16. Surgical GIT 1 Flashcards
What structures should you find for an equine exploration of the abdomen?
Ventral Midline incision - dorsal recumbency
-Gas decompression
Large colon
-Find iliocecal fold and follow oral to duodenocolic ligament
-Follow ascending colon from cecocolic fold to pelvic flexure, exteriorize the ascending colon and palpate
-Descending colon, palpate bands and fecal balls
-Palpate the stomach, duodenum, transverse colon, liver, spleen, diaphram, kidney and repro
Where do simple obstructions like to occur?
Stomach, ileocecal junction, cecum, right dorsal colon, pelvic flexure and small colon
What are some causes of simple obstruction?
Ascarid Impaction, Ileal Impaction, Cecal Impaction, Small Colon Impaction, Large Colon Impaction, Meconium Impaction
What can cause a gastric or stomach impaction?
-Excessive dry fibrous ingesta or material that forms a mass (persimmon seed or mesquite bean) (Wheat, barley, beet pulp)
-Dental disease and inability to properly chew
How do you diagnose a gastric impaction?
Endoscopy, at surgery, ultrasound maybe
How do you treat a gastric impaction?
Gastric lavage via NG tube
What type of impaction is most common in foals and weanlings 4-24 months old?
Ascarid Impaction
(Foal looks parasitized - after treatment)
How do you treat a foal with ascarid impaction?
Surgical - milk ascarid into cecum and allow patient to pass in feces
(severe enterotomy or R and A if bowel devitalized)
What is the prognosis for ascarid impacitons?
Guarded-necrotizing enteritis, adhesions, peritonitis and abscess formation
What is the most common non-strangulating lesion of the equine small intestines?
Ileal impaction
What feed stuff predisposes horses to Ileal impactions?
Bermuda (Southeast)
How can you diagnose Ileal Impactions?
Palpation via rectum 10-39%
Distended Small Intestines 87%
Ultrasound 99%
How can you treat ileal impactions?
Medically - fluid and analgesia
How do you diagnose a cecal impaction?
Rectal Palpation
What are the 2 types of cecal impaction?
Type 1: Firm ingesta - silent killer (diet, dentition, change in feed, less water intake, tape worm)
Type 2: Cecal dysfunction preventing cecal outflow into right ventral colon
How do you treat a cecal impaction?
medically - fluid, lax, NSAID, prokinetics
Surgical - typhlotomy
What is the most common type of colic?
Large colon tympany
Gas or Spasmodic colic
How do you treat gas colic?
Pain management
Withold feces
Buscopan
Where do large colon impactions most commonly occur?
Left ventral colon and pelvic flexure or right dorsal colon
What causes large colon impactions?
change in management or musculoskeletal injury
-Atropine or morphine
How do you manage large colon impaction?
medical usually successful (fluids, lax and analgesia)
-risk of rupture
-Nonresponsive - surgery
How do you diagnose large colon impaction?
Rectal Palpation
How does a right dorsal displacement occur?
Non-strangulating, malposition, gas without disrupting blood supply - mild to moderate pain and distension
-Colon moves around the base of the cecum between it and the body wall
-mature and large breed
How do you diagnose a Right dorsal displacement?
rectal exam - tinea horizonal, no pelvic flexure felt
How do you treat right dorsal displacement?
Surgical if medical fails - withold foos, fluids, analgesia, exercise, lidocaeine, trochar
Whats the prognosis for right dorsal displacement?
Excellent
Where does a left dorsal displacement go?
Left body wall and spleen without entrapment
Can migrate forward and become entrapped in nephrosplenic space
How do you diagnose left dorsal displacement?
Ultrasound
How do you treat left dorsal displacement?
Medical, roll, phenylephrine, surgery
(enterotomy)
-close nephrosplenic space
Where does a sand impaction typically occur?
Left ventral colon
What are clinical signs and which horse typically gets sand impaction?
Non-specific, poor doing, weight loss, diarrhea, chronic colic
Low on totem pole
How do you diagnose sand impaction?
Sand in feces, auscultation of beach, rads
How do you manage a sand impaciton?
Fever and inflammatory leukogram
- fluid, lax, nsaid, psyllium - 4 day NG tube
-Surgical if unsuccessful
What is do most horses who have enterolithiasis have in common?
Fed Alfalfa
How do you diagnose a enterolithiasis?
Chronic colic signs
Rads
Where are enterolithiasis commonly found?
Right dorsal colon, transverse colon and small colon
What is the treatment for enterolithiasis?
Surgery
What are some risk factors for small colon impactions?
Poor dentition, less water, poor hay, parasite damage
More likely to have diarrhea
How do you diagnose Small colon impaction?
Rectal palpation, decreased feces, straining to defecate
How do you treat small colon impaction?
fluids, lax, nsaid, surgery
Who gets meconium impactions?
Foals 3-24hr post
What are signs of meconium impaction?
Tenesmus, pain, distension
How do you treat meconium impaction?
Enema (fleet), soapy water, lax, iv fluid, surgery
What are some FB and Masses?
Lead rope, trash bag, hematoma, hypertopy, neoplasia
What do adhesions cause?
Chronic intermitant colic
-Surgery <2 months
What are some physiological obstructions?
Proximal enteritis, peritonitis, post op ileus, atropine
What are some signs you can treat on the farm?
Minimal PE changes
treatable diagnsosis
easy pain management
short duration
When should you refere the colic?
Moderate to devere dehydration, deteriorating, pain increase, duration long
