Changes

==Introduction==

==Introduction==

Grain overload is still a relatively common disease, and refers to the '''over-consumption of concentrates'''.  

Grain overload is still a relatively common problem, and refers to the '''over-consumption of concentrates'''. This may be by '''accident''', or deliberately induced.

It is the amount of '''soluble carbohydrate''' in the concentrate that is the problem, and [[Cereals and By-Products#Maize and Maize Gluten Feed|'''maize/corn''']]-containing products are a greater danger than a grain product such as [[Cereals and By-Products#Barley, Wheat & Oats|oats]]. [[Cereals and By-Products#Barley, Wheat & Oats|'''Barley''']] is also very high in soluble carbohydrates.

 

It is the amount of '''soluble carbohydrate''' in the concentrate that is the problem, and '''maize/corn'''-containing products are a greater danger than a grain product such as oats. '''Barley''' is also very high in soluble carbohydrates.

Some owners feed extra corn over the winter hoping to increase heat production and help the horse keep warm. This does not occur and the caecum and colon produce a lot more heat through the fermentation of fibre.

Some owners feed extra corn over the winter hoping to increase heat production and help the horse keep warm. This does not occur and the caecum and colon produce a lot more heat through the fermentation of fibre.

As the carbohydrates enter the stomach and intestines, the '''pH decreases''' and there is a change in the microbial flora. This results in '''acidosis and an increased risk of endotoxaemia'''.

As the carbohydrates enter the stomach and intestines, the '''pH decreases''' and there is a change in the microbial flora. This results in '''acidosis and an increased risk of endotoxaemia'''.

Grain overload is also a major contributor to the development of '''laminitis'''.

Grain overload is also a major contributor to the development of [[Laminitis - Horse|'''laminitis''']].

==Clinical Signs==

==Clinical Signs==

Other signs include: '''abdominal distension''', lameness caused by '''laminitis''', trembling, sweating.

Other signs include: '''abdominal distension''', lameness caused by '''laminitis''', trembling, sweating.

If endotoxaemia and hypovolaemic shock, gastritis and ileus develop, signs may include: '''purple mucous membranes''', '''tachycardia''', tchypnoea, gastric reflux, colonic distension, '''decreased intestinal motility'''.

If endotoxaemia and hypovolaemic shock, gastritis and ileus develop, signs may include: '''purple mucous membranes''', '''tachycardia''', tachypnoea, gastric reflux, colonic distension, '''decreased intestinal motility'''.

==Diagnosis==

==Diagnosis==

Clinical signs are also usually suggestive.

Clinical signs are also usually suggestive.

 

:[[Rectal Examination of the Horse|'''Rectal examination''']] may reveal: colonic distention with tight bands

'''Rectal examination''' may reveal: colonic distention with tight bands

:'''Haematology''' may reveal: polycythemia, neutropenia with a left shift and toxic changes in the neutrophils.

 

'''Haematology''' may reveal: polycythemia, neutropenia with a left shift and toxic changes in the neutrophils.

==Treatment==

==Treatment==

The most immediate concern is '''gastritis and stomach distension'''. In such cases the passage of a '''nasogastric tube''' is essential to prevent gastric rupture. The tube can then be left in place, or continuous monitoring for repeat distension should be performed.

The most immediate concern is '''[[gastritis]] and [[Gastric Dilation and Rupture - Horse|stomach distension]]'''. In such cases the [[Nasogastric intubation in the horse|passage of a '''nasogastric tube''']] is essential to prevent [[Gastric Dilation and Rupture - Horse|gastric rupture]]. The tube can then be left in place, or continuous monitoring for repeat distension should be performed.

If no reflux is obtained, '''activated charcoal or mineral oil''' can be given to reduce toxin absorption from the gastrointestinal system.

If no reflux is obtained, '''activated charcoal or mineral oil''' can be given to reduce toxin absorption from the gastrointestinal system.

==Prognosis==

==Prognosis==

It is good if treatment is instituted before clinical signs develop.

It is good if treatment is instituted before clinical signs develop. The prognosis is '''poor''' if there are moderate or severe clinical signs. Significant colic and abdominal distension often leads to death within 48 hours, even with the most aggressive therapy.  

 

The prognosis is '''poor''' if there are moderate or severe clinical signs.  

 

Significant colic and abdominal distension often leads to death within 48 hours, even with the most aggressive therapy.  

If '''laminitis''' occurs along with intestinal signs, the prognosis is '''grave'''.

If '''laminitis''' occurs along with intestinal signs, the prognosis is '''grave'''.

[[Category:To Do - Helen]]

[[Category:To Do - Review]]

[[Category:Alimentary Diseases - Horse]]

[[Category:Expert Review - Horse]]