Colic Flashcards by Corinne Perra

What important history information should you collect for an animal that is ocicing?

How long? 
When last normal? 
How severe? 
Intermittent or continuous? 
Meds given and any response ? 
What do they eat? Water supply? Heated? 
Where do they eat? 
Deworming history?

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What are the most common places for impactions in the GI?

Pelvic flexure

Right dorsal colon

Transverse colon

Small colon

Gastric impaction

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Most common place for sand impactions?

Right dorsal colon

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How can you confirm sand impaction?

Auscultation
Fecal float/skin
Abdominocentesis

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What are your top differentials if on rectal palpation you find a distended structure in the right dorsal quadrant ?

Cecal impaction or cecal tympany (dysfuntion)

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What intestinal parasites commonly can cause colonic impactions?

Strongylus vulgaris

Anoplocephala perfoliata (ileoceceal intussusception)

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What are the most common locations for enteroliths?

Transverse colon

Right dorsal
Small colon
Pelvic flexure

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What is the most common composition for enteroliths in horses?

Struvite

Mg Ammonium Phosphate

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T/F: most lesions of the small intestine are strangulating

True

58-85%

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What are the strangulating lesions of the SI?

Lipoma
EFE (epiploic foramen entrapment)

Volvulus
Mesenteric rent

Meckels diverticulum

Herniation
Intussusception

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Where is the most common location for lipomas to occur?

Small intestine (90%)

Small colon (10%)

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The treatment for a strangulating lipoma is resection and anastomosis. What are some complications that can arise from this surgery?

Shortening of mesentery can predispose to volvulus?

Adhesions

Ileus/impactions

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Boundaries of the epiploic foramen ?

Caudal process of the liver
Portal vein
Gastropancreatic fold

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T/F: most epiploic foramen entrapment are right to left ?

False

Left to right > 95%

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Predisposing factors do epiploic foramen entrapment?

Cribbing

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Complications and Pr sos is for EFE surgery?

Surgery is a manual reduction

Complication — portal vein tear

4x more likely to required repeat surgery

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Risk factors for large colon torsion?

Post parturient mare

Diet change

Recent access to lush pasture

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Clinical signs associated with large intestinal torsion/volvulus ?

Severe colic pain
-unable to control with analgesics

Rapid CV compromise

tachycardia
hemoconcentration

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First step for examination of a colicky horse?

NG tube

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When doing a rectal exam, what is normally palpated on the right?

Cecum
Right colon
R ovary

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When doing a rectal exam, what is normally palpated on the left?

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Left kidney
Spleen.
Left ovary
Left colon

When doing a rectal exam, what is normally palpated in the middle??

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Dorsal midline — aorta
Ventral midline — inguinal rings

Small colon

What is the FLASH technique for abdominal US?

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Left side

ventral abdomen
gastric window
splenic-renal window
left middle 1/3rd of abdomen

Right side

duodenal window
right middle 1/3rd of abdomen
cranial ventral thorax

How do you place an NG tube?

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Good restraint

Measure distance to pharynx

Guide tube ventrally and medially into the ventral meatus

Pass tube curving down
Will feel soft resistance at pharynx — stop then rotate tube 180 degrees and then gently bump the pharynx to simulate swallowing

Pass tube as horse swallows

How can you make sure your NG tube is in the correct place?

Watch the tube go down Negative pressure Create siphon — reflux feed material Palpate ventral neck

Complications to NG intubation?

Iatrogenic epistaxis Tube in trachea — will usually cough

You passed an NG tube.. now can you initiate reflux?

Create a siphon —pump water down tube, disconnect, then pull the tube back in short, jerky motions to create siphon

T/F: spontaneous reflux is never normal

True You should never get more back than what you put in. Can have a small amount of “net” reflux with indwelling tube

T/F: you should only give medication orally if you have a net postive reflux

False Never give medication through tube if “net” reflux is present

Where is the lesion usually located when there is a large amount of reflux?

Small intestine — anterior enteritis —impaction —strangulation

If colic pain is relieved by reflux and decompression, what is the likely cause of colic?

Anterior enteritis | Ileal impaction

If colic pain is NOT relieved by reflux and decompression, what is the likely cause of colic?

Mechanical obstruction/strangulation — persistent tachycardia —persistent pain

What is the location that you will do an abdominocentesis?

On or right of midline Caudal to xyphoid (most ventral)

What tubes do you ue for peritoneal fluid analysis?

Red top : TP (culture if indicated) EDTA: cytology, lactate

What is normal lactate levels in peritoneal fluid?

< 2

What is normal for WBC in peritoneal fluids?

<5000/uL in adults <1500/ul in foals

T/F: normal abdominocentesis rules out the need for surgery

False

Methods for pain managment for colic?

NSAID —flunixin meglumine 1mg/kg every 12hours (do NOT give more ofthen than q12hrs) A2 - Xylazine / detomidine/ romifidine Opioid - butorphanol Spasmolytics

When should colic be managed medically vs surgically?

Medically — mild to moderate pain or intermittent, easily controlled with medication Surgically — severe or persistent, unresponsive to meds

What do you do in PE of colicky foal?

TPR, bloodwork, IgG status Pain level and CV status Radiographs of abdomen US — umbilical vein <1cm —umbilical artery <1.3cm —arteries/urachus combo

Treatment of patent urachus?

Surgical if >2x normal size or combination with other perinatal infections

Common causes of foal colic?

Meconium impaction (should be passed in 1 day) Gastric ulceration Enteritis Inguinal hernia with ruptured tunic Sepsis Ruptured bladder (2-5days old)

Common causes of colic in older foals?

Gastroduodental ulcer — gastric outflow obstruction Enteritis SI volvulus Intussusception Impaction (ascarid)

Most common electrolyte derangement in foals

Hyponatremia Hypochloremia Hyperkalemia

Most common location of cystorrhexis in male vs female foals?

Male — dorsal aspect of the bladder | Female— urachal rupture

What is the the normal serum: peritoneal creatinine ratio?

>1:2

T/F: cystorrhexis is a surgical emergency

False Medically stabilize first — K+ >5.5 mEq/L —> muscle tremors and arrhythmias

Surgical approach for ruptured bladder?

Ventral midline Elliptical incision into bladder Remove urachal remnants Double ligate umbilical arteries and vein Trim edges of tear, close Broad spectrum ABs

Prognosis of cystorrhexis?

Excellent with good medical and surgical intervention

Why is there a guarded pronsosis for SI enterotomy in cases of ascarid impaction?

Adhesions formation

Surgical intervention for intussusception ?

Manually reduce, R/A — mesenteric difficulty —excessive mesenteric shortening - predisposes to volvulus

Surgical intervention for gastric outflow obstruction ?

Bypass— gastroduodenostomy | Secondary to pyloric stenosis from ulceration

Colic Flashcards

(52 cards)