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Equine Colic > General > Flashcards

General Flashcards

1
Q

What predisposes a horse to epiploic foramen entrapment?

A

Wind sucking

Crib biting

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2
Q

What predisposes a horse to an impaction colic?

A 
Dental disease
Reduced faecal output
Over fed hay 
Anoplocephala perfoliata - ileocaecal hypertrophy 
Sand 
Infiltrative bowel disease
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3
Q

What commonly causes a spasmodic colic?

A

Diarrhoea

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4
Q

What is the normal heart rate of a horse?

A

28-44

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5
Q

What is the normal respiratory rate for a horse?

A

12-15

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6
Q

What is the normal temperature for a horse?

A

37.5-38.4

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7
Q

Butylscopolamine

A

Buscopan

  • causes relaxation of the GI tract, facilitating rectal examination
  • can relieve spasmodic colic
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8
Q

How many taenial bands are there in the sections of the large intestine?

A

Caecum = 4
Ventral colon = 4
Right dorsal colon = 3
Left dorsal colon = 1

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9
Q

Rectal findings in left dorsal displacement / neprhosplenic entrapment.

A

Pelvic flexure / left colon trapped in the neprhosplenic space (dorsal left)
Spleen displaced towards midline
Trapped colon becomes distended with gas

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10
Q

How can you treat a left dorsal displacement / nephrosplenic entrapment?

A

Medical management
IVFT
Flunixin
Phenylephrine to cause splenic contraction

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11
Q

Rectal exam findings right dorsal displacement of the large colon.

A

Left dorsal and ventral colon displaced to lie between the caecum and right body wall
Caecum shifted towards midline
Pelvic flexure displaced cranially
+/- volvulus

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12
Q

How should you treat right dorsal displacement of the colon?

A

Surgical management

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13
Q

How does a pelvic flexure impaction feel on rectal examination?

A

Firm, doughy mass in the pelvic flexure

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14
Q

How can you treat pelvic flexure impactions?

A

Medical
Nasogastric tubing
Oral fluids - efferdryl

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15
Q

What will you find on rectal exam in a large colon torsion?

A

Colon distended and tympanic
Me sentry palpably oedematous
Colonic bands felt in a transverse direction

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16
Q

How can you treat a large colon torsion?

A

Mild-non strangulating lesions - medical

Strangulating lesions - surgical

  • plasma volume replacement
  • antibiotics - procaine penicillin
  • flunixin
  • polymyxin B
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17
Q

What will you feel on rectal examination in a horse with caecal impaction?

A

Caecum feels firm - felt in the right paralumbar area with taught caecal bands (4 taenia)

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18
Q

How should you treat a caecal impaction?

A

Mild - IVFT, oral fluids, efferdryl and flunixin

Severe - surgical
- caecum decompressed and ingesta removed

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19
Q

What size needle should you use for abdominocentesis?

A

18g 1.5 inches

Pink needle

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20
Q

What does mildly red abdominal fluid suggest?

A

Early strangulating lesion

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21
Q

What does serosanguinous abdominal fluid suggest?

A

Volvulus

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22
Q

What amount of nett reflux is significant?

A

2L +

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23
Q

Where are the 3 main regions to scan on the horse with colic?

A

Inguinal region
Ventral midline
Left paralumbar fossa

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24
Q

What are common causes of foal colic?

A

Meconium impaction
Ruptured bladder
Congenital abnormalities - atresia ani / coli / lymphangectasia

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25
Q

What type of colic is most common in donkeys?

A

Impaction - secondary to dental disease

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26
Q

What are the 3 most common causes of weight loss in the horse?

A

Dental disease
Parasitism
Inadequate diet

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27
Q

Differentials for protein losing enteropathy in the horse?

A 
Cyathostomins 
Strongyles 
Idiopathic
Infiltrative bowel disease
Neoplasia
Lawsonia intracellularis - 3-11mo
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28
Q

What are the three types of Infiltrative bowel disease?

A

Granulomatous enteritis
Lymphocytic-plasmacytic enteritis
Focal eosinophillic enteritis

CAUSES A PLE

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29
Q

How cla you treat Infiltrative bowel disease?

