"Shadow"
- 7 yr, American Saddlebred, Gelding
- Show horse, pleasure riding. Current light work schedule.
- Current vaccination for West Nile Virus, EEE, WEE, PHF, Influenza, EHV1 and Tetanus.
- Ivermectin q8wks for parasite control.
- Diet: 5lbs 12% sweet feed BID, free choice grass hay
- Housing: Stall, limited individual pasture turnout
- 2004: R eye trauma – corneal laceration & perforation, subsequent blindness & pthisis bulbi
- Intermittent bilateral forelimb lameness associated with foot conformation (club foot L fore) and sole bruising 1gm Phenylbutazone
q24h for 6 days prior to presentation
- No abnormalities noted by the owner the evening prior to presentation
- 8am: No abnormalities noted, exercise (light riding), groomed, stall confined and fed normal ration.
- 10am: Found recumbent, depressed, sweating, owners unable to get horse to stand. Referring vet contacted
- 12pm: Referring vet examination
Referring Vet Examination
- HR 110, RR 60, Temp 101.5°F
- MM injected with a toxic line, CRT 3s
- Sunken L eye, prolonged skin tent test
- Skin and distal extremities cold to touch
- Decreased digital pulses in all limbs
- Decreased gut sounds all quadrants, no gastric reflux, no abnormalities on rectal examination
- Profuse watery diarrhea
Treatment: Procaine penicillin IM 20000 IU/kg, Gentamicin IV 6.6 mg/kg, lactated Ringer's solution 7L IV
Referred to VTH
Examination at 6pm
- HR 72, RR 42, Temp 101.4
- MM purple, tongue cyanotic, CRT 3s
- Bilateral serous nasal discharge
- Depressed, sweating
- Decreased GIT motility all quadrants
- Profuse watery diarrhea
- Shifting weight in all limbs, increased digital pulses all limbs
- Decreased jugular fill
- Increased thirst, decreased appetite
Abdominal ultrasound:
- left dorsal colon wall thickness 0.2mm
- right dorsal colon wall thickness 0.4mm
- fluid filled colon and small intestine
Nasogastric intubation:
Problem list:
- azotemia
- dehydration
- hypochloremia, hyponatremia, hypocalcemia,
- hyperphosphatemia
- hypoalbuminemia
- leukopenia, neutropenia
- diarrhea
- suspected decrease in blood pressure & peripheral perfusion
- laminitis
Differential diagnosis:
- Phenylbutazone associated right dorsal colitis
- PHF
- Salmonella
- Clostridial colitis
- Endotoxemia
