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Alimentary - Abdominal Pain and Colic > Equine > Flashcards

Equine Flashcards

1
Q

What can be some causes of colic?

A

Spasmodic/gas

Impaction

Displacement

Strangulation

Liver Problems

Urogenital System Problems

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2
Q

What are some examples of things that look like colic but aren’t?

A

Laminitis

Neurologic disease

Botulism

Musculoskeletal Pain

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3
Q

Describe the clinical signs of colic (10)

A

Pawing

Trying to go down - not always fully recumbent

Rolling - incessant with colic - shavings everywhere

Abrasions - caused by rubbing head on ground when rolling

Recumbency

Muscle fasciculations

Looking at flanks

Restlessness

Kicking at abdomen

Sweating

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4
Q

What do most horses with colic not need?

A

Surgery

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5
Q

What needs to be determined first when examining a horse with colic?

A

Can it be treated in the field or does it need to be referred?

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6
Q

Why is it important to decide on whether to refer or not early?

A

Improves prognosis - increases chance of survival

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7
Q

What is mainly used to diagnose the cause of colic?

A

History

Physical Examination

Naso-gastric tube

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8
Q

What other examinations can be used to determine cause of colic?

A

Rectal examination

Abdominocentesis

Ultrasound examination

Clinical Pathology

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9
Q

What should be obtained from a history during a colic case?

A

Age

Time of onset

Degree of colic

Any treatments given

Previous colic

Last passed faeces

Management

Worming regime

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10
Q

Why are signalment and history important in colic cases?

A

Can help formulate a list of possible differentials

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11
Q

What needs to be focused on during a colic case physical exam?

A

Demeanor with signs of pain

TPR

GI borborygmi (gut sounds)

CV status

Abdominal distention

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12
Q

What is most likely the cause of colic if presenting with a fever as well?

A

Infection (an -itis)

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13
Q

What are the four grades of gut sound?

A

Hypermotile

Normal

Hypomotile

Absent

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14
Q

What does a high pitched ‘ping’ of the abdomen on a horse with colic suggest?

A

Gas distension of a viscus

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15
Q

What are the ways in which we can assess abdominal distension in horses with colic?

A

Paralumbar fossa

Ask the owner

Large intestine

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16
Q

What can we use to assess cardiovascular statue?

A

Mucous membrane colour

CRT

Pulse quality

Jugular fill

Limb temperature

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17
Q

What do abnormalities in cardiovascular status suggest with colic?

A

More complicated colic

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18
Q

What should be done in most colic cases?

A

Pass a nasogastric tube - horses can’t vomit so is only way to relieve gastric distension

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19
Q

What should you do if you get reflux via the nasogastric tube?

A

Don’t give anything via the tube

REFER!

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20
Q

What is considered abnormal when siphoning stomach contents via nasogastric tube?

A

Anything more than 2 litres which suggests small intestine dysfunction

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21
Q

What five things should be considered doing after inital examinations?

A

Monitor

Medical Treatment

Monitor Response to Treatment

Further Diagnostics

Refer

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22
Q

When should you decide to monitor a horse that has colic?

A

Short duration

Horse is no longer painful

Physical exam is unremarkable

No reflux upon nasogastro tubing

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23
Q

When should medical treatment be considered in a horse with colic?

A

Only mild abnormalities on physical exam

No reflux

May give even if horse seems comfortable

Oral if no reflux

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24
Q

What are the six main analgesia used for colics?

