EQ Investigating Colic

Question 1

Clinical signs associated with colic

Answer 1

Flank watching

Lying down

Pawing the ground

Rolling

Repeatedly getting up and down

Violent thrashing around

Question 2

Colic

Answer 2

Abdominal pain often associated with the gastrointestinal pain

Question 3

Pathophysiology of gastrointestinal pain. (x3)

Answer 3

Prevents the normal progression of intestinal contents

• Simple obstruction
• Strangulation obstruction
• Intravascular occlusion of blood supply

Question 4

What are the different classifications of colic? (x7)

Answer 4

Spasmodic

Impactions

Gastric distention (flatulence)

Obstructions (simple / strangulating)

Non-strangulating infarction

Inflammation (enteritis / colitis )

Idiopathic

Question 5

What initial advice could be given to an owner with a horse showing acute colic signs?

Answer 5

Put in a well bedded stable

Remove anything they may injury themselves on

Let the horse role if it wants

SHORT periods of walking exercise is fine

Question 6

What basic parameters should be assessed in a violently painful colic horse?

Answer 6

Heart rate - before xylazine administration

Succinct history

Clinical exam once safe

Question 7

What basic history should be assessed in colic cases?

Answer 7

• Signalment, use & pregnancy status
• Stereotypic behaviour
• Horse’s usual management – stabling, turnout and feeding
• Routine parasite prophylaxis & dental care
• Any changes in feeding, turnout or premises
• Any ongoing medical problems / medications
• Previous history of colic / diagnosis and treatment for this

Question 8

What questions should be asked about the colic episode?

Answer 8

• What signs of colic observed
• When these signs started or when the horse was last seen to be normal
• Feed intake & faecal output over last 24hours
• Any diarrhoea
• History of equine grass sickness on the premises

Question 9

What should your initial clinical exam include?

Answer 9

Heart rate (28-44bpm normal)

– prior to any drug administration

Mucous membrane colour

– Pink, most, CRT<2s

– Dark ring around gum margin

– Purple / white

Respiratory rate (12-15 bpm normal)

Temperature (37.5-38.40C normal)

Digital pulses

Question 10

Outline the auscultation quadrants which should be assessed on clinical exam of a colic case.

What would each quadrant usually contain?

Answer 10

1. Left dorsal - SI/ referred stomach
2. Left ventral - Left colon
3. Right dorsal - Caecum
4. Right ventral - Caecum/ right colon

Question 11

What sedative protocol would be preferred in colic cases?

Answer 11

Xylazine (+flunixin for NSAID)

Question 12

Outline the relevant rectal anatomy which should be assessed on rectal examination

Answer 12

X four quadrants

• Small intestine - small tubes
• Large intestine - taenial bands, pelvic flexure
• Caecum - taenial band (x1 ventral free band)
• Small colon

Question 13

Outline the procedure for performing abdomincentesis.

Answer 13

• Ventral midline
• Most dependent part of abdomen
• +/- clip, scrub
• 18 g, 1.5 inch needle
  
  • May need spinal needle if fat!
• Can use teat cannula - holes
  
  • Contra-indications – Marked intestinal distension

Question 14

What characteristics should peritoneal fluid be assessed under?

Answer 14

1. Quantity - rupture, effusion
2. Colour - normall straw coloured (haemorrhagic? Jaundice?)
3. Clarity - Normally clear, turbid, purulent?
4. Ingesta present - gut rupture

Lab - TP, WCC, Lactate

Question 15

What would an increase in peritoneal lactate when compared with plasma lactate indicate?

Answer 15

Surgical compromise of the gut - rupture

Question 16

Why do we use Naso-gastric intubation in colic cases?

Answer 16

Drainage of reflux in the stomach - gastric rupture is FATAL!

As a diagnostic test >2L of reflux is significant

Question 17

Grass sickness

Answer 17

Aetiology unknown although C. botulinum toxin is implicated