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Veterinary Equines Finals > Colic > Flashcards

Colic Flashcards

Types of colic Rectal exam Ulcers & diarrhoea Foal colic Choke Rectal tear grading

1
Q

List possible caecal colics

A

Caecal impaction

Caecal intussusception

Caecal tympany

Caecal volvulus

Non-strangulating infarction

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2
Q

Breed and age predilection for caecal impaction colic

A

Arabians

Appaloosa

> 15 years

(this might be different in hospitalised horses)

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3
Q

Risk factors for caecal impaction colic

A
  • Poor quality, coarse roughage
  • Poor dentition
  • Parasites: Anaplocephala perfoliata
  • Lack of exercise while using NSAID’s (hospital)
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4
Q

Two groups of cecal impactions

A

Mechanical obstruction - hard ingesta

Motility dysfunction - fluid ingesta with distention

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5
Q

Most likely diagnosis:

Decreased appetite and faecal output. Mild colic signs for days to weeks.

A

Cecal impaction colic

NOTE: cecal perforation can occur with little to no signs of colic

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6
Q

Rectal examination findings in suspect cecal impaction colic

A
  • Early in the course - tight (could be thickened) ventral band of cecum from right caudo-dorsal to cranio-ventral
  • Round cecal base may be palpable in the right caudo-dorsal abdomen
  • As it progresses the colon will empy and cecum gets heavier - not able to diagnose the impaction per rectum = abdomenl US
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7
Q

Factors that are important to note when performing an abdominal US on a suspect cecal impaction colic

A

Thickness of cecal wall

Texture of content

Will differentiate between mechanical obstruction and motility dysfunction

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8
Q

How to differentiate cecum from colon during rectal examination with suspect cecal impaction

A

If the distended structure is the cecum the examiner will not be able to pass a hand over the impaction dorsally because the cecum is attached to the dorsal body wall

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9
Q

Average thickness of equine cecal wall

A

18mm (0.18cm)

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10
Q

Average thickness of the equine duodenum

A

19.5mm (0.195cm)

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11
Q

Average thickness of the equine jejunum

A

18mm (0.18cm)

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12
Q

Average size of the equine stomach

(transcutaneous abdominal US)

A

5 intercostal spaces

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13
Q

Differential diagnoses for mild abdominal pain

A
  • Simple / nonstrangulating obstruction of the GI tract
    • Feed / sand impaction of large colon
    • Enterolithiasis
    • Large colon displacement
    • Tympany
    • Small colon impaction
    • Ileal impaction
    • Non-strangulatin infarction of the cecum (A. perfoliata)
    • Cecocecal / cecocolic intussesception
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14
Q

Medical management of cecal impaction

A
  • Keep off feed
  • IV and oral fluids
  • Laxatives / cathartics - MgSO4, psyllium
  • Analgesics - Flunixin meglumin (1.1mg/kg IV Q12)
  • Careful monitoring: repeated physical and rectal exams
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15
Q

Most important complications of cecal impaction colic

A

Cecal perforation - 25% - 57%

Recurrence - 13% - 29%

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16
Q

Name the 2 types of cecal intussesceptions

A

Cecocecal intussusception - apex invert into cecal body

Cecocolic intussusception - into the right ventral colon

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17
Q

Breed and age predisposition for cecal intussesception

A

Young horses: < 3 years

Standardbreds

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18
Q

Risk factors for cecal intussusception

A

Infectious factors:

  • Salmonella - abscessation of cecal wall
  • Strongylus vulgaris
  • Cyathostomins
  • Anaplocephala perfoliata

Dietary changes

Use of organophosphates

Use of parasympathomimetic drugs

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19
Q

Most likely diagnosis:

Mild, intermittent abdominal pain, scant feces, weight loss

Physical examination:

Normal with mild to moderate tachycardia and prolonged CRT

A

Chronic cecal intussusception

  • might alos have a fever
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20
Q

DD’s for a firm viscus in the right dorsal abdomen

A
  • Feed / sand impaction in the large colon
  • Right dorsal colon impaction with right dorsal displacement
  • Non-strangulating infarction of the cecum
  • Cecal impaction
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21
Q

DD’s for change in faecal output and character

A
  • Infectious colitis
  • Sand colitis
  • Cecal impaction
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22
Q

