Final: Little Part 1 - Colic 1 Flashcards
Give 2 reasons why impactions are more common in the winter.
Frozen water source / water too cold
Water heater malfunction (shocking the horse)
What type of feed causes ilial impaction?
Costal bermuda grass
What drug would you give a horse with a LDD/ nephrosplenic entrapment to help resolve the displacement?
Phenylephrine (then exercise horse q20 min and recheck by rectal and US)
Induces splenic contraction
Which flexure can be involved with a right dorsal displacement of the colon?
Pelvic
What are the most common places for impactions?
Pelvic flexure
RDC
Transverse colon
Small colon
Gastric impaction
What part of the colon does a sand impaction affect?
RDC
How can you differentiate a cecal from a colon impaction by rectal palpation (not bands)?
Cecum will be attached to the body wall dorsally
What is the prognosis post-op in a horse with a (uncomplicated, early diagnosed) cecal impaction?
Excellent
What conditions predispose to cecal impaction?
Previous orthopedic surgery
Ophthalmic issues
Change in exercise routine
What surgery is performed for a colonic impaction?
Pelvic flexure enterotomy
Elevate colon onto colon tray and incise pelvic flexure on anti-mesenteric aspect
What is the foramen of Winslow?
Epiploic foramen
Which tapeworm can cause ileocecal intussesceptions in horses?
Anoplocephala perfoliata
Where do bezoars or enteroliths become loged?
Transverse colon
What makes up enteroliths?
MAP (Magnesium ammonium phosphate/ Struvite)
What is the most common location for a strangulating lipoma? Where else do they occur?
Small intestine (90%)
Small colon (10%)
What are the boundaries of the epiploic foramen?
Caudate process of the liver
Portal vein
Gastropancreatic fold
What behavior predisposes to epiploic foramen entrapment? Why?
Cribbing
Changes intraabdominal pressure
What becomes entrapped in the epiploic foramen and in which direction does the entrapment usually occur?
Small intestine
Left to right (>95%)
What is the most major complication with an EFE surgery?
Portal vein tear -> Fatal hemorrhage
What are the risk factors for a large colon torsion? What is usually the presentation?
Post parturient mare
Diet change
Recent access to lush pasture
Presentation: Unrelenting severe pain
What must you do on every horse you are examining for colic?
NG tube
What drug can you administer to reduce the risk of a rectal tear during a rectal examination?
Buscopan (spasmolytic)
+/- epidural or lidocaine per rectum
Also LUBE!!!
What can be examined on the left side using the FLASH / FAST ultrasound technique?
- Ventral abdomen: Ventral colon, some small intestine
* Fluid, inguinal region (small intestine), tenea of ventral colon, thickening of ventral colon* - Gastric window
- Nephro-splenic window - LDD?
- Left middle third of the abdomen
What can be examined on the right side using the FLASH / FAST ultrasound technique?
- Duodenal window
* Duodenum doesn’t move - gastric outflow obstruction, enteritis* - Right middle third of the abdomen
* RDD-> Mesenteric vasculature between body wall and cecum*
T. Cranial ventral thorax
Chest pain (pleuropneuminia, pleuritis, pleural effusion = +++ pain) can mimic colic
A NG tube should be passed _________ to minimize the risk of hitting the ethmoid turbinates
Ventro-medially (as ventral as possible) into the ventral meatus
Which side of the neck are you looking at when passing an NG tube?
Left
What is the repsonse to NG decompression in a horse with ileus?
HR decrease
Depression (due to pain relief)
What is the repsonse to NG decompression in a horse with a mechanical obstruction or strangulation?
Minimal/no response
Persistent pain
Persistent tachycardia
Where do you stick a horse for abdominocentesis?
On or to the right of ventral midline - to avoid the spleen
Caudal to the xyphoid
What test can you perform to determine whether the hemorrhagic abdominocentesis sample you obtained is truly from the abdomen or if you aspirated the spleen?
PCV
If hit the spleen, PCV is higher than the blood
Why do you insert the cannula through gauze and then into the stab incision when performing an abdominocentesis?
To prevent blood contamination of the sample from superficial vessels in the skin
What is the normal WBC, TP, and lactate of peritoneal fluid?
WBC < 5000/uL (<1500 in foals)
TP <2.0
Lactate <2.0
When the lactate level in peritoneal fluid increaes from < ___ to > ____ the survival of the horse decreases from 90% to 30%
<6.0
>7.0
Which tube do you use for measuing TP and to obtain a culture from peritoneal fluid? Which tube is used for cytology and lactate?
RTT
LTT / EDTA
What components should be included in pain management of a colic patient?
NSAID: Flunixin BID (more if for anti-endotoxic effect because dose is 1/4)
A-2 agonists: Xylazine, Detomidine, Romifidine
Opioids: Butorphanol
Spasmolytics: Buscopan, Lidocaine
What diagnostic could you perform on a colicking foal that is not feasible in an adult?
Abdominal rads
What must you be sure to ultrasound on a colicing foal? What are the normal values?
Umbilical structures
Umbilical vein <1cm
Umbilical artery <1.3cm
Arteries/urachus combo <2.5cm (horizontally; measured just cranially to the bladder) Mickey mouse
When is colic surgery in a foal indicated (US findings)?
If umbilical structures are >2x their normal size
What are the 2 most common causes of newborn colic?
Meconium impaction
Gastric ulcers
What is the most common surgical colic in a 5 day old foal?
Ruptured bladder
What condition of older foals can result in a gastric/pyloric outflow obstruction?
Gastroduodenal ulcers
What does it indicate if a foal is stretched out and laying on it’s back?
Colic pain
Why are A-2s not indicated until a foal is 2 weeks of age?
A-2s induce bradycardia for which a foal cannot compensate
What gastroprotectants are commonly used in foals?
Ranitidine
Sucralfate
What surgical approach do you take to repair an inguinal hernia?
Inguinal
What e-lyte derrangements indicate cytorrhexis foals?
Hyperkalemia
Hyponatremia
Hypochloridemia
What potassium level in foals can lead to muscle tremors and arrythmias?
>5.5 mEq/L
What type of incision is made to repair a ruptured bladder in a foal? What must you be careful to avoid when making your approach?
Elliptical
Umbilical arteries (2) and vein (1)
Why is the prognosis for a foal with an ascarid impaction guarded?
+++ Intestinal damage already present and the amount of manipulation that will be required in surgery
