Acute Abdomen LA Flashcards
describe clinical signs of mild, moderate, and severe colic in horses
mild:
1. decreased appetite
2. depression, change in attitude
3. lying down
4. stretching out (posturing to urinate)
5. bruxism
6. flehman
moderate:
1. pawing
2. flank watching
3. kicking at abdomen
4. getting up and down
severe:
1. hard to keep standing
2. rolling
3. self-trauma: scrapes, lacerations, swellings of head, tuber coxae, point of hock
describe clinical signs of previous severe colic in horses (that you as the farm vet didn’t get to in time)
- exhausted
- less painful: intestine died, rupture of intestine (stop the stretch)
- maybe resolved, but rarely
describe signs of colic in cows, small ruminants, camelids
all:
1. anorexia
2. away from the herd
3. kicking at abdomen
cows:
1. treading
2. stretching out
3. laying down
4. kyphosis
small ruminants:
1. laying down
2. bruxism
3. vocalizing
4. splinting abdomen
camelids:
1. bruxism
2. groaning
3. getting up and down
4. rolling
describe look-alikes for colic and their signs that can mimic colic
extra abdominal systems
-neuro: botulism
-MSK: laminitis, rhabdomyolysis
-respiratory: pleuropneumonia
-cardiovascular: severe arrhythmias, CHF
signs that are common with colic and look-alikes:
1. pain
2. laying down, unable to/not willing to get up
3. not eating/decreased appetite
describe pathophysiologic categories for GI pain
- non-strangulating obstruction
- strangulating obstruction
- inflammation
- other: thrombotic dz
result in/cause pain via:
1. stretch receptors: distension, mesentery
2. chemoreceptors: ischemia, inflammation
describe intestinal (small and large) differentials for non-strangulating obstructions in horses
small intestine:
1. ileal impaction: MOST COMMON
2. other:
-ascarid
-ileal hypertrophy
-foreign body
large intestine:
1. spasmodic/unknown = most common
2. impactions:
-feed, sand, fecalith/bezoar, meconium
-of cecum, pelvic flexure, RDC, SC (where tract narrows)
3. enterolith: RDC and aboral/caudal to RDC
4. large colon displacements
-right dorsal displacement (RDDLC): colon ends up right of and under cecum
-left dorsal displacement (LDDLC): gets stuck between spleen and kidney
describe intestinal non-strangulating obstructions for other large animals
small intestine:
-camel: phyto/tricho bezoars
-cattle: fat necrosis
-small ruminants, pigs: foreign body
large intestine:
-camel: spiral colon fecalith, cecal impaction, atresia coli
-cattle: cecal dilation/dislocation, atresia coli
-pigs: spiral colon fecalith, constipation
describe strangulating obstructions in horse intestines
SI:
1. strangulating lipoma
2. epiploic foreign body entrapment
3. inguinal hernia
4. segmental volvulus
5. intussusception
6. gastrosplenic
and more!
LI:
1. large colon volvulus
2. SC strangulating lipoma
3. intussusception
describe intestinal strangulating obstructions in other large animals
small:
1. mesenteric volvulus
2. intussusception
3. camelid: epiploic foramen entrapment
4. cattle: hemorrhagic bowel syndrome/jejunal hemorrhage syndrome (blood clots obstruct lumen, thrombosis of mesentery)
large:
1. intussusception
2. camelids: spiral colon torsion
3. ruminants: cecal torsion/volvulus
4. pigs: mesenteric volvulus
describe inflammatory intestinal causes of acute abdomen
small:
1. anterior enteritis
2. IBD: RARELY presents as colic!
large:
1. colitis
2. typhlocolitis: cecum inflammation
3. IBD
describe next steps for non-strangulating, strangulating, and inflammatory lesions for horses for a field vet
non-strangulating:
-small: refer, medical tx to start in hospital
-large: treat or refer, medical tx to start
strangulating:
-small: refer or euthanize, sx or euthanize once refer
-large: refer or euthanize in field, sx or euthanize once refer
inflammatory:
-refer! will begin with medical treatment in hospital
describe next steps for acute abdomen in other LA
- surgery is more common than in horses
- more stoic animals than horses:
-if colic: concern for strangulating
-severe NSO: rupture reported somewhat frequently - diagnostic:
-high yield answers
-cattle standing: relatively low cost and risk - medical management;
-if confident inflammatory
-or for constipation in pigs
describe the diagnostic approach to acute abdomen
- signalment, history
-age, sex, breed
-increased incidence = increased index of suspicion
-response to pain and interpretation of clinical signs - basic colic exam
-PE
-NGT (horse)
-rectal (horse and cow) - select additional diagnostics:
-ultrasound
-abdominocentesis
-bloodwork
describe causes of acute abdomen in horses by AGE
foal:
-ascarid impactions
-jejunal intussusception
older:
-strangulating lipoma
clinical signs: older more stoic
describe causes of acute abdomen in cattle by AGE
calves:
-intussusception: most calves <2 months
-atresia: within 2-3 days
-volvulus: most common 1wk-6mo
adults:
-HBS usually >4yr
-cecal dilation/torsion
clinical signs: older more stoic
describe causes of acute abdomen by SEX
- peripartum mares:
-GI: LCV, cecal perforation
-extra-GI: uterine torsion, uterine artery - stallions: inguinal hernia, testicular torsion
- cows: cecal dilation/dislocation/torsion/volvulus (and abomasal dz)
clinical signs: mares more stoic, especially with foal
describe causes of acute abdomen in horses by BREED
- miniatures: non-strangulating LI like fecoliths
- STB, SB, TWH: inguinal hernia (if male)
- arabian, SB, morgan: enterolith
clinical signs: drafts and gaited often more stoic
describe causes of acute abdomen in cattle by BREED
- brown swiss: HBS, intussusception
- dairy breeds: cecal dilation/dislocation/torsion/volvulus
- angus and jersey: mesenteric fat necrosis
group colic by degree of severity and location
non-strangulating obstruction:
small intestine and large intestine: variable
strangulating obstruction:
-small and large intestine: severe at some point
inflammatory:
-small and large: mild/depressed if distension not severe
relate history and index of suspicion for differential diagnostics for acute abdomen
- manure:
-diarrhea: colitis, SC impaction
-cecal impaction: decreased, smaller piles/balls
-HBS: scant feces, melena - previous colic:
-recurrence LDDLC 2.5-21%
-adhesions in 20% of horses following colic surgery - medication:
-colitis and used antibiotics, could cause clostridium overgrowth
-NSAIDs: can cause RD colitis and cecal impaction - preventative care:
-tapeworms: can cause ileocecal intussusception and ileal impaction
-if the first dewormer was recent, could indicate ascarids - geography:
California: enteroliths common
-Arizona: sand due to sandy soil - time of year:
-HBS fall and winter - diet:
-alfalfa hay: enteroliths
-bermuda/coastal hay: ileal impaction - exercise:
-stall rest can cause cecal impaction - vices:
-cribbing: think EFE - repro:
-post breeding/collection: inguinal hernia
-peripartum mare:
–GI: LCV, cecal perforation
–non GI: uterine torsion, uterine artery bleed
-cows:
–freshening: cecal dilation/dislocation/torsion/volvulus
–peak milk production: HBS
