Colic

Question 1

Define colic

Answer 1

a generic term describing clinical signs associated with presence of abdominal pain

Question 2

2 main pathophysiological mechanisms that can lead to colic

Answer 2

1. Interference with blood supply to one of the abdominal components
2. Inflammation within or around those components

Question 3

What can cause interference with blood supply to abdominal organs? (3)

Answer 3

obstruction
strangulation
infarction

Question 4

3 things that can cause obstruction

Answer 4

impaction (food or parasite)
enteroliths
neoplasia

Question 5

3 things that can cause strangulation?

Answer 5

torsion
volvulus
pedunculated neoplasia

Question 6

2 things that can cause infarction

Answer 6

parasitic embolism

post-op complications

Question 7

What can cause inflammation within or around the abdominal components? (3)

(this is basically a list of 3 types of inflammation)

Answer 7

enteritis
peritonitis
colitis

Question 8

What is an addition pathophysiological mechanism that can cause abdominal pain?

Answer 8

excessive stretching of walls of hollow organs or surrounding mesentery can also activate pain receptors; this stretching can be independent of interference with blood supply and inflammation or as a result of one or both of those things

Question 9

List the 5 disease categories resulting from abdominal pain

Answer 9

1. Abnormal feed intake
2. Intestinal parasites
3. Foreign body ingestion
4. Neoplasia
5. Abdominal organ displacement

Question 10

What 3 things are considered abnormal feed intake and what do they result in?

Answer 10

1. Ingestion of too much of the wrong food can cause excess fermentation, excess gas accumulation, and stimulate inflammation which can lead to impaction
2. Ingestion of wrong type of food that causes excess fermentation that can lead to impaction and inflammation
3. Ingestion of undigestible food/FB resulting in impaction or obstruction

Question 11

What 2 problems can be caused by intestinal parasites?

Answer 11

1. impaction due to large number of parasites

2. infarction due to aberrant migration of parasites leading to a parasitic embolism

Question 12

What 2 things can neoplasia cause?

Answer 12

obstruction

strangulation

Question 13

What 3 things result in abdominal organ displacement?

Answer 13

strangulation
malpositioning of intestinal tract
volvulus/torsion

Question 14

Name 3 disorders associated with the stomach

Answer 14

1. Ulceration
2. Obstruction
3. Dilation

Question 15

What things may result in increased acidity of the stomach?

Answer 15

Due to certain feeding behaviors

• not enough roughages
• lack of ingestion in general
• ingestion of Timothy hay, grain, pelleted foods

Question 16

What causes stomach ulceration?

Answer 16

increased acidity of the stomach because the continuously secreted HCl isn’t being kept in check

Question 17

What can cause stomach obsturction?

Answer 17

impaction (food or parasite)
neoplasia
FB

Question 18

When is a patient at higher risk for stomach obstruction?

Answer 18

decreased water intake
dental Dz
decreased stomach motility
fed beet pulp, bran, straw, wheat, barley

Question 19

What causes gastric dilation?

Answer 19

ulcers
obstruction
ruptured stomach that leads to peritonitis

Question 20

What are disorders associated with the small intestine and their causes if applicable (5)

Answer 20

ulcers (acidic stomach pH)
infection (bacterial)
obstruction (impaction, adhesions)
strangulation (neoplasia, volvulus)
idiopathic

Question 21

2 Cecum Dz that may cause abdominal pain

Answer 21

Cecal Tympany- due to gas distention from increased fermentation

Impaction (food or parasite)

Question 22

2 Large colon Dz that may cause abdominal pain

Answer 22

obstruction (sand impaction, enterolith formation, organ displacement)

strangulation

Question 23

Although rare, what is the possible small colon disorder that can lead to colic

Answer 23

food impaction

Question 24

What can occur to the rectum that may result in colic

Answer 24

rectal tear

Question 25

Clinical Signs of colic

Answer 25

``` pacing sweating pawing rolling kicking at abdomen looking at flank crouching stretching repeated standing and laying down ```

Question 26

What are 2 important questions to consider with colic?

Answer 26

1. Where is the problem located? | 2. Is it surgical or medical?

Question 27

What information is often gathered for a colic PE if not severe presentation?

Answer 27

``` attitude of horse TPR rectal exam monitoring for improvement vs progression alteration of intestinal sounds ```

Question 28

What clinicals signs are seen on a PE for colic if severe presentation?

Answer 28

``` profound depression persistent tachycardia pyrexia hypothermia +/- tachypnea ```

Question 29

If nasogastric reflux is present, where is the problem likely located?

Answer 29

stomach or SI

Question 30

If distended abdomen in an adult is present, where is the problem likely located?

Answer 30

cecum or large colon

Question 31

If distended abdomen in an foal is present, where is the problem likely located?

Answer 31

cecum, large colon, or SI

Question 32

What additional diagnostics may be done for colic patients?

Answer 32

CBC/Serum Chem Panel -assesses for presence of inflammation and status of organs Abdominocentesis -if fluid present, analyze it to determine necessity of surgical intervention and prognosis for patient

Question 33

Define endotoxemia

Answer 33

an extremely severe, life-threatening condition characterized by toxins circulating through the bloodstream

Question 34

How does endotoxemia develop?

Answer 34

- via Dz that affects integrity of intestinal mucosa thus allowing bacteria and their toxins into systemic circulation (obstruction, strangulation, infarction) - result of reperfusion injury that happens following correction of any disorder that interrupts blood supply to intestines

Question 35

Clinical signs of endotoxemia

Answer 35

``` severe systemic inflammation rxn extreme weakness/depression pyrexia inflammatory leukogram circulatory shock ileus and laminitis ```

Question 36

List 5 nursing strategies for colic

Answer 36

1. pain control 2. walking 3. nasogastric tube passage 4. IVF 5. anti-inflammatories or antibiotics

Question 37

Why is pain control important in colic?

Answer 37

improves patient comfort | often makes P easier to handle

Question 38

What to pay attention to after giving analgesia

Answer 38

if there is a response or not

Question 39

Why does walking help some colic cases?

Answer 39

alleviates some pain because it stimulates intestinal motiltiy

Question 40

Why is a nasogastric tube passed? What does it do? What befits does it have?

Answer 40

- helps reveal presence and severity of gastric reflux while also decompressing any gas buildup in stomach - can also give mineral oil to alleviate impaction

Question 41

Why are IVF given? When should fluid not be given via nasogastric tube?

Answer 41

-affected segments of intestine often sequester large amounts of fluid within their lumen and contribute to dehydration; do not give via nasogastric tube if nasogastric reflux is present

Question 42

When are anti-inflammatoires/antibiotics given?

Answer 42

if enteritis or peritonitis is present

Question 43

What things should be reassessed throughout treatment

Answer 43

- status before re-administering any therapeutics - TPR - presence/worsening/improvement of any clinical signs, especially nasogastric reflux and abdominal distention