Equine Colic Flashcards
what is colic?
non-specific abdominal pain
when should you re-evaluate a plan for surgical intervention?
fever
leukopenia
diarrhea
what are the approaches to the abdomen?
ventral midline
paramedian
inguinal
ventral paramedian
parainguinal
suprapubic
how good of exposure can be achieved with a ventral midline approach?
good exposure 75% of intestinal tract
what should you use for suturing the skin?
3-0 monofilament absorbable
what are the benefits of a simple continuous suture?
faster to place
equalizes tension
fewer knots
how can you avoid contamination during anesthetic recovery?
adhesive barrier dressing
stent
when is the linea alba healed back to full tensile strength?
8 weeks
how long does PDS take to absorb?
180 days
what can cause gastric distention?
anterior enteritis
small intestinal strangulation
small intestinal obstruction
outflow obstruction (rare)
should you go to surgery for a gastric feed impaction?
not usually
what is the prognosis of gastric feed impaction?
up to 50% mortality
what are the obstructive lesions in the small intestine?
ascarid impaction
ileal impaction
what are the physical exam findings with small intestinal strangulating lesions?
presence nasogastric reflux
distended small intestine on palpation
distended, amotile small intestine on ultrasound (+/- thickened walls, +/- two populations)
how much of the small intestine can you safely remove?
50%
35 feet
which horses usually get strangulating lipomas?
older horses
overweight
what are the borders of the epiploic foramen?
liver
portal vein
caudal vena cava
pancreas
who usually gets intussusception?
<3 years old
who usually gets inguinal hernias?
stallions
who usually presents with ascarid impaction?
<1 year old
what can happen with the cecum?
cecal impaction
cecal torsion
cecal tympany
what is type I cecal impaction like?
dry/impacted feed
concurrent large colon displacement/impaction
typhlotomy
what are the obstructive lesions in the large colon?
feed impaction
sand impaction
enterolithiasis
what is the medical management for large colon gas colic?
banamine
buscopan
walking
withhold food
trocarization?
what can be found on rectal with large colon feed impaction?
usually impacted large colon
what is the medical management for large colon feed impaction?
banamine
fluids
mineral oil/electrolytes
walking
withhold/restrict food
when should surgery be performed on large colon feed impaction?
intractable pain
progressive abdominal distension
what can you access through the pelvic flexure?
ventral colon
dorsal colon
transverse colon
where are large colon enteroliths common?
california
florida
what can be felt on palpation with large colon enteroliths?
normal
gas
impaction of large colon
should you medically manage or go to surgery for large colon enteroliths?
go to surgery
what can be felt on rectal of large colon displacements?
malpositioning of colon
+/- gas distention colon and cecum
is medical management or surgery a better option for large colon displacements?
usually medical management
what can be felt on rectal with large colon volvulus?
tight bands
distended colon passing transversely across pelvic inlet
what are the strangulating lesions of the small colon?
lipoma
volvulus
do small colon strangulating lesions have high complication rates?
yes
what can you feel on rectal with small colon impaction?
tubular impaction in small colon
how many horses with small colon impactions have salmonella?
25%
what are rectal tears from?
rectal palpation: complication
parturition/dystocia
breeding accident
what is a grade I rectal tear?
mucosa/submucosa only
which grades of rectal tears should be referred to a surgical facility?
grade III and IV
what can rectal prolapse be secondary to?
diarrhea
repeated rectal examinations
small colon obstruction
rectal tears
which pathologies of the GI tract can be either medical or surgical?
displacements
obstructive
ingesta
what are the AAEP standards for euthanasia?
horse should not have to endure continuous or unmangageable pain from a condition that is chronic and incurable
horse should not have to endure medical or surgical condition with hopeless chance of survival
what is there limited access to through a ventral midline approach?
stomach
duodenum
distal ileum
base of cecum
distal right dorsal colon
transverse colon
terminal small colon
how long does vicryl take to absorb?
60 days
50% at day 21
what can cause colic from the stomach?
gastric distension
gastric food impaction
gastric ulceration
how can you treat gastric feed impaction?
IV fluids
gastric lavage
diet coke
no surgery
what are the causes of strangulating lesions of the small intestine?
lipoma
volvulus
epiploic foramen entrapment
incarceration in mesenteric rent
inguinal hernia
intussusception
what are colic signs with small intestinal strangulating lesions?
acute and severe
what does abdominocentesis yield with small intestinal strangulating lesions?
serosanguinous
what does treatment of small intestinal strangulating lesions often entail?
surgery with resection/anastomosis
no medical management
what does a horse with epiploic foramen entrapment often have a history of?
cribbing
can intussusception be acute or chronic?
yes
can you have normal abdominocentesis with an intussusception?
yes
how is the long term prognosis for small intestinal ascarid impaction?
poor
what are the clinical signs with cecal impaction?
insidious onset
small piles small manure balls
distended cecum on palpation
how is cecal impaction treated?
medical: only for mild
surgery: typhlotomy, +/- cecal bypass
what is type II cecal impaction like?
soft/fluid contents
motility disorder
cecal bypass
how does large colon gas colic present?
acute onset mild-marked pain
marked gas distension large colon
pings
is large colon gas colic usually treated with surgery or medical management?
medical management
how does large colon feed impaction present?
gradual onset pain- up to moderate
decreased manure output
“normal” after banamine
impacted large colon on rectal
where can a large colon feed impaction happen?
pelvic flexure
right dorsal colon
transverse colon
how does a large colon sand impaction present?
chronic/low grade colic signs
decreased manure
impaction on palpation
mineral density on radiographs
how can you treat large colon sand impaction?
usually medical: banamine, fluids, psyllium, walking, no food
surgery if severe: enterotomy
how does a large colon displacement present?
acute onset mild-marked
many permutations
how can you identify left dorsal displacement for large colon displacement?
cannot visualizer kidney adjacent to spleen
what does a large colon volvulus present like?
acute severe colic, intractable pain
endotoxic
palpation findings
serosanguinous abdominocentesis
what does a small colon strangulating lesion present like?
acute severe colic signs
serosanguinous abdominocentesis
maybe findings on ultrasound and palpation
why is there a high rate of complications with small colon strangulating lesions?
fatty mesentery
vascular pattern
dry ingesta
very muscular
small lumen diameter
collagenase producing bacteria
what does a small colon impaction present like?
gradual onset mild-moderate
decreased manure output
palpate tubular impaction in small colon
what might be done in surgery for a small colon impaction?
intraluminal lavage
what does a small colon enterolithiasis present like?
acute onset moderate-marked
no manure
gas distention large and small colon
what should you do for small colon enteroliths?
surgery
what should you do for grades III and IV rectal tears?
antibiotics
laxatives
analgesics
tetanus booster
IV fluids
rectal packing
refer to surgery
what is a type IV rectal prolapse?
rectum and small colon intussuscept through anus
