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Equine Medicine and Surgery > Lecture 3: Introduction to Equine Colic > Flashcards

Lecture 3: Introduction to Equine Colic Flashcards

1
Q

what is colic

A

Abdominal pain, GI origin

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2
Q

What is the most common cause of equine mortality

A

Colic

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3
Q

What are some things that can cause false colic

A

Myopathy, urinary obstruction, uterine torsion/contraction, peritonitis, pleuritis

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4
Q

What are some signs of colic

A

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

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5
Q

What is the number one problem with colic

A

Pain- sympathetic discharge leads to ileus, bowel shutdown, gas distention, displacement and strangulation

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6
Q

Any bowel compromise can lead to ___, ____, ___ with or without rupture bowel

A

Endotoxemia, shock, and death

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7
Q

How can colic lead to endotoxemia, shock and death

A

Normally the mucosal barrier is preventing the endotoxins from entering but a compromised bowel they can become absorbed

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8
Q

What are the origins of pain in colic

A
  1. Spasm
  2. Distention (Gas, visceral pain)
  3. Ischemia/hypoxia
  4. Inflammation
  5. Peritonitis-parietal pain
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9
Q

What can cause distention (gas, visceral pain)

A

Primary flatulence, proximal to obstruction, ileus

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10
Q

What is one of the most painful conditions in colic

A

Gas distention

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11
Q

What happened

A

strangulation obstruction

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12
Q

What happened

A

Strangulation obstruction—> epithelium is gone so endotoxins can rush in and blood also rushes in but venous outflow is blocked

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13
Q

What wrong

A

Ischemic strangulation obstruction- no blood but epithelium/villi gone

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14
Q

What are some specific questions to ask for colic history

A
  1. Degree and change in pain
  2. Last defecation
  3. Sweating
  4. Signs of pain
  5. Response to treatment
  6. Previous colic or abdominal surgery
  7. Duration of colic
  8. Last time fed-food and water
  9. Changes to food/water, medication, housing, travel, exercise, other horses
  10. Exposure to foreign bodies
  11. Pregnancy
  12. Recent worming
  13. Recent trauma, injury, or illness
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15
Q

What should you be evaluating related to pain in PE

A

Severity, continuous/intermittent, response/duration to pain control medication

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16
Q

What are some attitude behaviors in horses with colic

A

Depressed, anxious, intangible

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17
Q

Normal or abnormal MM?

A

normal

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18
Q

Normal or abnormal MM?

A

pale- beginning of shock, decreased BF, or so distended can’t breath

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19
Q

Normal or abnormal MM?

A

cyanotic rim- vasoconstriction

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20
Q

Normal or abnormal MM?

A

Vasodilatory stage of septic shock

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21
Q

On PE temperature in increased what does that tell you

A

Enteritis, rarely surgical

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22
Q

On PE temperature is decreased, what does that tell you

A

Shock

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23
Q

If pulse is bounding what does that tell you

A

Vasodilation

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24
Q

If pulse is weak what does that tell you

A

Shock

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25
Q

What are some reasons that respiration effort can increase

A

Abdominal gas distention and diaphragmatic hernia—> suffocating

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26
Q

You auscultate the abdomen during a colic, what are you likely to hear

A

Decreased/absent gut sounds due to pain resulting in sympathetic discharge—> decrease GI motility

Spasms- short not long and productive

Tympany- gas distention

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27
Q

What is ballottement

A

Percussion test where you poke abdomen and can sometimes see a fluid wave

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28
Q

When is it common to see a fluid wave

A

Foals with uroperitoneum

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29
Q

How can you assess parietal pain

A

Secession-depress and release abdomen by pushing fist into flank

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30
Q

Where do you listen for sand accumulation

A

Near xiphoid, ventral abdomen

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31
Q

What is the point of passing NG tube

A

Reflux- assessing for accumulated fluid in stomach

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32
Q

How do you perform NG tube for reflux purposes

A

Pump in water and then lower to create a siphon

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33
Q

In a normal rectal exam where is pelvic flexure

A

Left side

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34
Q

In normal rectal exam how should dorsal and ventral colon feel

A

Dorsal colon: smooth
Ventral colon: haustrae

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35
Q

T of F: SI is easy to find on normal rectal exam

A

False!

