colic decision making Flashcards
what are the influencign factors that affect the treatment of colic?
- Cause / severity of colic
- Prognosis following treatment
- Finances / insurance cover
- Owner’s wishes
- Availability & ease of transport
- Intrinsic factors e.g. age, concurrent disease
what types of colic are always medical?
- spasmodic colic
- gaseous colic
- anterior enteritis
- colitis
- gastric ulceration
- grass sickness (ileus)
what types of colic are sometimes meidical, sometimes surgical?
- colon displacement
- colon impactions (ingesta/sand)
- peritonitis
- non-gi lesions (eg kidney disease)
- SI simple obstructions
- parasites
what tpes of colics are always surgical (or euthanasia)?
- SI / small colon incarceration
- SI/ small colon volvulus
- colon torsion
what signalment factors have an effect on colic?
- stalion - scrotal hernia
- foal - mores likely to get intusseption
- tecently foaled - more room, intestines can move, torsion
what do pale or dark injected mucous membranes and prolonged CRT suggest in a horse with colic?
poor periferal perfusion, endotoxaemia
what is the normal HR for a horse? what HR is very concerning for a colic to have? What are the other heart things can occure with colic?
- Elevated due to pain, toxic shock and dehydration
- Pulse may be weak and ‘thready’
- Transient heart murmur not uncommon
what is the normal resp rate for a horse, what is an alarming raised RR?
what is the normal gut sounds heard in the horse?
- Gut sounds (borborygmi) occur constantly
→ left - Low grade constant grumbling – peristalsis in S.I. and colon
→ Right - Caecal emptying 1-3x / minute – sounds like a toilet flushing
what gut sounds can be heard in a colic and what do the different gut sounds mean for each type of colic?
abnormal sounds may also be heard, eg sand
how can you assess abdominal distension in colics?
- Difficult for us to tell between fat / distended– ask owner
- May expand between examinations
- May get a ‘ping’ following abdominal percussion
- Indicates gas distension with intestinal lumen
→ excess gas production or blockage passage of gas?
→ usually large intestine
what rectal temp is hypothermic for a horse and what does this mean?
under 37 - suggests cardiovascular compromise/shock
what rectal temp is mildly hypothermic for a horse and what is the significance of this?
37-37.5 - important in foals, probably irrelavent in adults
what temperature is normal in a horse?
37.5-38.5
what temperature is mildly hyperthermic in a horse and what does this suggest?
38.5-39 - may be due to pain
what temperature is significaly hyperthermic in a horse and what dose this suggest?
above 39 - suggests infectious.inflammatory condition
what is the normal colour, clarity, volume, WBC count, Total protein and lactate or peritoneal fluid?
yellow, clear, WBC < 5000cells /ul, TP < 30g/L, lactate < 2.0mmol/L
happens to the colour, clarity ,volume WBC count, total protein, and lactate of peritonal fluid with compromised intestine, ruptured intestine and peritonitis?
why is lactate value important in colic cases?
increased if circulatory compromise (eg hypovolaemia or shock) causing anaerobic respiration or compromised bowel present
◦ compare to peritoneal fluid lactate, if peritoneal fluid lactate is higher then intestinal cause
what pre-surgicla factors affect the success of colic surgery?
- duration of signs prior to surgery
- level of dehydration (TP and PCV)
- level of endotoxaemia (MM colour, HR)
- SAA
- Lactate (circulating v peritoneal)
what intra-operative/post surgicla factors affect colic surgery?
- specific lesion
- length of bowel involved
- if resection and anastomosis required
- experties of vet staff
- owner financial position
