Colic - Decision Making

Question 1

What can distend the abdomen of horse? And what may cause these?

Answer 1

Gas, fluid, Ingesta

Anatomical, mechanical or functional obstructions

Question 2

What types of mechanical obstruction are likely to cause a strangulating colic?

Answer 2

Volvulus
Torsion
Incarceration

Question 3

What things can cause ischaemia of the gut in horses?

Answer 3

Strangulation

Thrombosis - parasites (stronglylus vulgaris), coagulopathies, DIC

Question 4

What are the causes of non strangulating lesions and their treatment plans?

Answer 4

Spasmodic colic - spontaneously resolves
Impaction - fluid, worst cases need surgery
Displacement - will resolve but may need surgery at some point
Enteritis/Ileus - reflux will require relief (NGT) and intensive treatment
Typhlocolitis - diarrhoea => intensive treatment
Peritonitis - intensive treament/surgery

Question 5

What are the causes of strangulating lesions?

Answer 5

Volvulus around mesenteric root
Strangulating Lipoma
Epiploic foramen entrapment
Inguinal/Scrotal Hernia
intussusceptions
Diaphragmatic hernia
Mesenteric rent

LI
Torsion
Intussusception

Question 6

How can a SI vs. LI lesion be distinguished?

Answer 6

SI - will see reflux
- palpable SI on rectal/ultrasound findings of distension
LI - (abdominal distension)
- Impaction/gas distension rectally palpable
- Displacement palpable
- Usually no reflux.

Question 7

Why is it important to refer SI causes of colic?

Answer 7

Most of the causes of SI colic will require surgery or intensive medical treatment.

Question 8

Which cases of colic should be considered for referral?

Answer 8

STRANGULATING LESION
SI lesions
Lesions requiring intensive medical treatment
Non-resolving impactions
Recurring/undiagnosable

Question 9

What should be discussed with the owner prior to referral?

Answer 9

COST
Circumstances (e.g. age of horse)
Insurance
Expectations
Willingness to surgery?

Question 10

What signs may indicate the need for referral?

Answer 10

Mod/Severe pain
Recurrent pain
poor response to analgesia
CV compromise
severe abdominal distension
SI lesion signs
Signs of strangulating lesion

Question 11

What sorts of things can determine whether a colic is medical or sugical?

Answer 11

HISTORY
-Pain
-feeding
-response to analgesia
CV FITNESS
GI SYSTEMS
-Borborygmi
-passing of faeces
NGT/RECTAL
-Reflux
-Distension of SI?
TREATMENT RESPONSE
-Amount needed
-Reccurance