Colic-Post op management and complications

Question 1

What are common post-op colic surgery electrolyte deficiencies?

Answer 1

Calcium and magnesium

Question 2

What is hypokalemia typically caused by post-op colic?

Answer 2

Lack of intake, diuresis or GI loss through diarrhea

Question 3

What is the maximum dose of K supplementation that should be administered?

Answer 3

No greater than 0.5 mEq/kg/hr

Question 4

What is the goal of post-op fluid therapy?

Answer 4

Maintain enough vascular volume to sustain CO

Indicators of reasonable CO: HR <80; PCV < 50% and TP>4.1

Question 5

What are some post-op colic sx complications?

Answer 5

Hemorrhage
Colitis
Pain- manage with Flunixin meglumine or lidocaine
Endotoxemia

Question 6

What is used during the enterotomy to bind endotoxins (clostridial to be exact)?

Answer 6

Di-Tri-Octahedral Smectitie (DTO Biosponge)

Question 7

What medication binds to lipid A neutralizing endotoxin?

Answer 7

Polymyxin B

Question 8

What is a common post-op disease of colic sx?

Answer 8

Post-op ileus

Typically older horses with PCV >45% at presentation

Question 9

What is the most common cause of post-op ileus?

Answer 9

Strangulating SI

Question 10

What is the tx for post-op ileus?

Answer 10

Supportive tx: NG decompression, FLUIDS< address electrolyte imbalances, Ab

Question 11

What are three prokinetic agents used?

Answer 11

Lidocaine, Metoclopramide, Erythromycin

Question 12

How does lidocaine work for post-op ileus?

Answer 12

Decrease catecholamines and decrease prostaglandins –> decrease free radical production

Question 13

What is lidocaine toxicity portrayed as?

Answer 13

Muscle fasiculation, ataxia and seizures

DON’T BOLUS (needs to be in a period of time)

Question 14

How does metoclopramide work?

Answer 14

Smooth muscle and SI stimulator

Question 15

What are metoclopramide toxicity effects characterized as?

Answer 15

Excitement, restlessness, sweating, seizure

Question 16

When does post-op infection typically occur?

Answer 16

> 3d post-op

Question 17

What is the most common complication from incisional infection?

Answer 17

Hernia- typically due to violent recovery

Question 18

When should you attempt to repair a post-op hernia?

Answer 18

3 months post-op

You want to allow fibrosis to develop around the inguinal ring so you can suture it closed

Question 19

What is the second most common reason for a repeat surgery?

Answer 19

Adhesions

Question 20

What medication can be given to decrease edema and free radicals?

Answer 20

DMSO (best option)

Question 21

What is a complication that can occur due to necrosis of the bowel?

Answer 21

Peritonitis, can be fatal

Question 22

What are CS of peritonitis?

Answer 22

Colic, depression, anorexia, ileus, diarrhea, fever, tachycardia, tachypnea

Question 23

What is the peritoneal pH and peitoneal glucose post-op to be considered septic peritonitis?

Answer 23

Peritoneal pH: <7.2

Peritoneal glucose <30 mg/dL