Mild colic and pyrexia- peritonitis, diagnosis and treatment

Question 1

Peritonitis should be a differential for all cases of…

Answer 1

Mild colic

Question 2

List 4 common differentials for colic and pyrexia

Answer 2

peritonitis
colitis
enteritis
non-GI: pleuropneumonia and other infections

Question 3

Describe how to investigate mild colic

Answer 3

History
Physical exam
Rectal exam
NGT
±Haematology/biochemistry
Abdominocentesis

Question 4

Describe how to diagnose peritonitis

Answer 4

abdominocentesis:
high TNCC
high lactate
low glucose

Question 5

Describe how to treat a horse with peritonitis

Answer 5

Antibiotics - penicillin and gentamicin
IV fluids
+/- abdominal lavage/ drainage

Question 6

Why are IV fluids neccesaary in the colic patient?

Answer 6

Horses with colic may have concurrent hypovolaemia or endotoxaemia (sepsis).
Hypovolaemia requires IVFT to replace the fluid deficit
Endotoxaemia requires ICFT to ‘dilute’ the septicaemia in the blood

Question 7

How does colic cause hypovolaemia?

Answer 7

Colic causes horse to vomit and sweat a lot thereby reducing their fluid volume.
Colic also reduces a horses water intake as they refuse to drink (you can lead a horse to water…)

Question 8

What is the prognosis for a horse with mild colic?

Answer 8

Poor with GI rupture
Following abdominal surgery guarded
Without rupture generally good

Question 9

What is the purpose of flunixin in treating colic?

Answer 9

Has NSAID properties and is an Antiprostaglandin (reduces effects of endotoxemia)