Acute Abdomen Flashcards
Obj: definition of colic, predisposing factors, and most common causes of colic in horses
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Obj: Know how to perform a colic exam and the significance of the findings
Obj: how to differentiate between gas colic and more serious cause of colic
Obj: treatment for gas colic and analgesic choices
What are the predisposing factors for colic
- feed 9concentrates)
- stall confinement
- minimal grazing
- decreased water intake
- change in feeding/houseing
What are the most common causes of colic
- Gas colic
- Impaction
- Large colon displacement
What are all the parts of a colic exam? normal findings? abnormal?
- History: pain, signalment, deworming, water intake, prior colic episodes, ….
- Pain - most important parameter
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Heart Rate - 24-42 bpm normal
- elevated = pain or dehydration
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Respiratory rate - 8 -20 bpm normal
- increase - early indication of pain
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Temperature - 100 - 100.8F normal
- elevated - colitis, proximal enteritis
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GI sounds - Normal progressive borborygmi (intermittent sounds every 1-2 minutes)
- range from continuous (colitis) to decreased/absent
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Abdominal distension
- GI tract distention
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Stallions - testicles scrotum for swelling
- herniated bowel
- Mucous membranes - pink, moist
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Rectal Exam -
- GI tract distention w/ air
- GI tract impaction (pelvic flexure most common)
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Feces -
- hard, mucus covered - dehydration/impaction
- sand?
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Nasogastric tube -
- gastric distention
- NG reflux - proximal obstruction of the small intestine
- NOTHING PO
- Abdominocentesis - clear yellow TP < 2.5 gm/dl, WBC <10,000 normal
- indicated in complicated cases
- Blood work - indicated in complicated cases
- hyperglycemia, Increased PCV (>60%) and lactate concentrations - indicated significant problem
- poorer outcome
- hyperglycemia, Increased PCV (>60%) and lactate concentrations - indicated significant problem
- Ultrasound - transabdominal and/or rectal
- useful in foals, ponies, and minis
What are the indications to refer a case of colic?
- Pain - severe pain despite appropriate analgesic therapy
- Cardiovascular deterioration - toxic mm, rapid HR, weak pulse, shock
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Net NG Reflux -
- differential is small intestinal strangulating lesion (surgery!)
- Only IV fluids
What is gas colic? causes?
- Due to gas accumulation of the large colon and ileus
- Associated with:
- feeding infrequent meals and grain
- change of diet
- stabling
- motility disturbances
What are the results of a Colic workup on Simple Gas Colic?
- Pain: mild to moderate
- HR: N to mild increase 30-60
- Temp: N
- MM: N
- NG Reflux: N
- Rectal: N to mild large colon distension
- GI sounds: decreased to absent
- Abdominocentesis: N
- Blood work: N to mild dehydration
How is simple gas colic diagnosed?
- History
- PE
- Response to treatment
How is Colic treated?
- Analgesia:
- Sedation
- NSAID
- Buscopan
- Lidocaine
- Oral Fluids/laxatives/electrolytes
- withholding food
- Evaluate for further episodes
What are the analgesic options for Colic?
- Sedation: high level of analgesia, short duration, decreases GI motility
- Xylazine: alpha-2 agonist, IV/IM
- Detomidine: alpha-2 agonist
- good choice if surgery is not an option, trying to control moderate to severe pain, or for long trailer ride w/ very painful colic
- Butorphanol: mixed opioid antagonist/agonist
- usually in combo w/ alpha-2 agonist
- GI stasis
- Acepromazine: NO analgesia
- alpha antagonist
- vasodilator - not good for hypovolemia
- NSAIDs:
- Flunixin meglumine = best NSAID on relieving visceral pain
- low to moderate analgesia for 12hr
- Flunixin meglumine = best NSAID on relieving visceral pain
- Buscopan:
- anti-spasmodic and anti-cholinergic
- smooth muscle relaxation
- increased heart rate
- NOT indicated in horses with impactions or ileus
- anti-spasmodic and anti-cholinergic
- Lidocaine: CRI
- some analgesia, anti-inflammatory, and pro-motility effects
- NOT for simple gas colics
What is the idea behind providing oral fluids/laxatives/electrolytes to colic horses?
- May stimulate motility
