Day 6 - GI 3 Flashcards
Caecal impaction
- Primary: accumulation of solid ingesta
- Secondary: accumulation of liquid content
Can rupture, monitor!!
Primary caecal impaction - pathogen
- Gradual development as in large colon impactions
- Decreased caecal motility
- Content becomes firm and dry
- Normal defaecation is possible for a while
Primary caecal impaction - CS
- Mild colic signs
- Decreased appetite, defecation
- Decreased peristaltic sounds on right side
- Usually normal cardiovascular function
- Rectal palpation: Base of caecum is filled with ingesta (Ceacum is on right side)
Primary caecal impaction - Tx
- Fasting
- Fluid therapy
- Smasmoanalgesics: Buscopan, Flunixin
- Salt mixture (laxatives)
- Surgery (if non-responding)
Secondary caecal impaction
- Often orthopaedic
- After unrelated surgery
- Postoperative pain
- Difficult to recognise
- Near to rupture by the time colic signs appear
Rectal palpation: Distended caecum, liquid
Surgery
No salt, no more liquid faeces needed
Caecal impaction - DD
- Large colon impaction
- Right dorsal displacement of large colon
- Caecal tympany
- Mesenteric abscess
Large colon impaction
Frequent form of colic.
Feeding problems, dental disease, decr water, obesity/geriatric
Predil sites: Pelvic flexure, ampulla (end of right dorsal colon)
Rocking horse posture, colic signs
Tx:
- Spasmolytics, analgesics, sedatives: Butylscopolamine, Flunixin, phenylbutasone, xylasine, detomidine, butorphanol
- Laxatives, Salt mixtures
- Fluid therapy
- Fasting
- Controlled exercise
- Surgery
Small colon impaction
Simple similar to large, or following diarrhoe due to feed/impaction.
Normal colic signs, distended abd, fair general status
Rectal: Feel the impactions
Treatment
- Spasmoanalgetics
- Cathartics
- Rectal enema
- Oral or IV fluid therapy
- Surgery
Basic equipment
- Fluid administration system
- ECG
- Centrifuge
- Refractometer
- Glucosemeter
- Lactatemeter
- Urinalysis strips
- Microscope (cytology, Gram stain)
- Ultrasound including Doppler capabilities
- Oxygen tank and regulator
- Biosecurity equipment and personal protective equipment
Intermediate equipment
- Basic level equipment
- Blood gas, electrolyte, glucose analyser
- Complete blood count analyser- hematology
- Coagulation profile testing
- Blood pressure monitor (direct, indirect)
- Intravenous fluid pump delivery systems
- Sling and hoist
Advanced equipment
- Intermediate level equipment
- Pulse oximeter
- Mechanical ventilator
- Colloid osmometer
- Capnograph
- Continuous ECG (holter, telemetry)
- Syringe infusion pumps
Distributive shock
Abnormal distribution of blood. Due to acute trauma or anaphylaxis.
Consequence: Systemic inflammatory response syndrome
Hypovolemic shock
Due to blood loss, blood plasma loss, or fluid loss.
Decreased parameters in shock
- Hematokrit (Ht)
- Total plasma protein concentration (TPP)
- Albumin
- Lactate
- Creatinine and urea
Leukopenia, neutropenia
Catheters
- Polyethylene and polypropylene (highly thrombogenic)
- Silastick (Least thrombogenic)
- Over the wire can be kept for a week