A

Prednisolone

Moxidectin / praziquantel - to get rid of parasites

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30
Q

What disease causes cutaneous and GI signs in horses?

A

Multisystemic eosinophillic epitheliotrophic disease

Tx: dexamethasone

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31
Q

What forms of lymphoma are there in the horse?

A 
Alimentary
Generalised
Solitary
Cranial mediastinal 
Cutaneous
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32
Q

What forms of Infiltrative bowel disease may not be responsive to steroids?

A

Eosinophillic enteritis
Granulomatous enteritis
Lymphoplasmacytic enteritis
Alimentary lymphoma

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33
Q

What findings on bloods would make you suspect chronic bacterial infections?

A

Neutrophillia + hyperfibrinogenaemia + anaemia

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34
Q

What changes on blood will make you suspicious of a parasitic infection in horses?

A

Neutrophillia + hypoalbuminaemia + hyperglobulinaemia

NOT EOSINOPHILLIA

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35
Q

What pathologies do the common equine GI parasites cause?

A

Large strongyles - verminous arteritis and thromboembolic colic
Cyathostomins - colitis
Parascaris equorum - mechanical blockage
Anoplocephala perfoliata - colic

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36
Q

Where do gastric ulcers commonly occur in horses?

A

Margo Plicatus

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37
Q

What risk factors are there for EGGUS?

A

Stress and NSAIDs

38
Q

What risk factors are there for ESGUS?

A

Acid injury

39
Q

What general risk factors are there for gastric ulcers?

A 
High grain diets
Intermittent feeding
Exercise - leads to gastric production and increase abdominal pressure 
Transport 
Stabling
Confinement
40
Q

What is licensed to treat gastric ulcers in horses?

A

Omeprazole

41
Q

What are the differentials for chronic diarrhoea in the adult horse?

A 
Dietary
Dental disease
Parasites - S.vulgaris more chronic, Cyathostomins acute
Sand
Antimicrobial associated diarrhoea
NSAIDs - right dorsal colitis 
Gut oedema in heart failure 
Renal failure
Liver disease
Chronic IBD 
Alimentary lymphoma 
Chronic salmonellosis
42
Q

How should you treat chronic diarrhoea?

A 
Treat underlying disease
Gradually change diet
Fenbendazole / ivermectin 1st, then moxidectin 1 week later
Access to normal manure 
Anti-diarrhoea medications
43
Q

What are the most important causes of colitis in adult horses?

A 
Idiopathic 
Salmonella
Clostridia
NSAIDs - right dorsal colitis
Antibiotics 
Cyathostomins
44
Q

What organs can be damaged as a result of endotoxaemia?

A

Heart - reduced contractility
GIT - poor perfusion reduces the mucosal barrier
Laminitis
Kidneys

45
Q

Salmomellosis

A

Salmonella typhimurium
Asymptomatic carriers are the source - shed at times of stress

CS: colitis, neutropaenia, hyponatraemia, dehydration +/- septicaemia

Dx: 5 negative faecal samples to rule out - faecal culture

46
Q

Antibiotic Induced Diarrhoea

A

Penicillin
Ceftiofur
Erythromycin - given to the foal, causes mare to get D+

CS: mild transient diarrhoea or fulminant enterocolitis (severe)

Tx: withdraw ab + give metronidazole

Dx: faecal gram staining for clostridium, C.difficile toxin assay

47
Q

What complications should you make an owner aware of following a bought of acute colitis?

A

Laminitis
Thrombophlebitis
Haemodynamic renal failure
Chronic diarrhoea

48
Q

4-7% dehydrated

A

Decreased skin turgour
PCV 40-50%
CRT 2-3s

49
Q

7-9% dehydrated

A

Sunken eyes
Depressed
Sticky mm
PCV 50-60%

50
Q

9% dehydrated

A

Skin tent longer than 5 seconds
Mm dry
PCV 65% +

51
Q

What fluid should you give a mildly dehydrated horse with colitis?

