Digestion & Metabolism 2: Sx dz of Equine Colon Flashcards by Nellie O'Leary

4 components of the LI?

CECUM
COLON
RECTUM
ANUS

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what is the CAPACITY of the CECUM in horses? (in L) & what is its LENGTH?

30 L CAPACITY at 1 METER LONG

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where does the BULK of FERMENTATION occur in horses? what else commonly occurs here?

what important BIOCHEMICAL process occurs here?

BULK of fermentation = LARGE ASCENDING COLON, also COMMON LOCATION OF DZ

IMPORTANTLY, horse derives VOLATILE FATTY ACIDS here from fermentation for ENERGY

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what 2 things should be done upon PE for GI DISEASES IN HORSES?

what other 2 diagnostics are sometimes done?

PALPATION PER RECTUM
NASOGASTRIC TUBE to rule out ESOPHAGEAL/SI OBSTRUCTION

other 2 diagnostics?
1. BASELINE BLOODWORK
2. TRANSABDOMINAL US

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what is the MAIN differentiation between STRANGULATING & NON-STRANGULATING lesions in horses?

DEGREE OF ABDOMINAL PAIN

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what is the MOST COMMON STRANGULATING LESION in horses?

what 2 clinical signs do they usually present with?

what 2 tx options are available?

MOST COMMON STRANGULATING LESION = LARGE COLON VOLVULUS

2 clinical signs?
1. VERY PAINFUL
2. DISTENDED ABDOMEN

2 tx?
1. SURGERY
2. EUTHANASIA

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TYMPANY..
what kind of lesion is this?
often occurs after….
commonality?
2 important hx?
2 clinical signs?
PE is…
3 tx options? sometimes, which one is SUFFICIENT for recovery?
prognosis?

= NON-STRANGULATING LESION

often occurs after EATING A BIG MEAL & HORSE IS GASSY

COMMON

Hx?
1. LOW QUALITY HAY/FEEDS can cause this
2. can have a SEASONALITY (winter?)

clinical signs?
1. MILD to MODERATE PAIN
2. TRANSIENT in nature

PE often UNREMARKABLE

tx?
1. ANALGESIA (sometimes THIS ALONE is sufficient)
2. WITHOLD FEED
3. ENTERAL FLUIDS +/- IV FLUIDS

GOOD prognosis unless RECURRENT COLIC

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___ TYMPANY FEELS MUCH MORE DRAMATIC THAN ____ TYMPANY

CECAL TYMPANY&raquo_space;> COLONIC TYMPANY

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CECAL IMPACTION…
2 types? which one is more common/where?
often associated with what 5 things?
what 2 UNIQUE things can it be associated with?

2 types?
1. DRY/FIRM, more common in horses fed HAY in SOUTHEAST US
2. LIQUID = MORE COMMON OVERALL

often associated with..
1. GENERAL ANESTHESIA
2. Sx
3. NSAIDs
4. STALL CONFINEMENT
5. HOSPITALIZATION

2 UNIQUE things?
1. COASTAL BERMUDA GRASS HAY
2. ANOPLOCEPHALA PERFOLIATE (CECAL TAPEWORM)

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ANOPLOCEPHALA PERFOLIATE definition

CECAL TAPEWORM

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CECAL IMPACTION…
3 clinical signs?
diagnosis?
what 2 things can be detected using this diagnostic method?

3 clinical signs?
1. SLIGHTLY painful
2. INAPPETANT
3. DECREASED defecation

diagnosis based on ABDOMINAL PALPATION PER RECTUM

2 things?
= can feel CECAL TYMPANY ABNORMAL MOBILITY WHERE CECAL BAND IS

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TRANSABDOMINAL US be used to distinguish between IMPACTION in WHAT 2 REGIONS?

CECUM
RIGHT DORSAL COLON

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what MEDICAL TX OPTIONS do we have for CECAL IMPACTION? (6)

medical tx is often…

what DANGEROUS complication can still occur?

when would we use ERYTHROMYCIN for cecal impactions?

options?
1. feed restriction
2. oral water/electrolytes
3. mineral oil
4. IV fluids
5. analgesia
6. +/- motility stimulants

medical tx for CECAL IMPACTION is OFTEN NOT SUCCESSFUL

CECAL RUPTURE can still occur!

