Some human studies suggest that the route of administration is not as important as providing calories in itself; recommendations are still to institute early use of enteral nutrition if possible [82]. Current recommendations of the American Society for Parenteral and Enteral Nutrition are to avoid parenteral nutrition when the gastrointestinal tract can tolerate enteral nutrition [83]. Gastric protectants should be administered (0.5 mg/kg Omeprazol IV or 4.4 mg/kg omeprazole PO) to prevent gastric ulcers in adult horses and foals. Sucralfate (12 mg/kg PO q12 h) can be administered concurrently as mucosal protectant. H2 receptor antagonists (ranitidine 6.6 mg/kg q8 h PO) can be administered instead of omeprazole if it is unavailable or has proven to be ineffective in the patient [84].
Diagnosis and clinical signs
Clinical signs of gastric ulcers include recurrent colic, salivation and bruxism.
Treatment
Enteral feeding should be reintroduced gradually. Some foals may also require help to develop normal nursing behavior after prolonged periods of being off feed.
Expected outcome
Outcome is largely dependent on the underlying disease. Gastric ulcers in foals can perforate without prior clinical signs; in these cases prognosis is grave.
References
1 1 Fielding, C.L., Magdesian, K.G., and Edman, J.E. (2011). Determination of body water compartments in neonatal foals by use of indicator dilution techniques and multifrequency bioelectrical impedance analysis. Am. J. Vet. Res. 72: 1390–1396.
2 2 Fielding, C.L., Magdesian, K.G., Elliott, D.A. et al. (2004). Use of multifrequency bioelectrical impedance analysis for estimation of total body water and extracellular and intracellular fluid volumes in horses. Am. J. Vet. Res. 65: 320–326.
3 3 Malhotra, K. and Axisa, B. (2009). Low plasma albumin linked to fluid overload in postoperative epidural patients. Ann. Royal. Coll. Surg. Eng. 91: 703–707.
4 4 Murphy, E.L., Kwaan, N., Looney, M.R. et al. (2013). Risk factors and outcomes in transfusion‐associated circulatory overload. Am. J. Med. 126: 357 e329–338.
5 5 Woodcock, T.E. and Woodcock, T.M. (2012). Revised Starling equation and the glycocalyx model of transvascular fluid exchange: an improved paradigm for prescribing intravenous fluid therapy. Brit. J. Anaesth. 108: 384–394.
6 6 Brownlow, M.A. and Hutchins, D.R. (1982). The concept of osmolality: its use in the evaluation of “dehydration” in the horse. Equine Vet. J. 14: 106–110.
7 7 Rose, R.H. (2000). Fluid and electrolyte therapy: Assessment of fluid and electrolyte balance. In: Manual of Equine Practice, 2e (ed. R.J. Rose and D.R. Hodgson), 2. WB Saunders, Philadelphia.
8 8 Marik, P.E., Baram, M., and Vahid, B. (2008). Does central venous pressure predict fluid responsiveness? A systematic review of the literature and the tale of seven mares. Chest. 134: 172–178.
9 9 Magdesian, K.G., Fielding, C.L., Rhodes, D.M. et al. (2006). Changes in central venous pressure and blood lactate concentration in response to acute blood loss in horses. J. Am. Vet. Med. Assoc. 229: 1458–1462.
10 10 Fielding, C.L., Magdesian, K.G., Carlson, G.P. et al. (2007). Estimation of acute fluid shifts using bioelectrical impedance analysis in horses. J. Vet. Intern. Med. 21: 176–183.
11 11 Fielding, C.L. and Stolba, D.N. (2012). Pulse pressure variation and systolic pressure variation in horses undergoing general anesthesia. J. Vet. Emerg. Crit. Care. (San Antonio). 22: 372–375.
12 12 Fielding, L. (2014). Crystalloid and colloid therapy. Vet. Clin. N. Am. Equne Pract. 30: 415–425, viii–ix.
13 13 Cotton, B.A., Guy, J.S., Morris, J.A. Jr. et al. (2006). The cellular, metabolic, and systemic consequences of aggressive fluid resuscitation strategies. Shock. 26: 115–121.
14 14 Hardefeldt, L.Y. (2014). Hyponatraemic encephalopathy in azotaemic neonatal foals: four cases. Aust. Vet. J. 92: 488–491.
15 15 Lakritz, J., Madigan, J., and Carlson, G.P. (1992). Hypovolemic hyponatremia and signs of neurologic disease associated with diarrhea in a foal. J. Am. Vet. Med. Assoc. 200: 1114–1116.
