Colic-Post op management and complications Flashcards
What are common post-op colic surgery electrolyte deficiencies?
Calcium and magnesium
What is hypokalemia typically caused by post-op colic?
Lack of intake, diuresis or GI loss through diarrhea
What is the maximum dose of K supplementation that should be administered?
No greater than 0.5 mEq/kg/hr
What is the goal of post-op fluid therapy?
Maintain enough vascular volume to sustain CO
Indicators of reasonable CO: HR <80; PCV < 50% and TP>4.1
What are some post-op colic sx complications?
Hemorrhage
Colitis
Pain- manage with Flunixin meglumine or lidocaine
Endotoxemia
What is used during the enterotomy to bind endotoxins (clostridial to be exact)?
Di-Tri-Octahedral Smectitie (DTO Biosponge)
What medication binds to lipid A neutralizing endotoxin?
Polymyxin B
What is a common post-op disease of colic sx?
Post-op ileus
Typically older horses with PCV >45% at presentation
What is the most common cause of post-op ileus?
Strangulating SI
What is the tx for post-op ileus?
Supportive tx: NG decompression, FLUIDS< address electrolyte imbalances, Ab
What are three prokinetic agents used?
Lidocaine, Metoclopramide, Erythromycin
How does lidocaine work for post-op ileus?
Decrease catecholamines and decrease prostaglandins –> decrease free radical production
What is lidocaine toxicity portrayed as?
Muscle fasiculation, ataxia and seizures
DON’T BOLUS (needs to be in a period of time)
How does metoclopramide work?
Smooth muscle and SI stimulator
What are metoclopramide toxicity effects characterized as?
Excitement, restlessness, sweating, seizure
When does post-op infection typically occur?
> 3d post-op
What is the most common complication from incisional infection?
Hernia- typically due to violent recovery
When should you attempt to repair a post-op hernia?
3 months post-op
You want to allow fibrosis to develop around the inguinal ring so you can suture it closed
What is the second most common reason for a repeat surgery?
Adhesions
What medication can be given to decrease edema and free radicals?
DMSO (best option)
What is a complication that can occur due to necrosis of the bowel?
Peritonitis, can be fatal
What are CS of peritonitis?
Colic, depression, anorexia, ileus, diarrhea, fever, tachycardia, tachypnea
What is the peritoneal pH and peitoneal glucose post-op to be considered septic peritonitis?
Peritoneal pH: <7.2
Peritoneal glucose <30 mg/dL