A

Isotonic fluids

Or 10-20L oral fluid

52
Q

What fluid should you consider giving a very sick horse with colitis?

A

Hypertonic saline 7.2%

2-4ml/kg bolus

53
Q

How can you treat a case of colitis?

A

Isotonic hartmanns
Spiked with 20 mEq/L K+
Calcium if there is prolonged anorexia

Oral electrolyte solutions

Oral mucosal protectants

  • bismuth subsalicylate
  • activated charcoal
  • smectite
54
Q

How should you treat SIRS?

A

Flunixin

Polymyxin B

55
Q

What type of bilirubin always predominates in horses?

A

Unconjugated

56
Q

What liver enzymes are used in horses?

A

AST and SDH - hepatocellular damage

GGT - biliary tree (but also hepatocellular)

57
Q

What is the best prognostic indicator in liver disease?

A

Liver biopsy score

- a biopsy score of greater than 6 has a poor prognosis

58
Q

Ragwort toxicity

A

Senecio Jacobea
Clinical signs of liver failure may not occur until a year after

CS: weight loss, inappetance, mildly depressed, progressing to
Laryngeal paralysis - inspiratory dysponea
Hepatic encephalopathy
Gastric impaction colic
Photosensitisation
Haemorrhages
Icterus

Dx: increased GGT, small liver on US, megalocytosis on biopsy

Tx: unrewarding - esp if bilirubin over 50
Fluids and electrolytes
Moderate to low protein diet
Neomycin / metronidazole

59
Q

Cholangiohepatitis and cholelithiasis

A

Ascending bile duct infection from the GI tract
- classic - UNconjugated bilirubin (usually conjugated in the horse - bacteria Unconjugate the bilirubin

Remember - horses don’t have a GB so stones always in bile duct

CS: jaundice, fever, colic

Dx: marked increase in GGT, Pyrexia, bacteria in bile duct aspirate

Tx: long term antibiotics

60
Q

Immune mediated chronic active hepatitis

A

Progressive inflammatory disease

Corticosteroids + Azathioprine

61
Q

What are the risk factors for hyper lipaemia?

A 
Obese
Females 
Insulin insensitivity
Underlying disease - parasites creating NEB
Transport
Stress lactation 
Starvation

Basically a fat female that enters a NEB

62
Q

How does hyper lipaemia present and how can you treat it?

A

CS: anorexia, lethargy, weakness, may progress to CNS disease

Dx: cloudy serum
Hyperlipidaemia - triglycerides 1.5-5 - REVERSIBLE
Hyperlipidaemia - triglycerides over 5
Look for underlying disease - liver / renal disease

63
Q

How can you treat hyperlipaemia?

A

Treat underlying disease eg: parasites
Get the horse into a positive energy balance
Correct dehydration, electrolyte imbalances and acidosis
Insulin therapy

Adv risk of laminitis

64
Q

Indications for medical management of colic

A 
Mild to moderate pain without analgesia
Good response to analgesia
HR <50bpm
Gut motility continuing or improving
No nett reflux 
Resolving / no abdominal distension 
Normal peritoneal fluid 
Normal PCV, TP and systemic lactate
65
Q

How do you medically manage a colic?

A 
Analgesia 
NGT Tubing - reflux
Oral fluids eg: efferdryl
IVFT
Phenylephrine - reduces spleen size in NSE
Pysllium - bulk forming laxative
66
Q

Phenylbutazone

A

Moderate potency - good first line for mild to moderate pain
Doesn’t mask colic signs
12h duration

67
Q

Flunixin

A

Potent analgesia - may mask pain
- only use post operatively
May mask an increase in heart rate with SIRs

68
Q

What NSAID is in buscopan compositum?

