Equine Top Topic - Colic Flashcards
what is the most important factor in differentiating surgical from medical colics?
pain
T/F: horses that are repeatedly refractory to routine analgesics need colic surgery
TRUE
how is serum vs peritoneal lactate used to decide if a colicking horse needs to go to surgery?
lactate will be significantly higher in peritoneal fluid vs serum in surgical colic cases
proximal enteritis causing colic in a horse affectes what part of their gi tract?
small intestines
what is the classic case presentation of proximal enteritis in a horse?
mild colic/depression, fever, copious red-brown smelly nasogastric reflux
how is proximal enteritis in a horse diagnosed?
ultasound shows thick-waled hypomotile small intestines with some distension, peritoneal fluid has increased protein with normal WBC count
how is proximal enteritis in a horse treated?
iv fluids, analgesics, nasogastric decompression, laminitis, prophylaxis, and maybe surgical decompression
proximal enteritis as a cause of colic is more common in what horses? what clinical sign is very common with this type?
eastern US & europe, horses more depressed than colicky
what is the etiology of proximal enteritis?
unknown
what is the classic case presentation of large colon impaction?
mild intermittent colic with fairly normal PE parameters
how is large colon impaction diagnosed?
palpate impaction on rectal
how is large colon impaction treated?
enteral fluids & laxatives, analgesics as needed, & IV fluids if indicated
how is large colon impaction prevented?
maintain good dental care & appropriate parasite control, provide fresh water, & provide good quality hay
what are the most common sites of large colon impaction?
pelvic flexure, transverse colon, & base of cecum
how are sand impactions diagnosed? how are they treated?
radiographs - psyllium
what are cecal impactions associated with in colicky horses?
sudden decrease in activity level
what part of the gi tract is affected by spasmodic/tympanic colic in horses?
affects large colon
what is the classic case presentation of spasmodic/tympanic colic in horses?
acute onset of mild to severe colic, heart rate normal to increased, mucus membranes WNL, & typically, minimal gi sounds
how is spasmodic/tympanic colic diagnosed?
presentation, lack of significant findings on rectal/nasogastric intubation, systemically stable, & responds to first round of medical therapy
how is spasmodic/tympanic colic treated?
analgesics, sedatives, anti-spasmodics (buscopan), enteral fluids, & laxatives
how is spasmodic/tympanic colic prevented?
maintain a consistent diet/management, maintain good dental care, & appropriate parasite control
what is the most common cause of colic in horses?
spasmodic/tympanic
what are three key surgical colics?
large colon volvulus, small intestinal incarceration or strangulation, & large colon displacement (left dorsal or right dorsal displacement)
what is the classic case presentation of large colon volvulus?
acute severe pain with abdominal distension, often non-responsive to analgesics, significant tachycardia, varying degrees of systemic compromise depending on duration
how is large colon volvulus diagnosed?
presentation, extremely gas filled intestines on rectal exam, & ultrasound shows diffusely significantly thickened large colon wall
how is large colon volvulus treated?
surgery and potentially resection of the large colon
what is the prognosis of large colon volvulus?
guarded
how is large colon volvulus prevented?
unknown
T/F: large colon volvulus are most often clockwise, & may or may not involve the cecum
TRUE
T/F: the classic case of large colon volvulus is a broodmare just after foaling
TRUE
what is the classic case presentation of small intestinal incarceration/strangulation?
progressively painful,copious nasogastric reflux, & deteriorating metabolic status
how is small intestinal incarceration diagnosed?
distended loops of small intestines on rectal, copious nasogastric reflux, serosanguinous peritoneal fluid with increased lactate
how is small intestinal incarceration treated?
surgery, & potentially resection of the small intestines
how is small intestinal incarceration prevented?
unknown except for decreasing cribbing (can decrease risk of epiploic foramen entrapment)
what is the most common cause of a strangulating colic in older, obese horses?
pedunculated lipomas
where can incarceration of the small intestines occur in the body?
epiploic foramen, mesenteric rents, inguinal orifice, & umbilical orifice
what is the classic case presentation of large colon displacement?
mild then progressive pain with progressive abdominal distension or recurrent bouts of colic & metabolic status is slow to deteriorate
how is left dorsal colon displacement diagnosed?
can’t feel nephrosplenic space on palpation, on ultrasound, left kidney not visible & the spleen is displaced ventrally
how is right dorsal colon displacement diagnosed?
may feel tight taenia coursing near base of the cecum, & on ultrasound, may see colonic mesenteric vessels coursing along right lateral body wall in an abnormal location
how is left dorsal colon displacement treated?
phenylephrine to shrink spleen & lunge the horse, roll horse under GA, or surgical correction
how is right dorsal colon displacement treated?
IV fluids, withhold feed, analgesics, & often, surgery if pain is progressive or metabolic status is deteriorating
how is left dorsal colon displacement prevented? what about right dorsal displacement?
nephrosplenic ablation for LDD - unknown for RDD
why is the large colon prone to excessive movement/displacement?
only attached to the body wall at the base of the cecum