DD’s for abdominal pain associated with fever

A

Infectious colitis

Sand colitis

Small colon impaction

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23
Q

Treatment for both forms of cecal intussusception

A

Surgery

Prognosis is good if resection of compromised cecum is possible

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24
Q

Risk factors for cecal perforation

A
  • Brood mares at parturition
  • Cecal impactions
  • Infection with Anaplicephala perfoliata
  • Use of NSAID’s in hospitalised patients (for non GI problems)
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25
Q

Most likely diagnosis:

Broodmare post parturition showing signs of endotoxic shock (toxic MM’s), muscle fasiculations, tachycardia, tachypnoea, cold extremities, prolonges CRT

A

Cecal perforation during parturition

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26
Q

Pathophysiology for the following causes of cecal perforation:

- Broodmare postpartum

- NSAID’s

- A. perfoliata infection

(don’t forget cecal impaction)

A
  • Cecal distension cause by altered motility that rutpures due to increased abdominal pressure
  • Related to ulceration and masking signs of fluid / motility dysfunction cecal impaction
  • Unknown
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27
Q

DD’s for endotoxaemia

A

Colitis

Typhlitis

Enteritis

Large colon volvulus

Non-strangulatin infarction of large colon and cecum

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28
Q

DD’s for septic peritonitis

A

Cecal perforation

Gastric rupture

Idiopathic peritonitis

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29
Q

Rectal palpation findings in suspect cecal perforation

A

Pneumoperitoneum - floating sensation

Roughening of the surfaces of intestines - ingesta and fibrin formation

Crepitus over the cecum - associated with perforation

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30
Q

T/F: There is no nasogastric reflux with cecal perforation

A

False: Nasogastric reflux may occur due to ileus secondary to endotoxaemia and peritonitis

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31
Q

Most likely blood work results in the case of cecal perforation

A

Blood work will be consistent with endotoxemic shock

  • Haemoconcentration (increased Ht)
  • Leukopaenia due to Neutropaenia with a left shift
  • Azotaemia
  • Increased lactate
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32
Q

Expected findings on abdomintocentesis in a suspect cecal perforation case

A

Mixed population of intracellular bacteria and plant material

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33
Q

Expected findings of abdominal US in a suspect cecal perforation case

A

Increased abdominal fluid with a mixed echogenicity with hyperechoic, shadowing gas bubbles

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34
Q

Expected findings on a colic work-up for a suspect cecal perforation

A

Rectal palpation:

Pneumoperitoneum

Rough surface of intestines - food and fibrin

Nasogastric reflux:

Present due to ileus secondary to endotoxaemia

CBC:

Decreased Ht, leukopaenia (neutropania), Azotaemia, high lactate

Abdominocentesis:

Mixed population of intracellular bacteria

Abdominal US:

Increased abdominal fluid with mixed echogenicity

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35
Q

Treatment options for cecal perforation

A

None

Humane euthanasia

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36
Q

Causes of cecal tympany

A

Usualy secondary to large colon obstruction:

  • Feed / sand impaction
  • Large colon displacement
  • Large colon tympany
  • Large colon intraluminal obstruction
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37
Q

Causes of cecal volvulus

A

Congenital abnormalities of cecocolic fold and dorsal body wall attachment - increased movement of caecum

Secondary to large colon volvulus

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38
Q

Explain nonstrangulating infarction of the caecum

A

Loss of blood supply to the caecum not associated with strangulations

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39
Q

Risk factors of non-strangulating infarction of the equine caecum

A

High parasite load:

Strongylus vulgaris

Cyathostomin larvae

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40
Q

Etiology and pathophysiology of non-strangulating infarction of the caecum

A

Strongylus vulgaris - verminous arteritis (mesenteric artery and its branches)

Larval Cyathostomins - multifocal infarctions secondary to infestation with larval cyathostomins

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41
Q

Causes of Gastric dilation

A

Primary: After consumption of highly fermentable material (grain, grass clippings, apples)

Secondary: Reflux of SI fluid retrograde into the stomach due to SI obstruction / SI dysfunction with proximal duodenitis, jejunitis, post-op ileus

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42
Q

Physical findings:

Tachycardia, tachypnea

Decreased GI sounds

Depressed with colic signs, fever, dehydration

A

Gastric dilation

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43
Q

Diagnose suspected gastric dilation

A

US - Stomach is normally 5 intercostal spaces (primary)