ONLY IF CONFIRMED MICROBIAL INFECTION = ERYTHROMYCIN

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most of the time, CECAL IMPACTION is treated via ____ to avoid ____ ____

what CBC finding can help confirm our diagnosis?

2 diagnostics?

treated via TYPHLOTOMY to AVOID CECAL RUPTURE

INCREASED LACTATE can help increase suspicion of CECAL IMPACTION

2 diagnostics?
1. ABDOMINAL US
2. PERITONEAL FLUID ANALYSIS

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2 SURGICAL options for CECAL IMPACTION & which is more common?

what are we aiming to avoid with sx?

2 post-op procedures?

prognosis is…

2 options?
1. TYPHLOTOMY (more common)
2. COMPLETE or INCOMLETE BYPASS (JEJUNAL- or ILEO-COLOSTOMY), better for chronic cases

aiming to avoid CECAL RUPTURE

2 post-op procedures?
1. SLOW REFEEDING to AVOID IMPACTION AGAIN
2. DEWORM with CESTOCIDE (PYRANTEL, PRAZIQUANTEL)

prognosis is VARIABLE

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4 indications of TYPHLECTOMY?

SEVERE CONTAMINATION from a TYPHLOTOMY
ISCHEMIC NECROSIS
SEVERE ADHESIONS
ABSCESSATIONS

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2 most common regions of impactions at the LARGE (ASCENDING) COLON?

what KIND of lesion is this?

which location is the MOST COMMON CAUSE OF COLIC OVERALL?

what SEASON is this most common?

2 most common regions?
1. LEFT VENTRAL COLON at PELVIC FLEXURE
2. RIGHT DORSAL COLON where it ENTERS TRANSVERSE

this is a NON-STRANGULATING LESION

PELVIC FLEXURE or LEFT VENTRAL COLON IMPACTION is the MOST COMMON CAUSE OF COLIC OVERALL

LARGE (ASCENDING) COLON IMPACTIONS ARE MOST COMMON DURING WINTER

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LARGE (ASCENDING) COLON IMPACTIONS OFTEN ASSOCIATED WITH… (7)

poor feed quality
poor dentition
reduced water intake
parasitism
altered intestinal motility
CHANGE in management, housing, weather
shipping

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LARGE (ASCENDING) COLON clinical signs? (3)

what 2 things are usually NORMAL?

what AGE of horses are most likely to get this?

what 2 things must be felt to DIAGNOSE?

3 clinical signs?
1. MILD colic
2. DECREASED BORBORYGMI usually on LEFT SIDE
3. LACK OF FECES

2 normal things?
1. NO ABDOMINAL DISTENSION
2. NORMAL TPR

common in GERIATRIC horses

upon PALPATION PER RECTUM, must feel…
1. LI FILLED WITH FIRM, HARD INGESTA
2. ENLARGED LI

MEDICAL treatment for LARGE (ASCENDING) COLON IMPACTION (5)

what 2 SHOULD ALWAYS BE DONE? (starred)

ENTERAL WATER/ELECTROLYTES!! BETTER THAN IV FLUIDS **
MAYBE mineral oil/magnesium sulfate
WITHOLD FEED
ANALGESICS **
IV fluids sometimes, just to maintain HYDRATION if long-term

3 examples of ANALGESICS we can use for HORSES WITH LARGE (ASCENDING) COLON IMPACTIONS?

FLUNIXIN MEGLUMINE
IV LIDOCAINE
ALPHA-2 AGONISTS

3 indications for SURGICAL INTERVENTION for LARGE (ASCENDING) COLON IMPACTION?

what PROCEDURE do we perform?

which REGION of the colonic impaction is MOST AT RISK FOR RUPTURE?

prognosis for after sx?

3 indications?
1. NO FECES
2. ABSENT BORBORYGMI
3. ABDOMINAL DISTENSION

PROCEDURE = PELVIC FLEXURE ENTEROTOMY

RIGHT DORSAL COLON MOST AT RISK FOR RUPTURE

PROGNOSIS = GOOD –> EXCELLENT

horses with IMPACTION should be ____ CLOSELY

MONITORED

SMALL (DESCENDING) COLON IMPACTION…
3 signalments?
2 seasons most common?
5 other associations?

