Flashcards in Colic Decision Making Deck (31):
Give 2 examples of simple colics
Give 3 examples of potentially complicated colic
Displacement, enteritis, colitis
What is a definitive surgical colic?
What is a common cause of non-GI colic?
Pariparturient mare uterus
What are 3 general causes of abdominal pain?
- Distension (MECHANICAL: gas, fluid, ingesta or FUNCTIONAL)
- Inflammation/ischaemia of intestine
- Irritation of peritoneum
What are the 2 forms of mechanical obstruction?
- Non-strangulating eg. impaction , displacement
- Strangulating eg. volvulus, torsion, incarceration
Where are impactions usually seen?
- pelvic flexure and RDC -> thin transverse colon flexure
Where are displacements usually seen
What are functional obstructions?
Motility (paralytic) dysfunction - ileus etc. [blood supply not compromised]
- Enteritis, grass sickness [equine dysautonomia], post-surgical ileus
What are cuases of inflammation? Are these strangulating?
Enteritis, colitis, typhlitis, peritonitis
What are causes of ischaemia?
- Volvulus, torsion, incarceration
- Parasitic [migrating strongylus vulgaris larvae, coagulopathy, DIC] <- rarely seen now due to Ivermectin success, incidence may ^ due to resistence
Outline the 6 non-strangulating lesions that may cause colic
- Spasmodic colic
In horses where does the cause of diarrhoea ALWAYS originate?
How do SI pathologies manifest?
What time frame do you have for saving strangulating lesions?
~ 1 hour = viable intestine (distension of intestine and stomach)
~ 3-4hrs = Compromised intestine (leakage of blood/protein -> abdo, loss of fluid -> intestine [may -> hypovolaemic shock])
~ 6-8hrs = Dead intestine (absorption of toxins -> blood)
Give 7 causes of strangulating lesions of the SI to cause colic. Which is most common? Which is rare?
1. Volvulus (root of mesentry)
2. Strangulating lipoma [most common]
3. Epiploic foramen entrapment [R abdo between portal V and caudal vena cava]
4. Inguinal/scrotal hernia
6. Diaphragmatic hernia [rare]
7. Mesenteric rent
Give 2 causes of strangulating lesions of the LI to cause colic. How serious are these problems?
1. Colon torsion - very severe colic.
What clinical signs distinguish SI lesions?
- reflux (though may be absent)
- Distended SI (palpable on rectal, ultrasound)
What clinical signs distinguish LI lesions?
± abdo distension
- impaction/gas accumulation palpable on rectal
- distension of LI palpable on rectal
- no reflux (usually)
Give 2 SI conditions requiring medical Tx
- Grass sickness
Give 7 conditions requiring surgical Tx
- Volvulus (root of mesentry)
- Strangulating lipoma
- Epiploic foramen entrapment
- Inguinal/scrotal hernia
- Diaphragmatic hernia
- Mesenteric rent
How is grass sickness Dx?
Give 6 LI conditions requiring medical Tx
- Spasmodic colic
- Left dorsal displacement
- Right dorsal displacement
Give 2 LI conditions requiring surgical Tx
- Colon torsion
- Non-resolving displacement and impactions
In what situations should a colic be referred?
- SI lesions (Sx likely, medical cases need intense Tx)
- Conditions requiring intensive medical Tx (enteritis/colitis)
- Non-resolving impactions (IV fluids, surgery if displaced)
- Recurring/chronic colic for further work up
How much does a medical colic cost to treat in referral centres? Surgical colic? Colitis/enteritis?
How should referral be decided wrt owner?
- age of horse
- willingness to undergo abdo surgery
- insurance (type of cover, be aware colic may have been removed if suffered previously)
SEE LECTURE FOR FINDINGS ON HISTORY, PE, NGT, TX RELATED TO PROGNOSIS ETC.
What complications can be seen <2-4 weeks post-surgery?
- aneasthetic complications (1/100 die)
- post-op colic
- post-op ileus (reflux)
- incisional complications (dehiscence, infection)
What complications can be seen >2-4 weeks post-surgery?
- recurrent/chronic colic due to adhesions
- Incisional hernia