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Equine > Colic > Flashcards

Colic Flashcards

1
Q

non strangulating colic

A

muscle spasm, intestinal damage, tense mesenterium

lead to
vasoconstriction
splenic contraction
sweaitng
pain, exhaustrion

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2
Q

stragnulating disorders

A

local circulatory disorder and fluid sequestration
lead to
hypovolaemia

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3
Q

enteritis

A

wall permeabiliity and dysbacteriosis
lead to endotoxaemia

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4
Q

consequences of endotoxaemia

A

inflammatory mediators
DIC
organ dysfunction
vessel dilation
SIRS

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5
Q

consequence of peripheral circulatory failure

A

tissue perfusion
haemoconcetration
azotaemia
metabolic acidosis

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6
Q

aim of examination of colic horse

A

decide between medical and surgical therpay

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7
Q

what 2 systems should you focus on for the examination

A

cardiovascular and gi

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8
Q

normal heart rate

A

28-40bpm

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9
Q

potential rupture heartbeat

A

> 100bpm

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10
Q

physical exam of colic horse

A

behaviour
posture
body surface
skin tent test
skin temp
rectal temp

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11
Q

signs of colic in CV system

A

tachycarida, abnormal premature atrial depolarisation, tachypnoea, labored breathing

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12
Q

abdomen exam - visual

A

degree of distension
location of distension

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13
Q

scrotum exam - visual

A

enlarged
hot/cot
pain/no pain

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14
Q

ausculatation of abdomen location

A

left and right paralumbar fossa
left and right lower abdomen behind the costal arch

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15
Q

types of sounds

A

weak = mixing of ingesta
louder = propulsion of ingesta
longer, toilet flushing sound = right paralumbar fossa, ileo caecal, caeco caecal activity

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16
Q

sounds heard behind the xiphoid cartilage

A

colon

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17
Q

increased borborygmi

A

early stages of enteritis and colitis

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18
Q

reduced or absent sounds

A

impaction
obstruction
hypoperfusion
ileus
dislocation
torsion

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19
Q

aim of rectal palpation

A

diagnosis
distension
displacement

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20
Q

normally palpable in horse
14

A

rectal mucosa
bony pelvis
internal inguinal rings
small colon
bladder
cervix, uterus, ovaries
abdominal aorta
left kidney
spleen
pelvic flexure
left vetnral and dorsal colon
nephrosplienic ligament
base of caecum
peritoneum

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21
Q

FLASH

A

fast localised abdominal sonography of horse

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22
Q

7 regions for US

A

ventral abdomen
left middle 1/3 of abdomen
right middle 1/3 of abdomen
gastric window
duodenal window
renosplenic ligament
cranial vetral thorax

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23
Q

what is an indicator of right dorsal displacment of large colon

A

visualisation of colonic mesenteri vasculature

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24
Q

normal liquid from NG tubing

A

<0.5L

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25
Q

pH of normal NG tubing

A

<=5

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26
Q

needle technique of abdominalcentesis

A

18-19G needle at 90o angle
into ventral part of abdominal wall

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27
Q

teat cannula technique of abdocentesis

A

23-25g needle with 1-2ml of LA
short stab incision

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28
Q

edta tube for

A

nucleated cell count
cytology

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29
Q

plain tube for

A

TP
lactate
glucose

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30
Q

normal abdocentesis findings

A

small amount of fluid
pale/straw yellow
clear (newpaper test)
<25g/l TP
< 5.0 x10’9/L NCC
no RBC

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31
Q

lactate levels in colic

A

increased lactate levels due to low O2 delivery and inadequate oxygen utilisation

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32
Q

cause of spasmodic colic

A

individual susceptibilty
nutritional failure
cold water
meteorological factors
migratroy parasites

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33
Q

pathogenesis of spasmodic colic

A

smooth muscle spasm
hypermotility
vagotonia

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34
Q

clinical signs of spasmodic colic

A

sudden, mild, moderate colic
short bursts
normal vitals
increase borbogymi
spasm
gas production
loose faeces

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35
Q

differential diagnosis of spasmodic colic

A

tympany
ileus
impaction
acute gastric dilation
acute enteric
pregnancy colic
urinary colic

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36
Q

treatment of spasmodic colic

A

spasmolytics - buscopan
nsaids
hand walking
activated charcoal or other absorbents via NG tubing
IV fluids

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37
Q

prognosis of spasmodic colic

A

good if treated early

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38
Q

proximal enteritis is due to

A

unknown
fusarium spp
clostridium, salmonella isolated from reflux
diet change - increasae in concentrates