A

Metimazole

69
Q

Xylazine

A

10-30 mins
Good analgesia
Useful to facilitate rectal examination

70
Q

Romifidine

A

2-4h analgesia in colic cases
Usually combined with butorphanol
Good for moderate to severely painful colic so that need to be transported for surgery

71
Q

Detomidine

A

Potent analgesia
2-4h analgesia in colic cases
Usually combined with butorphanol
Good for moderate to severely painful colic so that need to be transported for surgery

72
Q

Butorphanol

A

Good for analgesia in colicky foals where NSAIDs are CI

73
Q

Morphine

A

Potent analgesia

For very painful colics post surgery

74
Q

Butylscopolamine / hyoscine

A

Smooth muscle relaxant
Care compositum contains NSAID

Facilitate rectal exam - reduced risk of tears
Spasmodic colic / mild colic pain

75
Q

Oral fluid therapy for a medical colic case

A

4-6L of oral fluids and electrolytes via NGT every 4 hours

76
Q

Which colics can be medically managed?

A

Spasmodic colic
Pelvic flexure impaction
Nephrosplenic entrapment
Sand colic

77
Q

Spasmodic colic

A

Mild to moderate pain
Increased gut sounds
Normal clinical parameters
Response to butylscopolamine and phenylbutazone

78
Q

Nephrosplenic entrapment

A

Ventral colon trapped in Nephrosplenic space

Medical if mild / moderate pain, not distended large colon and normal CVS parameters

Surgical if servers pain, deteriorated CVS parameters, no response to treatment

Us - failure to detect kidney and spleen - obscured by colon

79
Q

How can you medically managed Nephrosplenic entrapment?

A

Phenylbutazone

Phenylephrine infusion - over 15 minutes, then lunge for 10 mins

80
Q

Sand colic

A

Recurrent mild colic
- impaction or colon displacements also possible

Dx: Sand in faeces, seashore sound on auscultation, sand on abdominocentesis

Tx: remove source, lots of forage, psyllium - laxative

81
Q

Meconium impaction in foals

A

Common - failure to pass black tarry meconium after birth

Tx: soapy water / phosphate enema
Sedate mare and foal and elevate hindlimb for 30min

82
Q

When is euthanasia indicated in colic?

A

Uncontrollable pain despite potent analgesia

Severe CVS compromise
HR>90
Purple mm
PCV >60%

GI rupture - sudden onset profuse sweating and a reduction in pain
Brown red ingesta in abdominocentesis sample

83
Q

What are some indications for surgery?

A

Severe, unrelenting pain
Recurrence of pain despite moderate / potent analgesia
HR >60
Nett reflux over 2L
Reduced intestinal motility
Abdominal distension
Orange peritoneal fluid, increased total protein and lactate

84
Q

What are surgical colics?

A

Pedunculated lipoma
Epiploic foramen entrapment - wind suckers / crib biters predisposed
Large colon displacements - severe pain, no response to medical
Large colon volvulus
Large colon torsion

85
Q

What are the 3 worst colics for rapid loss of blood supply?

A
  1. Pedunculated lipoma
  2. Epiploic foramen entrapment
  3. Large colon volvulus
86
Q

What anastomoses are associated with a poorer prognosis?

A

Jejuno-caecostom

Large colon resection

87
Q

What should the rest period after colic surgery be?

A

8 weeks box rest and and 2-3x daily in hand walking
8 weeks small paddock turn out
8 weeks normal paddock and gradual return to exercise

88
Q

How should you manage non-resolving oesophageal obstruction?

A

Sedate
Butylscopolamine
Oxytocin
Pass a NGT to assess the level of obstruction
Pump water in using a stirrup pump and lavage until cleared
+/- antimicrobial if aspiration pneumonia suspected
Provide water but no feed for 24-48h

If not cleared by lavage endoscopic retrieval is indicated

89
Q

When should you expect oesophageal perforation?

A

Swelling and crepitus in the left cervical region
Investigate using endoscope
Guarded prognosis

90
Q

How should you initially manage carbohydrate overload?

A

Lavage gastric contents within warm water within 1-2h
Activated charcoal
Flunixin
Cryotherapy of the feet

91
Q

How should you manage a rectal tear?

A 
Grade 3 or above - refer
Pack the rectum 
Broad spectrum antibiotics - penicillin and gentamycin 
Flunixin meglumine 
Check tetanus status 
Epidural

Equine Colic (2 decks)

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