Colic in horses Flashcards
Causes of colic - 2
- GI viscus (usually; spasmodic/gas, impaction, displacement, strangulation)
- Other (liver, urogenital)
How horses express pain
Laminitis - recumbency
Neurologic - recumbency
Botulism - recumbency
MSK - tying up and severe lameness
Clinical signs - colic
incessant pawing, trying to go down, rolling incessantly, abrasions on head (suggests recumbency/rolling), recumbency (sternal to lateral the more severe it gets), muscle fasiculations, looking back at flanks, restlessness, kicking at abdomen, sweating
Causes of colic and %
Over 100 reported: 72% spasmodic and undiagnosed 14.5% pelvic flexure and other impactions 5-7% surgical 5.5% gas 1% colitis
Broad causes of colic - 5
Spasmodic/gas - motility, diet, parasites Impaction - usually large colon Displacement - usually large colon Strangulation Ulcers
Aim of examining a horse with colic - 2
- Does it need referral or can it be treated in the field (majority)?
- Make a diagnosis
3 most important features of a colic work-up
History, PE and NGT
Other features of a colic work-up 4
Rectal exam, abdominocentesis, ultrasound, clinical pathology
History to obtain during PE 7
age, time of colic onset, degree of colic shown, any treatments given, previous colic, last passed faeces, managment (diet, exercise, worming regime)
In what age of horses are strangulating lipomas more commonly seen?
Older horses (teenagers)
What should you focus on during the PE? 5
Demeanor (signs of pain), TPR, GI borborygmi, CV status (MM, CRT, pulse quality, turgor, jugular fill, limb temperature) and abdominal distension
Signs of mild colic pain - 7
occasionall pawing, looking at flanks, strectching out, intermittent recumbency, inappetence, backing up to wall, playing with water
Signs of severe colic pain - 4
sweating, violent rolling, dropping to ground, extreme rolling
Important information from TPR
T = take before rectal exam (introduces air): febrile = colitis/peritonitis/enteritis/rupture
P=may be increased due to anxiety/pain/hypovolaemia (higher suggests more severe colic)
R=may be increased due to anxiety/pain/abdominal distension
Where to listen for borborygmi?
4 quadrants (left dorsal, left ventral and vice versa)
What does a high pitched ping suggest?
Gas distension of a viscus (LI)
How do you assess abdominal distension?
Difficult, look at paralumbar fossa, ask owner if it appears different to normal
When should you pass a NGT?
All colics (opinion varies) as horses cannot vomit and gastric rupture may occur. This is the only way to relieve gastric distension.
What is an abnormal NGT finding?
NORMAL = 2L fluid (suggests SI dysfunction)
If you get any reflux, don’t give anything by the tube
Steps after initial PE
Monitor, medical treatment (analgesia, laxatives, fluids),monitor response to Tx, further diagnostics, refer
When to give medical treatment
Only if mild abnormalities on PE, no reflux, analgesia possibly even if horse appears comfortable, oral fluids if no reflux
Aims of a rectal exam
Identify normal structures, identify distension (SI/LI and type), identify displacements, identify abnormal structures (masses etc.)
Do you reach a diagnosis from rectal exam?
Often no. But it can raise your index of suspiscion
4 points to remember when doing a rectal exam
Restraint, sedation, spasmolytic and lubrication
