GI Exam + Decision Making

Question 1

What are some of the important pieces of information you should get from the owner for a colic case?

Answer 1

(History of previous colic, duration of current signs, severity of current signs, changes in signs over time, and response to any treatments performed)

Question 2

(T/F) Persistence of pain or worsening of pain following analgesic treatment for colic is associated with increased likelihood of surgery.

Answer 2

(T)

Question 3

What are critical pieces of a physical exam that should be examined in cases of colic?

Answer 3

(TPR, mucous membranes, check for abdominal distension, bilateral abdominal auscultation, and evaluation of pain levels)

Question 4

What are differentials for tachycardia in a colic case?

Answer 4

(Pain and/or hypotension)

Question 5

You’re examining a colicky horse and note a heart rate > 60 BPM, what is the next step you will take?

Answer 5

(Pass an NG tube and reflux them)

Question 6

Describe normal peritoneal fluid.

Answer 6

(Clear, yellow, protein < 2 g/dl, WBCs < 5000 cells, rare RBCs)

Question 7

What are some of the risks associated with abdominocentesis?

Answer 7

(Enterocentesis, bowel laceration, hemoabdomen, and omental herniation (foals mainly))

Question 8

What peritoneal fluid lactate value and/or change in lactate value are associated with significant prediction of a strangulating lesion?

Answer 8

(Being > 4 mmol/L at admission and/or an increase in lactate overtime)

Question 9

Hyperglycemia/hypoglycemia (choose) is common in horses with colic.

Answer 9

(Hyperglycemia → associated with non-survival)

Question 10

Why might a longer duration of signs of colic occurring be associated with a better outcome?

Answer 10

(Could indicate the lesion is less severe)

Question 11

Why might a shorter duration of signs of colic occurring be associated with a better outcome?

Answer 11

(It means earlier surgical intervention)

Question 12

Why might a shorter duration of signs of colic occurring be associated with a worse outcome?

Answer 12

(It means the lesion is quite severe if the signs are acute)

Question 13

(T/F) The severity of signs of colic correlates highly with the severity of the lesion.

Answer 13

(T, false negatives do occur though particularly with severe strangulation where the bowel is already dead so the horse cannot feel it)

Question 14

(T/F) The presence of abdominal distension in colic cases correlates with a need for surgical correction whereas the lack of abdominal distension cannot tell you anything about the need for surgery.

Answer 14

(T)

Question 15

How can you distinguish whether or not the excess reflux you got after passing an NG tube in a colicking horse was from enteritis vs a strangulating lesion?

Answer 15

(If they feel better afterwards = enteritis (because they were painful bc of the distended stomach) vs if they do not feel better afterwards = strangulating lesion (bc that lesion will still be present and still not feel very good))

Question 16

(T/F) Normal vs abnormal color of peritoneal fluid are both good indicators of medical vs surgical treatment being necessary.

Answer 16

(F, abnormal is good for indicating surgical but normal is not good for indicating medical treatment is all the horse needs, can have normal peritoneal fluid and a strangulating lesion)

Question 17

(T/F) Both TP and NCC of peritoneal fluid are poor indicators of whether a lesion is surgical or not.

Answer 17

(T)

Question 18

What is a hematocrit useful for in a colic case?

Answer 18

(Determining prognosis (HCT > 60 = grave prognosis), not very useful for decision regarding surgery)