Treating Medical GI Dz Flashcards
What are some diagnostics that can help you determine the severity of a case of colic?
(Ultrasound, abdominocentesis (look at the gross appearance, protein concentration, and lactate), and blood work (PCV, TP, blood lactate available on site (with the right equipment); +/- CBC, chem, blood gas)
What about the following things would indicate to you that you need to refer a colic case?
- Pain
- Heart rate
- CRT
- Reflux
- Rectal
- Pain (If it is unrelenting and/or only briefly controlled with sedation)
- Heart rate (Persistently elevated HR, >60 bpm)
- CRT (Slow)
- Reflux (Large amount of net reflex (> 6 to 8 liters))
- Rectal (Abnormal findings such as tight tenia bands, lots of distended bowel)
For the following scenario, assess the % dehydrated:
Skin tent of 2-3 seconds, mucous membrane moisture is fair, CRT is 1-2 seconds, PCV is 40-50%, and the TP is 6.5-7.5 g/dL
(4-6%)
For the following scenario, assess the % dehydrated:
Skin tent of 3-5 seconds, mucous membranes are sticky, CRT is 2-4 seconds, PCV is 50-65% and TP is 7.5-8.5 g/dL
(7-9%)
For the following scenario, assess the % dehydrated:
Skin tent is > 5 seconds, mucous membranes are dry, CRT is >4 seconds, PCV is >65% and TP is >8.5 g/dL
(>9%)
What is the comfortable oral fluid delivery volume for a 500 kg horse?
(10 L/30 min)
What is the issue with using plain water for repeated administration of fluids?
(It will lead to depletion of electrolytes stored in the cecum/colon)
Optimally you would make up for any fluid deficits quickly so how much of the deficit total do you want to administer in the first hour of fluid replacement?
(40-50%, give up to 10 L over first 30 minutes, then wait 30 minutes, then give up to another 10, repeat until 40-50% of deficit is administered, if the horse tolerates give the rest over 4-6 hours, add in losses and maintenance per hour)
What should you be monitoring throughout your oral fluid plan?
(Monitor for reflux, do not want to add more fluids if there is reflux, should also monitor protein/check for edema because they can become hypoproteinemic once rehydrated)
Oral fluids are effective in treating large colon impactions if what two things are true?
(There is GI motility and there is little net reflux)
What is the reflection coefficient?
(How readily a molecule can pass through a membrane, if it 0 = easy, if it is 1 = difficult, the RC is tissue specific (ex brain is near 1, liver is near 0))
Give some broad examples of diseases that decrease oncotic pressure due to low blood protein.
(Gut inflammation causing PLE, PLN, hepatopathy, peritoneal and/or pleural effusion, starvation, malabsorption)
Give some broad examples of diseases that decrease osmotic pressure due to electrolyte loss.
(Gut inflammation interfering with sodium absorption and retention, water overload, pleural and/or peritoneal effusion, ruptured bladder, and adrenal dysfunction)
Reduced membrane selectivity results when there is vasculitis, give some broad examples of diseases that induce vasculitis.
(Endotoxemia, infectious, and immune mediated)
What are some indications for a plasma transfusion?
(TP < 4 g/dL especially if the drop is rapid, edema, harsh/wet lung sounds + increased resp rate, and/or thickened bowel)
