Enfermedades Del Estomago y Del Intestino Delgado en Caballos

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Ana Pastor Rodriguez



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Factores protectores Factores perjudiciales

- Capa mucosa- bicarbonato- Adecuado flujo sanguneo de la mucosa- Prostaglandina E2 (PGE2)- Factor de crecimiento epidrmico- Motilidad gastroduodenal- xido ntrico

Extrnsecos:- Ejercicio- Dieta y/o restriccin de la alimentacin- Antiinflamatorios no esteroideos(AINEs)- Estrs medioambiental- Alteraciones gastrointestinales- H. pylori?

Intrinsecos:- cido clorhdrico (HCl)- cidos biliares y otros cidos (cidosvoltiles, cido lactico)- Pepsina- Anatoma del estmago

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Frmaco Dosis Intervalo VaOmeprazolOmeprazolRanitidinaRanitidinaFamotidinaFamotidinaMisoprostolSucralfato

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q 24 horasq 24 horasq 6 horasq 8 horasq 12 horasq 12 horasq 8 horasq 8 horas

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Figura 1. Tabla de decisin en el diagnstico de lceras gstricas

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Recomendaciones para el caballo con lceras gastricas1. Mantener al caballo comiendo un mnimo de 1-1,5 % de su peso en heno de buena

calidad durante todo el da2. Alimentar heno de alfalfa para ayudar a tamponar el pH cido del estmago3. Evitar al mximo el grano en las comidas. No administrar ms de 0,5 kg/100 kg de

animal.4. Utilizar aceite de maiz u otros suplementos dietticos para aumentar la cantidad

calorica de la dieta si es necesario.5. Considerar el uso teraputico o preventivo de anticidos en caballos de alta competicin

o situaciones estresantes.6. En caballos con necesidad de tratamiento antiinflamatorio (ej artritis crnica): Elegir AINEs con menores efectos en el tracto gastrointestinal (firocoxib, ketoprofeno,..) Disminuir la dosis de AINEs al mnimo para controlar el dolor Considerar el uso de protectores gstricos preventivo

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Nombre CaractersticasEnteritis eosinoflica Inflamacin celular inflamatoria difusa

con eosinfilos y linfocitos en lamucosa de intestino delgado

Enfermedad eosinoflica epiteliotrpica sistmica(MEED)

Infiltracin eosinoflica tambin enotros rganos (piel, hgado, pncreas,cavidad oral, esfago, pulmones..)

Enteritis granulomatosa Infiltracin linfoide y de macrfagos enlmina propia. Atrofia de vellosidades(leo ms marcada)

Enteritis linfoctica/plasmactica Infiltracin excesiva de linfocitos yclulas plasmticas en lmina propia

Linfosarcoma Tumor primario o metasttico #$-##3#%5'3@45+%#413+/%+1#-'4&'-045+104&'.=4(3'%6'/5'4'/%#$#--04#&6-504

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Frmaco Mecanismo Dosis EfectoNeostigmina Inhibe colinesterasa 0,022 mg/kg IV o

0,044 mg/kg SC oIM

Sin efecto en intestinodelgado. Parece ser tilen IG

Betanecol Estimula receptores de laacetilcolina

0,025 mg/kg SC Mejora el vaciamientogstrico y cecal. Puedecausar dolor abdominal ydiarrea

Metoclopramida Antagonista de la dopaminay estimula receptores 5-HT

0,01-0,05 mg/kgInfusin contnua0,04 mg/kg/h

Mejora motilidad peropuede causar excitacin ynerviosismo . Msefectivo en infusincontnua.

Cisaprida Estimula la liberacin deacetilcolina

No disponible

Eritromicina Estimula la liberacin demotilina

0,5-1 mg/kg IV en 60min

Efectivo en impactacincecal pero puede causarenteritis y diarrea

Lidocaina Disminuye catecolaminas,estimulacin de lamusculatura lisa,disminucin de lainflamacin

1,3 mg/kg en bolo (5min) seguido de 0,05mg/kg/min eninfusin contnua

No hay efecto directo dela motilidad. Disminuyeefectos adversos deflunixin sobre la mucosaintestinal.

Mosaprida Agonista de receptores 5HT4 0,5-2mg/ig IV Incrementa actividad deintestino delgado y ciego.No probado en casosclnicos.

Metilnaltrexona Antagonista de los receptoresopioides

1 mg/kg IV Disminuye efectos demorfina en motilidad

Tegaserod Agonista receptores 5-HT4 0,22 mg/kg PO Acelera trnsito, noprobado en casos clnicos

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1. Bird AR, Knowles EJ, Sherlock CE et al. The clinical and pathological features of gastricimpaction in twelve horses. Equine Vet J. Suppl. 2012 43: 105-110.

2. Buchanan BR and Andrews FM. Treatments and prevention of equine gastric ulcer syndrome. VetClin Equine (2003) 19: 575-597.

3. Kalck KA. Inflammatory bowel disease in horses. Vet Clin North Am Equine Pract. 2009. 25(2):303-315.

4. Taylor SD, Pusterla N, Vaughan B et al. Intestinal neoplasia in horses. J Vet Intern Med. 200620(6): 1429-1436.

5. Videla R and Andrews FM. New perspectives in Equine Gastric Ulcer Syndrome. Vet ClinEquine (2009) 25: 283-301.

6. White NA. Treatment of ileus and SIRS in horses with colic. Proceedings of the AAEP AnnualResort symposium. Vail, Colorado, USA. 2009: 329-337.

Documents

Enfermedades Del Estomago y Del Intestino Delgado en Caballos