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Large animal medicine I > GI -> Ileus > Flashcards

GI -> Ileus Flashcards

1
Q

T/F: The first third of the esophagus is striated muscle, and the caudal 2/3 of the esophagus is smooth muscle.

A

False. Prox 2/3 is skeletal, distal 1/3 is smooth

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2
Q

Define primary choke.

A

Esophageal obstruction with no actual issue with the esophagus itself.

Ex: dental issues, feed types

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3
Q

What are some risk factors with choke concerning horse management and husbandry?

A

Competition for feed -> bolting

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4
Q

What are some horses associated risk factors for choke?

A

Dental abnormalities (wavemouth), naturally fast eaters, underlying disease

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5
Q

What are some feed associated factors that can lead to choke?

A

Feed that expands with water: dry beet pulp, bran, hay cubes, pellets

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6
Q

What are some CxS seen with choke?

A

Profuse bilateral nasal discharge* (tint of food particles)

Salivation, gagging, retching, ‘colic’ signs

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7
Q

What is the landmark for nasogastric tubing?

A

13th rib

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8
Q

What is the best diagnostic tool for choke?

A

Endoscopy

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9
Q

What is the #1 complication with choke to worry about?

A

Aspiration pneumonia

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10
Q

What are some methods to treat choke?

A

Heavy sedation (lots of alpha2-agonist: xylazine)
NG tube and flushing
Oxytocin

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11
Q

On physical examination with a horse that has apparent GI complications, what does a high elevated heart rate suggest?

A

Strangulation of the intestines

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12
Q

How do you grade a horse with colic?

A

Grade 1 - mild. playing in water, pawing
Grade 2 - moderate. frequent pawing, kicking, crouching
Grade 3 - severe. rolling, thrashing, up and down constant

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13
Q

With GI auscultation, what does +, ++, +/-, and - indicate?

A

+ : present, normally usual sounds
++ : more than usual sounds
+/- : more or less, difficult to tell
- : absent sounds

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14
Q

With GI auscultation, what does LD, RD, LV, RV represent?

A

LD: left dorsal quadrant - small intestine and small colon
RD: right dorsal quadrant - cecum
LV: left ventral quadrant - large colon
RV: right ventral quadrant - large colon

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15
Q

If you observe the external abdominal outline of a horse with colic, what would a more proximal contour of the abdomen usually indicate? What if it was blown up like a tick?

A

Proximal contour - small intestine, large colon displacement

Tick size - large colon involvement

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16
Q

Because a horse cannot vomit, what is a big consequence that can occur?

A

Gastric rupture

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17
Q

When should NG intubation be attempted when dealing with a severe colicky horse?

A

Immediately (first)

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18
Q

What does a large volume (>2L) indicate about the location of the colic?

A

Large volume usually means small intestinal colic

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19
Q

What is the prognosis of a horse that has spontaneous reflux?

A

Poor prognosis

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20
Q

What would the pH be of the NG reflux fluid if it were <7? >7?

A

<7 : gastric

>7 : small intestine

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21
Q

What could you guess is a contributor of colic if the reflex from NG tubing is malodorous?

A

Infectious disease

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22
Q

What can transrectal palpation tell you on a colicky horse?

A

The type of distention (gas, liquid, etc), location, organ involved, and impact to other organs

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23
Q

T/F: Most of the structures in the abdomen cannot be reached by rectal palpation

A

True

24
Q

T/F: If you can palpate small intestine, there is something wrong

A

True

25
Q

When would abdominocentesis be indicated?

A

Only if it will add to information and the decision making process

26
Q

What are normal values to obtain from a fluid from abdominocentesis?

A

TP: <2.5 g/dL
WBC: <5,000 - 10,000 cells/uL
RBC: none

27
Q

What would you expect to see on TP, WBC, RBC values on an abdominocentesis of a horse that has colic?

A

Increased for all

28
Q

What can CBC, blood gas, and blood chemistries tell you about a horse with colic?

A

The status of the horse and severity of shock and disease

29
Q

What do you see on CBC with a case of inflammatory colic?

A

Low/normal total WBC count and neutrophil count

30
Q

What is the best imaging tool to aid in the diagnosis of a colicky horse?

A

Endoscopy

31
Q

T/F: Colic can be attributed to both GI-related and non GI-related pain in the abdomen.

A

True

32
Q

What are the three biggest risk factors for a horse to get colic?

A
  1. ) Diet
  2. ) Changes in exercise
  3. ) History of previous colic
33
Q

What are the four pathophysiologic GI causes of colic?

A
  1. ) True obstruction
  2. ) Non-strangulating infarction
  3. ) Ulcerations
  4. ) Inflammatory
34
Q

What is the physiological difference between strangulating and non-strangulating GI colic?

A

Gut wall compromise

35
Q

Which pathophysiologic GI cause of colic looks like a strangulation, but really isn’t?

A

Infarction (thromboembolic)

36
Q

T/F: Inflammatory pathophysiologic GI causes are strangulation forms of colic.

A

True

37
Q

Which part of the GI tract is most common associated with non-strangulating colic?

A

Large intestine

38
Q

What is the HR usually for non-strangulating colic? CV signs?

A 
HR = 60-70 bpm
CV = normal
RR = increased from pain
39
Q

How much reflux may you see with a NG tube on a non-strangulating lesion?

A

Typically none, since it is a large intestine situation

40
Q

What will you initially see with abdominocentesis of a non-strangulating colic, and what is the the 1st, 2nd, and last value to increase over time?

A 
Initially = normal
1st = TP increase
2nd = WBC increase
3rd = RBC increase
41
Q

T/F: Strangulating lesions are more painful than non-strangulating colic but have less CV compromise.

A

False. Higher heart rate, and CRT increased.

42
Q

What portion of the GI is typically affected by strangulating colic?

A

Small intestine

43
Q

How much reflux will you normally get with NG tube on a strangulating colicky horse?

A

> 5L

44
Q

What does the vascular compromise from strangulating colic lead to for the horse?

A

Metabolic acidosis, endotoxemic shock, hypovolemia, change in CV

45
Q

What do you initially see on abdominocentesis on a strangulating colic? What increases at the same time as the disease progresses?

A

Initially = serosanguinous fluid

Increases in TP, WBC, RBC at the same degree

46
Q

What is the single most important indicator for surgery in a colicky horse?

A

Persistent and/or uncontrollable pain

47
Q

What are some things to make sure you do before you send a colicky horse to a referral doctor?

A

NG tube, record the meds, no fluids

48
Q

T/F: Even if the horse has a strangulating colic, you may still see defecation.

A

True

49
Q

What meds would you give to treat spastic or mild colic?

A

Flunixin meglumine, dipyrone, busopan

50
Q

What meds would you give to treat moderate to severe colic?

A

Xylazine, butorphanol

51
Q

What are general methods used to treat colic, collectively?

A

No eating for a while, walking it off, NG intubation

52
Q

What can you give through the NG tube in a colicky horse with no reflux?

A

Mineral oil

53
Q

What are the most common ways a horse gets ileus?

A

Post-operatively, alteration of motility from an abnormality, obstruction, inflammation, drug-induction

54
Q

How can you treat ileus?

A

gastric decompression, FLUID THERAPY, pain control, prokinetics

55
Q

What are the best pain meds to use for ileus?

A

Flunixin megalmine

56
Q

What are the best prokinetic drugs to use for ileus?

A

Metaclopramide, cisapride, neostigmine

57
Q

What are the best #1 drug to use for ileus in all?

A

Lidocaine!

Large animal medicine I (6 decks)

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