Top 8 Acute Colics

Question 1

list some causes of small intestine disease that cause colic and what they are associated with

Answer 1

strangulating lipoma: OLDER horses usually

volvulus

intussusception: YOUNG horses, parasites

herniation

mesenteric entrapment

proximal enteritis: treated with medical management, mimics an obstruction

Question 2

clinical signs of small intestinal disease (colic) include

Answer 2

severe pain that does not respond to analgesics, shock, gastric reflux, big dilated loops on ultrasound, serosanguinous abdominal fluid, palpable distended SI on rectal palp

Question 3

how is small intestinal disease/colic treated?

Answer 3

surgical: can do resection of the intestine, only works if you catch it early enough :(

Question 4

why is it so important to treat large intestinal volvulus/impaction quickly?

Answer 4

you cant resect large intestine

Question 5

who is at risk for large intestinal volvulus?

Answer 5

broodmares

Question 6

what are clinical signs of large intestinal volvulus/impaction?

Answer 6

severe pain not responsive to analgesics, shock, NO GASTRIC REFLUX, abdominal fluid normal, palpable large intestinal gas distention on rectal palp

Question 7

how is large intestinal volvulus treated

Answer 7

surgery, but you cant resect any of it, have to catch it early

Question 8

colonic impaction is ultimately caused by what?

Answer 8

backup of fecal material, especially with decreased water intake, decreased manure production

Question 9

who is particilarily at risk for developing colonic impaction?

Answer 9

horses with bad dental care, decreased water intake, cold weather, minature horses

Question 10

clinical signs of colonic impaction include

Answer 10

mild or intermittent colic signs, decreased manure production, palpable firm feces on rectal palp,

Question 11

a minature pony presents for intermittent colic for the past week. some days she is pawing at the ground and looking at her flank, while other days she is normal again. the owner mentions her manure production is less so than normal. most likely diagnosis and treatment?

Answer 11

colonic impaction

treatment: oral fluids + laxatives or IV fluids

Question 12

you get called out on an emergency farm call to see Liddia, a 22 year old mare. she seems to be in severe pain since last night; she is pawing and looking at her flank, and she us sweating. When you arrive you pass an NG tube and get lots of gastric reflux back. You then do a rectal palp and feel distended loops of what feels like small intestine. number one differential?

Answer 12

strangulating lipoma/small intestinal disease

Question 13

you get called to go see Daisy, a 7 yo Broodmare, who is in severe pain. When you pass an NG tube you dont get any reflux back. on rectal palp her colon feels quite distended. number one differential?

Answer 13

large intestinal volvulus/impaction

Question 14

colonic tympany or “gas colic” is traditionally caused by what?

Answer 14

diet change or grain overload (think of grain overload in cattle and overproduction of gas from fermentation)

Question 15

clinical signs of colonic tympany incluide

Answer 15

spasmostic/intermittent colic pain, lots of farting, can progress without treatment. may be able to feel some gas on rectal palp but may be minimal.

Question 16

colonic tympany can be treated by

Answer 16

analgesics, sedation, and fluids

Question 17

true or false: colinic displacement can often be medically managed

Answer 17

true! usually no ischemic damage is done

Question 18

how is nephrosplenic ntrapment treated?

Answer 18

phenylephrine to shrink the spleen, exercise/trotting, or sedation and rolling

Question 19

what are risk factors for sand impaction/enterololiths?

Answer 19

sandy areas like california, florida, or arizona

horses fed on a dirt ground

malnourished animals

arabians

horses eating alfalfa hay

Question 20

how does an enterololith form/

Answer 20

precipitation of struvite salts (ammonium phosphate) around a foreign body

Question 21

what is a simple diagnostic to check for sand impaction?

Answer 21

fecal float, will see sand

Question 22

how are enteroliths treated vs sand impactions treated?

Answer 22

enteroliths require an enterotomy

sand can be medically managed

Question 23

what are some risk factors for gastric ulcers in horses?

Answer 23

stressed horses, prolonged time with empty stomach, NSAID use

Question 24

gastric ulcers are usually on which part of the stomach?

Answer 24

the squamous portion or non glandular portion

Question 25

a client of yours recently adopted a horse from an abusive situation. ever since the client got the horse, he has been intermittently acting colicky and has been on and off his feed. He is kept in a small box stall right now because the client wants to keep an eye on him and keep him away from her other horses. You examine the horse and he seems very up tight and nervous around both you and the client. PE and rectal palp are normal. Upon asking more questions, your client says she gave a dose of flunixin right when he arrived to her property to address a small laceration on the horse’s front right let (now healed). What should you do next to confirm your top ddx?

Answer 25

a fasted gastroscope to look for gastic ulcers

Question 26

how should gastric ulcers be treated?

Answer 26

omeprazole or other H2 blocker, feed alfalfa hay to reduce stomach acid, and make lifestyle changes to reduce stress.

Question 27

what is the classic signlament and history for ascarid impaction?

Answer 27

a young horse that has not been previously dewormed, then given a high dose of antihelmentics

Question 28

what is the name of the parasite that migrates to the cranial mesenteric artery and creates a thrombus causing an infarction?

Answer 28

stronglylus vulgaris

Question 29

colitis in horses can be caused by many things both infectious and non infectious. list a few examples that may appear similar to colic

Answer 29

infectious: salmonella, clostridium perfringens or difficile, potomac horse fever (neorickettskia), equine coronavirus

non infectious: diet change,, right dorsal coltiis secondary to NSAIDs,

Question 30

what makes a horse more likely to get urolithiasis?

Answer 30

geldings and stallions, alfalfa diet or high protein diet

Question 31

what kind of urinary stones do horses normally get

Answer 31

calcium carbonate

Question 32

who is at risk for uterine torison

Answer 32

mares in last trimester

Question 33

you get called out to see Trudy, a broodmare in her last trimester. she is acting colicky so you examine her. on rectal palp you feel tight bands of what feels like the broad ligament. ddx? how will you treat?

Answer 33

uterine torsion

anesthesia & roll the mare around the fetus to correct

Question 34

what drug should be given to treat sand colic?

Answer 34

psyllium

Question 35

a gastro reflux pH pf greater than ____ indicates that small intestinal contents are refluxing into the stomach

Answer 35

5

making it less acidic and more basic