colic Flashcards
where do gastric ulcers occur
80% in non-glandular area of the stomach and 20% in the glandular area of the stomach
risk factors of gastric ulcers
stress (transportation, housing, social order), nutrition (feeding, frequency), disease, adult horses in training, foals, medications (NSAIDs)
clinical signs of ulcers
weight loss, dull hair coat, poor performance, poor appetite, behavioral changes-pain, recurring colic
diagnosis of ulcers
physical exam/bloodwork, response to treatment, endoscopy (esophagus, stomach, duodenum)
treatment of ulcers
omeprazol (gastroguard-SID), ranitidine (zantac-BID-TID), cemitidine (tegament-TID), antacids (Neigh-lox-q2hr), sucralfate (carafate-BID-QID), address management or training issues, modify diet, treatment duration variable
what is colic?
non-specific term for abdominal pain, gastrointestinal, non-gastrointestinal (uterus, kidneys etc)
clinicals signs of mild colic
inappetence, pawing, looking at sides/flanks, biting at side/flank, frequently up and down, recumbency, mild sweating, “parking out”
clinical signs of severe colic
anorexia, dull attitude/depressed, agitation/restlessness, distended abdomen, rolling, thrashing, self-inflicting trauma, sweating
what causes GI Pain?
tension or mesentary, distended bowl, bowel ischemia or infection, smooth muscle spasms, adhesions, peritonitis (infection of the abdominal cavity)
general risk factors for colic
anatomy, management practices, sand, weather, diet/nutrition, cribbing, pregnancy, NSAIDs
NoN-GI causes of colic
hepatic disease, renal/urinaty tract disease, reproductive tract, laminitis, pleuropneumonia, mycopathy, peritonitis, neoplasia, internal abscesses, ruptured baldder, toxic causes
GI causes of medical colic
primary lymphanic colic (gas), spasmodic colic, impaction/sand, proximal enteritis, most left dorsal displacement, mild right dorsal displacement, gastric or duodenal ulcers
GI causes of surgical colic
enterolithiasis (Ca stone in horse’s gut), pedunculated lipomas, right dorsal displacement, intestinal volvulus, intussusception, hernias, mesenteric rents, mesodiverticular bands, epiploic entrapment
tympanic colic
gas distention or flatulent colic, abdominal distention, passage of large amounts of gas, primary timpani due to microbial fermentation of lush pasture, grain or pelleted feed, secondary timpani due to obstruction of cecum or colon=more serious!, may want to walk the horse
spasmodic colic
spasms and hyper motility of the intestinal tract, loud/frequent gut sounds, bouts of sharp pain, hyper-excitable horses are predisposed, cause unknown (imbalance of autonomic nervous system?, gut irritation by parasites, enterics, bad feed?), very common cause of colic, responsive to NSAIDs (ban amine), spontaneous recovery likely
impactions
dry indigestible feed or sand obstruction, firm/solid feed-filled large colon, ilium, cecum, small colon, common at the pelvic flexure/transverse colon/ileocecal opening., coarse feed, poor dentition, dehydration, cold weather and reduced water intake, dry/mucus covered fecal balls, meconium can impact in foals
left dorsal displacement
nephrosplenic entrapment, large colon becomes lodged in nephrosplenic space, gas distention causes the colon to rise over top of the spleen, at least 180 degree twist, warmbloods and large thoroughbreds more prone, ultrasound:cannot visualize the left kidney
nephrosplenic space
space formed by the left kidney, nephrosplenic ligament, dorsal edge of the spleen and dorsal body wall
medical management
analgesia-xylazine is the drug of choice, ban amine, butorphanol and others may also be used
decompression via nasogastric tube
fluid therapy (electrolyte solution, mineral oil, epsom salt, psyllium hydrophilic mucilloid)
other disease specific medication (buscopan, antibiotics, laminitis prophylaxis)
dietary modification or withhold feed
anthelmintics
dentistry
cardinal signs for going to surgery
severe abdominal pain that is refractory to analgesics, 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, better to go to surgery earlier than later
strangluation
vascular supply is cut off, acute/rapid/severe clinical course, severe unrelenting pain, sweating/increased heart rate and respiratory rate, more ischemia=more necrosis=poorer prognosis
strangulation pathophysiology
venous return stopped, region swells as arteries continue pumping blood, arteries cease to pump blood in, ischemia and necrosis of the region, loss of mucosal barrier integrity, bacteria and endotoxins move across compromised barrier into the bloodstream, loss of fluids and electrolytes
pedunculated colic
benign fatty tumor, wraps around small intestine (rarely small colon), closed loop strangulating obstruction, common in geldings and ponies >12 years old, +/- overweight, dissension, ileum and gastric reflux, surgical removal required
intussusception
telescoping of a piece of bowel into an adjacent segment, ileum/jejunum/cecum, caused by change in motility (enterics, diet changes,parasites, intestinal surgery or foreign body, acute or chronic pain, depression, anorexia, gradual shock and dehydration, stabilize and correct surgery