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36
Q

In normal rectal exam where should cecum be

A

On the right

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37
Q

In a normal rectal exam what should cecum feel like

A

Haustrae present, slight distention, presence of medial band

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38
Q

Where should spleen be in normal rectal exam

A

Against left abdominal wall

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39
Q

What quadrant would you check for nephrosplenic

A

Left dorsal quadrant

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40
Q

If there is fluid in abdomen what does it feel like

A

Arm floats in space

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41
Q

What part of intestines can occupy nephrosplenic space

A

Colon

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42
Q

What are some SI rectal exam abnormalities

A

The fact that you can feel them, mild distention (proximal enteritis), thicker bowel wall, taut distention is serious finding

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43
Q

What are the heart rate ranges for good, guarded and poor prognosis

A

Good: 40-59
Guarded: 60-100
Poor: >100

44
Q

What are the MM colors for good, guarded and poor prognosis

A

Good: pink
Guarded: red
Poor: cyanotic

45
Q

What is the MM refill time for good, guarded and poor prognosis

A

Good: 1-2 sec
Guarded: 3-4 seconds
Poor: > 4 seconds

46
Q

What is PCV for good, guarded and poor prognosis

A

Good: 35-45%
Guarded: 45%-65%
Poor: >65%

47
Q

What is peritoneal total protein in good, guarded and poor prognosis

A

Good: <2.5g/dl
Guarded: 2.5-4.5g/dl
Poor: >4.5g/dl

48
Q

What does PCV measure

A

Hydration/metabolic status

49
Q

What does an increase WBC tell you

A

Infection, stress, rarely colitis

50
Q

What does decrease WBC tell you

A

Endotoxemia-enteritis

51
Q

What does a normal CBC on horse with colic tell you

A

Displacement, strangulation

52
Q

What values do you want to correct on chemistry to improve bowel function

A

Electrolytes (K, Na, Ca, Mg)

53
Q

What should normal lactate value be

A

<2.5mmol/l

54
Q

What are the normal electrolyte values for Na+, K+, Cl-, and HC03

A

Na+: 135-145 meq/l
K+ 3.5-5.5meq/l
Chloride: 98-108 meq/l
HCO3 22-30meq/l

55
Q

What is lactate value for 90% survival

A

<7.5mmol/l

56
Q

What is lactate value for 60-70% survival

A

<7.5

57
Q

What is lactate value for 20-50% survival

A

7.5-10

58
Q

What is lactate value for <10% survival

A

> 10

59
Q

What is PCV for 90% survival

A

30

60
Q

What is PCV for 60-70% survival

A

40

61
Q

What is PCV for 20-50% survival

A

60

62
Q

What is PCV for <10% survival

A

> 65

63
Q

When collecting peritoneal fluid you should be cautious if bowel is ___ or ___

A

Heavy or distended

64
Q

What is the result of puncturing colon during peritoneal fluid collection

A

Punctured colon will be fine but WBC will go up so information is useful

65
Q

T or F: foals punctured colon seals right up so no worries if you puncture

A

Does not seal up so be careful

66
Q

What are two possibilities if you get frank blood in peritoneal fluid tap

A
  1. Splenic tap
  2. Hemoperitoneum

Tap more than one site to determine splenic vs hemoperitoneum

67
Q

How should normal peritoneal fluid appear

A

Clear yellow

68
Q

If peritoneal fluid is cloudy/turbid what does that tell you

A

Increased WBC

69
Q

If peritoneal fluid is serosanguinous what does that tell you

A

Bowel wall leaking

70
Q

Is peritoneal fluid has feed and bacteria in it what does that tell you

A

Intestinal tap or perforation

71
Q

What should total protein be from peritoneal tap

A

2g/dl or less

72
Q

If total protein is increased in peritoneal fluid what does that tell you

A

Bowel wall is leaking or peritoneal inflammation

73
Q

What is normal WBC in peritoneal fluid

A

300

74
Q

What is normal lactate value in peritoneal fluid and if it is abnormal what does that mean