3 signalments?
1. PONIES
2. FEMALES
3. OLDER horses

2 seasons?
1. FALL
2. WINTER

5 others?
1. POOR QUALITY ROUGHAGE
2. POOR DENTITION
3. INSUFFICIENT WATER INTAKE
4. INADEQUATE MASTICATION
5. LACK OF EXERCISE

CLINICAL SIGNS of SMALL (DESCENDING) COLON IMPACTION (5)

1. MILD to MODERATE abdominal PAIN 2. LACK of FECES or D+ 3. can develop ABDOMINAL DISTENTION 4. REDUCED BORBORYGMI 5. FEVER

INDICATIONS for SX for SMALL (DESCENDING) COLON? (5)

1. PERSISTENT PAIN 2. ABDOMINAL DISTENTION 3. PERITONEAL FLUID 4. ABSENT BORBORYGMI 5. LACK OF FECAL PRODUCTION

what are HIGH ENEMAS used for? how do they work?

HIGH ENEMAS used for SMALL (DESCENDING) COLON IMPACTIONS stick a STOMACH TUBE UP RECTUM & INTO COLON

BEZOARS... aka? = definition most likely in WHAT ages of horses/why? (2) 3 clinical signs? what 2 things would indicate sx?

CONGLOBLATES = concretion of foreign, indigestible material in the gastrointestinal tract most likely in... 1. YOUNG HORSES ingesting FOREIGN MATERIAL or HAIR 2. OLDER horses with POOR DENTITION 3 clinical signs? 1. LACK OF FECES IN RECTUM or SMALL VOLUME D+ 2. +/- ABDOMINAL DISTENTION 3. FEVER 2 signs for sx? 1. LACK OF FECES IN RECTUM 2. CANNOT BE PALPATED PER RECTUM

SAND ENTEROPATHY/IMPACTION... what KINDS of lesions are these? 3 hx indications for SAND? 3 hx indications for ENTEROPATHY? commonly diagnosed via... what location is COMMONLY affected by either one?

NON-STRANGULATING LESIONS Hx for SAND?? 1. FED ON GROUND 2. SANDY SOIL/certain geographical regions 3. RECURRENT COLIC Hx for ENTEROPATHY? 1. D+/loose feces 2. WEIGHT LOSS 3. POOR PERFORMANCE COMMONLY diagnosed via TRANSABDOMINAL US usually RIGHT DORSAL COLON affected by SAND/ENTEROPATHY

ID LESION & what u see

SAND IMPACTION see LACK OF SACCULATIONS & BIRHGT LINE

ID LESION

SAND IMPACTION

what kind of SYSTEM is present for SAND IMPACTIONS? what 2 things is it dependent on?

a SCORING SYSTEM that depends on... 1. DENSITY of impaction 2. SIZE of impaction

MEDICAL TX OPTIONS for SAND ENTEROPATHY/IMPACTION... (6) if there's a COMPLETE obstruction, then do... prognosis is generally ____ if...

1. PSYLLIUM 2. MAGNESIUM SULFATE 3. MINERAL OIL 4. IV FLUIDS 5. WATER/ELECTROLYTES 6. NPO or TROPHIC feeding COMPLETE OBSTRUCTION = EMERGENCY SURGERY! prognosis generally GOOD if we DON'T RUPTURE THE COLON

ENTEROLITHIASIS... what KIND of lesion is this? 2 historical signals? what BREED is GENETICALLY PREDISPOSED? round vs. polytetrahedral? tends to form WHERE

NON-STRANGULATING lesion 3 Hx? 1. ALFALFA hay 2. CALIFORNIA (high magnesium) GENETIC PREDISPOSITION in GRAY ARABIANS ROUND = SINGLE ENTEROLITH POLYTETRAHEDRAL = MULTIPLE, grinding against each other tends to form in RIGHT DORSAL COLON

ID LESION

ENTEROLITH

2 DIAGNOSTICS done for ENTEROLITHIASIS Dx? option for SURGICAL intervention? usually we need to do HOW MANY of these? 2 complications of sx?

