Colic Flashcards
Define colic
a generic term describing clinical signs associated with presence of abdominal pain
2 main pathophysiological mechanisms that can lead to colic
- Interference with blood supply to one of the abdominal components
- Inflammation within or around those components
What can cause interference with blood supply to abdominal organs? (3)
obstruction
strangulation
infarction
3 things that can cause obstruction
impaction (food or parasite)
enteroliths
neoplasia
3 things that can cause strangulation?
torsion
volvulus
pedunculated neoplasia
2 things that can cause infarction
parasitic embolism
post-op complications
What can cause inflammation within or around the abdominal components? (3)
(this is basically a list of 3 types of inflammation)
enteritis
peritonitis
colitis
What is an addition pathophysiological mechanism that can cause abdominal pain?
excessive stretching of walls of hollow organs or surrounding mesentery can also activate pain receptors; this stretching can be independent of interference with blood supply and inflammation or as a result of one or both of those things
List the 5 disease categories resulting from abdominal pain
- Abnormal feed intake
- Intestinal parasites
- Foreign body ingestion
- Neoplasia
- Abdominal organ displacement
What 3 things are considered abnormal feed intake and what do they result in?
- Ingestion of too much of the wrong food can cause excess fermentation, excess gas accumulation, and stimulate inflammation which can lead to impaction
- Ingestion of wrong type of food that causes excess fermentation that can lead to impaction and inflammation
- Ingestion of undigestible food/FB resulting in impaction or obstruction
What 2 problems can be caused by intestinal parasites?
- impaction due to large number of parasites
2. infarction due to aberrant migration of parasites leading to a parasitic embolism
What 2 things can neoplasia cause?
obstruction
strangulation
What 3 things result in abdominal organ displacement?
strangulation
malpositioning of intestinal tract
volvulus/torsion
Name 3 disorders associated with the stomach
- Ulceration
- Obstruction
- Dilation
What things may result in increased acidity of the stomach?
Due to certain feeding behaviors
- not enough roughages
- lack of ingestion in general
- ingestion of Timothy hay, grain, pelleted foods
What causes stomach ulceration?
increased acidity of the stomach because the continuously secreted HCl isn’t being kept in check
What can cause stomach obsturction?
impaction (food or parasite)
neoplasia
FB
When is a patient at higher risk for stomach obstruction?
decreased water intake
dental Dz
decreased stomach motility
fed beet pulp, bran, straw, wheat, barley
What causes gastric dilation?
ulcers
obstruction
ruptured stomach that leads to peritonitis
What are disorders associated with the small intestine and their causes if applicable (5)
ulcers (acidic stomach pH) infection (bacterial) obstruction (impaction, adhesions) strangulation (neoplasia, volvulus) idiopathic
2 Cecum Dz that may cause abdominal pain
Cecal Tympany- due to gas distention from increased fermentation
Impaction (food or parasite)
2 Large colon Dz that may cause abdominal pain
obstruction (sand impaction, enterolith formation, organ displacement)
strangulation
Although rare, what is the possible small colon disorder that can lead to colic
food impaction
What can occur to the rectum that may result in colic
rectal tear
Clinical Signs of colic
pacing sweating pawing rolling kicking at abdomen looking at flank crouching stretching repeated standing and laying down
What are 2 important questions to consider with colic?
- Where is the problem located?
2. Is it surgical or medical?
What information is often gathered for a colic PE if not severe presentation?
attitude of horse TPR rectal exam monitoring for improvement vs progression alteration of intestinal sounds
What clinicals signs are seen on a PE for colic if severe presentation?
profound depression persistent tachycardia pyrexia hypothermia \+/- tachypnea
If nasogastric reflux is present, where is the problem likely located?
stomach or SI
If distended abdomen in an adult is present, where is the problem likely located?
cecum or large colon
If distended abdomen in an foal is present, where is the problem likely located?
cecum, large colon, or SI
What additional diagnostics may be done for colic patients?
CBC/Serum Chem Panel
-assesses for presence of inflammation and status of organs
Abdominocentesis
-if fluid present, analyze it to determine necessity of surgical intervention and prognosis for patient
Define endotoxemia
an extremely severe, life-threatening condition characterized by toxins circulating through the bloodstream
How does endotoxemia develop?
- via Dz that affects integrity of intestinal mucosa thus allowing bacteria and their toxins into systemic circulation (obstruction, strangulation, infarction)
- result of reperfusion injury that happens following correction of any disorder that interrupts blood supply to intestines
Clinical signs of endotoxemia
severe systemic inflammation rxn extreme weakness/depression pyrexia inflammatory leukogram circulatory shock ileus and laminitis
List 5 nursing strategies for colic
- pain control
- walking
- nasogastric tube passage
- IVF
- anti-inflammatories or antibiotics
Why is pain control important in colic?
improves patient comfort
often makes P easier to handle
What to pay attention to after giving analgesia
if there is a response or not
Why does walking help some colic cases?
alleviates some pain because it stimulates intestinal motiltiy
Why is a nasogastric tube passed? What does it do? What befits does it have?
- helps reveal presence and severity of gastric reflux while also decompressing any gas buildup in stomach
- can also give mineral oil to alleviate impaction
Why are IVF given? When should fluid not be given via nasogastric tube?
-affected segments of intestine often sequester large amounts of fluid within their lumen and contribute to dehydration; do not give via nasogastric tube if nasogastric reflux is present
When are anti-inflammatoires/antibiotics given?
if enteritis or peritonitis is present
What things should be reassessed throughout treatment
- status before re-administering any therapeutics
- TPR
- presence/worsening/improvement of any clinical signs, especially nasogastric reflux and abdominal distention
