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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
Q

Why do you not want to overuse analgesia in colics?

A

Don’t want to mask pain as could give indication of a more serious disease

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26
Q

What are the main aims during a rectal of a horse with colic?

A

Identify normal structures

Identify distension

Identify displacements

Identify abnormal structures

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27
Q

What should a rectal exam be used as when examining a horse with colic?

A

Tool to provide more information regarding severity of problem - don’t reach diagnosis as can only palpate 20-40% of abdomen

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28
Q

What four things should be done when performing a rectal?

A

Restraint

Sedation

Spasmolytic

Lubrication

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29
Q

Describe how a rectal on a horse with colic should be carried out

A

Clock - either way but tick off structures as you go around

30
Q

Describe what you can feel upon a rectal in a horse

A

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
Q

What is an abdominocentesis?

A

Sampling of peritoneal fluid via teat cannula or needle

32
Q

Describe the make up of a normal peritoneal fluid

A

Clear, straw coloured

<5000/UL cell count

<25g/l protein

Macrophages and neutrophils on cytology

33
Q

Describe abnormal peritoneal fluid

A

Serosang colour

>5000/UL cell count

>25g/l protein

Bacteria and feed material on cytology

34
Q

What can ultrasound be used to evaluate in a horse with colic?

A

Peritoneal fluid

Size of viscus

Position of viscus

Liver, kidneys and spleen

35
Q

What does clinical pathology help to assess with colic?

A

Severity of colic

36
Q

What three things can cause abdominal pain with colicking horses?

A

Distension

Inflammation or ischaemia of intestine

Irritation of peritoneum

37
Q

What are the six types of non-strangulating lesions in a colicking horse?

A

Spasmodic colic

Impaction

Displacement

Enteritis/Ileus

Typhlocolitis

Peritonitis

38
Q

Describe spasmodic colic

A

Brief episode of pain of unknown origin that resolves with no/minimal treatment

39
Q

Describe impaction caused non-strangulating lesions in horses

A

Impacted feed material in large intestine

Resolves in most cases with enteral/IV fluid therapy

Only worst cases require surgery

40
Q

Describe displacement caused non-strangulating lesions

A

Large intestine shifts in abdomen without compromising blood supply

41
Q

Describe enteritis/ileus caused non-strangulating lesions in horses

A

Infection/inflammation of small intestine causes hypomotility or amotility

Large amounts of nasogastric reflux

Requires intensive medical treatment

42
Q

Describe typhlocolitis caused non-strangulating lesions in horses with colic

A

Infection/inflammation of large intestine

Variable amounts of diarrhoea

Requires intensive medical treatment

43
Q

Describe peritonitis caused non-strangulating lesions in horses

A

Infection/inflammation of peritoneum

Variable clinical signs

Requires intensive medical treatment or surgery

44
Q

Describe how strangulating lesions progress and cause more problems

A

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
Q

What are some causes of small intestinal strangulating lesions?

A

Volvulus

Strangulating lipoma

Epiploic foramen entrapment

Inguinal/scrotal hernia

Intussusceptions

Diaphragmatic hernia

Mesenteric rent

46
Q

What are some large intestinal caused strangulating lesions in horses?

A

Colon torsion

Intussusception

47
Q

Describe what may present with small intestinal lesions in horses

A

Reflux

Distended small intestine - palpable on rectal exam

48
Q

Describe what can be found with large intestinal lesions in horses

A

Abdominal distension

Impaction or gas accumulation palpable in large intestine

Displacement of large intestine palpable

Usually no reflux

49
Q

Which causes of colic is medical treatment usually used for?

A

Small intestine: Enteritis/ileus, grass sickness

Large intestine: Spasmodic colic, impaction, left dorsal displacement, right dorsal displacement, colitis and typhlocolitis

50
Q

Which causes of colic are surgical treatments usually used for?

A

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
Q

When should you always refer a colic case?

A

Slightest suspicion of strangulating lesions

52
Q

Which causes of colic should referral be considered?

A

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
Q

What things need to be addressed before referring a colic case?

A

Circumstances

Finances

Insurance

Expectations

Willingness to agree to surgery

54
Q

What are some signs that indicate need for referral?

A

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
Q

What are the reasons for surgery in colicking horses?

A

Abdominal surgery is diagnostic/therapeutic

Suspicion of strangulating lesions

Non-resolving displacement

Non-resolving impaction

Non-responsive or recurrent pain

56
Q

What would suggest medical lesions in a colicking horse upon signalment and history?

A

Low grade pain

Still interested in feed

No worsening over time

Lying down more than usual

No rolling, thrashing, kicking at abdomen

57
Q

What would suggest a surgical lesion in a colicking horse upon signalment and history?

A

Acute onset severe pain

Owner has already given one/multiple doses of analgesic

Sweating, rolling, kicking at abdomen

Progressive deterioration

58
Q

What would be suggestive of medical lesions in a colicking horse with the cardiovascular status?

A

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
Q

What would suggest a surgical lesion with cardiovascular status in colicking horses?

A

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
Q

What would suggest a medical lesion in the GIT in a colicking horse?

A

No change in abdominal shape

Good borborygmi

Passage of normal manure

No/reduced manure for some time

61
Q

What would suggest a surgical lesion in the GIT in a colicking horse?

A

Distended abdomen

No borborygmi

62
Q

What would be suggestive of medical lesions during physical examination of other organ systems in a colicking horse?

A

No other abnormalities

Fever

Icteric mucous membranes

63
Q

What would be suggestive of a surgical lesion in other organ systems in a colicking horse?

A

Increased respiratory rate

Abrasions or other signs of trauma from rolling

Profuse sweating

64
Q

What, during nasogastric intubation and rectal, is suggestive of a medical lesion?

A

No reflux

Normal palpation

Palpable impaction

Palpable displacement

65
Q

What, during narogastic tubing and rectal, is suggestive of a surgical lesion in a colicking horse?

A

Reflux

Little haemorrhagic/black reflux

Distended small intestine on rectal palpation

Tight gaseous distension of large intestine

66
Q

What is suggestive of medical lesions in response to treatment in a colicking horse?

A

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
Q

What is suggestive of a surgical lesion in response to treatment in a colicking horse?

A

Large dose of sedative required to examine horse

Little response to flunixin meglumine

Response short lived

68
Q

What appears during additional diagnostics that would be suggestive of a medical lesion in a colicking horse?

A

Normal abdominocentesis

High nucleated cell count and protein in abdominocentesis

Normal transabdominal ultrasonographic exam

69
Q

What appears during additional diagnostics that is suggestive of a surgical lesion?

A

Abnormal abdominocentesis or ultrasonographic exam

70
Q

What are some short term complications following colic surgery?

A

Anaesthetic comlications

Post operative colic

Post operative ileus

Incisional complications

Thrombosis

Peritonitis

Laminitis

71
Q

What are some long term complications after colic surgery?

A

Recurrent/chronic colic

Incisional hernia

Alimentary - Abdominal Pain and Colic (2 decks)

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