small   poorly defined inflammatory conditions
        treatment options is rapidly expanding. It   and occasionally also large intestinal   that affect the small and large intestine of
        is now firmly established that squamous   surgery . Potential benefits include   horses and may result in malabsorption.
                                                  [1]
        ulcers are quite different from glandular   prokinetic, anti-inflammatory and analgesic   Diagnosis has long relied on abdominal
        gastric ulcers in regard to predisposing   properties which are all indicated in post-  ultrasonography, oral glucose absorption
        factors, clinical signs and response to   operative patients. However, the clinical   tests and duodenal/rectal biopsies. At RVC
        treatment ÐÂÔÂÖ±²¥“ but a lot remains still to be   efficacy of lidocaine as prokinetic has been   Equine, we have recently introduced a new
        discovered.                         questioned and recent research suggests   test for malabsorption. Instead of using
          Recent research conducted at the RVC   that it has minimal, if any, impact on post-  a glucose absorption test a combination
        by Dr Mike Hewetson and presented at   operative reflux volume and duration [1, 2] .   of xylose and iohexol is used to assess
        the 2021 conference of the British Equine   An international multi-centred double   not only absorption but also intestinal
        Veterinary Association found no correlation   blinded study is currently underway to   permeability. The test is more specific and
        between clinical signs perceived by owners   further investigate the proposed clinical   has the potential for assessing both the
        and the presence or absence of glandular   properties of lidocaine and RVC Equine is   small and large intestine, which significantly
        lesions. This highlights the importance of   one of the participating hospitals. If owners   increases our ability to diagnose the
        gastroscopy in confirming a diagnosis of   agree to enrolment, horses with a small   condition and initiate appropriate treatment.
        gastric ulcers and evaluating response   intestinal obstruction included in the trial will   Colitis or typhlocolitis with or without
        to treatment by repeated gastroscopy as   receive either lidocaine or placebo (fluids)   diarrhoea is less common than colic but
        clinical signs and ownersÐÂÔÂÖ±²¥™ perception are   at no additional cost to the client, and post-  also a potentially life-threatening disease.




































          Equine gastroscopy py


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