Wednesday, April 15
Question of the Day
An adult horse presents for acute onset of depression and colic.
| Value | Normal |
|---|---|
| T = 101.9°F (38.8°C) | 99.0–100.6°F (37.2–38.1°C) |
| HR = 76 bpm | 28-40 bpm |
| BR = 28 brpm | 10-14 brpm |
| Mucous membranes = dark pink | pink |
| CRT = 4 seconds | < 2 seconds |
Passage of a nasogastric tube yields 18 L of malodorous, red-tinged reflux. Heart rate improves to 56 bpm following decompression. Abdominal palpation per rectum identifies multiple dilated loops of small intestine.
Abdominal ultrasound reveals small intestine that is uniformly mildly thick-walled with hypomotility, and the stomach is significantly enlarged.
Abdominocentesis yields dark yellow peritoneal fluid with high total protein (5 g/dL, normal < 2 g/dL) and a normal cell count. Peritoneal lactate is mildly increased, similar to peripheral lactate (both about 4.5 mmol/L, normal < 2 mmol/L).
What is the top differential?