A

Normal: 2mmol/l
Abnormal: dying bowel

75
Q

How can ultrasounds be useful in colic or colic like situation/what can you visualize

A
  1. Small bowel distention
  2. Thoracic contents
76
Q

What can you visualize with radiographs in colic situations

A
  1. Thoracic contents
  2. Enteroliths
  3. Foals-meconium- small intestinal distention
77
Q

What is gastroscopy used to visualize

A

Gastric ulcers

78
Q

Identify which one is normal vs abnormal and what is wrong

A

Top: normal, spleen (white), intestines (black)
Bottom: abnormal- colon in nephrosplenic space

79
Q

What does this show

A

free fluid- black area

80
Q

What do 1-3 show

A
  1. Distended SI
  2. Thickened SI
  3. Sand in colon
81
Q

What is this

A

enterolith

82
Q

what is the sand test

A

Mix manure with water in bag or rectal glove- sand will settle to bottom- test is positive

83
Q

Sand can erode the colonic mucosa leading to ___

A

Endotoxemia

84
Q

T of F: you can perform a rectal exam on foal

A

False

85
Q

T or F: foals are more likely to have WBC in peritoneal fluid without infection

A

True

86
Q

What are the main objectives of medical management of colic

A
  1. Pain control- most important- stop sympathetic discharge so bowel can start working
  2. Hydration
  3. Electrolyte and acid-base balance
  4. Endotoxemia and sepsis
  5. Regulation of intestinal motility and transit
87
Q

What are some short duration pain relievers for colic

A

Alpha 2 agonists:
1. Xylazine
2. Dormosedan

88
Q

What is dose for xylazine in pain control for colic

A

0.5-1mg/kg IV

89
Q

What is dose for dormosedan in pain control for colic

A

0.01-0.02 mg/kg IV

90
Q

What drugs can be used to reduce pain in colic and also have anti-endotoxin effect

A

NSAIDS
1. Banamine

91
Q

What is the dose for bananime in pain control for colic

A

1.1mg/kg IV

92
Q

What is a short acting anti-spasmodic agent for colic

A

Buscopan/N-butylscopolammonium bromide

93
Q

What is dose for Buscopan to tx spasmodic colic

A

0.3mg/kg IV

94
Q

What drugs can be used to control pain in colic but caution because they inhibit motility

A

Opioids
1. Butorphanol

95
Q

What is dose for butorphanol when treating colic

A

0.02-0.03mg/kg IV

96
Q

What drugs do you want to avoid or use educated caution in colic

A
  1. Opioids- butorphanol- inhibit motility
  2. Acepromazine- vasodilator- potentiates shock- can collapse
  3. Motility stimulants- increase spasm/pain, potentiate rupture
  4. Dioctyl sodium succinctness (DSS)- enhances Mg absoprtion
97
Q

What oral treatments can be passed through NG tube in colic

A
  1. Mineral oil- lubrication, prevents water absorption, transient marker
  2. Laxatives: magnesium sulfate, psyllium
  3. Rehydration- water and electrolytes
  4. Absorbents- charcoal, biosponge- for endotoxemia
98
Q

How can mineral oil be used to indicate functioning GI

A

Can pass through NG tube and if it shows up in feces bowel is working and can go back on feed

99
Q

What laxative is good to prevent Sand colic

A

Psyllium

100
Q

What is the maintenance IV fluids for colic

A

50-60 ml/kg/day

101
Q

How do you determine amount of liters needed to correct hypovolemia

A

= % dehydration (BW in kg)

102
Q

How much calcium should horses receive in IV fluids

A

5-20mL of 23% calcium gluconate per 1L of fluids

103
Q

T or F: if a horse is refluxing then you should pass mineral oils and laxatives through NG tube

A

False!

104
Q

When do you put your horse back on feed after colic

A

If nothing is coming out, don’t put anything in
Oil is good marker in feces

105
Q

What are some indications for surgery in colic

A
  1. Persistent intractable pain
  2. Incriminating rectal findings
  3. Metabolic status
  4. Peritoneal fluid findings
  5. Duration of above

Equine Medicine and Surgery (27 decks)

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