(SI hypomotility and distention (secondary))

Nasogastric tube - reflux of 10-20L

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44
Q

When having trouble passing the NGT through the cardia

A

Administer 20 - 40mL 2% Lidocaine down the NGT - promote cardiac sphincter relaxation

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45
Q

DD’s and possible complications of gastric dilation

A

DD’s:
Gastric impaction

Complication:

Gastric rupture

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46
Q

Definition of gastric impaction

A

Distension of the stomach with feed or a phytobezoar or trichobezoar

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47
Q

Which age group is most susceptible to trochobezoar

A

Foals: Indiscriminate hair ingestion

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48
Q

Risk factors for gastric impaction

A

Poor quality roughage

Beet pulp, wheat bran

Poor dentition

Dehydration

Concurrent GI disease resulting in generalised poor GI motility

Pyloric outflow obstruction

Actue / Chronic hepatic disease

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49
Q
A
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50
Q

Expected findings when passing a NGT in a suspect gastric impaction

A

Difficult to pass the NGT through the cardia - horse shows signs of pain

No significant reflux - feed is hard, dry and fibrous

Stale, fermented smell

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51
Q

Therapeutic goals for gastric impaction

A

Prevent gastric rupture

Hydrate gastric content to promote gastric emptying

Resolve inciting, concurrent intestinal obstruction (if present)

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52
Q

Risk factors for gastric rutpure

A

Any mechanical or functional lesion resulting in gastric outflow obstruction:

Gastric dilation / impaction

Gastric outflow obstruction

Grain overload

Gastric ulcerations (adult and foals)

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53
Q

Exepcted findings during a colic workup of a suspect gastric rupture:

A

Physical exam:

Profuse sweating with tachypnea

Depressed with injected MM’s (purple to grey) with increase CRT

Decreased to absent gut sounds

Rectal palpation:
Serosal surfaces feel “gritty” with pneumoperitoneum

CBC:

Polycythemia due to haemoconcentration

Leukopaenic

Hyperlactatemia >5mmol/L

Abdominal US:

Evaluation of dorsal abdomen obscured due to pneumoperitoneum

Increased free fluid with mixed echogenicity

Abdominocentesis:

Green/brown to haemorrhagic fluid - foul smelling

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54
Q

Racehorses and performance horses in active training are predisposed to which GI related condition

A

Gastric ulcers

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55
Q

Risk factors for gastric ulcers in horses

A

High concentrate diet

Stress: Shipping, showing, racing, training

Anorexia

NSAID’s and corticosteroid therapy

GI disease

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56
Q

Conditions associated with gastric ulcers in horses

A

Inflammatory bowel disease (IBD: idiopathic or autoimmune)

Gastric outflow obstruction

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57
Q

Most likely dagnosis:

Inappetence and depressed

Bruxism and hypersalivation

Weight loss

Discomfort when girthing or mounting

Hypersensitive to leg aids

Decreased performance (acute / chronic)

A

Gastric ulcers

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58
Q

List the mechanisms responsible for protecting the gastric mucosa from the extremely acidic gastric contents in horses

A

Mucus-Bicarbonate barrier

Gastric mucosal blood flow - Supported by prostaglandins like Prostaglandin E2

Eating, stimulating secretion of alkaline saliva

Absorption of gastric secretions by roughage

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59
Q

Confirmatory test for gastric ulcers

A

Gastroscopy

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60
Q

Therapeutic goals for gastric ulcers

A

Eliminate predisposing disease, stress, dietary cause

Increase gastric pH - limit further mucosa damage

Promote mucosal blood flow and support healing

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61
Q

Treatment of gastric ulcers

A

Disconitnue any NSAID’s

Decrease dietary concentrated and permit access to pasture

Proton pump inhibitors: Omeprazole (4 mg/kg PO Q24)

Mucosal protectants: Sucralfate (20mg/kg PO Q12)

Continue acid suppression therapy for 3-4 weeks to ensure complete mucosal healing

62
Q

Possible drug interactions when treating gastric ulcers

A

Sucralfate may prevent absorption of other drugs thus should not be given within 1-2 hours of other medications.

