Equine Emergency Surgery and Perioperative Care Flashcards
what are the most common emergency surgeries?
- Colic
- Dystocia
- Trauma
- Synovial sepsis
- Fracture repair
what is colic?
abdominal discomfort
what body systems are involved in colic?
– Liver
– Urinary tract
– Reproductive organs
how would you take a history for a colic patient from the owner?
- How long has the horse been colicking for?
- Severity of signs shown so far?
- When were faeces last passed?
- Breed/age/sex
- Has this happened before?
- Any management changes?
– Stabling / turnout
– Worming
– Geographical region
how would you take a history from a colic horse who came from a referring vet?
- TPR on initial presentation
- clinical findings so far
- medications administered?
- is surgery an option for owner? insurance? financial concerns?
what is needed for a colic assessment?
- Drugs
– Sedation (xylazine, detomidine and butorphanol)
– NSAIDs (flunixin)
– Buscopan / Buscopan compositum - Clippers
- Sterile prep solution (Chlorhexidine and surgical spirit)
- Catheter (12g or 14g long-stay catheters)
- Blood tubes
- Lactate reader
- Nasogastric tube
- Rectal gloves and lubricant
- Fluids (Isotonic and hypertonic)
- Ultrasound machine
what are you focusing on durig a physical exam of a colic horse?
- Demeanor, signs of pain, abrasions
- TPR
- GI borborygmi (gut sounds)
- Cardiovascular status (Mucous
membranes, pulses) - Abdominal distension
what bloods would you do for a colic horse?
PCV, TP, lactate
what procedure might you do for a colic horse?
Abdominocentesis
what should you do to prepare a colic horse for surgery?
- Ensure an IVC is present and patent
- Ensure the stomach has been decompressed (or an NGT is left in) Start clipping the abdomen if safe
– 20cm either side of midline, over the whole ventral abdomen - Remove shoes if safe
how would you prep theatre for a colic horse who has just been sedated?
- Theatre bed – ready to receive horse in dorsal recumbency
- Anaesthetic machine and circuit
- Hoist – ready and working by knockdown
- Clippers (x2)
- Urinary catheter (Suture)
- Surgical scrub
–Hose, hibi swabs, spirit swabs
–If the horse has been rolling ++, it will take a while
how wold you prep theatre after the colic horse has been prepped and is coming into theatre?
- Warmed fluids
- Carboxymethylcellulose (CMC)
- Surgical kit (x2)
- Fresh gloves +/- gowns in case of contamination /enterotomy/ resection
- Drapes (lots)
- Hose
- Colon table and dump drum
–(Colon contents may need to be emptied)
what is included in a resection kit?
- Buster drapes
- Doyen clamps (atraumatic bowel clamps)
- Suture material
- Fluids for lavage
what dressings would you use for a horse that has had colic surgery?
–Melolin
–Lap bandage as stent
–Adhesive spray
what should you do once the colic horse has been moved to recovery?
–Remove urinary catheter
–Bandage feet if shoes still on
–Towel dry as much as possible (will be saturated due to scrub/lavage during surgery
what post-op care should you provide to the colic horse?
– IVFT +/- Lidocaine CRI
– Analgesia
– Antimicrobials
– Incision care
what post-op complications can arise after colic surgery?
- endotoxaemia
- ileus
- colitis
- jugular thrombophelbitis
- peritonitis
- incisional infection
What should you do if a horse gets endotoxaemia?
– IVFT
– Flunixin +/- Polymixin B +/- hyperimmune plasma
– Can cause laminitis so ice boots pre-emptively + deep bed +/- frog supports
what should you do if a horse gets ileus?
– Nasogastric intubation regularly – gastric decompression
– Pro motility drugs – lidocaine, erythromycin, metoclopramide
– IV fluids
– Nil by mouth
– Monitor by ultrasound
what should you do if a horse gets colitis?
–IVFT!
–Isolation?
–Gastroprotectants e.g. misoprostol and sucralfate
what should you do if a horse gets jugular thrombophlebitis?
–Remove catheter
–Local anti-inflammatory treatment
–Consider anti-thrombolytics?
what should you do if a horse gets peritonitis?
– Diagnosed by abdominocentesis
– Broad spectrum antimicrobials (pen,
gent, metronidazole)
what should you do if a horse gets incisional infection?
– Antimicrobials if the horse is systemically
unwell
– Swab for culture and sensitivity before
encouraging drainage
what post-op monitoring should you do after colic surgery?
- Demeanour
- GIT borborygmi, faecal output/consistency, appetite
- Jugular vein (heat, swelling, pain, patency)
- Feet (comfort and digital pulses)
- Incision (oedema, discharge)
- Ensure geldings are not urinating on a belly bandage
