Colic Flashcards
colic
clinical syndrome associated with abdominal pain
causes
usually GIT but can be others
smooth muscle spasm
inflammation - colitis/ulceration
distension - impaction, gas accumulation
obstruction - impaction
tesnion on mysentery - displacement
tissue congestion/infarction or necrosis - torsion/volvulus, strangulation
signs
mild - restlessness, pawing, flank watching
gas build up, inflammation, smooth muscle spasms
moderate - lying down, groaning
impaction or simple obstruction
very fractious, violenet rolling
acute, severe strangulation
dull, unresponsive
end stage - severe illness, endotoxemia
general -
straining to urinate
inappetence
reduced faecal output
vocalising
agitation
pawing at the ground
lip curling
flank watching
lying down
excessive sweating
rolling/thrashing
straining
false colic - ddx
false colic - non GI cause
liver disase
renal disease
bladder disease (eg urolithiasis)
peritonitis
intra-abdominal abscess
intra-abdominal neoplasia
reproductive disorders
oesophageal obstruction
rhabdomyolysis
laminitis
pleuropneumonia
risk factors
recent changes - feeding, stabling, pasture access, exercise
dental history
parasites
vices
history
assess severity and duration
food and water intake since start
fecal output
treatment administered
previous history of colic
CV status evaulation
HR -
normal = 32-46
endotoxemia = mild >60, severe >100
pulse quality -
normal = strong
endotoxemia = moderate to weak
jugular refill -
normal = rapid
endotoxemia = slow to sluggish
mm colour -
normal = pink
endotoxemia = dark pink –> red –> purple
CRT -
normal = <2 seconds
endotoxemia >2 seconds
dehydration -
tacky or dry mm
dehydration assessment
6% - tacky mm, HR 40-60, CRT 2 seconds
8% - dry mm, HR 61-80, CRT 3 seconds
10% - dry mm, HR 80-100, CRT 4 seconds
12-15% - dry mm, HR >100, CRT >4 seconds
increasing PCT, TP and lactate
auscultation of GIT
hypermotility = increased smooth muscle activity, spasm colic
local hypomotility = localised stasis
general absence = GIT ileus, common in most colics
use for measure progression of case
other clinical parameters
rectal temperature - normal unless end stage shock
digital pulses - assess presence of laminitis
respiration - pain or endotoxemia
tachycardia - mild increase due to pain, severe then sign of hypovolemia
further diagnostics
nasogastric intubation -
see if fluid/ingesta reflux
>2litres is abnormal - small intestine obstruction
refer
relieve reflux to reduce pain
trans rectal exam -
may be able to feel abnormalities
abdominocentesis -
serosanguinous, increased protein - leakage of blood components
increased lactate - anaerobic tissue metabolism
presence of ingesta - rupture of GIT
high WBC count - peritonitis
abdominla ultrasound -
thickening of intestinalwall
distension of small intestine
motility of intestine
presence of displacements
peritoneal fluid
analgesia
pain makes it difficult to examien horse but analgesia can mask signs
short acting so can reassess
alpha 2s -
xylazine, detomidine, romifidine
rapid onset and short duration - quick re-assessment
opioid -
butorphanol
usually only for higher degrees of pain
NSAIDs -
slow onset, long duration
but owner probably already gave them bute
flunixine meglamine - strong anti inflammatory, can mask early signs of endotoxemia
spasmolytics -
rapid onset, short duration
treat spasm type colic
relax rectum prior to exam
buscopan
fluid therapy
enteric fluids -
usually indicated
not if nasogastric reflux
rehydrate colonic contents in case of impaction
purgatives -
liquid paraffin
epsom salts
indications for referral
non response to analgesia
significant CV compromise
rapid deterioration despite therapy
complex abnormalities on rectal exam
NG reflux
recurrent/chronic cases with unclear diagnosis
