Colic Flashcards
Colic
Abdominal pain
What is the #1 predisposing factor for colic?
Management
What causes ileal impaction?
Coastal bermuda
How much does a normal horse drink in a day?
5-10 gallons
How do you encourage a horse to drink?
ass gatorade, molasses or salt to the water to encourage drinking
How many piles of manure are normal in a horse?
8-11 piles
Most common places for impaction?
Pelvic flexure Right dorsal colon Transverse colon small colon Gastric impaction
How do you diagnose Sand impactions?
Auscultation
Fecal float/sink
Abdominocentesis - sand
Where do you commonly find sand impaction?
Right dorsal colon
Medical treatment of colonic impactions
Fluid therapy
Surgical treatment of colonic impactions
Pelvic flexure enterotomy
What is the treatment for verminous arteritis?
Anthelmintic/ivermectin
Where do you find anoplocephala perfoliata?
Ileocecal junction
What do Anoplocephala perfoliata cause?
Ileocecal intussusception
Where do you find Enteroliths/Bezoars?
Transverse colon
Strangulating lesions
Lipoma
Volvulus/torsion of large colon
Epiploic foramen entrapment
Mesenteric volvulus
Treatment of Lipoma
Exploratory celiotomy
Boundaries for Epiploic foramen entrapment
Caudate process of the liver
Portal vein
Gastropancreatic fold
Predisposing factors of Epiploic foramen entrapment
Cribbing
Treatment of Epiploic foramen entrapment
Manual reduction
Complication of Epiploic foramen entrapment
Portal vein tear
Where is Volvulus/torsion common?
Large colon
Risk factors of large colon torsion
Post parturient mare
diet change
recent access to lush pasture
What is the first thing to do after the PE for colic?
NG tube placement
What drugs can you use for relaxation of the rectum?
Lidocaine
Buscopan
What can be palpated in the middle abdomen?
Aorta
Inguinal rings
Small colon
What can be palpated in the right abdomen?
Cecum
Colon
R ovary
What can be palpated in the left abdomen?
left kidney
Spleen
Left ovary
Complications of NG intubation
Iatrogenic epistaxis
Tube in trachea
What should you never do if reflux is present?
give medication through the tube
What causes copious amounts of net reflux?
Anterior enteritis
Impaction
Strangulation
What causes smaller amount of net reflux?
large colon compressing duodenum
Pain management for Colic
NSAIDs
Alpha-2-agonists
Opioids
Spasmolytics
What is severe persistent pain unresponsive to medication an indication for?
Surgery
What are the causes for colic in a newborn foal?
Meconium impaction Gastric ulceration Enteritis Inguinal hernia with ruptured tunic sepsis
What are the causes for colic in a 2-5 days old foal?
Ruptured bladder
Gastric ulcers
Enteritis
What are the causes for colic in an older foal?
Gastroduodenal ulcer Enteritis SI volvulus Intussusception Impaction
What is the colt predisposition to colic?
Meconium impaction
inguinal hernia
What is the filly predisposition to colic?
Ruptured bladder
Ureteral abnormalities
Clinical signs of colic in the foal
On their back
Stretched out
straining
Pain management for foal colic
Benzodiazepine
Alpha 2s
NSAIDs
What drugs should not be used in foals less than 2 weeks of age?
Xyalazine
Treatment of inguinal hernia in newborns
Surgical intervention
IgG
Abx
Pain control
How do you approach males with ruptured bladder during surgery?
Dorsal aspect of the bladder
Ruptured bladder treatment
Medically stabilize
Surgery after stabilization
Fluids with calcium
Ruptured bladder surgery
Ventral midline Remove urachal remnants Double ligate umbilical arteries and vein Trim edges of tear Broad spectrum abx
Treatment of Ascarid impaction
SI enterotomy
What ascarid is responsible for Ascarid impaction?
Parascaris equorum
What is the treatment of Intussusception in older foals?
Surgical intervention:
Manually reduce
What is secondary to Gastric outflow obstruction?
pyloric stenosis from ulceration
What is the treatment for Gastric outflow obstruction?
Gastroduodenostomy
What is the best approach for celiotomy in the horse?
Ventral midline
What are two bad indicators of the exploratory celiotomy in horses?
Loss of negative pressure
Foul smell
Post op care for Colic surgery
CV support Pain management Anti-endotoxin therapy Prevent/treat infection Restore GI function Manage complication
What is the daily maintenance of a horse ?
50ml/kg/day
What abnormalities are common during recovery from colic surgery?
Hypocalcemia
Hypomagnesemia
What should you supplement in fluids for recovery from colic surgery?
Potassium
Calcium
Magnesium
What is the rate of potassium supplementation?
0.5mEq/kg/hr
What causes hypokalemia?
lack of intake
Diuresis
GI loss through diarrhea
When should you discontinue medication for recovery from colic surgery?
When the animal is eating, afebrile, and normal CBC
What is common during recovery from colic surgery?
Endotoxemia
Post op ileus
What fluids do you use for Cardiovascular volume and pressure?
Colloids
How do you manage endotoxemia?
FLUIDS! Flunixin meglumine DTO smectite (Biosponge) Polymixin B Plasma Heparin therapy
What is the most common lesion leading to POI during colic surgery recovery?
Strangulating SI
POI treatment
NG decompression
Fluids
Abx
Prokinetics: Lidocaine, Metoclopramide, Erythromycin
What does a Lidocaine CRI do for equine recovery from colic surgery?
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
What does a Metoclopramide do for equine recovery from colic surgery?
Increased ACH release
Stimulates smooth muscle in stomach and SI
Toxicity/Extrapyramidal effects
What does a Erythromycin do for equine recovery from colic surgery?
Motilin agonist
What are the sie effects of using Erythromycin?
Cramping
Colic
What are the incisional complications of colic surgery?
Infection
hernia
Suture sinus formation
Acute incisional dehiscnece
What is the most common complication from incisional infection?
Incisional hernia
Predisposing factors for acute total dehiscence
Violent recovery
Severe post op pain
Prolonged surgery time
Continuous suture pattern
What is the second most common reason for repeat surgery after colic surgery?
Adhesions
In what age group is adhesions most common after colic surgery?
Foals
How do you prevent adhesion formation after colic surgery?
Maintain intact mesothelial layer
Minimize trauma
Periop NSAIDs and Abx
Peritonitis Treatment
Stabilize patient FLUIDS NSAIDs Abx Closed drains