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39
Q

pathogenesis of proximal enteritis

A

increased secretion
decreased absoprtion
fluid and electrolyte loss
hyperperistalsis
macroscopic changes
haemoconcetnration
hypovolemia
decreased tissue perfusion
oliguria
microscopic changes
hepatic changes
peritoneal fluid

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40
Q

changes of peritoneal fluid in case of proximal enteritis

A

higher TP than in ileus
disproportionate TP to NCC

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41
Q

pathogenesis of increased secreation due to proximal enteritis

A

Na and Cl transported from intersitial to epithelium and to gut lumen
water follows ions

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42
Q

what contribute to secretion

A

bacterial toxins
inflammatory mediators

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43
Q

2 mechanisms for secretion

A

cAMP, cGMP system
Ca system

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44
Q

macroscopic changes of proximal enteritis

A

dark red haemorrhages
yellowish bands

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45
Q

microscopic changes of proximal enteritis

A

degeneration, necrosis, sloughing
neutrophil infiltration
haemorrhage on serosa

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46
Q

heptatic changes of proximal enteritis

A

ascending infection
endotoxins in portal system
biliary stasis
biliary hyperplasia
inflammation

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47
Q

clinical signs of proximal enteritis

A

lethargy
reflux
raised bcv
decreased peristalsis sounds
distended small intestinal loops

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48
Q

Lab analysis of proximal enteritis

A

increased PCV, TP, lactate
Hypo - Na, Cl, K
increased AST, AP, GGT
prerenal azotaemia
metabolic acidosis

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49
Q

abdo centesis of proximal enteritis

A

dark yellow, turbid
increased cell count
TP > 35g/l

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50
Q

differential diagnosis of proximal enteritis

A

mechanical ileus
pancreatitis
ileal impaction
alimentary lymphoma

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51
Q

prognosis of proximal enteritis

A

surgical is better than earlier

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52
Q

complications of proximal enteritis

A

laminitis
decreased body weight
thrombonphlebitis

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53
Q

treatment of proximal enteritis

A

NG tube
fluids
AB
nsaid
analgesia
prokinetic drugs
parenteral feeding

54
Q

fluids for aggressive rehydration in proximal enteritis

A

7% NaCl crystalloids

55
Q

AB for proximal enteritis

A

gentamicin
enrofloxacin
penicillin
metronidazole

56
Q

nsaid for proximal enteritis

A

flunixin

57
Q

analgesia for proximal enteritis

A

butophanol

58
Q

prokinetic drugs for proximal enteritis

A

lidocaine
metoclopramide

59
Q

parenteral feeding of proximal enteritis

A

dextrose
amino acids
lipids
isotonic solution
first 12hrs - 35%
second 12hrs - 60-65%
after 24hrs - 100%

60
Q

prevention of laminitis

A

palaption of hooves and digital arteries
cie poots
cast
ACP and low molecular weight heparin

61
Q

direct causes of diarrhoea

A

increase faecal water and electrolyte content
hypersecretion and malabsorption

62
Q

indirect causes of diarrhoea

A

acute colonic inflammation
enterotoxins bind to secretory receptors
VFA and Na malabsorption
abnormal microflora produces dissolved metabolites
abnormal intestinal motility

63
Q

sequalae of diarrhoea

A

significant and fast loss of Na, K, Cl, HCO3
loss of plasma to intestinal lumen
dehydration, metabolic acidosis, shock, renal insufficiency, death

64
Q

bacterial causes of acute colitis

A

salmenellosis
clostridiosis
neorickettsiosis

65
Q

parasitic causes of acute colitis

A

strongylosis
cyathostominosis
anoplocephalosis

66
Q

toxic causes of acute colitis

A

AB associated diarrhoea
right dorsal colitis
cantharidin toxicsosis

67
Q

misc causes of acute colitis

A

intestinal anaphlaxia
carb overload
sand enteropathy

68
Q

4 clinical forms of salmenellosis

A

carrier state
lethargy, anorexia, fever, neutropenia
peractue, acute entercolitis
speticaemia +/- diarrhoea

69
Q

clinical signs of salmenellosis

A

depression
anorexia
fever, tachycardia, tachypnoea
colic signs
profuse, watery diarrhoea
severe dehydration
prolonged CRT
acute laminitis
reflux
mm are dry, dark red, dirty red, purple

70
Q

rectal palpation of salmenellosis

A

large amounts of gas and fluid in caecum and large colon

71
Q

lab analysis of salmenellosis

A

PCV > 80%
low TP
leukopenia, neutropenia, thrombocytopaenia
hypo - Na, Cl, K
metabolic acidosis
prerenal azotaemia

