Introduction to Equine Colic Flashcards
Define colic
abdominal pain, GI origin
Is colic a diagnosis?
no it is a clinic sign
what is the most common cause of equine mortality?
colic
what are signs of colic?
pawing
lying down
rolling
backing up
stretching out
looking around at abdomen
rolling lips (flehmen)
If this horse is rolling, pawing, looking around at his abdomen, and presenting like this what do you think he has?
colic
what are some diseases that can cause false colic?
myopathy
urinary obstruction
uterine torsion/contraction
peritonitis/pleuritis
what does this indicate?
common sign of colic
How does pain from colic cause problems?
sympathtic discharge -> ileus, gas distention, displacement, strangulation
what are the origins of pain in colic?
spasm
distention - stretches visceral peritoneum
ischemia
inflammation
peritonitis-parietal pain
How can endotoxemia occur with colic?
any bowel compromise
what is the difference between strangulation and non-strangulating infarction?
strangulation - ischemia with distention
non-strangulating infarction - ischemia only
what is this?
strangulation obstruction
what is this?
strangulation obstruction
-epithelium gone
-endotoxins in
-hemorrhage
what are important things to ask for history with a colic?
degree and change in pain
last defecation
sweating
signs of pain
response to treatment
previous colic or abd surgery
how would you describe these MM?
normal
how would you describe these MM?
pale
how would you describe these MM?
injected/cyanotic rim
how would you describe these MM?
vasodilatory stage of septic shock
when is temperature increased and decreased with colic?
increased - enteritis
decreased - shock
when is the respiratory effort increased with colic?
abdominal gas distention
diaphragmatic hernia
when is pule bounding, weak, and inc?
bounding - vasodilation
weak - shock
inc - pain increases
what is boborygmi-productive intestial movement?
gurgle sounds
what happens to GI sounds with increased pain?
decrease - sympathetic discharge
when can you get a fluid wave sound?
on a foal (uroperitoneum)
limited in adults
what is secussion (depress and release abdominal) indicative of in a colic?
parietal pain
where do you listen for sand colic in a horse?
along xyphoid
what is a way to indicate if the reflux is gastric vs small intestine?
test nasogastric reflux pH
If a horse refluxes do you treat through the tube or thorough other means?
other mean
DONT treat through tube
During a rectal exam what large structure is on the left?
pelvic flexure
How do you tell the difference between the dorsal and ventral colon in a rectal exam?
dorsal - smooth
ventral - has haustrae
During a rectal exam what large structure is on the right?
cecum
where do you check for the nephrosplenic space?
left dorsal quadrant
where is the spleen felt during a rectal exam?
against left abdominal wall
what does it mean if during your rectal exam your arm is floating? (feels like you’re in space)
blood/hemoabdomen
ascites
How will peritonitis feel during a rectal? what is normal?
gritty/rough
normal - smooth
where can you normally feel the SI during a rectal?
you normally can’t feel it
how much of the SI must be distended to distend abdomen?
entire SI
what is a risk of rectals?
rectal tear
what do you do if you think you have a rectal tear?
go in with bear fingers and if found pack from cranial to tear
do you suture a rectum if there is a rectal tear?
no
Label each category for the colic prognosis - Good, Guarded, Poor
what is something to be aware of when evaluating a slow pulse in a colic horse?
vagal tone may slow pulse in severe cases
what does the PCV measure in a CBC?
hydration/metabolic status
what can a normal WBC indicate for a colic horse?
displacement, strangulation, other
what can an inc WBC indicate for a colic horse?
stress, infection, rarely colitis
what can electrolytes, blood gas, and enzymes indicate in BW for a colic?
