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RUSVM Large Animal Surgery 2017 > Colic > Flashcards

Colic Flashcards

1
Q

Colic

A

Abdominal pain

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2
Q

What is the #1 predisposing factor for colic?

A

Management

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3
Q

What causes ileal impaction?

A

Coastal bermuda

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4
Q

How much does a normal horse drink in a day?

A

5-10 gallons

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5
Q

How do you encourage a horse to drink?

A

ass gatorade, molasses or salt to the water to encourage drinking

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6
Q

How many piles of manure are normal in a horse?

A

8-11 piles

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7
Q

Most common places for impaction?

A 
Pelvic flexure
Right dorsal colon 
Transverse colon 
small colon 
Gastric impaction
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8
Q

How do you diagnose Sand impactions?

A

Auscultation
Fecal float/sink
Abdominocentesis - sand

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9
Q

Where do you commonly find sand impaction?

A

Right dorsal colon

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10
Q

Medical treatment of colonic impactions

A

Fluid therapy

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11
Q

Surgical treatment of colonic impactions

A

Pelvic flexure enterotomy

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12
Q

What is the treatment for verminous arteritis?

A

Anthelmintic/ivermectin

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13
Q

Where do you find anoplocephala perfoliata?

A

Ileocecal junction

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14
Q

What do Anoplocephala perfoliata cause?

A

Ileocecal intussusception

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15
Q

Where do you find Enteroliths/Bezoars?

A

Transverse colon

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16
Q

Strangulating lesions

A

Lipoma
Volvulus/torsion of large colon
Epiploic foramen entrapment
Mesenteric volvulus

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17
Q

Treatment of Lipoma

A

Exploratory celiotomy

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18
Q

Boundaries for Epiploic foramen entrapment

A

Caudate process of the liver
Portal vein
Gastropancreatic fold

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19
Q

Predisposing factors of Epiploic foramen entrapment

A

Cribbing

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20
Q

Treatment of Epiploic foramen entrapment

A

Manual reduction

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21
Q

Complication of Epiploic foramen entrapment

A

Portal vein tear

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22
Q

Where is Volvulus/torsion common?

A

Large colon

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23
Q

Risk factors of large colon torsion

A

Post parturient mare
diet change
recent access to lush pasture

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24
Q

What is the first thing to do after the PE for colic?

A

NG tube placement

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25
Q

What drugs can you use for relaxation of the rectum?

A

Lidocaine

Buscopan

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26
Q

What can be palpated in the middle abdomen?

A

Aorta
Inguinal rings
Small colon

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27
Q

What can be palpated in the right abdomen?

A

Cecum
Colon
R ovary

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28
Q

What can be palpated in the left abdomen?

A

left kidney
Spleen
Left ovary

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29
Q

Complications of NG intubation

A

Iatrogenic epistaxis

Tube in trachea

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30
Q

What should you never do if reflux is present?

A

give medication through the tube

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31
Q

What causes copious amounts of net reflux?

A

Anterior enteritis
Impaction
Strangulation

32
Q

What causes smaller amount of net reflux?

A

large colon compressing duodenum

33
Q

Pain management for Colic

A

NSAIDs
Alpha-2-agonists
Opioids
Spasmolytics

34
Q

What is severe persistent pain unresponsive to medication an indication for?

A

Surgery

35
Q

What are the causes for colic in a newborn foal?

A 
Meconium impaction 
Gastric ulceration 
Enteritis
Inguinal hernia with ruptured tunic 
sepsis
36
Q

What are the causes for colic in a 2-5 days old foal?

A

Ruptured bladder
Gastric ulcers
Enteritis

37
Q

What are the causes for colic in an older foal?

A 
Gastroduodenal ulcer
Enteritis
SI volvulus 
Intussusception 
Impaction
38
Q

What is the colt predisposition to colic?

A

Meconium impaction

inguinal hernia

39
Q

What is the filly predisposition to colic?

A

Ruptured bladder

Ureteral abnormalities

40
Q

Clinical signs of colic in the foal

A

On their back
Stretched out
straining

41
Q

Pain management for foal colic

A

Benzodiazepine
Alpha 2s
NSAIDs

42
Q

What drugs should not be used in foals less than 2 weeks of age?