72
Q

diagnosis of salmenellosis

A

5 faecal samples
rectal biopsy
PCR

73
Q

characterisitcs of salmenellosis

A

zoonotic
enterotoxin -> pge synthesis –> increased secretion –> diarrhoea
salmonella enters enterocytes
fibrinonecrotic typholocolitis
interstitial oedema
intramural thrombosis or infarct
ulcer in large intestine

74
Q

cause of clostridiosis

A

c. perfringens A,B,C
c. difficile

75
Q

clinical signs of clostridiosis

A

death without diarrhoea
typholocolitis
acute laminitis

76
Q

typhlocolitis signs in clostridiosis

A

depression
anorexia
fever, tachycardia, tachypnoea
colic signs
profuse haemorrhagic diarrhoea
dehydration
brick or dirty red mm

77
Q

diagnosis of clostridiosis

A

anaerobic culture
ELISA
PCR

78
Q

cyathostominosis 3rd larval stage

A

may stay in hypobiotic state in caecal and large colon wall

79
Q

cyathostominosis 4th larval stage

A

migrate though large intestinal mucosa

80
Q

clinical signs of cyathostominosis

A

seasonal - early spring following deworming
typhocolitis

81
Q

typhocolitis in cyathostominosis

A

colic signs
severe diarrhoea
decreased body weihgt
dehydration
sc oedema on limbs and ventral abdomen
death

82
Q

diagnosis of cyathostominosis

A

isolation of larva from faeces
rectal biopsy
large colon biopsy

83
Q

antiobiotic associated diarrhoea

A

disruption of normal flora
similar to salmonellosis
diarrhoea developes 2-6days of AB therapy

84
Q

AB associated with antiobiotic associated diarrhoea

A

clindamycin
lincomycin
TTC
trimethoprim
erythromycin
rifamicin
metronidazole

85
Q

diagnosis of antiobiotic associated diarrhoea

A

rule everything else out

86
Q

right dorsal colitis

A

after phenylbutazone admin
gastric ulcers
thickened wall of right dorsal colon

87
Q

diagnosis of right dorsal colitis

A

lapratomy
necroscopy

88
Q

cantharidin toxicosis

A

toxin of blister beetles
difficult to diagnose

89
Q

clinical signs of cantharidin toxicosis

A

anorexia
lethargy
fever
tachycardia
colic signs
diarrhoea
mixed shock
oral, lingual vessicles and ulcers
pollakuria, haematuria, diluted urine

90
Q

colitis x AKA

A

intestinal anaphlyaxia

91
Q

clinical signs of colitis x

A

hypovolaemia and endotoxic shock
abdo pain
profuse diarrhoea
weakness
collapse
death without diarrhoea

92
Q

colitis x and IgE

A

IgE mediated type 1 hypersensitivity localised to large intestine
IgE independant anaphylactoid rxn

93
Q

which part of the large intenstines is hanging freely

A

left part (pelvic flexure)

94
Q

aetology of colic

A

horses cant vomit due to sharp angulation of pylorus
free pelvic flexure
change in diet
poor quality concentrate
low fibre
decreased water parasites

95
Q

EGUS affects

A

any region affected by gastric acid

96
Q

EGUS effects

A

hyperkeratosis to perforation

97
Q

2 types of EGUS

A

equine squamous gastric disease
quine glandular gastric disease

98
Q

ESGD primary

A

associated with intensive managemnet in animals with normal gi tract

99
Q

ESGD secondary

A

occurs secodary to delayed gastric emptying resulting from other disease states

100
Q

EGGD types

A

autonomically - cardia, fundus, antrum, pylorus
descriptively - focal/multifocal/ diffuse. mild/ mod/ severe

101
Q

prevalence of EGUS

A

TB > sport > foals> regular adults

102
Q

cause of ulcers

A

imbalance of
- inciting factors - hcl, pepsini, bile
- protective facotrs - mucus bicarbonate, pge, circulate
acid exposure
extrinsic factors
- NSAIDS, cox1, stress, conc low feeds, low fibre, decreased salive, delayed gastric emptying,
exercise - pressure increases

103
Q

treatment of ulcers

A

continuous feeding
ppi
h2 antagonists - ranitidine
misoprostol
sucralfate

104
Q

acute gastric dilation and impaction
pathogenesis

A

o Fermentation: gas, volatile fatty acids, lactate
o Fluid influx in to lumen of stomach - > gastric dialation and colic, sometimes gastric rupture
o Gastric dialation, colic
o Pressure on diaphragm, compromised respiration
o Decreased venous return
o Hypovolaemic shock
o Gastric rupture