2 diagnostics? 1. RADIOGRAPHY 2. EXPLORATORY CELIOTOMY SURGICAL intervention? = PELVIC FLEXURE ENTEROTOMY, often needs MULTIPLE 2 complications? 1. SMALL COLON NECROSIS 2. SMALL COLON PERFORATION

RIGHT DORSAL DISPLACEMENT... what type of lesion is this? 2 clinical signs? what's usually normal? diagnosis via... (1 main one, and another one) 2 indications for sx?

NON-STRANGULATING LESION 2 clinical signs? 1. MILD to MODERATE colic 2. GAS DISTENTION CARDIOVASCULARLY STABLE diagnosis? 1. USUALLY ABDOMINAL PALPATION PER RECTUM 2. US also possible 2 indications for sx? 1. VERY PAINFUL 2. LACK OF BORBORYGMI

LEFT DORSAL DISPLACEMENT... 3 clinical signs? what's usually normal? diagnosis? (1 main one, one for CONFIRMATION)

3 clinical signs? 1. MILD to MODERATE colic (intermittent) 2. GAS DISTENTION ON THE LEFT 3. DECREASED BORBORYGMI ON THE LEFT CARDIOVASCULARLY STABLE diagnosis? 1. PALPATION PER RECTUM 2. TRANSABDOMINAL US FOR CONFIRMATION

ID LESION

LEFT DORSAL DISPLACEMENT of the COLON

LEFT DORSAL DISPLACEMENT OF COLON is usually treated via ____ give 4 examples? can also be treated under ___ ___ to... prognosis?

usually treated via MEDICAL MANAGEMENT examples? 1. WITHOLD FEED 2. FLUNIXIN MEGLUMINE 3. IV FLUIDS 4. PHENYLEPHRINE if TRAPPED BY SPLEEN to cause SPLENIC VASOCONSTRICTION & DEC IN SIZE can also be treated under GENERAL ANESTHESIA to ROLL OFF OF THE SPLEEN EXCELLENT PROGNOSIS

LARGE COLON VOLVULUS is most common in what kind of horses? what ELSE can commonly occur in these horses? what KIND of lesion is this?

MOST COMMON IN POSTPARTUM MARES HEMORRHAGE can also occur in these horses THIS IS A STRANGULATING LESION

LARGE COLON VOLVULUS... 4 clinical signs? treatment?

4 clinical signs? 1. ACUTE onset of SEVERE PAIN 2. MARKED ABDOMINAL DISTENTION 3. CLINICAL EVIDENCE OF POOR PERFUSION 4. TACHYCARDIA & DARK MMs treatment? = usually EMERGENCY SX to DEROTATE THE COLON

3 POST-OP treatments/what they do for LARGE COLON VOLVULUS? prognosis?

1. IV FLUIDS (crystalloids/colloids) to prevent HYPOPROTEINEMIA or SYSTEMIC INFLAMMATORY RESPONSE SYNDROME 2. ANALGESIA for PAIN 3. ANTI-ENDOTOXIN THERAPY/ANTICOAGULANTS prognosis is FAIR

COLOPEXY is used to PREVENT what 2 conditions? what's the ALTERNATIVE procedure we could perform?

COLOPEXY used to prevent... 1. RIGHT DORSAL COLON DISPLACMENT 2. LARGE COLON VOLVULUS could also TAKE OUT WHOLE COLON

CECOCOLIC INTUSSUSCEPTION = ??? usually associated with WHAT? can be diagnosed with (1 usual, 2 other options)

= APEX OF CECUM INTUSSUSCEPTS into RIGHT VENTRAL COLON usually associated with ANOPLOCEPHALA PERFOLIATA (cecal tapeworm) diagnosed USUALLY with PALPATION PER RECTUM, but also... 1. US 2. EXPLORATORY SX

STRANGULATING PEDUNCULATED LIPOMA of the SMALL COLON.. common in WHAT AGE OF HORSES? what 3 clinical signs do we see? what can we FEEL upon PALPATION? what diagnostic can CONFIRM diagnosis?

common in GERIATRIC horses 3 clinical signs? 1. ACUTE onset of MODERATE COLIC SIGNS 2. ABDOMINAL DISTENTION 3. NO FECES IN RECTUM on palpation, can feel PEDICLE ENCIRCLING SMALL COLON diagnosis confirmed with PERITONEAL FLUID ANALYSIS