Colic I Flashcards
How many anatomic bands does the ventral colon, pelvic flexure,dorsal colon and small colon have?
VC: 4 PF: 1 DC: 3 SC: 2 Palpable bands=anatomical #-1
What is the #1 predisposing factor for equine colic?
Poor management
What is the order of the intestinal sequence?
RVC –> SF –> LVC –> PF –> LDC –> DF–>RDC –> TC (can’t feel)
Where are the two most common sites of impaction?
LVC and PF
If there is distention in the L flank, where is the distention most likely arising from?
LC
What kind of reflux will the small intestine produce?
Large volume, high pH
What kind of reflux will the LI produce?
No/small volume, low pH
What will you feel on rectal palpation if there is a a strangulating lesion in the small intestine/small colon?
Loop “sausages”
What will you feel on rectal palpation if there is a strangulating lesion in the large colon?
Balloon like
What time of the year are impactions most commonly seen?
In the fall, you will likely tx medically
What are the five most common areas of impaction?
Pelvic flexure Right dorsal colon Transverse colon Small colon Gastric impaction
Where do sand impactions commonly occur?
Right dorsal colon
What is the primary tx for sand impactions?
Medical management by using psyllium
What is the medical treatment for feed impactions?
Fluid therapy- give them oral and IV fluids
What is the surgical treatment for feed impactions?
Pelvic flexure enterotomy
What are ascarid impactions precipitated by?
Deworming in the last 24 hours
these horses do poorly in surgery
What is an enterolith made up of?
Magnesium ammonium phosphate
What does it mean when an enterolith is triangular vs. circular?
Triangular: more than one
Circular: only the one
What is a LDD caused by?
Nephrosplenic entrapment (phenylephrine tx to cause splenic contraction allowing the colon to be released from the space)
What are majority of SI colic cases caused by?
Strangulating lesions (intestinal accidents)
What type of strangulating colic is commonly seen in the SI of older QH?
Strangulating lipoma
What is the treatment for a strangulating lipoma?
Exploratory celiotomy w/ resection and anastamosis
What is another name for the epiploic foramen?
Foramen of winslow
What are the boundaries of the epiploic foramen?
Caudate process of liver
Portal vein
Gastro-pancreatic fold
What is a common complication of surgical treatment of an epiploic foramen entrapment?
Portal vein tear
What portion of the GI system most commonly has a volvulus/torsion?
Large colon
What are risk factors for a volvulus/torsion?
Post partum mare
Diet change
Recent access to lush pasture
What is the first thing that should be done when examining a colic patient?
Insert a NG tube- can be life saving!
What medication can be used when initially assessing a colic horse?
Spasmolytics (Buscopan) or lidocaine
What are palpable organs in the middle of the abdomen?
Aorta (dorsal)
Inguinal rings
Small colon
What are palpable organs on the right of the abdomen?
Cecum, colon and right ovary
What are palpable organs on the left of the abdomen?
Left kidney, spleen, left ovary
What is an excellent diagnostic tool to evaluate the GI in real time?
US
T/F: Nasogastric intubation is both diagnostic and therapeutic
TRUE
T/F: spontaneous reflux is normal
FALSE- never give medication if this is occurring
What are some complications of NG intubation?
Iatrogenic epistaxis (hit the nasal turbinates) Tube in trachea
If there is copious amounts of net reflux where is the problem likely to be?
Small intestine (anterior enteritis, impaction, strangulation)
What is the response to decompression if the problem was anterior enteritis or ileal impaction in terms of the HR and pain level?
HR decreases Pain relief (depression)
What is the response to decompression if the problem was mechanical obstruction/strangulation in terms of the HR and pain level?
Persistent HR and pain
Where should you perform an abdominocentesis?
Right of ventral midline, caudal to xyphoid (most ventral)
What is the local block used when performing a cannula technique?
Carbocaine
What is the TP and lactate levels of normal abdominal fluid?
TP < 2.0
Lactate < 2.0
T/F: Normal abdominocentesis rules out the need for surgery
FALSE
What is an NSAID given for colic pain management?
Flunixine meglumine
What are some alpha-2 agonists given for colic pain management?
Xylazine, detomidine, romifidine
What is an opioid given for colic pain management?
Butorphanol
What is a spasmolytic given to horses for colic?
Buscopan (reserved for severe pain)
What level should IgG be over in order to determine successful PT?
> 800
What are the normal measurements of the umbilical vein, artery and artery/urachus combo on US?
Umbilical v.: <1 cm
Umbilical a: <1.3 cm
Arteries/urachus: <2.5 cm
When is a foal colic case caused by the umbilicus surgical?
When the umbilicus is >2x the normal size
What is the most common cause of newborn colic?
Meconium impaction
What are some causes of colic in a 2-5 day old foal?
Ruptured bladder
Gastric ulcers
Enteritis
What if a foal is painful after nursing, what would we commonly attribute that to?
Gastric ulcers
Why do we not give alpha-2 agonists until 2 weeks of age?
These will decrease the overall cardiac output
What is the treatment for meconium impaction?
Fleet enema
Warm soapy water, 4% acetylcysteine
What is the term for ruptured bladder?
Cystorrhexis
Where does a ruptured bladder typically show itself in a male vs. female foal?
Male: dorsal aspect of bladder
Female: urachal rupture
What is the typical bloodwork for a ruptured bladder?
Hyperkalemia, hyponatremia, hypochloremia
What is noticed on the ECG of a foal with a ruptured bladder?
Tented T waves and potentially bradycardia because of hyperkalemia
What should be the first thing done to treat a foal with a ruptured bladder?
Medically stabilize first, this patient has a very high K and that needs to be stabilized first
What does K level over 5.5 mEq/L cause?
Muscle tremors and arrhythmias
What is the ultrasonographic appearance of an intussusception?
Bulls-eye appearance
What does excessive shortening of the mesentery predispose a horse to?
Volvulus
Where does the volvulus twist from in the SI?
Twists at the root of the mesentery in a corckscrew formation
What occurs secondary to pyloric stenosis from ulceration?
Gastric outflow obstruction
What is the tx for gastric outflow obstruction?
Gastroduodenostomy
What is the treatment for ascarid impaction?
SI enterotomy
