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CVSOH BVSc4 > GI - colic > Flashcards

GI - colic Flashcards

1
Q

What are the 4 types of medical colic?

A

Spasmodic
Undiagnosed
Gas
Impaction

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2
Q

What are the 9 Ps that indicate that a horse needs emergency colic surgery?

A

Pain
Passage of time
Pulse
Pass a tube
Palpate per rectum
Peritoneal fluid
PCV
Pyrexia
Per abdominal ultrasonography

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3
Q

Should you give a horse with medical colic flunixin? What is it?

A

Pain relief - masks some signs of colic pain eg. pain but there are other ways of telling
so can give but just change monitoring accordingly

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4
Q

What should you do if the horse is still in pain despite having a full dose of flunixin?

A

Surgery

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5
Q

What analgesia/sedation should you give a horse that has mild to moderate pain from a medical colic?

A

IV phenylbutazone - pain relief
Hyoscine (buscopan) to aid rectal exam
Xylazine - sedate

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6
Q

What is spasmodic colic?

A

Spasm of the muscle layers in the small intestine causing pain

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7
Q

What are some risk factors for spasmodic colic?

A

Excitement
Exercise
Fatigue
Parasites - tapeworm
Changing diet

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8
Q

What signs do you use to diagnose spasmodic colic?

A

Recent onset
Mild-moderate pain
Intermittent
Passes all the Ps
Responds to treatment

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9
Q

What is the treatment for spasmodic colic?

A

Spasmolytic agent - buscopan
NSAIDs
Phenylbutazone/half dose flunixin
Starve for 8 hours then back to normal

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10
Q

What should you do after the horse has recovered from spasmodic colic?

A

If reoccurs multiple times then investigate - probably not spasmodic
Reduce future risk factors
Review parasites and teeth

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11
Q

What is gas colic?

A

Excess production of gas in the large intestine
Pain from stretching intestinal wall

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12
Q

What are some risk factors for gas colic?

A

Diet change
Rich grass/haylage
Too much concentrates
Parasites
Poor dentition

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13
Q

How can you diagnose gas colic?

A

Passes the Ps
Rectal - gas distended but still squishy intestines

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14
Q

What can gas colic be a precursor to?

A

LI displacement
LI torsion

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15
Q

What is the treatment for gas colic?

A

Buscopan
Phenylbutazone
NSAIDs
STOMACH TUBE WITH WATER - activates gastro-colic reflex

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16
Q

What should you do before stomach tubing with water a gas colic case?

A

Always check for reflux first

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17
Q

What is the location for most impactions in the horse?

A

At the pelvic flexure - intestinal narrowing, active pacemakers

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18
Q

What can impaction of the intestines cause in horses?

A

Stretches mucosal wall - pain
Vascular compromise

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19
Q

What are the risk factors for LI impactions?

A

Reduced water intake
Physical exertion
Reduction in exercise - sudden box rest
Parasite migration
Dental disease

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20
Q

What are LI impactions associated with in donkeys?

A

Dental diastema

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21
Q

How do you diagnose LI impactions?

A

Pass the Ps
Abnormal rectal
Had some risk factors, pain

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22
Q

What is something that you can do to diagnose a LI impaction that is very risky?

A

Peritoneal tap - risk puncturing intestine

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23
Q

What is the treatment for LI impactions?

A

Hydrate ingesta - oral fluids via stomach tube
Magnesium sulphate - draws more fluid into LI
Analgesia - phenylbutazone

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24
Q

What should you not use to treat LI impactions?

A

Pro-motility drugs - can cause intestinal rupture
Liquid paraffin - may help but doesnt break down impacted material

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25
Q

What parasites can cause ilial impactions?

A

Parascaris
Tapeworm

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26
Q

What is a secondary cause of caecal impactions?

A

After surgical procedures causing pain eg. orthopaedic

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27
Q

What is dangerous about caecal impactions?

A

Can be hard to detect and then rupture without warning - fatal

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28
Q

How do you diagnose a caecal impaction?

A

Rectal - impaction over RHS

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29
Q

Why does sand cause colic?

A

Irritates LI wall causing recurrent colic, poor motility, and inflammation
This can lead to impaction

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30
Q

How do you diagnose sand impaction?

A

From the history
Sedimentation test - poo and water mixed, sand will settle at bottom
Lateral abdominal radiograph

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31
Q

What is the treatment for sand impaction?

