Equine GI disease pt 1 Flashcards
horse stomach capacity and location
- can we see abdominal distension with dilation of the stomach?
Stomach: capacity of 4- 5 gallons
- Completely enclosed by the rib cage, thus will not see abdominal distension with dilation of the stomach.
horse small intestine length, diameter
- location
- how long is the mesentery for each part?
A. Average length of 22 metres (70 feet)
B. Average diameter is 3.5 to 4.0 cm - 6 to 7.0 cm when become stretched
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C. Separated in 3 segments:
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1. Duodenum
a. Originates on the right side of the abdomen
b. Descending portion closely associated with the right lobe of the liver, the right dorsal colon and the right kidney
c. Mesoduodenum is short (fixed). At the last rib the duodenum turns towards the midline, then becomes jejunum
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2. Jejunum
a. Suspended by a long mesentery - up to 50 cm in length at the distal aspect of the jejunum
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3. Ileum
a. About 2 feet long
b. Differentiate by a fold of tissue at the anti mesenteric side that becomes continuous with the dorsal tenial band of cecum as the ileocecal fold
horse LI length
A. Cecum to anus 7 - 8 metres
horse large intestine components
Separated into cecum, large colon, and small colon
cecum shape, orientation
- bands
- folds
- haustra?
- connection
a. Comma shaped, apex running forward along the abdominal floor
b. 4 tenial bands* (lateral, dorsal, medial and ventral)
(1) Ileocecal fold continuous with the dorsal band of cecum on the lesser curvature and the anti-mesenteric band of the ileum
(2) Cecocolic fold arises from the lateral cecal band and attaches to the lateral free band of the RVC
c. Presence of haustra**
d. Base attached dorsally by connective tissue to the abdominal wall
horse large colon
- components
> bands
> haustra?
> location
a. Right ventral colon (RVC)
(1) Diameter of 20-25 cm
(2) 4 tenial bands (Lateral and medial free bands, lateral and medial bands)
(3) Presence of haustra
(4) End at sternal flexure
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b. Left ventral colon (LVC)
(1) Diameter of 20-25 cm
(2) 4 tenial bands (Lateral and medial free bands, lateral and medial bands)
(3) Presence of haustra
(4) End at pelvic flexure (8-9 cm)
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c. Left dorsal colon (LDC)
(1) 1 tenial band (mesenteric)
(2) End at diaphragmatic flexure
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d. Right dorsal colon (RDC)
(1) Up to 50 cm
(2) 3 tenial bands
(3) End at transverse colon
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e. Transverse colon - 8 cm in diameter
horse small colon length, location, bands, haustra?
a. Approximately 3 metres in length
b. The coils are mingled with those of the small intestines
c. 2 tenial bands (mesenteric and anti mesenteric)
d. Presence of haustra
what are tenia and haustra?
Tenia: longitudinal bands of muscle
Haustra: sacculations of the bowel found at the level of the cecum, RVC, RDC and small colon
what is colic? divided into what broad types?
A. General term describing several conditions with symptom of abdominal pain
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B. Divided into:
1. True Colic pain originating from the digestive tract
2. False Colic originating from elsewhere
Differential Diagnosis (false colic) must include:
A. Reproductive problem
1. Mares in Heat
2. Advancing Pregnancy
3. Rupture of the middle uterine artery
4. Ruptured ovarian granulosa cell tumour
5. Uterine Torsion
6. Breeding Injuries
a. Vaginal Tear
b. Rectal Perforation
7. Testicular Torsion
8. Thrombosis of Testicular Artery
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B. Urinary tract disease
1. Urinary calculi
2. Kidney Disease
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C. Liver disease
1. Cholelithiasis
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D. Haemorrhagic Shock
1. Rupture of a cranial mesenteric aneurysm
2. Splenic rupture
3. External hemorrhage
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E. Respiratory problem
1. Pleuritis
2. Acute exacerbation of respiratory obstructive disease
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F. Others
1. Tetanus
2. Laminitis
3. Rabies
4. Grass Sickness
5. Myositis
mild colic clinical signs
- Mild colic signs: anorexia, depression, teeth grinding, yawning
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1. Yawning
2. Extended neck stretching of upper lip in flehmen like response
3. Teeth grinding
4. Anxiety in the eyes
5. Looking at flanks with ears pinned back
6. Dullness and depression
7. Groaning
moderate colic clinical signs
- Moderate colic signs: looking at flanks, pawing, groaning, muscle tremor, frequent small urination, rolling
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1. Pawing at the ground with front feet
2. Lashing out with hind legs
3. Muscle tremors particularly in hot blooded horses
4. Patchy sweating
5. Frequent posturing to urinate but passing only small amounts
6. May want to lean against the wall or lie on the ground
7. Rolling
8. Resting in unnatural positions, on back or dog sitting with forelegs extended.
9. May have abnormal feces, diarrhea, foul smelling, or hard and dry
severe colic signs
- Severe colic signs: violent rolling, kicking at belly, crash to the ground, abdominal
distension, might attempt to vomit
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1. As with moderate but more severe
2. Pain usually continuous
3. Violent rolling, kicking at belly
4. Flip laterally and crash to the ground (up and down)
5. Total disregard for self or handlers
6. Traumatise self the head on the supraorbital process, lower legs and the hocks
7. Sweating, generalised, will steam and drip sweat from under belly continuously
8. Distended abdomen
9. Laboured breathing
10. Might attempt to vomit appearance of greenish discharge at the nostrils, not at the mouth
11. Rolling on its back relief by taking the tension off the mesentery
What to do in case of colic?