Especially H2 receptor antagonists (Cimetidin, Ranitidine)

63
Q

Foals with gastric ulcers are usualy diagnosed with which GI disorder

A

Gastroduodenal ulcer disease (GDUD)

64
Q

Most likely diagnosis:

Foals with mild colic

Bruxism and hypersalivation

Inappetence and diarrhoea with poor condition

A

Gastroduodenal ulcer disease (GDUD)

65
Q

DD’s for GDUD in foals

A

Infectious enterocolitis

Pyloric stenosis (congenital)

Small intestinal obstructive lesions

66
Q

Confirmatory test for GDUD in foals

A

Gastroduodenoscopy

67
Q

Risk factors for large colon impaction colic

A
  • High grain diet
  • Change in exercise - increased stabling
  • Cribbing / windsucking
  • Parasites
  • Dental abnormalities
  • Medication: Amitraz, atropine, general anaesthesia
  • Cold weather and cold water = decreased intake
68
Q

Types of large colon impaction colic

A

Primary large colon impaction

Secondary large colon impaction

69
Q

Cause of secondary large colon impaction

A
  • Right dorsal colon displacement
  • Enteroliths
  • Fecaliths
  • Bezoars
  • Dehydration of ingesta in large colon secondary to SI obstruction (not a true impaction)
70
Q

History and chief complaint:

Horse presented with mild - moderate colic with decreased to absent faecal production

Most likely diagnosis

A

Large colon impaction

71
Q

Most common intestinal sites for impaction

A

Pelvic flexure

Transverse colon

Right dorsal colon - ileocecal valve

72
Q
A
73
Q
A
74
Q

Therapeutic goals for large colon impaction colic

A

Hydrating ingesta

Pain management

Monitoring: Be aware of any GI or cardiovascular compromise

75
Q

Acute general treatment of large colon impaction

A
  1. Withhold all feed!!
  2. Enteral fluid: Iso / Hypotonic fluid, 3-6L every 2-3 hours
  3. IV fluid: replace fluid deficits especially if nasogastric reflux is present (2x maintenance: 120ml/kg/d)
  4. Cathartics / laxatives: MgSO4
  5. Analgesics: Flunixin meglumine @ 1.1mg/kg IV Q12
76
Q

Chronic treatment of large colon impaction colic

A

Dietary modification: grass and complete pelleted food

Stimulate water intake

Make any changes gradually: amount of stabling time

77
Q

Recommended monitoring for large colon impaction colic

A

Unrelenting pain

Nasogastric reflux

Progressive abdominal distension

Systemic deterioration: increase HR, Poor pulse quality cold extremeties, increased CRT

GI deterioration: Abdomincentesis to evaluate

78
Q

Causes of large colon intraluminal obstructions

A

Fecalith

Trichobezoar

Phytobezoar

Combinations of above

79
Q

Predisposition for fecalith

A

Miniature horse

80
Q

Predisposition for trichophytobezoar

A

Miniature horse foals

81
Q

Risk factors for fecaliths

A

Poor quality roughage

Poor dentition

Decreased water consumption

82
Q

Risk factors for trichophytobezoar

A

Foals chewing on the mare’s tail

Access to foreign material in conjunction with inadequate exercise (boredom)

83
Q

Possible complications of fecaliths / thrichophytobezoar (large colon intraluminal obstructions)

A

Postoperative complications: Diarrhoea, inappetence, impaction at surgical site

84
Q

Acute general treatment of large colon intraluminal obstructions (fecalith / trichophytobezoar)

A

Surgical exploration and removal

85
Q

Chronic treatment for large colon intraluminal obstruction (fecalith / thrichophytobezoar)

A

Provide good quality roughage

Fresh water

Apptopriate dental care

86
Q

What is large colon intussusception

A

One segment of the colon telescoping into an adjacent segment of the colon

  • Colo-colic intussusception
87
Q

Predisposition for large colon intussusception

A

Young horses < 3 years

  • same as for other forms of intussusception
88
Q

History:

Mild, recurrent colic with soft feces

Mild tachycardia, increased temperature and variable borborygmi

2 yr old horse

A

Large colon intussusception

89
Q

Cause of large colon intussusception

A

Hypermotility

  • could also be associated with intraluminal mass in the leading edge of the intussusceptum
90
Q