A

Lots of fluids
Analgesia
Feed psyllium - binds up the sand and forms jelly

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32
Q

What are common causes of small colon impactions?

A

Eating plastic bags
Salmonella?

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33
Q

What causes gastric impactions?

A

Unknown - motility disorder?

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34
Q

How do you diagnose gastric impactions?

A

Difficult to pass stomach tube
Spleen pushed caudally on rectal
Large stomach on ultrasound

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35
Q

How do you treat gastric impactions?

A

Stomach tube lavage
Coke
Difficult surgery

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36
Q

What is the prognosis of gastric impaction?

A

Poor
Not very common though

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37
Q

What is choke?

A

Oesophageal impaction

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38
Q

What are the signs of acute choke?

A

Froth at nose
Food material coming from nose
Gag
Cough
Head and neck extended

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39
Q

What predisposes to choke?

A

Eating very quickly
Dental abnormalities

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40
Q

What is the treatment for choke?

A

Sedate - puts head down
Lavage obstruction back out of the oesophagus by pouring water in and then tube down to empty out again - takes ages

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41
Q

When should you refer choke?

A

If secondary effects of choke eg. dehydration, aspiration pneumonia, rupture

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42
Q

What is equine grass sickness?

A

Equine dysautonomia - acquired degenerative polyneuropathy
Neurones of autonomic and enteric nervous system damaged causing dysphagia

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43
Q

What causes grass sickness?

A

Thought to be caused by a toxin - clostridium botulinum toxicoinfection?
But unknown

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44
Q

What horses are at risk of getting grass sickness?

A

Young horses - between 3 and 5
Location
If been in contact with EGS cases
If recently moved to the premises
Soil disturbance
Spring

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45
Q

What are the different forms of grass sickness?

A

Acute
SUbacute
Chronic

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46
Q

What occurs during acute grass sickness?

A

GI ilius causing SI and gastric distention, severe abdominal pain and death

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47
Q

What are the signs of acute grass sickness?

A

Hypovolaemia
Tachycardia
High PCV/TP
Distended SI
Corrugated LI impaction
Sweating
Pyrexia
Dysphagia
Ptosis

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48
Q

What causes death from equine grass sickness?

A

Cardiac failure - reduced circulating volume
Gastric rupture

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49
Q

How is subacute form of grass sickness different to acute form?

A

Course of disease 3-7 days
Clinical signs less severe
Usually dont reflux initially

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50
Q

What are the signs of subacute grass sickness?

A

Large colon impactions - colic
Rhinitis sicca - sound like darth vader
Dysphagic - lose weight
Patchy sweating

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51
Q

What is the prognosis of subacute grass sickness?

A

May be euthanased
May progress to chronic

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52
Q

What are the features of chronic form of grass sickness?

A

Occurs over weeks to months
Rapid severe weight loss
Mild recurrent colic
Rhinitis sicca
Sweating
Narrow base stance - elephant on a ball

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53
Q

How is grass sickness diagnosed?

A

Exclusion based diagnosis
Phyenylephrine eye test on ptosis - not very accurate
Tongue biopsy - difficult
Ileal biopsy - best
Ex-lap
Post mortem

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54
Q

How do you treat acute grass sickness?

A

IV fluids
Gastric decompression
Histology results - if positive PTS
PTS if doesnt improve

55
Q

When should you treat for grass sickness?

A

Horse wants to eat and is able to eat - no reflux or dysphagia
Committed owner
No colic

56
Q

What is the treatment for chronic grass sickness?

A

High energy, easily swallowed palatable food
Lots of supportive care

57
Q

What is the prognosis for chronic grass sickness?

A

50% will survive
Residual abnormalities - mild dysphagia, sweating

58
Q

What is duodenitis-proximal jejunitis (DPJ)? What does it cause?

A

Inflammed and oedema of duodenum and jejunum from bacteria or unknown aetiology
Causes ilius, reflux, colic, GI distention, hypovolaemia, endotoxaemia

59
Q

What are the clinical signs of peritonitis in horses?

A

Toxaemia
Weakness
Colic
Tachycardia/Tachypnea
Circulatory failure
Sweating
Red gums

60
Q

How do you diagnose peritonitis?

A

If its fever and colic combined then it will either be colitis or peritonitis
Take PERITONEAL FLUID SAMPLE
Colitis usually accompanied by diarrhoea

61
Q

What can be seen on peritoneal fluid sample to diagnose peritonitis?

