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Equine final practical exam - Surgery > 11. Clinical examination of the colic patient with different disorders, topical anatomy > Flashcards

11. Clinical examination of the colic patient with different disorders, topical anatomy Flashcards

1
Q

What is coli?

A

Acute abdominal pain.

There are many causes of colic and symptoms range from very mild to violent

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2
Q

Origins of colic:

A
  1. Gi-tract
  2. Urinary colic
  3. Uterine torsion
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3
Q

Causes of colic:

A
  1. Change in diet
  2. Decreased water uptake
  3. Parasitic infections
  4. Meterological changes
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4
Q

What are the different types of colic?

A
  1. gas colic
  2. spasmodic colic
  3. impaction colic
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5
Q

Gas colic =

A

caused by excessive production of gas in any portion of the horse’s intestinal tract. It is believed that sudden changes in feed may contribute to gas colic

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6
Q

Spasmodic colic =

A

defined as painful contractions of the smooth muscle in the intestines

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7
Q

Impaction colic =

A

caused by obstructions in the bowel, typically in areas where the large intestine changes in direction or diameter. These obstructions may be caused by dry, firm masses of feed, or foreign material such as dirt or sand

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8
Q

Important to remember when examining a colic patient:

A

Quick ,systematic and effective examination. Focus on Cardiovascular and GI-system

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9
Q

Examination steps for a colic patient:

A
  1. History
  2. Physical examination
  3. Ancillary methods
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10
Q

Important to ask under history:

A
  1. Which colic signs: duration, grade, frequency
  2. Which medications given prior
  3. Previous colic episodes?
  4. Change in feeding?
  5. Change in management?
  6. Deworming?
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11
Q

Steps to perform under “physical examination”:

A
  1. Behaviour and posture
  2. Body surface: dry/sweaty, skin temp.
  3. Temperature
  4. Heart rate
  5. Respiratory rate
  6. mucous membrane
  7. CRT
  8. Shape and size of the abdomen
  9. Abdominal auscultation
  10. Rectal palpation
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12
Q

Behaviour and posture signs of colic:

A
  1. Frequently looking to their side
  2. Biting or kicking the abdomen
  3. Lying down
  4. rolling
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13
Q

Heart rate in case of colic:

A

Mild: Over 50
Severe: Over 100 - could indicate ruptured intestines!!

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14
Q

Mucous membrane in case of colic:

A

Usually darker

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15
Q

Landmarks for abdominal auscultation:

A
  1. Paralumbar fossa
  2. Lower abdomen, behind the costal arch
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16
Q

What can it indicate if there are no abdominal sounds?

A
  1. Impaction
  2. Obstruction
  3. Hyperfusion
  4. Ileus
  5. Dislocaton
  6. Torsion
17
Q

What can it indicate if there are increased abdominal sounds?

A
  1. Early enteritis/colitis
  2. mild spasmodic colic
18
Q

What to look for in case of rectal palpation?

A
  1. Displacement
  2. Distension
19
Q

Name some ancillary methods of colic examination:

A
  1. Ultrasound
  2. X-ray (rare!)
  3. Nasogastric tubing
  4. Abdominocentesis
  5. Lactate in blood + peritoneal fluids
20
Q

What can be observed during US of a colic patient?

A
  1. Visualisation of the colonic mesenteric vasculature
    = indicator for right dorsal displacement of the large colon.
  2. Distension of small intestinal loops
  3. Fluid accumulation
21
Q

When do we perform abdominocentesis

A

In severe cases!

22
Q

What does the numbers indicate?

A
  1. Normal transudate
  2. Darker red, modified transudate
  3. Red, blood = Strangulation for several hrs
  4. Yellow, opaque = Exudate, indication acute peritonitis
  5. Brown, plant materal = indication rupture
23
Q

What can increased lactate levels indicate?

A

Over 4.4 mmol/L indicates strangulation, and it will keep increasing with fluid therapy

24
Q
A
  1. Diaphragm
  2. Heart
  3. Pharynx
  4. Esophagus
  5. Liver
  6. Right kidney
  7. Small intestine
  8. Base of caecum
  9. Rectum
  10. Small colon
  11. Caecum
  12. Right ventral colon
  13. Right dorsal colon
25
Q
A
  1. Oesophagus
  2. Liver
  3. Stomach
  4. Left kidney
  5. Small intestine
  6. Rectum
  7. Sternal flexure, left ventral colon
  8. Diaphragmatic flexure, left dorsal colon
  9. Heart
  10. Diaphragm
  11. Pharynx
26
Q

Disorders of a colic patient:

A
  1. Obstipation
  2. Colitis
  3. Large colon displacement
27
Q

Clinical signs of obstipation:

A
  1. Apatic
  2. Decreased apetite
  3. increased heart rate
  4. decreased gut sound
  5. With palpation we might find a hard structure
28
Q

Blood measurements in case of obstipation:

A
  1. Increased haematocrit
  2. Increase total protein
  3. increased creatinine
  4. Leukopenia (decreased leukocytes)
29
Q

Treatment of obstipation:

A
  1. Fluids
  2. Laxatives: paraffin oil, bismouth salt
  3. Walking
30
Q

Complications of obstipatoin:

A
  1. Rupture
  2. Colitis
  3. Peritonitis
31
Q

Clinical signs of colitis:

A
  1. soft faeces
  2. thickened intestinal wall
  3. Fluid visible
  4. Severe: have gas
32
Q

Causes of colitis:

A

Can be both contagious or non-contagious

Contagious:
1. Parasites
2. Bacteria (salmonella feks)
3. Vuris (rotavirus)

Non-contagious:
1. change in diet
2. Stress
3. Weather
4. Tumour
5. Poisoning

33
Q

Treatment of colitis:

A
  1. Hay
  2. Fluids
  3. Painkillers (flunixin)
  4. Charocal
34
Q

Complications of colitis:

A
  1. dehydration
  2. bacteriaemia
  3. toxins
  4. pneumonia

Increased risk of secondary problems and death!!

35
Q

clinical signs of large colon displacement:

A
  1. Colic signs
  2. lays down
  3. Bloated
  4. Bad condition (sweating, cold limbs)
  5. increased heart rate
  6. no gut sounds
  7. CRT = 5 sec
36
Q

Treatment of torsion:

A

in severe cases it might be euthanised

otherwise surgery

37
Q

Treatment of left/right dorsal displacement:

A

Not severe: trotting, faster + slower movements

Severe: surgery

38
Q

Complications.

Cause and treatment!

A

1.Pneumonia: due to NG-tube. T: tracheal lavage, AB?

  1. Lamnitis: due to endotoxaemia. T: ice boots, cast elevation,

Equine final practical exam - Surgery (12 decks)

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