Decision Making Regarding GI Diseases Flashcards
how quickly should you be able to decide to cut or not to cut?
often this decision can be made in the first 10-30 minutes of your evaluation. A definitive diagnosis is not always available nor required in order to make a decision.
what would be on a GI dz r/o list for stallions?
testicular torsion, inguinal hernia
what would be on a GI dz r/o list for mares?
uterine artery rupture, uterine torsion
what would be on a GI dz r/o list for older horses?
strangulating lipomas, epiploic foramen entrapment
ponies have a __ odd of colon displacement and __ odds of strangulation of the small intestine by lipomas
ponies have a decreased odd of colon displacement and increased odds of strangulation of the small intestine by lipomas
miniature horses have __ odds of strangulating small intestinal lesions
miniature horses have decreased odds of strangulating small intestinal lesions
draft horses have __ odds of cecal conditions
draft horses have increased odds of cecal conditions
T/F: recurrent and chronic intermittent colic is associated with previous surgical intervention
T
T/F: severity of signs is highly correlated with severity of GI disease
T
whats unique about pain associated with severe strangulation?
minimal signs of pain may be present and interpretation may be clouded by severe obtundation
critical PE information GI disease
- TPR (tachypnea, tachycardia, fever)
- Mucous membranes (color, CRT)
- Abdominal distension
- Auscultation (borborygmi, abnormal sounds)
- Pain level
increased heart rate is associated with __ survival past 80 bpm
increased heart rate is associated with decreased survival past 80 bpm
what are some factors highly suggestive of GI disease when examining the abdomen and rectal exam?
Abdominal distension has a 90% chance of surgery with moderate to severe surgery. Absent borborygmi has an OR 11.97 while a distended small intestine on rectal has an OR 31.42
what reflux volume is suggestive of GI disease?
> 5 liters (OR 3.45)
T/F: unless alternative diagnosis is available, most horses that respond poorly to analgesics are surgical candidates
T
when does peritoneal fluid color indicate surgery?
when its an abnormal color (an other color than yellow) or there is presence of visible hemolysis in PF supernatant
T/F: TP and NCC are not very predictive or useful for deciding to go to surgery
T
Lactate when elevated is correlated with need for surgical intervention. Peritoneal lactate better predicts intestinal ischemia than plasma lactate.
Lactate when __ is correlated with need for surgical intervention. __ lactate better predicts intestinal ischemia than plasma lactate.
A PFL of > __ at admission and and/or an increase in PFL overtime are significant indicators of strangulating lesions
A PFL of > 4 mmol/L at admission and and/or an increase in PFL overtime are significant indicators of strangulating lesions
T/F: both a high lactate and high hct carry a grave prognosis for GI disease
T
T/F: hyperglycemia is associated with non survival in horses with colic/GI disease
T
Serum lactate is a very useful marker for severity of GI disease. what are elevations due to and whats the prognosis?
Elevated serum lactate is due to decreased tissue perfusion, cytopathic hypoxia or decreased clearance. Colic cases with lactate 6.5 +/- 0.9 mmol/l died and survivors had lactate of 2.7 +/- 0.2 mmol/l.
what are the 3 most useful prognostic parameters for colic patients?
heart rate, PCV, abnormal mucous membranes
on abdominal ultrasound presence of an __ distended small intestine is strongly suggestive of a need for surgery
on abdominal ultrasound presence of an amotile distended small intestine is strongly suggestive of a need for surgery
