Unit 2 - GI Colic Flashcards
What is colic?
abdominal pain most likely localized to the GI tract
Is mortality associated with colic higher in horses less than a year of age or greater?
greater
What percentage of colic are simply medical and not surgical?
80-85% are medical - 30% resolve without treatment
What are the influencing factors for survival of colic?
Delay of treatment, underlying disease, shock and endotoxemia, improvements in anesthesia, and fluid therapy
What are the risk factors to developing colic?
Previous colic episodes, round bale feeding, course or poor-quality hay, high concentrate diets, acute decrease in exercise, cribbing, late pregnancy to 150 days post-partum, possibly weather changes
What clinical signs are associated with colic?
Rolling, pawing, looking at flank, abnormal behavior, grinding teeth, lifting the upper lip, not passing manure, sweating, abnormal posture, and anorexia
What information should you get about a horses history in a colic case?
signalment, recent changes, duration of colic, medical history, previous episodes of colic
What should you examine during physical examination in a colic case?
Attitude, abdominal distension, fecal consistency, TPR, MM, CRT, GI auscultation
What is the normal T for horses?
99-101 F
What is the normal HR for horses?
30-42 bpm
What is the normal RR for horses?
12-20 bpm
What may increased HR indicate?
pain, endotoxemia, and decreased vascular volume
What are signs of endotoxemia in the mm?
brick red color, blue or purple, toxic line
How do you check hydration status on a horse?
CBC/chemistry panel, mucus membranes, and a skin tent (neck or upper eyelid)
What is a normal PCV in horses?
30-40%
What is a normal TS in horses?
6-7 g/dl
What is the prognosis for survival if a patient has a PCV of greater than 60%?
Poor prognosis for survival
Where should GI auscultation be done?
4 quarants - dorsal and ventral in the right and left flank
In 1 minute, how many ‘episodes’ of sounds should you hear on GI auscultation?
1-2 episodes of sounds
What behavior is associated with pain?
Violent, uncontrollable, continous and older horses are stoic
What are signs of mild pain?
laying down, looking at abdomen, occasionally rolls
What can cause mild GI pain?
large colon impactions or displacements
What are signs of moderate pain?
active rolling, continuous discomfort
What can cause moderate GI pain?
large colon displacements and gas distension
What are signs of severe pain?
violently throwing self on ground and very little awareness of surroundings
What are the causes of severe pain?
Vascular compromise to bowel, large colon torsion, and small intestinal strangulating lesion
What diagnostics should be done for colic?
Blood work, nasogastric tube, rectal examination, abdominocentesis, and ultrasound
What bloodwork should be done in colic cases?
PCV/TS, lactate, CBC, and serum chemistry
Why do you want to pass a NG tube early on in treatment?
Because they cannot vomit, it will help releive pressure in the stomach that will ultimately make them more comfortable
What volume of reflux is normal?
1-2 liters
What volume of reflux is significant?
> 4 liters - don’t give mineral oil
Can a rectal examination aid in colic diagnosis?
It may aid in determining where and if the distension is gas or solid, but determining a definitive diagnosis is rare
What complication is associated with rectal examination?
rectal tears
Why would you want to do a fecal assessment in colic cases?
For gross evaluation, fecal flotation to determine if parasites are the cause, and to determine if there is sand sediment
Where should you do an abdominocentesis?
at the right of midline
What does normal periotoneal fluid look like?
clear, yellow peritoneal fluid
What are some abnormal fluid consistencies from abdominocentesis?
Cloudy, serosanguinous, or reddish brown +/- plant material
What does serosanguinous fluid indicate?
there is blood in the peritoneal fluid
What does reddish brown +/- plant material fluid indicate?
There is a rupture or you accidently went into the GI tract
What diagnostic tool is helpful for evaluation of colic?
ultrasound
Why is ultrasound a good diagnostic tool?
Abdominal effusion and character, evaluate bowl wall thickness, SI distension, and nephrosplenic space
Bare with me here, there are a lot. What are the indications for referral in colic cases?
Persistent HR > 60 bpm Red, injected, purple mucus membranes Increasing severity of clinical signs Marked abdominal distension Unrelenting pain Chronic, intermittent pain >2 days duration Distended small intestine Spontaneous reflux/large volumes of reflux Large colon palpable in the pelvic inlet Serosanguinous abdominocentesis Thickened intestinal walls
What is the medical treatment for colic?
Pain control, hand walking, fluid therapy (they will need a lot), gastric decompression, laxatives, restrict food intake, and prokinetics
What can be used for pain control in colic cases?
NSAIDs, sedatives, and analgesia
What type of fluid do you want to use for IV fluid therapy?
isotonic replacement fluid - LRS, Plasmalyte A, and Normasol-R
What electrolyte deficits can you correct with IV fluid therapy?
Calcium, potassium, magnesium
What is the most common NSAID used for colic treatment?
Flunixin meglumine (Banamine)
Does Flunixin meglumine mask surgical colic pain?
no
What other NSAIDs can be used to treat colic pain?
Phenylbutazone, ketoprofen, Dipyrone
What sedatives can be used in colic cases?
Xylazine, Detomidine, and Romifidine
What sedative can mask surgical colic pain?
Detomidine
Why would you want to give N-butylscopolammonium bromide to a colic patient?
It is a parasympatholytic that provides temporary ileus to relax the intestine
What analgesic is the most commonly used in colic patients?
Butorphanol tartrate
What drug is butorphanol often given with?
Xylazine, Detomidine, and Romifidine
What laxatives do you want to give to colic patients?
mineral oil, magnesium sulfate, dioctyl sodium sulfosccinate (DSS), water, and Psyllium
What does mineral oil do in the GI tract?
it lubricates it
What type of laxative is magnesium sulfate?
it is an osmotic
What type of laxative is DSS?
it is a detergent
When is it good to use Psyllium as a laxative?
It is bulk forming so it is good for particulate colic (sand, gravel)
