Colic Flashcards
Colic
-non-specific term for abdominal pain
-can be gastrointestinal
-can be non-gastrointestinal
What can present as colic?
pneumonia and muscle pain
Can colic lead to laminitis?
yes
Can laminitis lead to colic?
yes
Are the majority of colics gastrointestinal or non-gastrointestinal?
gastrointestinal
Where can colic occur non-gastrointestinally?
-liver
-spleen
-kidneys
-repro tract
Non-gastrointestinal causes of colic
-hepatic disease
-renal/urinary tract disease
-reproductive tract
-laminitis
-pleuropneumonia
-myopathy
-peritonitis
-neoplasia
-internal abscesses
-ruptured bladder (foal)
-toxic causes (NSAIDS, blister beetle, poisonous plants, etc.)
Mild colic clinical signs:
-increased HR (50-55)
-discolored mucous membranes
-inappetence (only eats good food)
-pawing
-looking at sides/flanks
-biting at sides/flanks
-frequently up and down
-recumbency
-mild sweating
-“parking out”
Moderate to severe colic clinical signs:
-increased HR (60-65)
-discolored mucous membranes (white, brick red, purple)
-anorexia
-dull attitude/depressed
-agitation/restlessness
-distended abdomen
-rolling
-thrashing
-self-inflicted trauma
-sweating
What causes GI pain:
-tension on mesentary (the bowel itself)
-distended bowel
-bowel ischemia or infraction
-smooth muscle spasms
-adhesions (parts of the organs get glued to each other)
-peritonitis
What causes GI pain:
-tension on mesentary (the bowel itself)
-distended bowel
-bowel ischemia or infraction
-smooth muscle spasms
-adhesions (parts of the organs get glued to each other)
-peritonitisG
General colic risk factors:
-anatomy
-management practices (when feed, what feed, how feed, turnout, etc.)
-sand
-weather (dramatic changes, extreme weather, dehydration)
-diet/nutrition
-cribbing
-pregnancy
-NSAIDS
Why can a horses stomach explode?
it doesn’t reach the abdominal wall when its full, so horses do not get the feeling of being “full” and can keep eating until their stomach explodes
What is a common site in the intestines for blockage?
the pelvic flexure (in between the left ventral colon and dorsal colon)
What is the path of food through the GI tract?
stomach - duodenum - jujunum - ileum - cecum - right ventral colon - sternal flexure - left ventral colon - pelvic flexure - left dorsal colon - transverse colon - descending colon - rectum
Plumbing goes from ______ to _______ size
large to small
When should you walk a horse that is colicing?
only walk them when they are thrashing, rolling, pawing, etc. (don’t walk them when they are standing or laying quietly)
Medical GI causes of colic:
-primary tympanic colic
-spasmodic colic
-impactions/sand
-proximal enteritis
-most left dorsal displacements (nephrosplenic entrapment)
-mild right dorsal displacements
-gastric or duodenal ulcers
Which colic self resolves?
spasmodic colic
What is done to resolve medical colics?
medications are given and palpations
Surgical GI causes of colic
-enterolithiasis
-pedunculated lipomas
-right dorsal displacements
-intestinal volvulus
-intussusceptions
-hernias
-mesenteric rents
-epiploic entrapment
Enterolithiasis
calcified deposit (usually from alfalfa)
Pedunculated lipomas
loops/loop strangles the intestine
Intestinal volvulus
surgery reconnects live parts of the body
Hernias
when an organ is somewhere it shouldn’t be
Mesenteric rents
a mesenteric tare
-loop goes through the tare
Who is more prone to epiploic entrapment?
cribbers
What are signs your horse should go to surgery?
-severe abdominal pain that is refractory to analgesics (won’t react to banamine)
-abnormal peritoneal fluid (discolored/hemorrhagic; increased protein and white cell count)
-distended or displaced bowel on rectal exam
-progressive deterioration of cardiovascular status
-significant gastric reflux
-recurrent abdominal pain with unknown etiology
Characteristics of tympanic colic
-gas distension or flatulent colic
-abdominal distension
-passage of large amounts of gas
What causes primary tympany colic?
microbial fermentation of lush pasture, grain, or pelleted feed
What causes secondary tympany colic?
obstruction of the cecum or colon
Is primary or secondary tympany more serious?
secondary
Characteristics of spasmatic colic:
-spasm and hypermotility of intestinal tract
-loud, frequent gut sounds
-bouts of sharp pain
-very common cause of colic
-spontaneous recovery
-responsive to NSAIDS
What causes spasmodic colic?
unknown but could be
-imbalances in autonomic nervous system
-gut irritation by parasites, enteritis, bad feed
What types of horses are predisposed to spasmodic colic?
hyperexcitable horses
Characteristics of impaction/sand colic
-dry or indigestible feed or sand obstruction
-firm, sand/feed filled large colon, ileum, cecum, small colon
Where does impaction colic often occur?
-pelvic flexure
-transverse colon (at right dorsal colon)
-ileocecal opening
-dry mucus covered fecal balls
What can cause impaction colic?
-coarse feed
-poor dentition
-dehydration
-cold weather and reduced water intake
-meconium in foals
Characteristics of left dorsal displacement:
-nephrosplenic entrapment
-nephrosplenic space (space formed by the left kidney, nephrosplenic ligament, dorsal edge of the spleen, and dorsal body wall
-large colon becomes lodged in nephrosplenic space
-gas distention causes colon to rise over top of the spleen
-180 degree twist
What to look for when ultrasounding for a left dorsal displacement?
you cannot visualize the left kidney
What horses are more prone to left dorsal displacements?
warmbloods and large thoroughbreds
What is the medical management of a left dorsal displacement?
-at a farm or equine hospital
-analgesia (banamine is first administered, then xylazine, then butorphanol)
-decompression via nasogastric tube
-fluid therapy (oral or IV) - electrolyte solution, mineral oil, epsom salts, psyllium hydrophilic mucilloid
-buscopan, antibiotics, laminitis prophylaxis
-dietary modification or withhold feed
-anthelminitics
-dentistry
Strangulation colic
vascular supply cut-off (an area of the intestines)
Pathophysiology of strangulation
-venous return stopped
-region swells as arteries continue pumping blood
-arteries cease to pump blood in
-ischemia and necrosis of that region
-loss of mucosal barrier integrity (bacteria and endotoxin move across compromised intestinal wall; loss of fluid/electrolytes)
-dehydration
-cardiovascular compromise due to endotoxic shock
-decreased peripheral perfusion
Symptoms of strangulation:
-acute, rapid, and severe clinical course
-sever, unrelenting pain
-sweating
-increased HR
-increased RR
-more ischemic = more necrosis = poorer prognosis (need to move fast)
Characteristics of pedunculated lipoma
-pendunculated benign fatty tumor (“ball and chain”; mesenteric fat)
-wraps around small intestine (rarely colon)
-closed loop strangulating obstruction
Symptoms of pedunculated lipoma?
distension, ileus, and gastric reflux
What horses are more prone to pedunculated lipoma?
-geldings and ponies > 12 yrs. old
-horses that are over or under weight
Characteristics of Intussusception
-telescoping of a piece of bowel into an adjacent segment
-ileum, jejunum, cecum
-stabilize and correct surgically
Causes of intussusception
-caused by a change in motility
-enteritis
-diet changes
-parasites (ascarids, tapeworms, migration, treatement)
-intestinal surgery or foreign body
Symptoms of intussusception
-acute or chronic pain
-depression, anorexia
-gradual shock and dehydration