Most common sites for colo-colic intussusception

A

Left ventral colon

Left dorsal colon

Pelvic flexure

91
Q

Expected findings during a colic work-up for a suspected colo-colic intussusception

A

Rectal palpation:

Distended parge colon and cecum - most consistent finding

If palpable the intussusception will feel like a doughy mass

NGT:

Reflux is not expected

CBC:

Leukocytosis, hyperfibrinoginemia

Abdominocentesis:

Increased fluid with nucleated cells and variable protein

92
Q

Acute general treatment of colo-colic intussuscpetion

A

Surgical reduction / resection

93
Q

Predisposition for left dorsal displacement of the large colon

(Nephrosplenic entrapment)

A

Large breed horses

94
Q

Risk factor left dorsal displacement of the large colon (neprhosplenic entrapment)

A

Deep nephrosplenic space

  • Possibly why large breed horses are predisposed to LDDLC
95
Q
A
96
Q

History:

Horse showing mild to moderate colic signs, with no fecal production and a slight abdominal distension in the left paralumbar fossa

Most likely diagnosis

A

Left dorsal displacement with large colon tympany

(Nephrosplenic entrapment)

97
Q

Pathophysiolocy of nephrosplenic entrapment

A

Changes in motility and gas distension = abnormal migration of the pevlic flexure

Abnormal migration:

  1. Left large colon can migrate lateral to the spleen and dorssaly until it reaches the nephrosplenic space
  2. Pelvic flexure migrate cranially then caudally and pass through the nephrosplenic space from cranial to caudal
  3. Left colon rotates 180 so that left dorsal colon is ventral to the left ventral colon
98
Q

Expected findings during a colic work-up for a suspect left dorsal displacement (neprhosplenic entrapment)

A

Rectal palpation:
Distended large colon caudal to neprhosplenic space and compressed within the nephrosplenic space

Ventro-medial displacement of the spleen

Can’t palpate the nephrosplenic space / ligament

NGT:

Present in 43% - almost half the cases: pressure on the duodenum of tenstion of the mesentery

CBC:

Normal

Abdomincentesis:
Splenic blood

Abdomnial US:

Can’t visualise the left kidney adjacent to the spleen

99
Q

Acute general treatment of a neprhosplenic entrapment

A

If pain and distension is not severe:

Phenylephrine @ 3-6ug/kg/min for 15 min = Splenic contraction (Monitor for reflex bradycardia)

Then walk / trot / lunge

If pain and distension is severe:

Surgical exploration

100
Q

Possible complications of medical management of neprhosplenic entrapment

A

Rupture

Displacment

Volvulus

(All of the large colon)

101
Q

Recommended monitoring of medically managed nephrosplenic entrapment

A

Unrelenting pain

Nasogastric reflux

Progressive abdominal distension

Systemic deterioration: increased HR, prolonged CRT, poor pulse quality, cold extremeties

102
Q

Risk factors for large colon nonstrangulating infarctions

A

High parasite load - Strongylus vulgaris

Coagulopathies associated with severe GI disease and sepsis = predispose to thromboembolic disease

103
Q

How does Strongylus vulgaris cause large colon nonstrangulating infarction

A

Verminous arteritis of the cranial mesenteric artery: larval migration

104
Q

Predisposition for right dorsal colon displacement

A

Large breed horses

105
Q

Pathophysiology of right dorsal displacement

A
106
Q

Expected findings during a colic work-up of a suspect right dorsal displacement colic

A

Rectal palpation:

Distended large colon with bands coursing transversely across the abdomen

Can’t palpate the ventral band of the cecum

Can’t palpate the pelvic flexure

NGT:

May be present due to pressure on the duodenum

Blood work:

Normal or similar to mild dehydration (prerenal azotemia, elevated packed cells, elevated total protein)

107
Q

Acute general treatment of right dorsal displacmenet

A

Surgical explortionis recommended: can’t be diagnosed otherwise

108
Q

What is large colon tynpany

A

Commonly known as gas / spasmodic colic

Accumulation of gas in the large colon secondary to excessive fermentation or functional obstruction (ileus)

109
Q

Risk factors for gas / spasmodic colic (large colon tympany)

A

Highly fermentable diet (high carbohydrate)

Roughage with high surface area (cut grass)

Tapeworm infestation (A. perfoliata)

