Abdominal pain and colic Flashcards
4 intestinal causes of colic
- gas
- impaction
- displacement
- strangulation
4 things confused with colic
- laminitis
- musculoskeletal pain
- neurologic disease
- botulism
9 ways a horse expresses pain
- restlessness
- recumbent outside normal routine
- pawing
- going to lie down then getting back up again
- rolling without shaking of shavings, can also get abrasions from rolling
- muscle fasciculations (twitching)
- looking at flank
- kicking abdomen
- sweating
normal amount of nasogastric reflux from horse
2 litres
increased amount of nasogastric reflux from a horse indicates
proximal obstruction
normal fluid from equine abdominocentesis appearance
clear to straw coloured
12 things you can feel on horse rectal
- to the left the large intestine
- pelvic flexure of large intestine
- left kidney
- bladder
- reproductive tract
- small colon
- spleen
- inguinal rings
- mesenteric root
- aorta
- small intestinal distension
- caecum
what does the large intestine of the horse feel like (3)
- sacculations
- wide diameter
- taeniae bands
what does pelvic flexure of large intestine horse feel like (2)
- smooth
- mesenteric band
what does horse small colon feel like (3)
- sacculations
- 2 taeniae bands
- faecal balls
what does small intestinal distension in a horse feel like
bicycle tyres
enteritis define
inflammation of small intestine
what does enteritis cause in horses (2)
- hypomotility
- increased nasogastric reflux
typhlocolitis define
inflammation of large intesting
typhlocolitis causes (1)
variable amounts of diarrhoea
peritonitis define
inflammation of peritoneum
6-8 hours post small intestinal strangulation horse
intestine dies
4 things suggestive of medical lesion in colic horse
- its not getting worse
- low grade pain
- still interested in food
- lying down more than usual
9 things suggestive of surgical lesion horse colic
- acute onset
- worsening over time
- multiple pain relief given
- sweating
- kicking
- rolling
- severe pain
- no gut sounds
- abnormal abdominocentesis
SA back pain can look like..
abdominal pain
6 SA signs of abdominal pain
- grunting
- growling
- behaviour change
- prayer position
- tachycardia
- tachypnoea
pneumoperitoneum define
gas in peritoneal cavity
pneumoperitoneum radiographic appearance
- more distinct lines between intestines
3 techniques for abdominocentesis
- open needle
- closed needle
- 4 quadrant
closed needle abdominocentesis how to
insert needle with attached syringe, apply gentle negative pressure
open needle abdominocentesis how to
insert needle without syringe attached
open needle abdominocentesis pros
less likely for occlusion of the needle
open needle abdominocentesis cons
can cause pneumoperitoneum so radiograph first
4 quadrant abdominocentesis how to
insert 4 needles around umbilicus at same time
peritoneal lavage how to
inject 22ml/kg of sterile saline by gravity, then remove it. this can be used for cytology
4 things occur if remove majority of colon
- reduced storage capacity
- increased pooing frequency
- decreased absorption ability
- watery poo
megacolon define
flaccid enlargement of the colon
megacolon causes 6 things
- chronic constipation
- large colon filled with poo
- weight loss
- anorexia
- vomiting
- tenesmus
sacculectomy
removal of anal glands
7 clinical signs of gastric dilated volvulus
- agitation
- restlessness
- lethargy
- progressive abdominal distension
- unproductive vomiting
- retching
- collapse
4 effects of GDV
- caudal vena cava obstruction
- increased gastric pressure and avulsion of short gastric vessels
- stretching and avulsion of splenic vessels
- cranial pressure on diaphragm
3 things happen in GDV due to vena cava obstruction
- decreased venous return
- decreased cardiac output
- hypovolaemia
2 things happen in GDV due to increased gastric pressure and avulsion of short gastric vessels
- mucosal haemorrhage
- ischaemia and gastric wall necrosis
GDV what happens due to stretching and avulsion of splenic vessles
splenic necrosis
GDV causes what due to increased pressure on diaphragm
decreased ventilation
define incisional gastropexy
incise wall of abdomen and stomach before stitching together so that they heal together
define belt loop gastropexy
cut of a bit of stomach and loop it through hole made in abdominal wall, then sex together.
3 hepatic zones
- periportal
- midzonal
- centrilobular
size of liver lobule
2mm in diameter
where in liver lobule is periportal zone
around portal triads
where in liver lobule is centrilobular zone
bordering the hepatic venule (central vein)
2 types of portosystemic shunt
- congenital
- aquired
define portosystemic shunt
where blood bypasses the liver
acquired portosystemic shunt how
in older animal fibrosis occurs in liver causing formation of thin walled shunts
tension lipidosis
focal areas of subcapsular fatty change
capsular fibrosis
commonly seen in horses, large tags are seen on liver surface
telangiectasis
foci of sinusoidal dilation. see red discoloration like a blood blister
3 effects of passive venous congestion on the liver
- enlarged liver with rounded borders.