16 16 Wong, D.M., Sponseller, B.T., Brockus, C. et al. (2007). Neurologic deficits associated with severe hyponatremia in 2 foals. J. Vet. Emerg. Crit. Care. 17: 275–228
17 17 Dunkel, B., Palmer, J.E., Olson, K.N. et al. (2005). Uroperitoneum in 32 foals: influence of intravenous fluid therapy, infection, and sepsis. J. Vet. Intern. Med. 19: 889–893.
18 18 Geor, R.J. (2007). Acute renal failure in horses. Vet. Clin. N. Am. Equine Pract. 23: 577–591, v–vi.
19 19 Arieff, A.I., Llah, F., and Massry, S.G. (1976). Neurological manifestations and morbidity of hyponatremia: correlation with brain water and electrolytes. Medicine. 55: 121–129.
20 20 Biswas, M. and Davies, J.S. (2007). Hyponatraemia in clinical practice. Postgrad. Med. J. 83: 373–378.
21 21 Sterns, R.H., Riggs, J.E., and Schochet, S.S. Jr. (1986). Osmotic demyelination syndrome following correction of hyponatremia. New. E.g. J. Med. 314: 1535–1542.
22 22 Adrogue H.J. and Madias, N.E. (2000). Hyponatremia. New. Eng. Med. J. 342: 1581–1589.
23 23 Mohmand, H.K., Issa, D., Ahmad, Z. et al. (2007). Hypertonic saline for hyponatremia: risk of inadvertent overcorrection. C.J.A.S.N. 2: 1110–1117.
24 24 Groenendyk, S., English, P.B., and Abetz, I. (1988). External balance of water and electrolytes in the horse. Equine Vet. J. 20: 189–193.
25 25 Watson, Z.E., Steffey, E.P., VanHoogmoed, L.M. et al. (2002). Effect of general anesthesia and minor surgical trauma on urine and serum measurements in horses. Am. J. Vet. Res. 63: 1061–1065.
26 26 Epstein, V. (1984). Relationship between potassium administration, hyperkalemia and the electrocardiogram – an experimental study. Equine Vet. J. 16: 453–456.
27 27 Vincent, J.L. (2007). Metabolic support in sepsis and multiple organ failure: more questions than answers. Crit. Care Med. 35: S436–S440.
28 28 Eicker, S.W. and Ainsworth, D.M. (1984). Equine plasma banking: collection by exsanguination. J. Am. Vet. Med. Assoc. 185: 772–774.
29 29 Wilson, E.M., Holcombe, S.J., Lamar, A. et al. (2009). Incidence of transfusion reactions and retention of procoagulant and anticoagulant factor activities in equine plasma. J. Vet. Intern. Med. 23: 323–328.
30 30 Feige, K., Ehrat, F.B., Kastner, S.B. et al. (2003). Automated plasmapheresis compared with other plasma collection methods in the horse. J. Vet. Med. A. 50: 185–189.
31 31 Hardefeldt, L.Y., Keuler, N., and Peek, S.F. (2010). Incidence of transfusion reactions to commercial equine plasma. J. Vet. Emerg. Crit. Care (San Antonio). 20: 42–425.
32 32 More, S.J., Aznar, I., Bailey, D.C. et al. (2008). An outbreak of equine infectious anaemia in Ireland during 2006: Investigation methodology, initial source of infection, diagnosis and clinical presentation, modes of transmission and spread in the Meath cluster. Equine Vet. J. 40: 706–708.
33 33 Aleman, M., Nieto, J.E., Carr, E.A. et al. (2005). Serum hepatitis associated with commercial plasma transfusion in horses. J. Vet. Intern. Med. 19: 120–122.
34 34 Chandriani, S., Skewes‐Cox, P., Zhong, W. et al. (2013). Identification of a previously undescribed divergent virus from the Flaviviridae family in an outbreak of equine serum hepatitis. Proc. Nat. Acad. Sci. USA. 110: E1407–1415.
35 35 Ramsay, J.D., Evanoff, R., Wilkinson, T.E. Jr. et al. (2015). Experimental transmission of equine hepacivirus in horses as a model for hepatitis C virus. Hepatology. 61: 1533–1546.
36 36 Sacks, M. and Mosing, M. (2017). Volumetric capnography to diagnose venous air embolism in an anaesthetised horse. Vet. Anaesth.