Colic Flashcards
What are the sources of abdominal pain?
Originating from GI proper
- stretch of GIT wall
- pull on mesentary
- inflammation in intesintal wall
- pain from ischemia
Originating from peritoneum
- stimulation of inflammatory mediators
- stimulation of reflexes leading to decreased mobility and distention
What are consequences of a lack of aboral flow in the gIT?
Distention with gas or fluid
- rapidity and severity depends on degree of obstruction
- distended bowel likely to be palpable transrectally
Backflow of content
- large vol can accumulate in large colon
- small intestinal obstructions result in reflux in hose
Compromise of vsculature or bowel wall
-inflmmatory abdominal fluid -
CV collapse
What do you expect heart rate to be in a case with simple obstruction ?
Normal to slightly elevated (40-70)
What do you expect heart rate to be in strangulating lesions?
Very elevated
Early 50-90
Late 70-120
Pulse rates over _______ are seen in diseases that produced severe cardiovascular compromise and are therefore more likely fatal
80
Fever with a colic indicates what etiology
Infectious
Eg salmonellosis or PHF
What breeds of horses are known for being stoic?
Draught horses
Ponies
Donkeys
Grade this colic
Pawing occasionally
Walking and looking at flanks
Mild
Grade this colic
Up and down constantly Walking Quivering Rolling Trashing
External injuries
Severe
Grade this colic
Paying, kicking abdomen with hind limbs
Crouching and getting up and down
Moderate
How can you tell the difference between colic pain and laminitis pain?
Colic horses are continuously moving
Laminitis horse are planted
In what quadrant would you find the small intestine and small colon?j
LD
In what quadrant would you find the large colon?
LV and RV
In what quadrant would you find the cecum?
RD
How many contractions per minute should you hear in the RD quadrant
1-3
T/:F you can evaluate motility of the GIT from a single auscultation
False
Need multiple auscultations to evaluate change
Both increased and decreased motility are significant
T/F: most strangulating lesions manifest in increased GI sounds initially?
True
What are the two types of motility?
Propulsive and segmental
Abdominal enlargement proximal (under ribs). Are associated with what pathology?
Small intestine
Cranial displacement of the LC
If the flank area is blown up like a tick, what pathology is this associated with?
Large colon involvement
Can be associated with generalized peritonitis and GIT rupture
What are the only two situations in which you would do a percutaneous decompression?
Surgery is refused by client and want to try incase decompression helps resolve (salvage procedure)
Severe compromise that can lead to life threatening situations — prolong survival to surgery
What is likely the cause of an enlargement in the right flank?
Gas accumulation in the cecum
An enlargement in the left flank is likely due to ??
Large colon
What are complications associated with percutaneous decompression
Peritonitis
Rupture (very rarely)
What should be the FIRST procedure attempted when evaluating a moderate to severe colic horse
Especially if HR > 70-80bpm
Nasogastric intubation
T/F: you would expect more volume of reflux with a strangulating lesion compared to a non strangulating lesion
True
A reflux volume > ______ is considered significant
2
If you have a small volume of reflux..
what should you consider as the cause?
Very early in disease
Very proximal SI disease
Generalized ileus causing SI reflux
Enlargement of LC, enough to start causing outflow obstruction from stomach
An alkaline pH with a large amount of reflux localized lesion to ??
Small intestine
T/F: small intestine in normally palpated in the left dorsal quadrant in a healthy horse
False
Should not normally be able to palpate small intestine unless abnormal (distended)
What are the normal values for an abdominocentesis for TP, WBC, and RBC?
Tp < 2.5
WBC < 5000-10000 cells/uL
RBC none
What is the progression of fluid changes due to strangulation lesions?
1 hour: increase protein
3-4hrs: increased RBC
6 hrs: WBC incensed
High white blood cells and hyperfibrinogenemia are expected with what kind of colic diseses?
Longer duration infectious processes
Eg chronic septic peritonitis form intra abdominal abscessation or occasionally masses/tumors
T/F: In inflammatory colics, there is often a low normal total WBC count from CBC
True
Resection of increased degree of endotoxemia
What is the most clearly identified risk factor for colic?
Diet
- changes in feeding practices
- change in type of concentrate
- change in type of batch hay
- feeding large amounts of concentrates
- feeding round bales or atypical hay
Exercise pattern
- increased risk with increased housing
- increased time spent stabled
- decreased access to pasture
History of previous colic
What are the pathophysiologic causes of GI colic?
True obstructions
— simple obstruction ( non strangulating)
—strangulating
Non strangulating infarction (thromboembolic )
— parasitic migration (s. Vulgaris)
Ulceration
Inflammatory pain
— enteritis, colitis
— peritonitis
— mucosal, mural, peritoneal
Strangulating OR non-strangulating?
Acute
Mild to moderate pain
HR 60-70bpm
CRT >2sec, pulses normal
Increased resp rate
Non- strangulating
Changes seen on abdominocentesis associated with non strangulating colic?
Typically normal TP and WBC
As disease progresses TP will increase first followed by WBC
RBC seen once disease has progressed enough to cause gut wall compromise
Strangulating or non-strangulating?
Sever pain
HR 80-100pm
CRT 3sec, toxic line, congested mm
RR increased
Strangulating
What changes do you expect to see in an abdominocentesis in a colic with a strangulating lesion?
Slight serosanguinous with mild increase in protein and WBC
TP, WBC, and RBC will all be incresed
Toxic neutrophil follow
TP> 3 and RBC > 20,000 —> severe irreversible necrosis
Tp> 5.4 —> survival in SI disease is markedly decreased
What analgesics will you use for a spasmodic and/or mild colic?
Flunixin meguline
Dipyrone : spasmolytic —> only for spasmolytic colics
Buscopan (related to dipyrone)
What analgesics will you use in a moderate to severe colic?
Xylazine - effective within 5mintues
Detomidine — more potent is Xylazine not cutting it.. or lasts longer for transport
Butorphanol
Good for GI pain, and no decrease in motility
(Usually give with xylazine)
