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Module 16 > Approach to Conditions of GIT in the Foal and Horse > Flashcards

Approach to Conditions of GIT in the Foal and Horse Flashcards

1
Q

what are the classifications of colic (5)

A
  1. simple medical: spasmodic, flatulent/tympanic
  2. obstructive
  3. non strangulating infarction
  4. enteritis/colitis
  5. false colic
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2
Q

what are the types of obstructive colics (4)

A
  1. intraluminal
  2. extraluminal
  3. strangulating
  4. ileus
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3
Q

what are intraluminal obstructive colics (2)

A
  1. impaction
  2. enterolith
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4
Q

what are extraluminal obstructive colics (4)

A
  1. displacement
  2. compression
  3. adhesion
  4. mural mass
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5
Q

is the degree of pain a foal is in linked to the severity of the condition

A

no

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6
Q

what are foals more prone to (4)

A
  1. meconium impaction (<24 hours)
  2. congenital abnormalities
  3. intussusception
  4. pyloric stenosis
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7
Q

what are weanlings prone to

A

ascarid impactions

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8
Q

what information do we need to prioritize for our ddx

A

recent colic history

management history

medical history

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9
Q

what are some history questions you want to know from the owner (8)

A
  1. try to assess the duration: when did signs start, last seen normal
  2. assess severity: what colic signs? be specific
  3. fecal output? amount and consistency
  4. appetite
  5. management: feeding (any changes), turnout/stable, exercise, deworming, dental history
  6. access to pasture
  7. types of pasture
  8. concentrate (type, amount, changes)
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10
Q

what does coastal bermuda hay cause

A

ileal impactions

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11
Q

what can alfalfa hay cause

A

enterolithiasis

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12
Q

what are stabled horses more susceptible to

A

impactions

pelvic flexure > cecal > gastric

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13
Q

what parasites are associated with colic (2)

A
  1. anoplocephala perfoliata (tapeworm): ileal impaction, intussusceptions
  2. strongylus vulgaris: non-strangulating infarction
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14
Q

what is the relationship between dentals and colic (2)

A
  1. increasing time since last dental exam increases risk of large colon impaction –> poor dentition leads to longer fibre length
  2. recent over rasping also causes impactions
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15
Q

what medical history can increase the risk of colics (3)

A
  1. previous colic or colic surgery
  2. recent NSAID or antimicrobials (colitis)
  3. orthopaedic injury
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16
Q

how do orthopaedic injuries increase the risk of colic

A

pain increased risk of cecal impaction

stable rest increases risk of pelvic flexure impaction

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17
Q

what should you observe before you examine the horse (5)

A
  1. assess pain level
  2. muscle fasciculations
  3. sweating
  4. abdominal contour (distention)
  5. environement (feed quality, water, bedding)
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18
Q

what should you do before you admin sedation or analgesics (5)

A
  1. heart rate
  2. mucus membranes
  3. pulse quality
  4. respiratory rate
  5. GI sounds?
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19
Q

what heart rate is concerning

A

> 60 bpm

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20
Q

how can you determine if there is endotoxemia in your clinical exam

A

toxic line –> dilation of capillary beds in the mouth

21
Q

what should you listen for in you GI auscultations

A

assess over 4 quadrants

increased vs decreased sounds

gas ‘ping’

22
Q

what else should be in your physical exam (6)

A
  1. BCS
  2. resp auscultation
  3. digital pulses
  4. assess for trauma (eyes, limbs)
  5. check jugular veins
  6. temperature
23
Q

when should you perform immediately an NG intubation (3)

A
  1. reflux seen from nostrils
  2. HR >60bpm
  3. gastric dilation on US
24
Q

what are the risks of nasogastric intubation (4)

A
  1. tracheal intubation (aspiration pneumonia)
  2. hemorrhage from ethmoturbinates (ensure placement is in ventral meatus)
  3. trauma to retropharyngeal recess or esophagus (lubrication, gentle pressure, extra caution if dehydrated)
  4. gastric rupture (not too much water)
25
Q

how do you create a siphon with NG intubation

A

use water to create a siphon action

measure water in and reflux out, calculate the net reflux

26
Q

how much net reflex is considered normal

A

<2 L

27
Q

how much net reflex indicates lack of gastric emptying and what colics might be present

A

>2L

ileus, obstruction, enteritis

28
Q

what might indicate gastric impaction with NG intubation

A

copious amounts of feed on lavage

29
Q

is gastric reflux a significant finding always

A

yes

30
Q

what does transrectal palpation allow you to assess

A

contents of caudal abdomen

31
Q

what might be required to facilitate a transrectal palpation (3)

A
  1. sedation
  2. buscopan
  3. twitch
32
Q

what are the risks of a rectal palpation

A
  1. rectal tear
  2. injury to you
33
Q

how can you prevent rectal tearing (5)

A
  1. appropriate restraint
  2. lubrication
  3. relaxation
  4. increased risk if stallion, Arab, very small, dehydration
  5. do not push against contractions
34
Q

what is present dorsally in a rectal palpation

A

aorta

35
Q

what is felt in the left of the rectal palpation

A

kidney, spleen agaisnt body wall

36
Q

what is felt in the ventral left of the rectal palpation

A

pelvic flexure

37
Q

what is felt in the right of the rectal palpation

A

band of cecum

38
Q

what is rectal palpation most useful for (2)

A
  1. impactions of the large or small colon (firm contents palpated)
  2. gas distention: displacement/torsion (tight teniae bands –> possibly in abnormal orientation)
39
Q

where is the left dorsal and ventral colon normally found

A

left side medial to the spleen, smooth colon dorsal, sacculated colon ventrally

40
Q

what would indicate a colon impaction

A

abnormal contents in the left dorsal and ventral colon, pelvic flexure

41
Q

where is the cecum normally found

A

right side with bands palpable

42
Q

what would indicate a cecal impaction

A

abnormal contents in the cecum on rectal palpation

43
Q

what would indicate a cecal torsion

A

abnormal position in rectal palpation

44
Q

what should you be able to feel with the small colon

A

fecal balls, anti mesenteric band

45
Q

what findings are always significant with transrectal palpation (4)

A
  1. small intestine is always abnormal
  2. tight bands from distention/displacement
  3. abnormal organ position or content
  4. free gas of feed material (rupture)
46
Q

what should you do if there is a rectal tear (5)

A
  1. immediately inform owner (boss, insurance)
  2. assess extent of the tear (rectal palpation or endoscopy)
  3. recommend referral for all grade 2, 3, or 4 tears or if you feel further assessment is required
  4. anitmicrobials
  5. reduce straining and further fecal contamination (epidural anesthesia, rectal packing, buscopan)
47
Q

what should you do if you plan to refer (3)

A
  1. speak to hospital (history and details of drug admin, ask for cost)
  2. prepare client (estimate cost for medical care and/or surgery)
  3. stabilize patient for transport
48
Q

how wouls you stabilize a patient for referral (3)

A
  1. analgesia approrpiate for duration of travel
  2. place NG tube in place if reflux (one way valve ex. glove finger with hole)
  3. fluid therapy if required (clinical dehydration) IV or enteral (not if suspect SI abnormality)

Module 16 (26 decks)

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