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Digestive Sys Exam 3 > Colic Workup (Mudge) > Flashcards

Colic Workup (Mudge) Flashcards

1
Q

Although sometimes not readily available or necessary in every case, what is a great way to identify a free fluid-filled small intestine?

A

Abdominal Ultrasound

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2
Q

What is abdominocentesis helpful for?

A

To diagnose small intestinal strangulation/ischemia and peritonitis

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3
Q

(T/F) Abdominal Radiography are helpful for diagnosis of enteroliths and sand impaction

A

True

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4
Q

Colic in Foals – Differential Diagnoses:
- Meconium impaction (usually < 2 days of age)
- Enterocolitis
- Inguinal hernia with ruptured tunic
- Gastroduodenal ulceration
- Ruptured bladder (usually newborn)
- Atresia coli (congenital, signs in 0-2 days)

A

Neonate (<2 weeks)

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5
Q

Colic in Foals - Differential Diagnoses:
- Gastroduodenal ulceration -> gastric outflow obstruction
- Enterocolitis
- Small intestinal volvulus, intussusception
- Fecalith, especially in Miniature horses

A

Older Foals

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6
Q

Initial Treatment of Colic
List the Pain Management options:

A
  • Alpha-2 Agonists: Sedation with an intravenous alpha2 agonist (e.g. xylazine) is usually the most effective medication for short-term pain management
  • Opioids: (i.e. butorphanol) can also be useful for pain management, although they may further decrease GI motility
  • Non- steroidal anti-inflammatory drugs (NSAIDs) such as flunixin meglumine (‘Banamine’) are commonly used to treat abdominal pain
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7
Q

Enteral Fluids:
What can help to soften ingesta, but are not part of a fluid therapy plan?

A
  • Laxatives such as magnesium sulfate
  • Mineral oil
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8
Q

What is something that is not needed in the majority of colic cases, but necessary for horses with signs of shock, large volumes of reflux, or severe dehydration?

A

IV Fluids

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9
Q

What are 5 different behaviors that could indicate colic in the horse?

A
  • Pawing
  • Rolling
  • Kicking at abdomen
  • Stretching out as if to urinate
  • Flank watching
  • Inappetance
  • Depression
  • Increased incumbency
  • Decreased defecation
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10
Q

What is the normal range of heart rate in an adult horse?

A

30-40/min

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11
Q

What are 3 reasons that you might see more than 2 liters of net reflux after passing an NG tube in an adult horse?

A
  • Anterior enteritis
    • Usually large volumes of reflux (5-15L)
      -Often fetid/malodorous
  • Small intestinal strangulation
    • Variable amounts of reflux
    • Often sour/fermentation
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12
Q

What are the normal values for total protein and lactate in abdominal fluid?

A

Total protein: < 2.5 g/dl (clear, yellow)
Lactate: < 2.0 mmol/l (or < blood lactate)

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13
Q

Getting a head start - Pattern Recognition:
10 yr old Arabian in California

A

Enterolith

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14
Q

List the Normal Vital signs for Adult Horses:

A

Heart Rate: 30-40 bpm (> 60 – pain, hypovolemia, SIRS)
Temperature: 99-100.5 F (Fever may indicate enteritis/colitis)
Respiratory Rate: 8-16 breaths/min

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15
Q

Pain:
Associated with strangulating lesions or severe, acute intestinal distention or mesenteric tension

A

Severe Pain

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16
Q

Pain:
Associated with incomplete obstructions

A

Mild, insidious, or intermittent pain

17
Q

A horse’s stomach can only hold _______ liters (average adult horse)

A

10-15

18
Q

Rectal Examination
List the abdominal structures palpated per rectum:

A
  • Caudal aspect of large colon and cecum
  • Small colon
  • Bladder
  • Uterus & ovaries (mare)
  • Caudal aspect of left kidney and spleen
19
Q

List the possible conditions you can diagnose with Rectal examination:

A
  • Large colon impaction
  • Large colon displacement/volvulus
  • Small colon impaction
  • Small intestinal distention
20
Q

Rectal Examination Tips:
What is good for smooth muscle relaxation?

A

Buscopan

21
Q
  • Auscult ventral abdomen - sounds “like the ocean”
  • Mix feces with water and allow to settle in the rectal sleeve
  • Radiographs = gold standard, but impractical in the field
A

Sand test

22
Q

Definition:
Fluid distension and wall thickness

A

Small intestinal disease

23
Q

Small Intestinal Distention
DO NOT give any additional fluids through the tube if:

A
  • You palpate distended small intestine on rectal exam
  • You visualize distended small intestine on ultrasound
  • get >2L net reflux

> > Will likely need a referral for IV fluids and frequent NG refluxing «

24
Q

You pass a tube on a 500kg horse and obtain 10 liters net reflux. Which of the following is part of your treatment plan?
a. Give 10L water and electrolytes via NG
b. Start broad-spectrum antibiotics
c. Place an IV catheter for continuous IV fluids
d. Recommend exploratory surgery

A

c. Place an IV catheter for continuous IV fluids

25
Q

List the indications for Abdominocentesis:

A
  • Baseline when treating conditions like LC impaction
  • Diagnose ischemic intestine
  • Confirm gastrointestinal rupture
26
Q

Abdominocentesis - Diagnoses:
- Could be blood contamination
- Check lactate - if abd > blood, likely ischemia (strangulation)
- Serial taps can be helpful if in the gray zone

A

Serosanguinous

27
Q

Abdominocentesis - Diagnoses:
- Submit for cell count and cytology
- Lactate may be high with bacterial sepsis

A

Cloudy/Cellular

28
Q

Abdominocentesis - Diagnoses:
- Confirm rupture vs enterocentesis - intracellular bacteria on cytology (+ septic shock)

A

Green/plant material

29
Q

Which of the following is a simple obstruction?
a. Transverse colon impaction
b. Peritonitis
c. Inguinal hernia
d. Large colon volvulus

A

a. Transverse colon impaction

30
Q

Which type of colic would most commonly be seen in a neonatal (< 2 weeks old) foal?
a. Ascarid impaction
b. Large colon impaction
c. Cecal tympany
d. Enterocolitis

A

d. Enterocolitis

31
Q

What is your top differential diagnosis for a young foal (e.g. 3‐6 weeks old) that is colicky and lying on it’s back?

A

Gastric ulceration

32
Q

What would be your treatment of choice for softening a pelvic flexure impaction in an adult horse?

A

Water and electrolytes via nasogastric tube

33
Q

List 4 possible causes of chronic or recurrent colic:

A
  • Gastric Ulcers
  • Enteroliths
  • Sand accumulation
  • Large colon impaction or displacement
  • Intra-abdominal mass
34
Q

Your client calls on emergency about her favorite mare, who is 4 weeks post‐foaling and has suddenly
developed signs of severe abdominal pain and abdominal distension. You are over an hour away from
the farm with another emergency. What do you advise your client?

A

Hitch up the trailer and prepare to take her to the nearby referral center if she doesn’t get
better in the next 10 minutes

Digestive Sys Exam 3 (7 decks)

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