A

Neutrophils

62
Q

What is the treatment for peritonitis?

A

Euthanase if rupture
Fluids, flunixin
Antibiotic - penicillin, gentamycin

63
Q

What is the risk of doing surgery in peritonitis case?

A

Adhesions

64
Q

What causes IBD?

A

Immune mediated disease

65
Q

What are the clinical signs of IBD?

A

Acute or chronic colic
+/-Diarrhoea with no fever
+/-Weight loss

66
Q

How do you diagnose IBD?

A

Biopsy - preferably by ex-lap, can do rectal

67
Q

What is the treatment for IBD?

A

Prednisolone - corticosteroids
Diet - hay, yeasacc, probiotics
Increase short fibre - grass

68
Q

What are the two types of gastric ulcer a horse can get?

A

Squamous and glandular

69
Q

Where is a glandular ulcer most likely to form in horses?

A

In the pylorus

70
Q

What are risk factors for equine gastric ulcer syndrome?

A

Exercise
Periods with an empty stomach
Concentrates

71
Q

What are the clinical signs of equine gastric ulcer syndrome (EGUS)?

A

Poor performance
Recurrent colic
Polyphagia, weight loss
Change in behaviour/attitude

72
Q

How can you diagnose equine gastric ulcer syndrome?

A

Gastroscopy

73
Q

How do you treat equine gastric ulcer syndrome?

A

Proton pump inhibitor - omeprazole
Graze - no long periods without food
Less concentrates, more roughage

74
Q

What does hypermetric bounding pulses mean in horses?

A

Circulatory shock

75
Q

What does weak thready pulses mean in horses?

A

Circulatory failure

76
Q

What does red mucous membranes mean?

A

Circulatory shock?

77
Q

What does purple rings mean around the teeth?

A

Endotoxaemia

78
Q

Where per rectum can you palpate the pelvic flexure in horses?

A

Left ventral quadrant

79
Q

What on nasogastric intubation suggests obstruction?

A

Large amounts (more than 1-2L) of dark malodorous fluid
Is usually light coloured mucous

80
Q

What does high lactate suggest?

A

Tissue ischaemia

81
Q

Where do you do abdominal paracentesis in a horse?

A

Ventral midline 4 inches caudal to the sturnum

82
Q

What is the normal colour of abdominal fluid?

A

Clear or straw coloured

83
Q

What does amber/orange abdominal fluid indicate?

A

Vascular compromise eg FIP

84
Q

What does red/black abdominal fluid indicate?

A

Necrosis

85
Q

What does cloudy abdominal fluid indicate?

A

Cellular - peritonitis

86
Q

What are red flags of colic?

A

Nasogastric reflux more than 5L
Rectal findings - dilated SI, colon torsion
Severe mm congestion
Unrelenting pain
HR more than 60bpm

87
Q

What percenage of colic cases are surgical?

A

7-9%

88
Q

What are the survival rates for medical and surgical colic?

A

medical -91% survive
Surgical - 69% survive

89
Q

What is the first structure visible as you incise into the abdomen?

A

Caecum

90
Q

What is an anti adhesion treatment in equine surgery?

A

Carboxymethylcellulose - CMC

91
Q

What is the blood supply to the small intestine?

A

Cranial mesenteric artery
Caecocolic artery

92
Q

What is a common cause of strangulating intestinal lesions in horses?

A

Lipomas - usually older fat pony geldings

93
Q

How long does it take for the intestinal mucosa to become necrotic?

A

4-5 hours

94
Q

What is any intussception involving the caecum linked to?

A

Tapeworms

95
Q

What is the most common indication for intestinal surgery in foals between 2-4m old?

A

Small intestinal volvulus

96
Q

What is the epiploic foramen?

A

Slit like opening into the omental bursa in right dorsal abdomen

97
Q

What vices predispose a horse to epiploic foramen entrapment herneation?

A

Wind sucking
Crib biting

98
Q

What are common internal hernias in horses?

A

Nephrosplenic space
Epiploic foramen entrapment
Gastrosplenic ligament incarceration

99
Q

What is the mesodiverticular band?

A

Resisdual persistent embryonic vitteline duct - forms a mesenteric pouch which SI gets trapped in

100
Q

What is Mechels diverticulum?

A

A remnant of the embryonic yolk sac which can form diverticulum of jejunum and trap SI

101
Q

What is the most common external hernia? Is it dangerous?