A

Xyalazine

43
Q

Treatment of inguinal hernia in newborns

A

Surgical intervention
IgG
Abx
Pain control

44
Q

How do you approach males with ruptured bladder during surgery?

A

Dorsal aspect of the bladder

45
Q

Ruptured bladder treatment

A

Medically stabilize
Surgery after stabilization
Fluids with calcium

46
Q

Ruptured bladder surgery

A 
Ventral midline 
Remove urachal remnants
Double ligate umbilical arteries and vein 
Trim edges of tear 
Broad spectrum abx
47
Q

Treatment of Ascarid impaction

A

SI enterotomy

48
Q

What ascarid is responsible for Ascarid impaction?

A

Parascaris equorum

49
Q

What is the treatment of Intussusception in older foals?

A

Surgical intervention:

Manually reduce

50
Q

What is secondary to Gastric outflow obstruction?

A

pyloric stenosis from ulceration

51
Q

What is the treatment for Gastric outflow obstruction?

A

Gastroduodenostomy

52
Q

What is the best approach for celiotomy in the horse?

A

Ventral midline

53
Q

What are two bad indicators of the exploratory celiotomy in horses?

A

Loss of negative pressure

Foul smell

54
Q

Post op care for Colic surgery

A 
CV support 
Pain management 
Anti-endotoxin therapy 
Prevent/treat infection 
Restore GI function 
Manage complication
55
Q

What is the daily maintenance of a horse ?

A

50ml/kg/day

56
Q

What abnormalities are common during recovery from colic surgery?

A

Hypocalcemia

Hypomagnesemia

57
Q

What should you supplement in fluids for recovery from colic surgery?

A

Potassium
Calcium
Magnesium

58
Q

What is the rate of potassium supplementation?

A

0.5mEq/kg/hr

59
Q

What causes hypokalemia?

A

lack of intake
Diuresis
GI loss through diarrhea

60
Q

When should you discontinue medication for recovery from colic surgery?

A

When the animal is eating, afebrile, and normal CBC

61
Q

What is common during recovery from colic surgery?

A

Endotoxemia

Post op ileus

62
Q

What fluids do you use for Cardiovascular volume and pressure?

A

Colloids

63
Q

How do you manage endotoxemia?

A 
FLUIDS!
Flunixin meglumine 
DTO smectite (Biosponge)
Polymixin B
Plasma
Heparin therapy
64
Q

What is the most common lesion leading to POI during colic surgery recovery?

A

Strangulating SI

65
Q

POI treatment

A

NG decompression
Fluids
Abx
Prokinetics: Lidocaine, Metoclopramide, Erythromycin

66
Q

What does a Lidocaine CRI do for equine recovery from colic surgery?

A

Decreased catecholamines
Suppresses primary afferent neuron activity
Directly stimulates smooth muscle
Inhibits prostaglandin decreasing inflammation in gut wall, granulocyte migration/lysosomal enzyme release, free radical production

67
Q

What does a Metoclopramide do for equine recovery from colic surgery?

A

Increased ACH release
Stimulates smooth muscle in stomach and SI
Toxicity/Extrapyramidal effects

68
Q

What does a Erythromycin do for equine recovery from colic surgery?

A

Motilin agonist

69
Q

What are the sie effects of using Erythromycin?

A

Cramping

Colic

70
Q

What are the incisional complications of colic surgery?

A

Infection
hernia
Suture sinus formation
Acute incisional dehiscnece

71
Q

What is the most common complication from incisional infection?

A

Incisional hernia

72
Q

Predisposing factors for acute total dehiscence

A

Violent recovery
Severe post op pain
Prolonged surgery time
Continuous suture pattern

73
Q

What is the second most common reason for repeat surgery after colic surgery?

A

Adhesions

74
Q

In what age group is adhesions most common after colic surgery?

A

Foals

75
Q

How do you prevent adhesion formation after colic surgery?

A

Maintain intact mesothelial layer
Minimize trauma
Periop NSAIDs and Abx

76
Q

Peritonitis Treatment

A 
Stabilize patient 
FLUIDS
NSAIDs
Abx
Closed drains

RUSVM Large Animal Surgery 2017 (14 decks)

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