Introduction to Equine Colic

Question 1

Define colic

Answer 1

abdominal pain, GI origin

Question 2

Is colic a diagnosis?

Answer 2

no it is a clinic sign

Question 3

what is the most common cause of equine mortality?

Answer 3

colic

Question 4

what are signs of colic?

Answer 4

pawing
lying down
rolling
backing up
stretching out
looking around at abdomen
rolling lips (flehmen)

Question 5

If this horse is rolling, pawing, looking around at his abdomen, and presenting like this what do you think he has?

Answer 5

colic

Question 6

what are some diseases that can cause false colic?

Answer 6

myopathy
urinary obstruction
uterine torsion/contraction
peritonitis/pleuritis

Question 7

what does this indicate?

Answer 7

common sign of colic

Question 8

How does pain from colic cause problems?

Answer 8

sympathtic discharge -> ileus, gas distention, displacement, strangulation

Question 9

what are the origins of pain in colic?

Answer 9

spasm
distention - stretches visceral peritoneum
ischemia
inflammation
peritonitis-parietal pain

Question 10

How can endotoxemia occur with colic?

Answer 10

any bowel compromise

Question 11

what is the difference between strangulation and non-strangulating infarction?

Answer 11

strangulation - ischemia with distention
non-strangulating infarction - ischemia only

Question 12

what is this?

Answer 12

strangulation obstruction

Question 13

what is this?

Answer 13

strangulation obstruction
-epithelium gone
-endotoxins in
-hemorrhage

Question 14

what are important things to ask for history with a colic?

Answer 14

degree and change in pain
last defecation
sweating
signs of pain
response to treatment
previous colic or abd surgery

Question 15

how would you describe these MM?

Answer 15

normal

Question 16

how would you describe these MM?

Answer 16

pale

Question 17

how would you describe these MM?

Answer 17

injected/cyanotic rim

Question 18

how would you describe these MM?

Answer 18

vasodilatory stage of septic shock

Question 19

when is temperature increased and decreased with colic?

Answer 19

increased - enteritis
decreased - shock

Question 20

when is the respiratory effort increased with colic?

Answer 20

abdominal gas distention
diaphragmatic hernia

Question 21

when is pule bounding, weak, and inc?

Answer 21

bounding - vasodilation
weak - shock
inc - pain increases

Question 22

what is boborygmi-productive intestial movement?

Answer 22

gurgle sounds

Question 23

what happens to GI sounds with increased pain?

Answer 23

decrease - sympathetic discharge

Question 24

when can you get a fluid wave sound?

Answer 24

on a foal (uroperitoneum)
limited in adults

Question 25

what is secussion (depress and release abdominal) indicative of in a colic?

Answer 25

parietal pain

Question 26

where do you listen for sand colic in a horse?

Answer 26

along xyphoid

Question 27

what is a way to indicate if the reflux is gastric vs small intestine?

Answer 27

test nasogastric reflux pH

Question 28

If a horse refluxes do you treat through the tube or thorough other means?

Answer 28

other mean DONT treat through tube

Question 29

During a rectal exam what large structure is on the left?

Answer 29

pelvic flexure

Question 30

How do you tell the difference between the dorsal and ventral colon in a rectal exam?

Answer 30

dorsal - smooth ventral - has haustrae

Question 31

During a rectal exam what large structure is on the right?

Answer 31

cecum

Question 32

where do you check for the nephrosplenic space?

Answer 32

left dorsal quadrant

Question 33

where is the spleen felt during a rectal exam?

Answer 33

against left abdominal wall

Question 34

what does it mean if during your rectal exam your arm is floating? (feels like you're in space)

Answer 34

blood/hemoabdomen ascites

Question 35

How will peritonitis feel during a rectal? what is normal?

Answer 35

gritty/rough normal - smooth

Question 36

where can you normally feel the SI during a rectal?

Answer 36

you normally can't feel it

Question 37

how much of the SI must be distended to distend abdomen?

Answer 37

entire SI

Question 38

what is a risk of rectals?

Answer 38

rectal tear

Question 39

what do you do if you think you have a rectal tear?

Answer 39

go in with bear fingers and if found pack from cranial to tear

Question 40

do you suture a rectum if there is a rectal tear?

Answer 40

no

Question 41

Label each category for the colic prognosis - Good, Guarded, Poor

Answer 41

Question 42

what is something to be aware of when evaluating a slow pulse in a colic horse?

Answer 42

vagal tone may slow pulse in severe cases

Question 43

what does the PCV measure in a CBC?

Answer 43

hydration/metabolic status

Question 44

what can a normal WBC indicate for a colic horse?

Answer 44

displacement, strangulation, other

Question 45

what can an inc WBC indicate for a colic horse?

Answer 45

stress, infection, rarely colitis

Question 46

what can electrolytes, blood gas, and enzymes indicate in BW for a colic?

Answer 46

Electrolytes - correct for bowel function BG - acid base correction Enzymes - not usually a problem

Question 47

what can a dec WBC indicate for a colic horse?