A

Umbilical hernia - rarely causes pathology

102
Q

What are the two types of inguinal hernia? What do they cause?

A

Indirect - common, reducible, fine
Direct - tear in peritoneum, intestine in subcut tissue, local swelling and necrosis, painful

103
Q

How do acquired inguinal hernias occur in horses and how are they treated?

A

Post mating
Castration complication
Testicle gets congested due to pressure on vessels - castrated

104
Q

What diseases do you do intestinal biopsies for in horses?

A

Chronic IBD
Recurrent intermittent colic
Malabsorption
Neoplasia
Equine grass sickness

105
Q

What is the order of the large intestine in horses?

A

Right ventral colon - sternal flexure - left ventral colon - pelvic flexure - left dorsal colon - diaphragmatic flexure - right dorsal colon - small colon - rectum

106
Q

What is the most common colon entrapment? What is the other name for it?

A

Nephrosplenic entrapment
= left dorsal displacement

107
Q

What causes nephrosplenic entrapment?

A

Excess gas production and altered motility

108
Q

What horses tend to get nephrosplenic entrapment?

A

Mature performance horses - 4-8 years

109
Q

What are the signs of nephrosplenic entrapment?

A

Pain
Spleen displaced medial and ventral on rectal palpation
Colon distended

110
Q

How do you treat nephrosplenic entrapment?

A

Starve
Fluids
Analgesia
Phenylephrine - splenic contraction
Rolling - right recumb to left
Surgical correction

111
Q

What is the success rate for medically managing nephrosplenic entrapment cases?

A

75% success rate

112
Q

What causes RIGHT dorsal displacement of the colon?

A

Thought to be impaction at the pelvic flexure - displaces cranially causing twisting of colon

113
Q

What is found on rectal examination of right dorsal displacement of the colon?

A

Bands on the distended colon run transversely across the pelvic inlet
Cant feel caecum

114
Q

Which colon displacement does high GGT indicate?

A

Right dorsal displacement

115
Q

What is the most critical problen affecting the horses large colon that requires urgent surgery?

A

Large colon volvulus

116
Q

Where does larhe colon volvulus tend to occur?

A

Sternal flexure
Or at right ventral colon attachment to caecum

117
Q

What causes large colon volvulus? What horses are typically affected?

A

Unknown cause
But usually affects larger horses, particularly multiparous brood mares that foaled in last 3 months

118
Q

What happens in a caeco-caecal or caeco-colic intussuception?

A

Tip of cecum invaginates into the body
May continue so its inside out

119
Q

What are the risk factors with caeco-caecal or caeco-colic intussuception?

A

Prone to rupture
May not be able to reduce - may need resecting
Abdominal contamination risk

120
Q

What is the name for mineralised concretions of food material?

A

Enteroliths

121
Q

What are the pain scoring systems in horses?

A

Horse grimace scale
Equine acute abdominal pain scale
Post abdominal surgery pain assessment scale

122
Q

What is the maintenance for fluids?

A

2ml/kg/hr
So roughly 1L/hr for 500kg horse

123
Q

How do you feed a horse that is refluxing?

A

No food by mouth
Hydrate by IV
May need to muzzle to stop horse eating bedding
Only feed small amount of water and hand picked grass/wet mash concentrates once stop refluxing

124
Q

What is used to significantly reduce incisional infections?

A

Belly bandage

125
Q

How should horses exercise post operatively?

A

Initial box rest for 6 weeks - very short hand walks
Small paddock after 6 weeks
Ridden exercise after 3 months

126
Q

What percentage of horses get post op colic?

A

28-30%

127
Q

How do you manage rectal tears?

A

Incomplete tear - starve then laxative diet with antibiotics
Complete tear - euthanase

128
Q

What are two potential complications of colic surgery immediately post op?

A

Endotoxaemia
ilius

129
Q

What can endotoxaemia lead to?

A

Laminitis
Disseminated intravascuar coagulation

130
Q

How do you treat endotoxaemia?

A

Fluids
Flunixin
Hyperimmune plasma

131
Q

How do you treat ileus immediately post op?

A

Nasogastric intubation
FLuids
Prokinetics - lidocaine

132
Q

What is a reaction to the jugular catheter in horses?

A

Jugular thrombophlebitis

133
Q

What is usually the treatment for adhesions?

A

Euthanasia

CVSOH BVSc4 (86 decks)

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