Page 820 - Equine Clinical Medicine, Surgery and Reproduction, 2nd Edition

Gastrointestinal system: 4.2 The lower gastrointestinal tr act 795

VetBooks.ir 4.121 4.122

Fig. 4.121 Large solitary (round) enterolith. Fig. 4.122 Intraoperative view of the right dorsal
(Photo courtesy Graham Munroe) colon. Two stay sutures have been applied before
performing an enterotomy to exteriorise a large round
enterolith.

Prognosis Clinical presentation
Medical treatment may resolve some foreign body The most common presenting complaints are weight
obstructions, in which case the prognosis for a full loss, diarrhoea and recurrent colic. Behavioural
recovery is good. For those cases that require surgery, changes and persistent leucopenia may also occur.
the prognosis is dependent on the extent of bowel
damage and the accessibility of the obstruction. If Differential diagnosis
a large amount of the bowel has been damaged or Other causes of protein loss and weight loss should
the vascular supply has been compromised, then the be considered, including protein-losing nephropa-
prognosis is guarded. An obstruction causing leak- thy, eosinophilic enterocolitis and intestinal lym-
age of ingesta and peritonitis would have a grave phosarcoma. Other differentials for non-specific
prognosis. chronic GI disease, such as EGUS and sand enter-
opathy, should also be considered.
LYMPHOCYTIC/PLASMACYTIC ENTERITIS
Diagnosis
Definition/overview Hypoproteinaemia, consisting mainly of hypoal-
Lymphocytic/plasmocytic enteritis is a form of buminaemia, is common. Anaemia is commonly
inflammatory bowel disease. There is no age, sex or present. The white blood cell (WBC) count is usu-
breed predilection. ally normal but may be decreased. Urinalysis and
abdominocentesis are usually normal. Abdominal
Aetiology/pathophysiology ultrasound examination may be performed but is
The aetiology is unknown, and the pathophysiology usually unremarkable.
is unclear. It is characterised by infiltration of the Carbohydrate absorption testing should be per-
intestinal wall with lymphocytes and plasmacytes into formed. Decreased absorption is usually present,
the lamina propria. Lesions tend to occur diffusely except with early disease or focal lesions. Rectal
throughout the GI tract. Fibrotic changes are occa- mucosal biopsy can be diagnostic if the disease
sionally observed but granulomatous changes are not. involves the rectum.