GI: When Things Go Wrong

Question 1

what is choke

Answer 1

-blockage in esophagus caused by a mass of dry forage or a solid object (ex carrot), or any other obstruction

Question 2

how do you diagnose choke

Answer 2

-repeated coughing
-distress
-discharge from mouth and nostrils which may be foamy saliva and food
-may take treats but unable to swallow
-hard mass palpable on left side
-NG tube confirms

Question 3

how do you treat choke

Answer 3

-many resolves on own
-massage esophagus
-if condition persists for > 1 hour, sedate and push NG tube to push obstruction to stomach
-water may break up obstruction

Question 4

how serious is choke

Answer 4

-not life threatening
-most resolve w/out complications
-rarely, it can persist for extended periods of time causing damage to esophagus

Question 5

what are the complications of choke

Answer 5

-risk of aspiration of fluids if it persists > 1hour, NG tube is passed multiple times w water (will use antimicrobials and anti inflamm to protect against aspiration pneumonia)
-nosebleeds (due to tube)
-strictures (permanent narrowing) develop causing chronic choke

Question 6

what is equine gastric ulcer syndrome (EGUS)

Answer 6

-erosion of stomach lining

Question 7

what % of mature horses in training have ulcers, are foals also at risk

Answer 7

-60-90
-yes

Question 8

how are gastric ulcers managed

Answer 8

-increased grazing time (most important)
-reduce stress (modify training schedule and care during transport)
-gastrogard, zantac, sucralfate

Question 9

how serious are gastric ulcers

Answer 9

-impacts performance
-most ulcers treated and ctrled w omeprazole

Question 10

what does gastrogard, zantac, and sucralfate do, which one is expensive

Answer 10

-gastro & zantac: block receptors in stomach involved in acid secretion
-sucralfate: adheres to ulcerated areas of stomach to act as a protectant
-gastro is expensive

Question 11

what are the complications of gastric ulcers

Answer 11

-may perforate
-may reflux into esophagus

Question 12

what is colic

Answer 12

-abdominal pain
-describes disorders of intestines, from gas to impactions/blocks, to twists or loops of intestine

Question 13

if capillary refill time is 1-2, 2.5-4, >4 seconds, what are the horses chances of survival w colic

Answer 13

1-2 has 90%
2.5-4 has 50%
>4 has 12%

Question 14

what does a horse w colic look like

Answer 14

-sweat, pawing, looking at his flank
-increased heart and respiratory rate
-rolling on ground
-refuse food and not pass any manure

Question 15

how is colic diagnosed

Answer 15

-physical exam
-assess pain lvl by observing behav
-auscult GI sounds: gas or spasmodic colic has increased sounds, impaction or displacement or twist will have decreased
-rectal exam (impaction, gas, displacement)
-NG tube
-abdominocentesis

Question 16

how is colic treated

Answer 16

-spasmodic and gas: light exercise
-impaction or blockage: laxative through NG tube, IV fluids
-pain ctrl via anti-inflam, flunixin, meglumine
-sedate: xylazine, detomidine w butorphanol
-antispasm: buscopan
-surgery for twists/displacement (complex or simple)

Question 17

what are the two categories of coli

Answer 17

-medical
-surgical

Question 18

how serious is colic

Answer 18

-varies from minor self-limiting bellyache to life threatening and needing surgery
-full recovery from surgery takes 3-6 mo

Question 19

what are the complications of colic

Answer 19

-most medical resolve w/out problems
-surgical: endotoxins can cause shock and laminitis, adhesions disrupting motility, incisional hernias
-pain ctrl: the medications may mask the symptoms of colic so we do not know how serious it is

Question 20

what is the diff b/w spasmodic and gas colic

Answer 20

-spasmodic: spasms or cramping of intestinal segments
-gas: build up w/in intestinal loops

Question 21

what are the clinical signs and outcome of spasmodic and gas colic

Answer 21

-acute, severe pain
-louder than normal borborygmi
-self limiting
-manage pain, prognosis is good
-gas colic may progress to displacement

Question 22

what is impaction colic

Answer 22

-blockage of feed in intestines
-mild, intermittent pain that progresses
-decreased fecal output
-quiet borborygmi
-pain mgmt: laxative, IV, rarely surgery
-prognosis good if no complications
-rare rupture of intestines

Question 23

what is enterolith colic

Answer 23

-stone forms in intestines causing blockage
-acute intermittent pain as stone moves
-identified by radiographs
-mild episodes resolve w pain mgmt
-surgical removal
-cause of chronic colic in some areas

Question 24

what is displacement colic

Answer 24

-loop of intestine moves into abnormal position
-mild, intermittent clinical signs progressing to severs
-decreased borborygmi
-small amts of feces
-manage pain, roll the horse
-often needs surgery
-prognosis good if identified early and intestine is not opened in surgery
-can persist for days or weeks

Question 25

what is torsion colic

Answer 25

-section of intestines twist around itself
-acute, uncontrollable pain
-signs of toxicity: high heart rate, dark mucous membranes, no borborygmi
-surgery required
-surgery needs to happen fast, prognosis is poor if lg parts of intestine removed as it compromises intestinal health
-may not make it to surgery in time due to pain and damge
-complications w toxicity if lots of intestine dies

Question 26

what is strangulation colic

Answer 26

-section of intestine constricted by becoming trapped b/w 2 structures or something wrapped around it
-acute, uncontrollable pain
-signs of toxicity: same as torsion
-surgery required
-need surgery fast to minimize toxin release, may do well if small section of intestine removed and recognized early
-most commonly caused by lipoma wrapping around loop of intestine

Question 27

what are tips to prevent colic

Answer 27

-regular deworming
-regular feeding
-several small meals a day
-high quality feed
-gradually increase pasture time
-daily exercise
-access to fresh water always
-routine dental work