105
Q

acute gastric dilation and pimpaction
clinical signs

A

o Sudden onset, fast progression
o Severe, continuous colic, sweating
o Tachycardia
o Decreased GI motility
o Negative rectal findings
o Diagnostic nasogastric tubing
o Haemoconcentration, Hyperlactataemia
o Enlarged stomach on ultrasound visible on left side

106
Q

acute gastric dilation and pimpaction
diagnosis

A

NG tube
US

107
Q

acute gastric dilation and pimpaction
treatment

A

o Spasmolytics, analgesics
o Stomach tubing and lavage o IV fluid therapy

108
Q

primary gastric content

A

acute gastric dilation

109
Q

secondary gastric content

A

reflux
caused by ileus

110
Q

methods to open abdomen

A

ventral midline
paramedial approach
inguinal approach
median approach (seperate prepuce)
parainguinal
suprapubic paramedia

111
Q

lesions of intestinal wall

A

distension
ischaemic mucosa
vascular closure

112
Q

distension

A

in case of stranguation
can cause permanent damage after 4hrs

113
Q

ischaemic muscosa

A

tips of villi will die
endotoxins enter blood
mainly in small intestine

114
Q

reperfusion injury

A

infiltration by neutrophils
adhesions (postop ileus)

115
Q

right side of taenia

A

antimesenteric side

116
Q

when to operate in case of colic

A

violent colic
worsening clinical signs and lab values
tympany
swollen intestinal wall

117
Q

how to assess intestinal viability

A

fluorescin dye
surface oximetry
doppler
histopath

118
Q

small intestine stragulation obstructions

A
  • Volvulus
  • Epiploic foramen
  • Pedunculated lipoma
  • Mesenterial tears
  • Intussusception
  • Inguinal hernia
    -Umbilical hernia
  • Diaphragmatic hernia
119
Q

small intestines non stragulation obstructions

A
  • Ileum impation
  • Muscular hyperthrophy
  • Ascarid impactions
  • Duodenitis, proximal jejunitis
  • Neoplasia
  • Gastroduodenal obstruction
  • Miscellaneous simple obstruction
120
Q

symptoms of duodenitis - prox jejunitis

A

fever
leucocytosis
reflux
elevated temp

DONT DO SURGERY

121
Q

caecum disorders

A
  • Caecum impaction
  • Caecocaecal invagination
  • Caecocolonal invagination
  • Caecum volvulus, torsion
  • Caecum infarction
122
Q

type I caecum impaction

A

hard –> mechanical

123
Q

type II caecum impaction

A

fluid –> paralytic
(worse)
need to do a jejunumcolostomy

124
Q

diseases of ascending colon

A
  • Large colon tympany
  • Impaction
  • Displacement
  • “Sand colic”
  • Enterolithiasis
  • Large colon displacement
  • large colon torsion
125
Q

RDD
dight dorsal displacement

A

apex of caecum located in pelvis

126
Q

LDD

A

tympanic ventral colon btw spleen and left abdomen
heart rate < 40
lower pcv
no blood flow to spleen

127
Q

most violent colic

A

volvulus / torsion

128
Q

full torsion

A

no artery or venous blood supply

129
Q

half torsion

A

150o rotation
veins are obturated but artery can still bleed - DEATH

130
Q

diseases of descending colon

A

impaction
lipoma pendulans
enterolith

131
Q

non intestinal colic diseases

A
  • Cardiovascular
    o A. iliaca thrombus, pericarditis
  • Thorax
    o Pleutitis, pleuropneumonia
  • Abdomen
    o Neoplasia
    o Abscess
    o Peritonitis
    o Haematoma
  • Liver
    o Cholelithiasis
    o Cholangiohepatitis
  • Spleen
    o Abscess
    o Splenomegaly
  • Urinary tract
    o Nephrolith
    o Pyelonephritis
    o Cystitis
    o Bladder rupture
  • Mare genital tract
    o Ovulation
    o Theca granuloma tumor
    o Uterine torsion
    o Contraction
  • Stallion genital tract
    o Testicle torsion
    o Orchitis
  • Muscle bone
    o Laminitis
    o Rhabdomyolysis
    o Ligamentum prepubicum rupture
  • Nervous system
    o Tetanus
    o Botulism
    o Lyssa
    o END
132
Q

4 types of abdominal hernias

A
  1. umbilical hernia
  2. Traumatic hernia
  3. Postoperative hernia
  4. Prepubic tendon rupture

Equine (25 decks)

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