A

Dipyrone

Phenylbutazone

Flunixin meglumine

Xylazine

Detomidine

Butorphanol

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25
Why do you not want to overuse analgesia in colics?
Don't want to mask pain as could give indication of a more serious disease
26
What are the main aims during a rectal of a horse with colic?
Identify normal structures Identify distension Identify displacements Identify abnormal structures
27
What should a rectal exam be used as when examining a horse with colic?
Tool to provide more information regarding severity of problem - don't reach diagnosis as can only palpate 20-40% of abdomen
28
What four things should be done when performing a rectal?
Restraint Sedation Spasmolytic Lubrication
29
Describe how a rectal on a horse with colic should be carried out
Clock - either way but tick off structures as you go around
30
Describe what you can feel upon a rectal in a horse
**Large intestine** - wide diameter with sacculations and taenial bands; dominates left hand side **Small colon** - sacculations, two taenial bands and faecal balls **Small intestine** - not normally palpable **Caecum** **Left kidney** **Spleen** **Bladder** **Reproductive Organs** **Inguinal Rings** **Mesenteric Roots** **Aorta**
31
What is an abdominocentesis?
Sampling of peritoneal fluid via teat cannula or needle
32
Describe the make up of a normal peritoneal fluid
Clear, straw coloured \<5000/UL cell count \<25g/l protein Macrophages and neutrophils on cytology
33
Describe abnormal peritoneal fluid
Serosang colour \>5000/UL cell count \>25g/l protein Bacteria and feed material on cytology
34
What can ultrasound be used to evaluate in a horse with colic?
Peritoneal fluid Size of viscus Position of viscus Liver, kidneys and spleen
35
What does clinical pathology help to assess with colic?
Severity of colic
36
What three things can cause abdominal pain with colicking horses?
Distension Inflammation or ischaemia of intestine Irritation of peritoneum
37
What are the six types of non-strangulating lesions in a colicking horse?
Spasmodic colic Impaction Displacement Enteritis/Ileus Typhlocolitis Peritonitis
38
Describe spasmodic colic
Brief episode of pain of unknown origin that resolves with no/minimal treatment
39
Describe impaction caused non-strangulating lesions in horses
Impacted feed material in large intestine Resolves in most cases with enteral/IV fluid therapy Only worst cases require surgery
40
Describe displacement caused non-strangulating lesions
Large intestine shifts in abdomen without compromising blood supply
41
Describe enteritis/ileus caused non-strangulating lesions in horses
Infection/inflammation of small intestine causes hypomotility or amotility Large amounts of nasogastric reflux Requires intensive medical treatment
42
Describe typhlocolitis caused non-strangulating lesions in horses with colic
Infection/inflammation of large intestine Variable amounts of diarrhoea Requires intensive medical treatment
43
Describe peritonitis caused non-strangulating lesions in horses
Infection/inflammation of peritoneum Variable clinical signs Requires intensive medical treatment or surgery
44
Describe how strangulating lesions progress and cause more problems
One hour - Viable intestine - distension of intestine and stomach with fluid Three-four hours - Compromised intestine - leakage of blood and protein into abdomen as well as fluid loss into intestine Six-eight hours - Dead intestine - absorption of toxins into blood
45
What are some causes of small intestinal strangulating lesions?
Volvulus Strangulating lipoma Epiploic foramen entrapment Inguinal/scrotal hernia Intussusceptions Diaphragmatic hernia Mesenteric rent
46
What are some large intestinal caused strangulating lesions in horses?
Colon torsion Intussusception
47
Describe what may present with small intestinal lesions in horses
Reflux Distended small intestine - palpable on rectal exam
48
Describe what can be found with large intestinal lesions in horses
Abdominal distension Impaction or gas accumulation palpable in large intestine Displacement of large intestine palpable Usually no reflux
49
Which causes of colic is medical treatment usually used for?
**Small intestine:** Enteritis/ileus, grass sickness **Large intestine:** Spasmodic colic, impaction, left dorsal displacement, right dorsal displacement, colitis and typhlocolitis
50
Which causes of colic are surgical treatments usually used for?
**Small intestine:** Volvulus, strangulating lipoma, epiploic foramen entrapment, inguinal/scrotal hernia, intussusceptions, diaphragmatic hernia, mesenteric rent and grass sickness **Large intestine:** Colon torsion and non-resolving displacements and impactions
51
When should you always refer a colic case?
Slightest suspicion of strangulating lesions
52
Which causes of colic should referral be considered?
Small intestinal lesions - either surgery or intensive therapy needed Conditions requiring intensive medical treatment Non-resolving impactions Recurring colic/chronic colic If you are not sure and owner is willing
53
What things need to be addressed before referring a colic case?
Circumstances Finances Insurance Expectations Willingness to agree to surgery
54
What are some signs that indicate need for referral?
Moderate to severe pain Recurrent pain Pain poorly responsive to analgesia Signs of cardiovascular compromise Severe abdominal distension Signs of small intestinal lesion Signs of strangulating lesion
55
What are the reasons for surgery in colicking horses?
Abdominal surgery is diagnostic/therapeutic Suspicion of strangulating lesions Non-resolving displacement Non-resolving impaction Non-responsive or recurrent pain
56
What would suggest medical lesions in a colicking horse upon signalment and history?
Low grade pain Still interested in feed No worsening over time Lying down more than usual No rolling, thrashing, kicking at abdomen
57
What would suggest a surgical lesion in a colicking horse upon signalment and history?
Acute onset severe pain Owner has already given one/multiple doses of analgesic Sweating, rolling, kicking at abdomen Progressive deterioration
58
What would be suggestive of medical lesions in a colicking horse with the cardiovascular status?
**No signs of compromise:** ​ * Normal heart rate * Pink mucous membranes * CRT less than 2 seconds * Normal skin tenting * Good jugular filling * Warm extremities and ears * Good pulse quality
59
What would suggest a surgical lesion with cardiovascular status in colicking horses?
**Cardiovascular compromise:** * Tachycardia * Abnomal membrane colours * CRT greater than two seconds * Prolonged skin tent * Delayed/no jugular filling * Cold extremities and ears * Poor pulse quality
60
What would suggest a medical lesion in the GIT in a colicking horse?
No change in abdominal shape Good borborygmi Passage of normal manure No/reduced manure for some time
61
What would suggest a surgical lesion in the GIT in a colicking horse?
Distended abdomen No borborygmi
62
What would be suggestive of medical lesions during physical examination of other organ systems in a colicking horse?
No other abnormalities Fever Icteric mucous membranes
63
What would be suggestive of a surgical lesion in other organ systems in a colicking horse?
Increased respiratory rate Abrasions or other signs of trauma from rolling Profuse sweating
64
What, during nasogastric intubation and rectal, is suggestive of a medical lesion?
No reflux Normal palpation Palpable impaction Palpable displacement
65
What, during narogastic tubing and rectal, is suggestive of a surgical lesion in a colicking horse?
Reflux Little haemorrhagic/black reflux Distended small intestine on rectal palpation Tight gaseous distension of large intestine
66
What is suggestive of medical lesions in response to treatment in a colicking horse?
Signs of pain controlled with small dose of sedative No recurrence of colic signs after initial dose Horse remains comfortable for a day or two
67
What is suggestive of a surgical lesion in response to treatment in a colicking horse?
Large dose of sedative required to examine horse Little response to flunixin meglumine Response short lived
68
What appears during additional diagnostics that would be suggestive of a medical lesion in a colicking horse?
Normal abdominocentesis High nucleated cell count and protein in abdominocentesis Normal transabdominal ultrasonographic exam
69
What appears during additional diagnostics that is suggestive of a surgical lesion?
Abnormal abdominocentesis or ultrasonographic exam
70
What are some short term complications following colic surgery?
Anaesthetic comlications Post operative colic Post operative ileus Incisional complications Thrombosis Peritonitis Laminitis
71
What are some long term complications after colic surgery?
Recurrent/chronic colic Incisional hernia

Alimentary - Abdominal Pain and Colic (2 decks)

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