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Equine Medicine & Surgery > Equine Surgery > Flashcards

Equine Surgery Flashcards

1
Q

What is the initial challenge in an acute abdomen/colic horse patient?

A

determine if the case will respond to medical tx or needs surgery

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2
Q

How many acute abdomen/colic cases will respond medically?

A

90-95%

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3
Q

What are some reasons that a colic horse that DOESNT respond to medical management wouldnt end up going to surgery?

A

-horse not worth it- money or emotionally

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6
Q

What would an abdominocentesis show on a colic horse that needs to go to surgery?

A

serosanguineous

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7
Q

What would the HR, CRT and MM color look like on a colic horse that tell me he needs to go to surgery?

A

HR >80bpm

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8
Q

What is the single test I can use to determine if a colic horse needs abdominal surgery?

A

There is NO SINGLE TEST

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10
Q

I have a colic horse that has pain I cant control with any pain meds I give it- is this a medical or a surgical candidate?

A

surgical if pain is difficult to control

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11
Q

If there has been alot of contamination in my abdominal exploration surgery- what should i put in place?

A

drain- positive suction is better than a penrose

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13
Q

In flank abdominal surgery when do i enter on the left side? the right?

A

left side- for exploratory, (most cases you enter here)

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14
Q

What do I feel on a rectal exam of a colic horse that is a surgical candidate?

A

distended small bowel and markedly enlarged large bowel

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16
Q

How do i physically locate a large bowel problem in the abdomen during surgery?

A

-palpate mesenteric attachment of RD colon and cecum- helps tell if there is a volvulus

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17
Q

I have a colic horse and im not sure if its a surgical candidate, should I send it to surgery now? or can i wait and see?

A

Send to sx now! even if you havent proven what it is- its better to not lose time

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18
Q

Which is more common- primary or secondary gastric dilation?

A

secondary very common- usually happens with small intestine ileus

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19
Q

What are the 3 approaches for surgical exploration of the abdomen?

A
  1. ventral midline
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21
Q

An owner calls with a foal who is on NSAIDs for another problem, now the foal isnt eating, salivating, looks colicy, and is laying on its back- what do you suspect?

A

Gastric ulcers that have resulted in a pyloric stenosis!

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23
Q

How do I diagnose a horse with gastric neoplasia?

A

endoscopy, or cytology performed on gastric washings

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24
Q

What are pros and cons of a paramedican approach to the abdomen?

A

-less surgical exposure

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25
Q

What does simple obstruction mean?

A

no blood flow is compromised

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27
Q

“Trigger” has an adhesion from a previous abdominal surgery thats causing a simple obstruction in his small intestine- when i open this abdomen to fix this- what can i do to prevent recurrance?

A
  • suture serosa over the damaged area
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28
Q

T or F: a flank approach to the abdomen is good for diagnosing the problem, but usually we have to do a ventral midline to fix it anyway

A

TRUE

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29
Q

What are signs that the large bowel is the problem? small bowel?

A

large bowel- might feel on rectal, no reflux

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30
Q

How does an abdominal abscess cause a small intestine simple obstruction?

A

abscess causes adhesions!

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32
Q

Anterior enteritis clinical signs can look very similar to what? what is the difference?

A

small intestine simple obstructions

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33
Q

When evaluating the small intestine for problems in abdominal surgery is it better to start cranially or caudally and why?

A

start caudally- easier to find landmarks like the cecum/cecocolic ligament and then to work forward/orally

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34
Q

Strangulating obstructions of SI differ from simple obstructions how?

A

stragulation obstructions= markedly restricted blood flow

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35
Q

In gastric dilation in the horse- should i pass a stomach tube before or after anesthesia and why?

A

BEFORE- because horse has to swallow the tube and probobly cant do this when under anesthesia

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36
Q

Intussusception of small intestines in most likely to occur at what age of horse? whats the most common place?

A

foals

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37
Q

I have opened the abdomen on a colic horse and found that the stomach has ruptured- what do i do now?

A

euthanasia- when ingesta is free in the abdomen a horse will not survive that degree of peritonitis =(

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38
Q

By what time should i surgically repair a volvulus if i want to leave the bowel in place?

A

by 6 hours!- or you have to resect and anastomose (usually this happens)

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39
Q

What is the treatment for a foal with gastric ulcers and pyloric stenosis?

A

gastrojejunostomy (stomach to small intestine)

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40
Q

Do we take horses to surgery that have gastric neoplasia? why?

A

No- equine stomach is very hard to access for surgery

41
Q

What are the 2 types of internal hernias?

A
  1. epiploic foramen entrapment
42
Q

Ascarid impactions of the small intestine are usually seen in horses how old? why?

A

foals/weanlings

43
Q

How does Meckel’s diverticulum cause a problem in the small intestine?

A
  • can be axis for volvulus
45
Q

What does this mesodiverticular band look like anatomically?

A

extends from one side of mesnetery of jejunum to the antimesenteric side- so it forms a trangular pocket where intestines can get trapped!!!

47
Q

What are the 5 ways we can repair an umbilican hernia in a horse/foal?

A
  1. time- correct on its own
48
Q

What age of horses get pedunculated lipomas?

A

older horses

49
Q

I am asculting a horse and I think i hear intestinal sounds in the thorax- is this normal?

