20.Decision making in GIT Disease Flashcards

1
Q

What critical questions should you be asking about GI disease?

A

What is the severity of the condition
Is referral indicated
Is surgery indicated
Whats the prognosis

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2
Q

How soon should you decide to cut or not to cut?

A

first 10-30 min of your evaluation
-Rolling in agony
-Harming itself

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3
Q

Do you have to have a definitive diagnosis to refer or cut?

A

No!

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4
Q

What is the minimum database for diagnosis?

A

Hx, PE, Rectal exam, NG, response to therapy

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5
Q

What are some other diagnostics?

A

CBC, Chem, Blood gas, abdominocentesis, ultrasound, rads, exploratory

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6
Q

What is some critical history to have?

A

Signalment, hx previous colic, duration, severity, changes over time, response to treatment

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7
Q

What are the important pieces of information you need to know about signalment?

A

Sex, Breed, Age

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8
Q

What are important pieces of history you need to know?

A

History of colic
Duration of signs

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9
Q

What type of colic is suspected based on the following history:

Acute onset, severe colic, minimally responsive to alpha 2 agonists

A

Strangulating Obstruction

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10
Q

What type of colic is suspected based on the following history:

Insidious onset of colic of several days duration

A

Non-strangulating obstruction or displacement

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11
Q

What type of colic is suspected based on the following history:

History of recurrent episodes

A

Sand, enterolithiasis, gas, ulcers, impaction

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12
Q

What type of colic is suspected based on the following history:

Horse had limited access to water

A

Large colon impaction

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13
Q

What type of colic is suspected based on the following history:

Feces has diarrhea with progressive colic

A

Small colon impaction

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14
Q

What type of colic is suspected based on the following history:

Persistent soft, watery diarrhea, fever, dull mentation and inappetance

A

Colitis

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15
Q

What type of colic is suspected based on the following history:

Variable pain, shock signs, sweating, muscle fasciculation and reluctance to move

A

GI rupture

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16
Q

What type of colic is suspected based on the following history:

Mild to moderate followed by severe?

A

Secondary LC displacement and volvulus

17
Q

What type of colic is suspected based on the following history:

Feeding bermuda grass hay

A

Ileal impaction

18
Q

What type of colic is suspected based on the following history:

change to lower-quality fibrous feed

A

Colon or cecal impaction

19
Q

What type of colic is suspected based on the following history:

Increased concentrate in diet

A

Proximal enteritis, large colon displacement

20
Q

What type of colic is suspected based on the following history:

Feeding alfalfa

A

Enterolithiasis

21
Q

What type of colic is suspected based on the following history:

Moldy hay

A

Proximal enteritis or gastritis

22
Q

What type of colic is suspected based on the following history:

Gradual weight loss, intermitant soft stool, feeding on grand in particular area

A

Sand impaction

23
Q

What type of colic is suspected based on the following history:

Recent deworming in young horse

A

Ascarid impaction

24
Q

What type of colic is suspected based on the following history:

Chronic NSAID

A

Right dorsal colitis, ulcer

25
Does sign of severity correlate with need for surgery?
Yes, if severe pain need surgery
26
What are some important parameters to check?
TPR, MM, CRT, Abdominal distension and sounds, Pain level
27
What is the prognosis if the horse is shocky with a high HR?
Gaurded
28
What GI parameters help ID if surgery may be needed?
Abdominal distension and abnormal borborygmi and abnormal rectal palpation
29
If you get back NG reflux then what could be occuring?
Functional or mechanical obstruction
30
What additional tests may help determine prognosis?
Abdominocentesis, peritoneal fluid analysis (color and turbidity) -Normal color medical, abdnormal color surgical
31
What is the normal range for peritoneal TP? NCC?
TP: <2.5g.dl NCC: <10,000 Lactate: < peripheral (>4mmol/L) (elevated = surgery) -Periferal predicts intestinal ischemia
32
Are wbc helpful to tell if they need surgery?
No
33
What is the prognosis with a HCT>60?
Poor
34
What is hyperglycemia associated with in colic horses?
Non-survival
35
What does an elevation in serum lactate mean?
Marker for severity of disease Elevation due to decrease in tissue perfusion, cytopathic hypoxia or decreased clearance (6 bad, 3 ok)
36
What are the top prognostic indicators for survival in colic?
HR, PCV, MM, Blood lactate
37
How is abdominal ultrasound helpful?
Can Id a strong positive, help with abdominocentesis site
38
How helpful are abdominal rads?
Low, help diaphragmatic, enterolithiasis and sand