Weight loss: Case discussions (Proceedings)


Weight loss: Case discussions (Proceedings)

Apr 01, 2010

Case 1: Recurrent colic and weight loss

A 5-year-old Oldenburg gelding used for dressage, was presented for evaluation of mild bouts of recurrent colic, more frequent over the past month. The colic signs included flank watching and intermittent sternal recumbency and were either self-limiting or responsive to a single dose of Banamine. Additional history included that the gelding was sometimes slow to finish its grain and moderate weight loss had developed over the past 3 months. Evaluation by the referring veterinarian included unremarkable physical exam findings on several occasions and results of a complete blood count and serum chemistry profile were normal. A fecal exam for parasites was negative.

The gelding was referred for further diagnostic evaluation including gastroscopy and abdominal ultrasonography. The latter exam had normal findings while gastroscopy revealed several mild erosions above the margo plicatus. Treatment with GastroGard was pursued for 4 weeks with little improvement observed.

About 4 months later, the horse developed an acute abdominal crisis with abdominal distension and gas distension of the large colon was found on rectal examination. Passage of a nasogastric tube recovered 12 liters of serosanguinous gastric fluid and fluid collected via abdominocentesis appeared grossly normal. The horse continued to show moderate colic signs despite administration of multiple analgesic medications and, consequently, was referred for further diagnostic evaluation.

At presentation, the gelding was dull but not showing signs of colic pain. Rectal temperature was normal, heart rate was 50/min, and oral membranes were mildly toxic. Rectal palpation revealed several loops of mildly distended small intestine and gas distension of the cecum. Passage of a nasogastric tube recovered 13 liters of serosanguinous reflux and abdominocentesis recovered a grossly normal looking peritoneal fluid. The following images were observed via abdominal ultrasonography of the inguinal region:

Case 2: Recurrent colic, weight loss, decreased appetite, and intermittent fever

A 12-year-old Thoroughbred hunter-jumper gelding, was presented for evaluation of a decreased appetite and intermittent mild fever over the past week. The gelding had been purchased about 1 year previously and had been in somewhat poor body condition at that time but had gained weight with the current owner. Two mild colic bouts that resolved with a single dose of Banamine had also been observed over the past 6 months.

During the past week the gelding had been treated with oxytetracycline and Banamine for suspected Potomac Horse Fever but a lack of expected improvement prompted submission of blood samples that revealed elevated liver enzyme activities (AST 545 IU/L and GGT 111 IU/L), prompting referral for further evaluation

The following image was observed via transabdominal ultrasonography:
At presentation, the gelding was had normal vital parameters but was mildly dull and dehydrated. Rectal palpation was normal and abdominocentesis recovered normal looking peritoneal fluid. The following images were observed via abdominal ultrasonography:

Hot topics on dvm360

Can you save this client? (Yes.)

VETTED - Sep 19, 2016