Colic: diagnostics Flashcards
What should you check first when a patient presents with colic?
LISTEN TO HEART
Check mucous membranes and CRT
—— Assess for CVRS shock / sepsis
What is the normal heart rate range for a horse?
30-40 bpm
Why might the heart rate of a horse be slightly raised in a horse with colic?
Pain
Why might a horse with colic be tachycardic?
CVRS shock
If a horse is colicing with a heart rate greater than 60 bpm what should you do?
PASS A TUBE IMMEDIATELY
Why might a horse’s mucous membranes be dark pink/red, what is the first thing you should do?
ENDOTOXIC SHOCK - congested mm due to tachycardia and post capillary venous constriction
immediate administration of IV fluids
What behavioural signs may indicate that a horse is in pain. Rank them from least to most severe.
Recumbancy Pawing Trying to go down Rolling Abrasions (often over zygomatic arch)
Why might a horse with colic appear depressed upon examination?
Has had a severe episode overnight (look for abrasions around zygomatic arch)
Should you give sedation to a patient with colic?
Yes BUT after you have assessed heart rate, mucous membranes and pain status.
(Unless the horse is so agitated that it is unsafe to proceed with initial examination)
What acronym can you use to guide consult with owners of colicing horses?
SHED-C
Signalment
History (medical)
Environment
Diet
Complaint
What important questions should you ask clients of colicing horses?
Age Time of colic onset Degree of colic shown Any treatments given Previous colic Last passed faeces Management Worming regime
How many times should a normal horse pass faeces in a day?
4-6 times per day in hospital
Up to 10 at home
What is a common reason for colic in young horses?
Obstructions
Particularly due to parasites i.e. ascarids
What is a common cause of colic in older horses?
Pedunculated (strangling) lipomas
Name some environmental and dietary risk factors for colic.
Environment:
Recent change in management
Recently transported
Diet:
Recent/sudden change in diet
What is the normal TPR for a horse?
37.5 - 38.5
20-40
8-16
When doing a full exam of a colicing horse, what are some key areas to focus on?
Demeanour - signs of pain/abrasions TPR CV status GI borborygmi Abdominal distension
What could cause a high temperature in a colicing horse?
Colitis
Peritonitis
Enteritis
Rupture - enterotoxaemia
How can you use heart rate to assess the severity of the colic?
20-40 normal
40-60 mild
60-80 severe, likely surgical + need to refer
80+ poor prognosis
How could you assess distension of the abdomen?
Ping - auscultation and percussion
What might abdominal distension indicate about the cause of the colic?
Large colon problem
What would a lack of GI sounds indicate?
Decreased peristalsis, possible ileus
What do you need to perform a rectal examination of a horse?
Gloves Lube Spasmolytic (e.g. Buscopan) Sedation RESTRAINT
What can you feel when rectally palpating a horse?
Aorta Left kidney Nephrosplenic space Caudal edge of spleen Pelvic flexure Caecum
Bladder
Reproductive organs
What could be mistaken for masses during rectal palpation?
Faecal balls
What would small intestinal distension feel like upon palpation?
Bicycle tyres
What might a distended large intestine feel like upon palpation?
Balloons of gas
Can you palpate a normal small intestine?
No
Why is it important to pass a nasogastric tube in horses with colic?
HORSES CAN’T VOMIT
If there is an obstruction, fluid will accumulate until the stomach ruptures.
How do you pass a nasogastric tube in a horse?
Lubricate tube
Measure distance to stomach (usually around 2m) and mark
Pass tube down ventral meatus
Use syringe to get negative pressure then drop the end of the tube below the level of the stomach (into a bucket!) to ‘siphon’ stomach contents.
What could nasogastric siphoning tell you about the cause of a colic?
If more than 2 litres of fluid, likely to be a small intestine problem/obstruction
How can ultrasound be useful in finding the cause of a colic?
Evaluate peritoneal fluid Size of viscus (small intestine) Position of viscus (large intestine) Liver Kidneys Spleen
How could you diagnose nephrosplenic entrapment using ultrasound?
CAN’T SEE THE KIDNEY
How could you assess peritoneal fluid in a colicing horse?
Abdominocentisis
Put needle at the most ventral part of the abdomen
What can peritoneal fluid tell you about a colic?
Leakage of albumin (small protein) - cloudy
Presence of neutrophils
Presence of RBCs - serosanguinous - LOTS OF GUT DEATH
Gut contents - ingesta - rupture
How could you tell if you had performed an accidental enterocentesis?
Brown/green colour, few cells, free bacteria
Horse has otherwise normal TPR
What are the five physio;pig all categories of colic?
Distension (spasmodic) colic
Non-strangulating lesions
Strangulating lesions
Inflammatory lesions
Non-GIT colics
Which type of colic always requires surgical intervention?
Strangulating lesions
What inflammatory lesions may cause colic?
Colitis
What are the two types of non-strangulating lesions?
Obstructions
Displacements or entrapments
How would you treat an obstruction?
Enteral fluids to soften impaction,
Withhold food
Give analgesics
What does BAR stand for?
Bright Alert Responsive
What does NDR stand for?
‘Not doing right’
Behaviour seems off but no obvious injuries or clinical signs
