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Equine Med Final (Old Material) > Colic (Key points only) > Flashcards

Colic (Key points only) Flashcards

1
Q

Reasons for colic being common?

A
  • Anatomy (long mesentery, changes in intestinal diameter)
  • Physiology (inability to vomit)
  • Management (stabling, diet, exercise)
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2
Q

7 p’s of a colic exam

A
  • Pain
  • Pass a tube
  • Paracentesis
  • Palpate
  • Pulse
  • Perfusion
  • PCV/TP
  • Peristalsis
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3
Q

What should you do if the horse has a heart rate over 60 bpm before doing anything else (if it’s for a colic examination)?

A
  • Pass an NG tube

- They are painful

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4
Q

Tips for differentiating between enteritis and surgical colic lesion **

A
  • In enteritis, they are more likely to be febrile (LESS LIKELY in colic; not impossible)
  • Leukopenia/neutropenia and band neutrophils more common with enteritis/colitis
  • Belly tap: Protein will be elevated but everything else WNL on a horse with enteritis
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5
Q

Features of enteritis

A
  • Usually have a temperature
  • More often associated with leukopenia/neutropenia and band neutrophils
  • High HR, then pass an NG tube, 20 L of reflux off, and they look like they’re fine
  • Protein will be elevated but everything else WNL on a horse with enteritis
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6
Q

Rectal palpation in horses with colic important points

A
  • Requires adequate restraint
  • Set of stocks
  • Sedated with or without a twitch
  • Lidocaine per rectum +/- lidocaine
  • Copious lubrication
  • Be gentle
  • If you feel a lot of gas distention or bicycle tires, that’s like small intestine
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7
Q

Some specific things you can palpate on rectal exam

A
  • “Bicycle” tire small intestines (NOT NORMAL)
  • If you feel a lot of gas on the right side, that’s cecum
  • Pelvic flexure sits on the left hand side; if you feel tight bands going cranially, things are probably displaced
  • If there’s a mass, want to know if it’s indentable or not (tells you how long it’s been there)
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8
Q

Minimum data sets for colic horses

A
  • Hematocrit
  • Total protein
  • Lactate
  • Total leukocyte and differential count
  • Electrolytes
  • Renal enzymes
  • Liver enzymes
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9
Q

What do elevated liver enzymes on a colicking horse suggest?

A
  • Right dorsal displacement

- Cholestasis

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10
Q

What are three things that are different about horse blood?

A
  • Don’t release reticulocytes
  • Serum and plasma is more yellow due to carotenoids
  • Splenic contraction can increase their PCV quite a bit
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11
Q

Reasons for increased PCV

A
  • Dehydration (#1)
  • Splenic contraction (common)
  • Lab error
  • Then other things (shunts, chronic low oxygen tension, neoplasia)
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12
Q

SIRS and effect on PCV and protein

A
  • Can increase PCV because the endothelium becomes leaky –> water is lost
  • Hypoproteinemia common in horses with SIRS due to altered endothelial function and protein can be lost into a damaged GI lumen
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13
Q

Negative prognostic indicators

A
  • High PCV/low protein divergence
  • Increased lactate values are also a sign of poor perfusion
  • Trends are most important
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14
Q

Normal lactate (abdominal or peripheral)

A
  • <2 mmol/L
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15
Q

Normal abdominal fluid

  • TP:
  • WBC:
  • Lactate:
A
  • TP <2.5 g/dL
  • lactate <2mmol/L
  • WBC <5,000 cells/µL
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16
Q

Plasma lactate and prognosis

A
  • <6 has a positive predictive value of ~96%
  • No horses with lactate of >10 mmol/L survived large colon
  • Neither peripheral nor peritoneal values predicted survival if a non-strangulating lesion
17
Q

What is normal abdominal fluid color?

A
  • Fine white wine colored
  • If it’s reddish or brownish, that’s NOT NORMAL
  • Likely would need to go to surgery
18
Q

Signs of a strangulating lesion on abdominal ultrasound

A
  • Distended, thickened, amotile small intestine

That is very suggestive of a strangulating lesion

19
Q

What is suggested if you can see the spleen but not the kidney?

A
  • Nephrosplenic entrapment
20
Q

What is suggested if you see vessels dorsal and lateral to the cecum on ultrasound?

A
  • Right dorsal displacement
21
Q

How can you diagnose sand and enteroliths?

A
  • Radiography
22
Q

Signs a horse should go to surgery

A
  • Pain that is persistent and uncontrollable
  • Positive rectal findings
  • Large volumes of nasogastric reflux (although horses with enteritis can have a lot of fluid)
  • Deterioration of systemic condition
  • Failure to pass feces for a prolonged period of time
23
Q

What is most likely in a colicking >12 year old horse?

A
  • Strangulation of the small intestine caused by a pedunculated lipoma
  • Could also be an impaction secondary to poor dentition and varied intestinal motility
  • Other SI lesions tend to be younger (7.7 years, epiploic foramen entrapment 9.6 years)
24
Q

Most likely lesion in a colicking wide-bodied horse like a quarter horse, draft breed, or warmblood?

A
  • Right dorsal displacement
  • Remember the mesenteric vessel changes and GGT should be elevated too
  • Often between 4-10 years old
25
Q

Most likely lesion in a colicking mini horse or donkey?

A
  • Small colon obstruction with a fecalith
26
Q

Most likely lesion in a colicking post-foaling broodmares?

A
  • Large colon volvulus

- Could happen pre-partum too

27
Q

Bermuda grass hay is associated with what?

What geographic location is associated with the Bermuda grass hay?

A
  • Ileal impaction

- southeastern US

28
Q

What is a geographic risk factor for an enterolith?

A
  • Being from CA
29
Q

What information should you get on a history of a colicking horse?

A
  • Defecation (amount and consistency)
  • Appetite
  • Water consumption
  • Urination
30
Q

What is the lesion most associated with cribbing or wind-sucking?

A
  • Epiploic foramen entrapment

- Increased pressure

31
Q

What should you use to try and break up an impaction?

A
  • NOT mineral oil

- Water orally

32
Q

What would you think of if you couldn’t see the spleen on ultrasound?

A
  • Left dorsal displacement
33
Q

Stomach colic dfdx?

A
  • Ulcers

- Gastric impaction (endoscopy as dfdx)

34
Q

SI intestine impaction reflux

A
  • If it’s been colicking and you palpate small intestine but hasn’t refluxed yet, it has to be DISTAL small intestine
  • you might not get reflux yet
35
Q

Small intestinal colic dfdx

A
  • Impaction
  • Strangulating lipoma
  • Torsion of small intestine (VERY painful)
  • Rent in the mesentery
  • Ascarid impaction in foals
  • Enteritis
  • ileal impaction (can have normal belly tap)
  • Anoplocephala perfoliata (painiful)
36
Q

What are Small colon impactions associated with sometimes?

A

Salmonella

37
Q

Non-surgical option for left dorsal dispolacement

A
  • Phenylephrine to contract the spleed
  • Can increase blood pressure
  • can result in a fatal bleed
  • You can also roll the horse

Equine Med Final (Old Material) (11 decks)

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