- oozes blood when cut
- enhanced lobular pattern, nutmeg liver
2 vacuolar hepatopathies
- hydrophic change
- glycogenosis
define hydrophic change (liver)
water accumulation in hepatocytes
define glucogenosis (liver)
glycogen accumulation in hepatocytes
severe glucogenosis liver appearance (2)
- pale
- enlarged
lipidosis
fatty liver
4 causes of lipidosis
- obesity
- starvation
- increased energy demand
- abnormal liver function
lysosomal storage disease
inherited deficiency of lysosomal enzymes so there is a build up of metabolites
amyloidosis
amyloid proteins that can not be got rid of get stored under the endothelium and basement membrane of tissues
amyloidosis liver appearance (3)
- pale
- enlarged
- friable
liver amyloidosis microscopic appearance
homogenous acidophilic material that gets a green birefringence when stained with congo red
3 different patterns of liver necrosis
- random
- zonal
- massive
cause of random liver necrosis
blood bourne infection
2 causes of zonal liver necrosis
- ischaemia
- toxic damage
cause of massive liver necrosis
deficiencies
4 patterns of liver fibrosis
- periacinar
- biliary
- post necrotic scaring
- cirrhosis
periacinar pattern liver fibrosis appearance
fibrosis occurs around the central vein
cause of periacinar fibrosis in the liver
chronic passive congestion
biliary pattern liver fibrosis cause
accompanies inflammation
where biliary pattern fibrosis in the liver is seen
centered on portal triads
cause of postnecrotic fibrosis of the liver
seen after necrosis
cirrhosis pattern of the liver fibrosis appearance
extensive fibrotic lesions, may be concurrent with nodular regeneration
define hepatitis
inflammation of liver parrenchyma
common cause of hepatitis
infection
cholangitis define
inflammation of biliary ducts
cholangiohepatitis define
inflammation of liver parenchyma and bile ducts
acute hepatitis usually involves
necrosis then the inflammation
4 processes of healing after acute hepatitis
- regeneration
- repair by fibrosis and scarring
- encapsulation by abscessation
- persistent granulomatous disease
3 causes of viral hepatitis
- adenovirus
- herpesvirus
- coronavirus
adenovirus cause
canine infectious hepatitis
3 features of canine infectious hepatitis
- infects young dogs
- v. infectious
- long term shedding of virus in urine
canine infectious hepatitis causes
- widespread haemorrhage
- lymph node and tonsil enlargement, reddening and sometimes haemorrhagic
cause widespread haemorrhage in canine infectious hepatitis
as has tropism or endothelium
animals recovering from canine infectious hepatitis may have
uveitis
uveitis define
inflammation of the uvea (coloured bit of eye)
4 herpesvirus causing viral hepatitis
- equine viral rhinopneumonitis
- infectious bovine rhinotracheitis
- feline viral rhinopneumonitis
- aujezskys disease in pigs
coronavirus causing hepatitis
feline infectious peritonitis
how does feline infectious peritonitis cause hepatitis (3 steps)
- enteric coronavirus mutates
- systemic vasculitis and effusions
- multiple organ pyogranulomatous lesions
2 forms feline infectious peritonitis
- wet (effusive)
- dry (granulomatous)
6 bacterial causes of hepatitis
- fusobacterium necrophorum in cattle
- infectious necrotic hepatitis
- bacillary haemoglobinuria in cattle
- tyzzers disease
- leptospirosis
- salmonellosis
fusobacterium necrophorum cause what in cattle
bacterial necrosis
fusobacterium cecophorum enters the body how in cattle
- via umbilical infection in calves
- rumenitis in cattle
appearance of fusobacterium necrophorum in liver (2)
- multiple pale foci of necrosis
- develop into abscesses
fusobacterium necrophorum microscope appearance
coagulative necrosis with bacteria at edges
cause infectious necrotic hepatitis
clostridium novyi type B
3 appearance of infectious necrotic hepatitis
- extensive subcutaneous venous congestion and oedema
- fibrinous peritoneal, thoracic and pericardial fluid
- pale foci of necrosis surrounded by haemorrhage
cause of bacillary haemogobinuria
clostridium haemolyticum
bacillary hemoglobinuria is similar to
infectious necrotic hepatitis
3 clinical signs of bacillary haemoglobinuria
- anaemia
- jaundice
- haemaglobinuria
liver and kidney appearance bacillary haemaglobinuria
- large necrotic foci on liver
- haemoglobin staining kidney
cause of tyzzers disease
clostridium piliforme
leptospirosis causes (4)
- haemolytic anaemia
- widespread haemorrhage
- icterus
- hepatocyte dissociation
hepatocyte dissociation in leptospirosis causes (2)
- cholestasis
- hemosiderin accumulation
cholestasis
bile cant flow
5 clinical signs salmonellosis
- fever
- dehydration
- diarrhoea
- hemorrhagic inflammation in the ileum
- pale foci of necrosis on liver (paratyphoid nodules)
ascaris suum migration causes
milk spot liver
fibrous tags are caused by
parasite migration through the liver
acute toxic liver disease causes
widespread haemorrhage
how does acute toxic liver disease cause widespread haemorrhage
- reduced clotting factors are in the blood and liver isn’t making any more to replace those lost.
2 causes toxic liver disease
- blue-green algae
- iron
3 causes chronic toxic liver disease
- ragwort
- aflatoxins
- copper
cholecystitis define
inflammation of the gall bladder
common reactions to cholecystitis
hyperplasia
4 things that cause biliary tree obstruction
- parasites
- gall stones
- compression by inflammation or neoplasia
nodular hyperplasias in the liver are seen commonly in…
older dogs
appearance nodular hyperplasia
spherical nodules in liver which vary in colour
microscopy nodular hyperplasia (4)
- cells larger
- more glycogen in cells
- portal areas still visible
- compressed adjacent tissue
pancreatic hypoplasia is seen in
young dogs and calves
clinical signs pancreatic hypoplasia
- fat in poo
- loss of body condition despite pot bellied and polyphagia
acute pancreatitis presentation (4)
- shock
- cardiovascular collapse
- increased lipase and amylase
- fat necrosis around pancreas
chronic pancreatitis can lead to
exocrine pancreatic insufficiency