Answer 47

endotoxemia-enteritis *fever would be seen too with enteritis*

Question 48

As the lactate value goes up in BW what happens to the prognosis?

Answer 48

it goes down

Question 49

what will happen to a belly tap that has punctured a colon in an adult horse vs foal?

Answer 49

adult - WBC will go up and will seal over, tap useless foals - do not seal over, can be fatal

Question 50

what will happen to a belly tap that has hit the spleen?

Answer 50

not fatal but not useful frank blood will be the sample hemoperitoneum

Question 51

How should normal peritoneal fluid appear?

Answer 51

clear yellow - like pee

Question 52

What does the following appearance of peritoneal fluid indicate - coudy/turbid, serosanguinous, feed and bacteria contaminated, blood?

Answer 52

coudy/turbid - inc WBC serosanguinous - bowel wall leaking feed and bacteria contaminated - intestinal tap or perforation blood - splenic tap or hemoperitoneum

Question 53

what should the total protein of peritoneal fluid be?

Answer 53

2 g/dL or less

Question 54

what is an increased total protein of peritoneal fluid indicative of?

Answer 54

bowel wall leaking or peritoneal inflammation

Question 55

what is the normal WBC for peritoneal fluid?

Answer 55

300

Question 56

what do you do if you find feed material in a belly tap?

Answer 56

repeat 3x more or explore (surgery)

Question 57

Describe the peritoneal fluid

Answer 57

L - normal middle - serosanguinous, bowel wall leaking R - feed contaminated, possible ruptured bowels

Question 58

what can ultrasound show you for a colic case?

Answer 58

small bowel distention thoracic contents

Question 59

what can radiographs show you for a colic case?

Answer 59

thoracic contents enteroliths foals - meconium

Question 60

what can gastroscopy show you for a colic case?

Answer 60

gastric ulcers

Question 61

what is the pathology?

Answer 61

colon trapped in nephrosplenic space

Question 62

what is the pathology?

Answer 62

free fluid in abdomen

Question 63

what is the pathology?

Answer 63

distended SI

Question 64

what is the pathology? (probe is along xiphoid)

Answer 64

sand in colon

Question 65

what is the pathology? (SI)

Answer 65

thickened SI

Question 66

what is the pathology?

Answer 66

enterolith stone in cranial abdomen

Question 67

what is this?

Answer 67

sand test

Question 68

what can sand do to the colonic mucosa?

Answer 68

endotexemia

Question 69

when do you do a rectal on foals?

Answer 69

YOU DONT

Question 70

when can you get a ballottement of fluid wave with foals?

Answer 70

ruptured bladder

Question 71

Is an adult or foal more likely to have a high WBC in peritoneal fluid without infection?

Answer 71

foal

Question 72

what is one of the most important things for medical management of colic?

Answer 72

pain control

Question 73

what are the broad aspects of medical management of colic?

Answer 73

pain control hydration electrolytes and acid-base balance endotoxemia and sepsis regulation of intestinal motility and transit

Question 74

what drugs do you use to break the pain cycle in a colic case?

Answer 74

a2 - xylazine, dormosedan NSAID - banamine Anti-spasmotic - buscopan Opioids (only if needed, inhibits motility so want to avoid) - butorphanol

Question 75

which medications used to break the pain cycle have the purpose of analgesia only?

Answer 75

alpha 2 - xylazine, dormosedan

Question 76

what drug do you give in a colic for anti endotoxin effect?

Answer 76

banamine

Question 77

what drug do you give in a colic for anti-spasmotic effect?

Answer 77

buscopan

Question 78

Do you want to use opioids in a colic?

Answer 78

no they inhibit motility a2 are very potent and can help enough

Question 79

what type of drugs do you want to avoid in a colic case?

Answer 79

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

Question 80

what are some oral treatments you can give for colic?

Answer 80

mineral oil - transit marker, prevent abs, lubrication laxatives - impaction rehydration - dehydration absorbents - endotoxemia

Question 81

what is the purpose of IV fluids in a colic horse?

Answer 81

combat shock and relieve impaction

Question 82

what is the maintenance dose of IV fluids?

Answer 82

50-60 ml/kg/day

Question 83

what is the correction of hypovolemia IV fluid formula?

Answer 83

= %dehydration x BW (kg)

Question 84

calculate the total volume of fluid this horse needs

Answer 84

Question 85

how much supplemental calcium is administered in fluids?

Answer 85

5-20ml of 23% calcium fluconate per 1L of fluids

Question 86

How do you feed a colic horse?

Answer 86

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

Question 87

what are the indication for surgery for a colic horse? *****

Answer 87

persistent intractable pain incriminating rectal findings metabolic status and reasons peritoneal fluid findings duration of above

Question 88

what should be considered when referring a colic case?

Answer 88

not responding to treatment cant handle treatments needed for animal in field worsening likely to occur distance to referral center far time/day