- broadly, what are our options / things we should consider?
A. Prevention of further damage
B. Take a good history
C. Observe
D. Physical examination
E. Per rectum examination
F. Nasogastric intubation
G. Abdominal paracenthesis-abdominocenthesis
H. Laboratory Tests
I. Trocharization of the large bowel
J. Imaging techniques
how to prevent further damage in the case of a colic, before doing anything else?
- what can violent rolling cause?
- If animal rolling violently may cause
a. Rupture of an internal organ
b. Fracture of spinous processes of the withers
c. Produce an organ displacement or volvulus
how to prevent further damage in the case of a colic, before doing anything else?
- suggestions to avoid injury
- To avoid injury, you may suggest
a. Walk the horse
b. Off feed
c. Do not administer home remedies
d. DO NOT GET HURT
e. Bandage lower legs
f. If in a stall, get into an arena or outside onto pasture
how to prevent further damage in the case of a colic, before doing anything else?
- initiate therapy in severe cases? what to do?
- Severe cases may need to initiate therapy immediately
a. Presence of ingesta at the external nares - get a nasogastric tube in!
b. Violent colic - may need to administer analgesics > take a heart rate before
what to investigate when you take a history for a colic case?
- Signalment
- Duration and nature of the colic signs
- Passage of feces? consistency?
- Diet, availability of water
- Previous colic?
- Worming history
- History of medical treatment (NSAID)
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1. When?
2. Nature of colicky signs
a. Acute Vs chronic
b. Progression?
3. Passage and nature of feces (mucus)
4. Age of animal
5. Anorexia? Water access?
6. Diet? Recent change? (new oats, fresh hay, or apples producing rapid fermentation)
7. Worming history
8. History of previous colic
9. Vaccination history
10. Regular dental care
11. Any accident, injury, or recent infections, e.g. diaphragmatic hernia, rent in mesentery, malignant edema
12. Sex
a. Mare history of recent breeding, pregnant?
b. Male inguinal hernia
13. Previous abdominal surgery (adhesions) - Palpate the midline
14. History of medical treatment (NSAID intoxication)
what to observe for in a colic case as soon as you arrive?
Observe the horse and environment:
* are these signs typical of abdominal pain?
* severity of signs
* abdominal distension
* signs of injury
* look at the environment
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1. Look at stall or surroundings for signs of damage, pawing, pacing, rolling…
2. Position of the ears
3. Is the horse depressed, or alert?
4. Self induced trauma? (wounds on the eyelid…)
5. Abdominal distention
a. large bowel > most likely viscera producing a noticeable enlargement of the abdomen
what parameters should we look at for a physical exam during a colic call
- pulse
- rate
- quality
<><> - temp
<><> - cardiovascular signs
- mucous membranes: colour, CRT
- skin
<><> - respiratory system
- rate
- chest auscultation
<><> - auscultation of the abdomen
- motility, typmany
> evaluate four quadrants
> percussion
<><> - reproductive system
- stallion > palpation of scrotum
what is a normal heart rate for a horse? what rates indicate medical problems?
- when might we need an ex-lap?
(1) 36 beats/min normal
(2) 40-60 beats/min usually medical problem
(3) 60-80 beats/min may need exploratory laparotomy
(4) 80-100 beats/min likely needs an exploratory laparotomy
(5) >100 beats/min very serious
how does pulse quality relate to prognosis for a colic?
(1) Stronger the pulse the better the prognosis
(2) Weak irregular pulse indicates a failing heart (metabolic acidosis, endotoxic shock)
when should we take our rectal temp for a colic call?
- what does an increased temp indicate? decreased?
a. Take temperature before performing a per rectum examination
b. Colic with acute pain may have a slight elevation
c. +/- increased with peritonitis or infectious diarrhea
d. Temperature subnormal with shock
what are we looking for when we examine the skin during a PE for colic?
- sweating
- extremeties
- resiliency
(1) Sweating > severe pain or rupture
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(2) Feel extremities for uneven temperature distribution
(a) if cold > shock with vasoconstriction
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(3) Skin resiliency test
(a) rough guide to assess total body hydration
(b) skin on the side of the neck good place, upper eyelids not good
