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GI2 > Equine 4 - colic > Flashcards

Equine 4 - colic Flashcards

1
Q

where is the large colon attached to the body

A
  • caecum
  • right dorsal colon
    (right ventral colon attached to right dorsal and caecum)
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2
Q

list the order of sections of the large intestine following from the caecum

A 
cauceum 
RVC
sternal flexure 
LVC 
pelvic flexure 
LDC
diaphragmatic flexure 
RDC 
transverse colon 
descending colon
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3
Q

which sites are predisposed for impaction

A

the 180 degree bends - especially the pelvic flexure

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4
Q

what does SCOD stand for

A

simple colonic obstruction and distension - all forms of large colon disease except those causing vascular obstruction

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5
Q

what are the risk factors of SOCD

A 
windsucking/crib-biting 
stabling 24 hours a day 
history of travel in past 24 hours 
recent change in exercise program 
absence of use of moxidectin/ivermectin in previous 12months 
increasing hours in stable 
history of colic 
less regular dental care
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6
Q

describe a primary pelvic flexure impaction

A

flexure pushes back into pelvic inlet

build up of ingesta causing it to feel doughy

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7
Q

describe a secondary pelvic flexure impaction

A

occurs secondary to sequestration of fluid in the small intestine so none makes it to the colon. will feel very hard due to lack of fluid

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8
Q

what may be the primary causes of secondary PF impaction

A

ileal impaction
anterior enteritis
equine grass sickness
other strangulating lesions if chronic

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9
Q

how is primary PF impaction treated

A

NG intubation of fluids - 6L every 30-60mins (no proof that paraffin is better)
alternative - provide analgesia and wait for passage
can remove ingesta surgically if too painful

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10
Q

what is a key disadvantage to using paraffin in NG intubation

A

if administered down the trachea accidentally it will kill the horse as it prevents gas exchange

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11
Q

how is a left dorsal displacement (nephrosplenic entrapment) felt on rectal exam

A

can’t feel left kidney or spleen or feel displaced spleen

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12
Q

how is a simple left colon displacement felt on a rectal exam (retroflexion of pelvic flexure)

A

cannot feel flexure

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13
Q

how is right dorsal displacement felt on a rectal exam (colon moves between caecum and body wall)

A

feel horizontal taenial bands of colon on right side rather than vertical band of caecum

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14
Q

what are the clinical signs of colon displacement

A
  • abdominal distension (especially on left for LDD)
  • reduced gut sounds
  • varying degrees of pain (LDD > RDD)
  • usually cardiovascularly stable - HR normal/slightly high, PCV and lactate normal
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15
Q

how are colon displacements treated and what is the prognosis

A 
medical initially as gut is still functioning 
surgery if pain becomes unmanageable 
prognosis good (but some predisposed to recur)
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16
Q

what is a large colon volvulus

A

entire colon twists around the long axis involving both dorsal and ventral colons usually site of right dorsal and ventral colon. signs depend on degree of rotation

17
Q

describe an 180 degree large colon volvulus

A

mild pain
often present like a displacement
not ischaemic or vascularly compromised so manage medically and hope it untwists

18
Q

describe a 270 degree volvulus

A

usually complete rotation but no vascular compromise

19
Q

what are the clinical signs of a volvulus over 270 degrees

A

severe, uncontrollable pain
vascular compromise - tachycardia, dehydration, congested mm
abdominal distension
rectal - distended, tympanitic, oedematous LI, abnormal position, tight taenial bands

20
Q

describe a volvulus over 360 degrees

A

complete obstruction and vascular compromise

21
Q

why do horses with 360 degree volvulus lose a significant proportion of circulating blood volume and cardiovascular compromise

A

venous occlusion but blood still pumped in until it reaches a point of arterial occlusion which traps the blood. Enters submucosal space then get fluid sequestration and protein loss . pressure on the diaphragm also worsens CV compromise

22
Q

what causes SIRS in colon volvulus

A

dying gut allows bacterial toxins to pass through the gut wall.

23
Q

how are colonic torsions treated

A

midline laparotomy incision
exteriorise (30-40kg - may perform enterotomy at pelvic flexure to reduce weight from ingesta but blood remains)
untwist
euthanase if bowel is non-viable
colon resection rarely performed in UK - difficult due to congestion and mural oedema

24
Q

how are horses managed post-op after correction of a colonic volvulus

A

same as for SI surgery
care over hydration and serum protein
may require plasma transfusion

25
Q

list particular complications after colonic volvulus correction

A

SIRS
diarrhoea/colitis
laminitis due to septic shock
hypoproteinaemia

26
Q

what is the prognosis for colonic volvulus correction

A

360 - poor. directly related to CV status before surgery , higher risk of post-op colic

27
Q

how are caecal diseases diagnosed

A

rectal examination

28
Q

describe caecal impactions

A

often seen in orthopaedic patients following box rest
failure of treatment may lead to rupture
often not diagnosed until late in disease - only mild pain early on

29
Q

describe caecal intussusception

A

usually younger horses
high association with tapeworm burden
feel some change if not the intussusception itself

30
Q

name types of caecal disease

A

impactions
intussusceptions
local infarction
involvement in large colon torsions (apex in twist)

31
Q

what is the prognosis for caecal diseases

A

poor unless there is no ischaemia or only focal ischaemia of the caecal apex

32
Q

list some diseases of the small colon

A
  • strangulated by lipomas
  • impaction (may be presumptive in ponies too small to rectal)
  • intussusception
33
Q

what is the prognosis for small colon surgery

A

excellent compared to other LI lesions

34
Q

what anatomical landmarks would you expect to feel in a normal horse rectal

A 
clockface 
12 - aorta 
11 - left kidney, nephrosplenic ligament, caudal border of spleen 
7 - pelvic flexure 
6 - uterus if female 
3-5 - caecum 
NOT small intestine
35
Q

what pharmacological agents may make a rectal exam safer

A

IV buscopan
lidocaine per rectum
ketamine per rectum
sedation - A2A

36
Q

what are the landmarks for abdominocentesis in a horse

A

most dependent part of the abdomen
midline
5cm caudal to xiphoid
US to detect fluid pockets

37
Q

what are the immediate treatment options for nephrosplenic entrapment

A

phenylephrine then lunging - causes spleen to contract to help dislodge the colon. lunging aids dislodging
rolling - drop onto right side, rolled into sternal then onto left

38
Q

what are the surgical treatment options for nephrosplenic entrapment

A

nephrosplenic space ablation
large colon colopexy
large colon resection

GI2 (27 decks)

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