History of colic

Recent travel

Poor dentition

110
Q

Acute general treatment of gas / spasmodic colic (large colon tympany)

A
  1. Withhold feed
  2. Analgesics: Flunixin meglumine, a2 agonists, butorphanol
  3. IV fluids - support cardiovascular function & treat dehydration
  4. Gentle exercise - walking: may stimulate GI motility = natural evacuation of gas
111
Q

What is colonic volvulus

A

Rotation of the colon around the mesenteric axis (same as the long axis of the large colon)

112
Q

Predisposition to large colon volvulus

A

Postpartum mares

Recent diet change: exposure to lush pastures

113
Q

Most common location for large colon volvulus

A

At the level of the ceco-colic ligament

  • Less commonly at the level of the sternal-diaphragmatic flexure
114
Q

DD’s for severe colic

A

Large colon volvulus (morethan 270 degrees is strangulating)

Strangulating lesions of the SI:

  1. SI volvulus
  2. Epiploic foramen entrapment
  3. Strangulating lipome
  4. Severe colitis
115
Q

DD’s for large intestinal distention on recta palpation

A

Feed / sand impaction

Enterolithiasis

Large colon tympany

Large colon displacement

Intraluminal obstructions

116
Q

DD’s for endotoxaemia (Colic related)

A

Large colon volvulus (more than 270 degrees is strangulating)

Colitis

Nonstrangulating infarction of the large colon

117
Q

Expected findings during a colic work-up for a suspect large conlon volvulus

A

Rectal palpation:

Normal or sever gas distension of colon and cecum

NGT:

Reflux is unlikely

CBC:
Normal or Leukopaenia due to Neurtopaenia with a left shift = increased severity of systemic compromise

VBG:
Hyperlactatemia = poor perfusion and ischemia of strangulated area

Abdominocentesis:

Normal (evennin sever cases) or Increased TP (decreased prognosis)

Abdominal US:

Thickening of large colon wall

(patient is usually to painful for abdominal US)

118
Q

Acute general treatment of large colon volvulus

A

Preoperative stabilization - rapid fluid resuscitation

Surgical correction of large colon volvulus

During surgery: asses viability of the large colon

Post-op care:

Fluid therapy, colloid support, antiendotoxic treatment, antimicrobials and pain management

119
Q

Cause of small colon impaction

A

Fecal impaction: physical obstruction of the small colon with feces

120
Q

Predisposition for small colon impaction

A

Young horses

Elderly horses >15yrs

Miniature / ponies

Mares

121
Q

Risk factors of small colon impaction

A

Ingesting bedding

Poor quality roughage

Poor dentition

Inadequate hydration

Parasitiv damage

Motility issues

IBD

122
Q

Etiology of small colon impaction (Fecal impaction)

A

Idiopathic

Salmonella infection

Poor dentition

123
Q

DD’s for small colon non-strangulating lesions (early stages)

A

Small colon enterolith

Small colon fecaliht

Small colon bezoar

Small colon neoplasia

Small colon foreign body

124
Q

DD’s for small colon nonstrangulating lesions (later stages)

A

Small colon lipoma

Small colon intussusception

Small colon volvulus

Small colon herniation

125
Q

Expected findings during a colic work-up of a suspect small colon impaction

A

Rectal palpation:

Cylindrycal, firm, sausage shaped small colon

Distended large colon

Occasionally distended small intestines

CBC:

Leukopaenia / leukocytosis with left shift

Adbdominocentesis:

Normal or Increased protein and WCC, serosanguineous fluid

Abdominal US:

Gas distended large colon

126
Q

Acute general treatment of small colon impaction

A
  1. Withhold feed
  2. Analgesics: Flunixin meglumine (1.1mg/kg IV Q12)
  3. Fluid therapy: IV and oral (if no reflux)
  4. Laxatives: MgSO4 (1g/kg PO Q24)
  5. Butylscopolamine (0.3mg/kg IV) (Buscopan)
127
Q

Possible complications of small colon impaction

A

Peritonitis

Endotoxaemia

Laminitis

Adhesions

Reobstruction

Jugular thrombophlebitis

Diarrhoea

Pyrexia

Incisional infection / hernia

Recurrent colic

128
Q

IMPORTANT NOTE for horses with small colon impaction

A

43% are diagnosed with Salmonella infection

= FECAL CULTURE / PCR

129
Q

Chronic treatment of small colon impaction

A

Nutrition NB

Low-residue diet = prevent trauma to the small colon for 5 - 7 days

130
Q

Which small colon colic commonly presents as a rectal prolapse?

