Equine Colic Flashcards
What is the usual cause of colic? What else may cause it?
- Usually GI
- May be due to liver/urogenital etc. causes
Which conditions may be confused for colic?
Recumbency caused by
- Laminitis
- CNS problems
- Botulism
- Musculoskeletal pain (typing up and severe lameness)
List some more unusual signs of colic
Muscle fasciculations (shivering)
Sweating
Abrasions to head and face
Foals may lie on back like a dog
Do the majority of colics require surgery?
NO! 5-7% only
Majority just spasmodic/undiagnosed, minimal intervention required
Give 5 causes of colic
- Spasmodic/gas - motility? diet? parasites?
- Impaction - usually large colon
- Displacement - usually large colon
- Strangulation
- Ulcers
For what 2 reasons are colics referred?
- further evaluation/medical treatment
- surgery
> make a diagnosis
What is the first step to take when examining a horse on farm?
Assess from a distance - need for immediate treatment?
What history should be obtained for a colic case?
- Age
- Time of colic onset (or time last seen normal)
- Severity of colic
- Treatments currently on or given
- Previous colic
- Last passed feaces
- Management change
- Worming regime
How many piles of feaces should be passed overnight?
6/7
What are the 3 main stages of a colic work up? What else may potentially be carried out?
History, PE, NGT
- rectal, abdominocentesis, ultrasound, clin path
What type of colic are older horses predisposed to?
Strangulating lipoma in SI
What does a recent change in activity level predispose to?
Impaction of LI
What should the focus of an emergency PE be for a colic workup?
- Demeanor, pain
- TPR
- Borborygmi (gut sounds)
- CV status
- ?abdominal distension
Will horses with simple colic appear depressed?
No
When should temperature be taken?
Before rectal
What does a febrile colic (pyrexic) suggest?
Colitis, enteritis, perotonitis, rupture
Simple colics DO NOT HAVE FEVER
Why may pulse rate be increased other than CV problems?
Anxiety/stress
Pain
Hypovolaemia
Why may resp rate be increased other than rep problems?
Pain
Anxiety
Abdominal distension
What is the normal HR of a horse and what may be seen in a colic?
36-40 normal, colic 60-100+
How are gut sounds described?
+++ Hypermotile
++ Normal
+ Hypomotile
- Absent
Are the quadrants of borborygmi representative of certain parts of the gut?
No
Can horses be “pinged” like a cow? What is pinging?
Yes - simultaneous percussion and auscultation
- high pitched ping suggests distension of a viscus (usually LI)
How may abdominal distension be assessed?
Paralumbar fossa
Ask the owner (without using a leading question)
Usually LI
What parameters may be assessed to look at CV status? What do abnormalities suggest?
- MMs
- CRT
- Pulse quality
- Jugular fill
- Limb temp
> more complicated colic
What should be done after history and PE for all colics?
Pass a NGT
- horses cannot vomit so gastric rupture is possible
- only way to relieve fluid/gas build up is NGT
- if >2L passed, indicative of a SI blockage, surgery indicated
If you get reflux, what should be given via the NGT?
NOTHING!
What options are available after passing an NGT?
- monitor
- medical Tx (analgesia, laxatives, fluids (oral/IV))
- monitor response to Tx
- further diagnostics
- refer?
In what situations would monitoring be appropriate?
- short duration colic
- horse no longer painful
- PE unremarkable
- No reflux
In what situations would medical Tx be appropriate?
- mild PE abnormalities, no reflux
- may give analgesia even if horse seems comfortable [be aware masking clinical signs]
- oral fluids
What are the aims of rectal exam?
- ID normal structures
- ID distension SI/LI
> gas
> ingesta (impaction) - ID displacements
- ID abnormal structure (masses etc.)
How many friends has Laura got?
0
How much of the abdomen can be palpated on rectal? Does this usuallly lead to a diagnosis?
20-40%
- often dont reach a diagnosis
How can the LI be distinguished from the small colon on rectal?
- LI has wide diameter with sacculations and taenial bands (EXCEPT pelvic flexure - smooth with mesenteric band only)
- Dominates LHS
Small colon has sacculations, 2 taenial bands and feacal balls
Is the SI palpable on rectal?
Not normally
Which side is the ceacum palpable on?
Right
What non GIT organs are palpable on the left?
Spleen
Kidney
What central/symetrical structures are palpable on rectal?
Bladder, repro organs, inguinal rings, mesenteric root, aorta
Do large colon impactions require surgery?
NO
What is SI distension said to feel like on rectal?
Bike tyres
What is the Tx for SI distension?
- Surgery
- NGT immediately if havent already
Why may a rectal be indicated/ contraindicated?
> helps with diagnosis
helps with prognosis
X risk to you
X risk to horse (rectal tears)
What type of needle is used for abdomenocentesis? What information does this provide?
- Teat cannula or normal large needle
- Assessment of bowel health (compromised gut -> leakage of cells and protein)
- be aware gut may be hit accidentally -> sampling of intestinal contents *
What does ultrasound allow you to evaluate?
> decision to go to surgery can be based on this alone
- peritoneal fluid (^ cells -> hyperechogenicity)
- size of viscus (SI)
- position of viscus (LI)
- liver, kidneys, spleen
What does clinical pathology help to evaluate?
- Severity of colic
- circulatory status
- electrolyte status
- PCV and plasma total solids
- Heamatology and biochem used to differentiate conditions eg. enteritis and choliangiohepatitis
