Primary assessment of colic

Question 1

Which side of the horse is the caecum on

Answer 1

Right

Question 2

Describe briefly how ingesta through the horses SI —> LI

Answer 2

stomach into the duodenum –> jejunum –> ileum –> caecum –> right ventral colon –> left ventral colon –> left dorsal colon –> right dorsal colon –> descending colon into rectum

Question 3

List 7 clinical signs that are associated with severe/ critical cases of colic

Answer 3

Signs of self trauma
Throwing themselves on the floor
Dullness and depression => can indicate septicaemia
Abdominal distention
Heart rate >60bpm
Discoloured MM
Absence of gut sounds in one or more quadrants

Question 4

What areas of the history are most important to get in a colic case

Answer 4

Signalment, behaviour and attitude
Current episode - how long, changes in signs
Previous history of colic
Recent changes in management
Owner factors - what they want
Any preventative medicine used - worming etc.

Question 5

What are the 5 main things to check on a physical exam

Answer 5

1. Pain
2. Heart rate
3. Mucous membranes
4. Gut sounds
5. Temperature

Question 6

Describe how to assess pain in the horse

Answer 6

Pawing, kicking, flank-watching, rolling, attempts to lie down, sweating
Demeanour
Facial expression - pain scoring

Question 7

Give the 3 most commonly used diagnostic tests used for colic in the field

Answer 7

1. Response to analgesia
2. Rectal examination
3. Nasogastric intubation

Question 8

When is a rectal exam indicated in cases of colic

Answer 8

Clinical signs of colic
Recent history of colic
Demonstrates severe pain
High HR >60bmp

Question 9

When is a rectal exam contraindicated

Answer 9

Risk to vet, handler, or horse which cannot be managed by restraint/sedation
Unacceptable risk of rectal tear e.g. small pony

Question 10

Why would you perform a nasogastric intubation in a horse with colic

Answer 10

Both diagnostic and therapeutic
Allows you to see if there is excessive build up of fluid in the stomach
Allows you to remove the excess fluid

Question 11

When is using a nasogastric tube indicated

Answer 11

Spontaneous nasogastric reflux
Suspected critical cases

Question 12

Give 2 potential complications associated with nasogastric intubation

Answer 12

Epistaxis
Administration of treatment into the lungs

Question 13

What is a potential complications associated with rectal exam

Answer 13

rectal tear

Question 14

What are the 4 grades of rectal tears

Answer 14

Grade I - mucosa and submucosa torn
Grade II - muscular layer only torn
Grade IIIa and b - all layers torn except serosa or mesorectum
Grade IV - all layers torn

Question 15

What first aid can you give to treat a rectal tear

Answer 15

Identify it, inform the owner
Sedate horse and give spasmolytic
Remove faeces from rectum and tear
Give NSAIDs and broad spectrum antibiotics to treat septic shock and peritonitis
If you can - epidural and pack rectum
Refer

Question 16

What are the surgical options for a rectal tear

Answer 16

Direct suturing if possible, plus temporary indwelling rectal liner and colostomy

Question 17

Why should you not use liquid paraffin in cases of impaction colics

Answer 17

If tube is in the wrong place major risk of lipid pneumonia - and no evidence of it being better than water

Question 18

What are the 5 different types of colic

Answer 18

Impaction
Displacement
Torsion
Strangulation
Obstruction

Question 19

List some non-intestinal causes of colic

Answer 19

Renal Disease
Urogenital tract disorders
Liver disease
Peritonitis
Thoracic disease

Question 20

How should you treat a horse if you inadvertently put the NG tube into the trachea

Answer 20

NSAIDs
Broad spectrum ABs

Question 21

How do you check the NG tube is in the oesophagus in a horse?

Answer 21

Watch left of neck during placement
-Suck back on tube: oesophagus closes round tube
-Listen and smell contents