A

Small colon intussusception

131
Q

DDs for small colon intussusception (commonly presents as rectal prolapse)

A

SC lipoma

SC volvulus / impaction

SC enterolith / fecalith / bezoar

SC neoplasia

132
Q

Acute general treatment of small colon intussusception

A

Analgesics: Flunixin meglumine 1.1mg/kg IV Q12

Fluid therapy: dependent on hydration status

Surgery

133
Q

Possible complications of small colon intussusception and treatment

A

Peritonitis

Enteritis

Adhesions

Incisional infection / herniation

Pyrexia

Diarrhoea

Jugular thrombophlebitis

Laminitis

Reobstruction

Recurrent colic

134
Q

Recommende monitoring after treating small colon intussusception

A

Pain management

Reflux

Abdominal distension

Fecal output

PVC / TP

135
Q

Predisposition for strangulatin lipoma

A

Fat horses

Geldings

>15 yrs (no younger than 9 yrs)

Ponies / Quarter horses / Standardbreds

136
Q

DD’s for strangulating lipoma

A

SC enterolith / fecalith / bezoar

SC impaction / volvulus / intussusception

SC neoplasia / foreign body

137
Q

Expected findings during a colic work-up of a suspect strangulating lipoma

A

Rectal palpation:

Difficult to enter abdomen

Gas distended large colon / SI (secondary)

CBC:
Leukopenia / leukocytosis / normal

Abdominocentesis:

Increased protein and WCC with serosanguineous appearance

Abdominal US

Gas distende large colon / SI distension

138
Q

Acute general treatment of strangulating lipoma

A

Analgesics: Flunixin meglumine 1.1mg/kg IV Q12

Fluid therapy

Exploratory celiotomy if unresponsive to analgesics

139
Q

Possible complications of strangulating lipoma and treatment

A

Peritonitis / Enteritis

Laminitis

Adhesions

Reobstruction / recurrent colic

Diarrhoea

Pyrexia

Jugular thrombophlebitis

Incisional infection / hernia

140
Q

Recommended monitoring after treating strangulating lipoma

A

Pain management

Progressive abdominal distension

Fecal output

Reflux

PCV / TP

141
Q

Cause of Ascarid impaction in the SI

A

Parascaris equorum

142
Q

Predisposition for SI Ascarid impaction

A

Young horses (5 months): foals, weanlings, yearlings

143
Q

Risk factors for SI Ascarid impaction

A

Poor parasite control

Deworming foals with paralytinc dewormers:

  • Ivermectin (ML)
  • Pyrantel (Pyrimidine)
  • Piperazine
144
Q

What is the epiploic foramen

A

The epoploic foramen is the opening to the omental bursa

145
Q

Which parts of the SI are involved in epiploic foramen entrapment colic

A

Ileum - 70%

Jejunum - 40 - 60%

146
Q

Predisposition for epiploic foramen entrapment colic

A

Males (geldings / stallions)

Thoroughbreds

Thoroughbred crosses

Crib biters

Wind sucking

147
Q

DD’s for epiploic foramen entrapment

A

Small intestinal volvulus

Gastrosplenic entrapment

Strangulation through mesenteric defect

Strangulating lipoma

148
Q

Confirmatory test of epiploic foramen entrapment

A

Transcutaneous abdominal US

  • Multiple loops of small intestine in the right ventral paralumbar fossa with low to no motility and mural thickening
149
Q

Acute general treatment of epiploic foramen entrapment

A

Surgical reduction of entrapment

(Surgical emergency)

150
Q

Possible complications after surgical reduction of epiploic foramen entrapment

A

Ileus

Intra-abdominal adhesions

Complications at the anastomosis site

Incision site infection / hernia

151
Q

Recommended monitoring after surgical reduction of epiploic foramen entrapment

A

Cardiovascular system (endotoxaemia)

Nasogastric reflux (ileus)

Recurring signs of colic (intra-abdominal adhesions)

Incisional complications

Slow return to oral intake

152
Q
A

Veterinary Equines Finals (8 decks)

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