Electrolytes - correct for bowel function
BG - acid base correction
Enzymes - not usually a problem
what can a dec WBC indicate for a colic horse?
endotoxemia-enteritis
fever would be seen too with enteritis
As the lactate value goes up in BW what happens to the prognosis?
it goes down
what will happen to a belly tap that has punctured a colon in an adult horse vs foal?
adult - WBC will go up and will seal over, tap useless
foals - do not seal over, can be fatal
what will happen to a belly tap that has hit the spleen?
not fatal but not useful
frank blood will be the sample
hemoperitoneum
How should normal peritoneal fluid appear?
clear yellow - like pee
What does the following appearance of peritoneal fluid indicate - coudy/turbid, serosanguinous, feed and bacteria contaminated, blood?
coudy/turbid - inc WBC
serosanguinous - bowel wall leaking
feed and bacteria contaminated - intestinal tap or perforation
blood - splenic tap or hemoperitoneum
what should the total protein of peritoneal fluid be?
2 g/dL or less
what is an increased total protein of peritoneal fluid indicative of?
bowel wall leaking or peritoneal inflammation
what is the normal WBC for peritoneal fluid?
300
what do you do if you find feed material in a belly tap?
repeat 3x more or explore (surgery)
Describe the peritoneal fluid
L - normal
middle - serosanguinous, bowel wall leaking
R - feed contaminated, possible ruptured bowels
what can ultrasound show you for a colic case?
small bowel distention
thoracic contents
what can radiographs show you for a colic case?
thoracic contents
enteroliths
foals - meconium
what can gastroscopy show you for a colic case?
gastric ulcers
what is the pathology?
colon trapped in nephrosplenic space
what is the pathology?
free fluid in abdomen
what is the pathology?
distended SI
what is the pathology? (probe is along xiphoid)
sand in colon
what is the pathology? (SI)
thickened SI
what is the pathology?
enterolith
stone in cranial abdomen
what is this?
sand test
what can sand do to the colonic mucosa?
endotexemia
when do you do a rectal on foals?
YOU DONT
when can you get a ballottement of fluid wave with foals?
ruptured bladder
Is an adult or foal more likely to have a high WBC in peritoneal fluid without infection?
foal
what is one of the most important things for medical management of colic?
pain control
what are the broad aspects of medical management of colic?
pain control
hydration
electrolytes and acid-base balance
endotoxemia and sepsis
regulation of intestinal motility and transit
what drugs do you use to break the pain cycle in a colic case?
a2 - xylazine, dormosedan
NSAID - banamine
Anti-spasmotic - buscopan
Opioids (only if needed, inhibits motility so want to avoid) - butorphanol
which medications used to break the pain cycle have the purpose of analgesia only?
alpha 2 - xylazine, dormosedan
what drug do you give in a colic for anti endotoxin effect?
banamine
what drug do you give in a colic for anti-spasmotic effect?
buscopan
Do you want to use opioids in a colic?
no they inhibit motility
a2 are very potent and can help enough
what type of drugs do you want to avoid in a colic case?
opioids - inhibit motility
acepromazine - vasodilator potentiates shock
motility stimulants - inc pain and inc risk of rupture with obstruction
dioctyl sodium succinate (DSS) - don’t have time
what are some oral treatments you can give for colic?
mineral oil - transit marker, prevent abs, lubrication
laxatives - impaction
rehydration - dehydration
absorbents - endotoxemia
what is the purpose of IV fluids in a colic horse?
combat shock and relieve impaction
what is the maintenance dose of IV fluids?
50-60 ml/kg/day
what is the correction of hypovolemia IV fluid formula?
= %dehydration x BW (kg)
calculate the total volume of fluid this horse needs
how much supplemental calcium is administered in fluids?
5-20ml of 23% calcium fluconate per 1L of fluids
How do you feed a colic horse?
if nothing coming out then nothing goes in
once pass normal pile of feces, offer 1/2 normal ration then after another 2 piles return to normal diet
what are the indication for surgery for a colic horse? *****
persistent intractable pain
incriminating rectal findings
metabolic status and reasons
peritoneal fluid findings
duration of above
what should be considered when referring a colic case?
not responding to treatment
cant handle treatments needed for animal in field
worsening likely to occur
distance to referral center far
time/day
