Digestion & Metabolism 2: Sx dz of Equine Colon Flashcards
4 components of the LI?
- CECUM
- COLON
- RECTUM
- ANUS
what is the CAPACITY of the CECUM in horses? (in L) & what is its LENGTH?
30 L CAPACITY at 1 METER LONG
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
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
what is the MAIN differentiation between STRANGULATING & NON-STRANGULATING lesions in horses?
DEGREE OF ABDOMINAL PAIN
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
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
___ TYMPANY FEELS MUCH MORE DRAMATIC THAN ____ TYMPANY
CECAL TYMPANY»_space;> COLONIC TYMPANY
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)
ANOPLOCEPHALA PERFOLIATE definition
CECAL TAPEWORM
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
TRANSABDOMINAL US be used to distinguish between IMPACTION in WHAT 2 REGIONS?
- CECUM
- RIGHT DORSAL COLON
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
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
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
4 indications of TYPHLECTOMY?
- SEVERE CONTAMINATION from a TYPHLOTOMY
- ISCHEMIC NECROSIS
- SEVERE ADHESIONS
- ABSCESSATIONS
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
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
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)
- MILD to MODERATE abdominal PAIN
- LACK of FECES or D+
- can develop ABDOMINAL DISTENTION
- REDUCED BORBORYGMI
- FEVER
INDICATIONS for SX for SMALL (DESCENDING) COLON? (5)
- PERSISTENT PAIN
- ABDOMINAL DISTENTION
- PERITONEAL FLUID
- ABSENT BORBORYGMI
- 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…
- PSYLLIUM
- MAGNESIUM SULFATE
- MINERAL OIL
- IV FLUIDS
- WATER/ELECTROLYTES
- 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?
- IV FLUIDS (crystalloids/colloids) to prevent HYPOPROTEINEMIA or SYSTEMIC INFLAMMATORY RESPONSE SYNDROME
- ANALGESIA for PAIN
- 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
