EQ Medical colic

Question 1

What are the indications for medical colic treatment (rather than surgical)?

Answer 1

Mild-mod pain, good analgesic response, <50bpm HR, GI motility continues or improves, no net reflux, resolving abdo distension, normal peritoneal fluid, normal PCV/ TP/ lactate, elevated temperature

Question 2

Discuss the different analgesic classes used for colic treatment.

Answer 2

1. NSAIDs - Good, anti-endotox effects, beware masking effects of flunixin,
2. Alpha2s - good, may reduce GI motility,
3. Opiates - reduce GI motility (combi with a2),
4. Antispasmodics - smooth muscle relaxation (for spasmodic cases)

Question 3

What are the disadvantages of using flunixin?

Answer 3

Masks SIRS, HR and pain response as well as colic signs.

Question 4

When is use of flunixin definitely indicated?

Answer 4

Referral is not an option, exact diagnosis is known, referral decision has been made

Question 5

When should walking NOT be used in a colic case?

Answer 5

In horses who will be prone to GI ruptures

Question 6

What protocol can be used for oral fluids in the colic case?

Answer 6

4-6L every 4 hours

Question 7

On rectal exam of a colic case you palpate a firm structure in the left caudal abdomen. What aetiology may you expect?

Answer 7

Pelvic flexure impaction

Question 8

In cases of pelvic flexure impaction, what medical treatment may be undertaken and why?

Answer 8

Oral fluids - flush, epsom salts - encourage drinking, IV fluids (if not drinking),

Question 9

When would you consider a nephrosplenic entrapment case medical rather than surgical?

Answer 9

Normal cardiovascular parameters, non-severe pain, mild-mod gaseous distension

Question 10

When might psyllium be considered a useful treatment?

Answer 10

Cases of sand impaction - GI lubricant

Question 11

What are the indications for euthanasia of colic cases?

Answer 11

Uncontrollable pain, severe CV compromise, GI rupture