Changes

==Diagnosis==

==Diagnosis==

'''Primary gastric dilation''' should be suspected if there are copious amounts of [[Colic Diagnosis - Naso-gastric Intubation|gastric reflux]] in the absence of small intestinal distension on [[Colic Diagnosis - Rectal Examination|rectal examination]] and the absence of endotoxaemia.  A retrospectvie diagnosis of '''primary gastric dilation''' can be made if colic signs cease following decompression, and other clinical parameters return to normal.  Primary gastric dilation does not cause any significant change in peritoneal fluid parameters until rupture occurs.(Proudman)

'''Primary gastric dilation''' should be suspected if there are copious amounts of [[Colic Diagnosis - Naso-gastric Intubation|gastric reflux]] in the absence of small intestinal distension on [[Colic Diagnosis - Rectal Examination|rectal examination]] and the absence of endotoxaemia.<ref name="Proudman">Proudman, C.J, Baker, S.J (1994) Satellite Article: Gastric disease in the adult horse: a clinical perspective.  ''Equine Vet Educ'', 6(4):178-184.</ref> A retrospective diagnosis of '''primary gastric dilation''' can be made if colic signs cease following decompression, and other clinical parameters return to normal.  Primary gastric dilation does not cause any significant change in peritoneal fluid parameters until rupture occurs.<ref name="Proudman">Proudman, C.J, Baker, S.J (1994) Satellite Article: Gastric disease in the adult horse: a clinical perspective.  ''Equine Vet Educ'', 6(4):178-184.</ref>

'''Secondary gastric dilation''' should be considered if there is persistent [[Colic Diagnosis - Clinical Signs|colic]], repeated retrieval of [[Colic Diagnosis - Naso-gastric Intubation|nasogastric reflux]], intestinal distension on [[Colic Diagnosis - Rectal Examination|rectal examination]] and clinical signs of [[Colic Diagnosis - Clinical Signs|endotoxaemia]].  These are all indications for '''exploratory laparotomy''' to look for an intestinal obstruction.   

'''Secondary gastric dilation''' should be considered if there is persistent [[Colic Diagnosis - Clinical Signs|colic]], repeated retrieval of [[Colic Diagnosis - Naso-gastric Intubation|nasogastric reflux]], intestinal distension on [[Colic Diagnosis - Rectal Examination|rectal examination]] and clinical signs of [[Colic Diagnosis - Clinical Signs|endotoxaemia]].<ref name="Proudman">Proudman, C.J, Baker, S.J (1994) Satellite Article: Gastric disease in the adult horse: a clinical perspective.  ''Equine Vet Educ'', 6(4):178-184.</ref> These are all indications for '''exploratory laparotomy''' to look for an intestinal obstruction.   

NB: ''excessive fluid within the stomach is not always detected by nasogastric intubation, despite repeated attempts with frequent repositioning of the tube. Furthermore, gastric impaction with solid food material may be too firm to be retrieved by this method.''(Proudman)  

NB: ''excessive fluid within the stomach is not always detected by nasogastric intubation, despite repeated attempts with frequent repositioning of the tube. Furthermore, gastric impaction with solid food material may be too firm to be retrieved by this method.''<ref name="Proudman">Proudman, C.J, Baker, S.J (1994) Satellite Article: Gastric disease in the adult horse: a clinical perspective.  ''Equine Vet Educ'', 6(4):178-184.</ref> 

'''Gastric rupture''' results in septic peritonitis which will be reflected in the nature of fluid collected by [[Colic Diagnosis - Abdominocentesis|abdominocentesis]]:

'''Gastric rupture''' results in septic peritonitis which will be reflected in the nature of fluid collected by [[Colic Diagnosis - Abdominocentesis|abdominocentesis]]<ref name="Proudman">Proudman, C.J, Baker, S.J (1994) Satellite Article: Gastric disease in the adult horse: a clinical perspective.  ''Equine Vet Educ'', 6(4):178-184.</ref>:

*Foetid, turbid sample containing particulate matter

*Foetid, turbid sample containing particulate matter

*White cell count >40 x 10^9/l

*White cell count >40 x 10^9/l

*Protein content >30g/l.

*Protein content >30g/l.

Findings on [[Colic Diagnosis - Rectal Examination|rectal examination]] may include:

Findings on [[Colic Diagnosis - Rectal Examination|rectal examination]] may include<ref name="Proudman">Proudman, C.J, Baker, S.J (1994) Satellite Article: Gastric disease in the adult horse: a clinical perspective.  ''Equine Vet Educ'', 6(4):178-184.</ref>:

*A 'gritty feeling' on the serosal surfaces of intestine due to adherent food material

*A 'gritty feeling' on the serosal surfaces of intestine due to adherent food material

*An impression of 'space' in the abdomen due to gas in the peritoneal cavity.(Proudman)

*An impression of 'space' in the abdomen due to gas in the peritoneal cavity.

[[Colic Diagnosis - Clinicopathologic Evaluation|Laboratory findings]]<ref name="Camp">Campbell-Thompson, M.L, Merritt, A.M (1999) Alimentary system: diseases of the stomach.  In Colahan, P.T, Mayhew, I.G, Merritt, A.M, Moore, J.N ''Equine medicine and surgery'', St Louis, Mosby, pp 699-715.  In: Sanchez, L.C (2010) ''Other Disorders of the Stomach'' in Reed, S.M, Bayly, W.M. and Sellon, D.C (2010) '''Equine Internal Medicine''' (Third Edition), ''Saunders'', Chapter 15.</ref> may include:

[[Colic Diagnosis - Clinicopathologic Evaluation|Laboratory findings]]<ref name="Camp">Campbell-Thompson, M.L, Merritt, A.M (1999) Alimentary system: diseases of the stomach.  In Colahan, P.T, Mayhew, I.G, Merritt, A.M, Moore, J.N ''Equine medicine and surgery'', St Louis, Mosby, pp 699-715.  In: Sanchez, L.C (2010) ''Other Disorders of the Stomach'' in Reed, S.M, Bayly, W.M. and Sellon, D.C (2010) '''Equine Internal Medicine''' (Third Edition), ''Saunders'', Chapter 15.</ref> may include:

*Haemoconcentration

*Haemoconcentration