A

Can be normal because the diaphragm of horse is so bell shaped

50
Q

What part of the country do we see most dital ileum impactions in? why?

A

southeast USA

51
Q

Simple obstructions of the large colon differ in presentation of simple obstructions of small intestine how?

A

simple obstruction of colon dont usually look like an acute abdomen

53
Q

Where do impactions of large colon usually happen?

A

pelvic flexure or right dorsal colon

54
Q

I suspect a horse of having an impacted large colon, what signs tell me i need to do surgery on this horse?

A

intractable pain, excess gastric reflux, unresponsive to medical therapy for several days

55
Q

Is small intestine neoplasia common? what can be done surgically?

A

uncommon

56
Q

Impactions of the cecum are usually due to what?

A

a motility problem

58
Q

Enteroliths are usually found where?

A

right dorsal colon

60
Q

A horse with nephrosplenic ligament colon entrapment is in what kind of pain?

A

some pain but not intense (where as if it was a strangulation it would be intense pain)

61
Q

What is a super cool drug we can give for nephrosplenic entrapement and what does it do?

A

Phenylephrine- causes spleen to contract so hopefully the colon can slide off and go back to normal position

62
Q

What are some surgical options to help anterior enteritis? what is the goal of these surgeries?

A

Jejunocecotomy & Duodenocecotomy

63
Q

What are some non-surgical methods we can try to help cure a nephrosplenic ligament entrapment?

A
  • pick horse up my rear legs so colon moves dorsally
64
Q

What are some general characteristics of a strangulating SI obstruction?

A
  • severe lactic acidosis
65
Q

The large colon is more likely to torse where?

A

diaphragmatic and sternal flexure

66
Q

Where is a volvulous of large colon or cecum likely to happen?

A

just cranial to the mesenteric attachment to the right body wall

68
Q

Horses can do fairly well with how much large colon removed?

A

up to 90%

69
Q

“Penelope” is a post-partum friesian horse with a large colon volvulus i just took to surgery, I discovered that the entire cecum is non-viable, what is the next step?

A

euthanasia- if entire cecum and large colon are non-viable this is the only answer =(

70
Q

What is the definition of a volvulus?

A

twisting of a segment of bowel on its mesentery so blood flow & intestinal contents obstructed

71
Q

Rectal prolapse happens most in what species?

A

pig!

72
Q

What are some causes of rectal prolapse in all species?

A

-estrogens in feed relax the anal region

73
Q

Anatomically what is the epiploic foramen and what are the borders?

A

epiploic foramen = entrance to the omental bursa

74
Q

What are 3 surgical techniques to fix a rectal prolapse?

A
  1. replace and purse string suture
75
Q

How does a rectal ring work for a rectal prolapse?

A

ring inserted and heavy suture wrapped around so that external part dies and sloughs off- a way to amputate the rectum

76
Q

In epiploic forament entrapment what part of the intestines most likely gets trapped? what is prognosis? what sx can we do?

A

usually jejunum

77
Q

What is a grade 4 rectal rupture and what is the prognosis?

A

4= thru mucosa, muscularis and serosa

81
Q

What are 2 embryonic anomalies in the horse small intestine that can cause obstructions?

A
  1. meckels diverticulum
85
Q

What forms a mesodiverticular band?

A

persistence of distal segment of a vitelline artery and associated mesentery

87
Q

T or F: umbilical hernias can sometimes present as an acute abdomen?

A

TRUE- small hernias are more likely to do this compared to large ones

92
Q

Are ventral hernias (except umbilical) likely to cause acute abdomen? why?

A

Not likely because ring is too large to strangulate bowel usually

93
Q

What is a mesenteric thrombus or thromboembolic colic?

A

thrombus causing reduced or no blood flow to segments of bowel

95
Q

What is the best way to give a horse with a simple colon obstruction that has no gastric reflux fluids?

A

best to give fluids orally if possible (10Liters per hour)- this is better than IV lfuids

96
Q

What is the general surgical procedure for impacted large colon?

A

-ventral midline laparatomy

101
Q

T or F: horses can GET an impacted cecum when recovering from another painful surgery?

A

true- chronic pain can cause cecum impaction

105
Q

What is an example of a non-strangulating displacement of the colon?

A

nephrosplenic ligament entrapment- Left colon is trapped dorsal to the spleen/nephrosplenic ligament

106
Q

I have an ancient 20 year old horse and I want to give phenylephrine to help cure this colon entrapment without surgery- what should i be worried about?

A

fatal hemorrhages reported in horses over 15yrs old!

109
Q

What surgical procedure can i do to prevent nephrosplenic entrapment?

A

-close the nephrosplenic space by suturing the base of the spleen to the ligament

114
Q

Large brood mares right after delivery of a foal are likely to get what surgical condition? what kind of pain are they in?

A

large colon volvulus

117
Q

When should a horse suspected of large colon torsion/volvulus be on the operating table for best prognosis?

A

within 2-3 hours we should be operating!

123
Q

What type of anesthesia do we do to surgically repair a rectal prolapse?

A

-caudal epidural in all spp except pig

129
Q

Rectal ruptures happen in what species most and why?

A

horses

Equine Medicine & Surgery (8 decks)

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