Colic I Flashcards
(99 cards)
1
Q
Where do impactions most commonly occur?
A
Ileum, cecum and sm/lg colon
2
Q
What can cause impactions?
A
Food, sand and enteroliths
3
Q
What are the two types of non-strangulating lesions?
A
Impactions and displacements
4
Q
What is another name for a LDD?
A
Nephrosplenic entrapment
5
Q
What are the most common places for an impaction?
A
(1) pelvic flexure
(2) RDC
(3) TC
(4) SC
(5) Gastric
6
Q
What is the path of blood supply to the cecum?
A
Cranial mesenteric a. -> ileocolic a. -> cecal a. -> lat and medial cecal a.
7
Q
What does the medial cecal a. supply?
A
The cecal apex
8
Q
What artery supplies the ventral colon?
A
The colic branch of the ileocolic a.
9
Q
What artery supplies the dorsal colon?
A
The right colic a. from the right and middle colic aa.
10
Q
What artery supplies the ileum?
A
The ileocecolic a. -> ileal a.
11
Q
How do you diagnose a sand impaction?
A
(1) auscultation (sounds like an ocean)
(2) fecal float/sink in a glove
(3) abdominocentesis that produces sand instead of fluid
12
Q
Where does sand settle?
A
RDC
13
Q
What kind of colic (acute, chronic, intermittent or continuous) and pain does a cecal impaction cause?
A
Acute or chronic intermittent colic with mild to moderate pain
14
Q
What is the surgical treatment for a colonic impaction?
A
Pelvic flexure enterotomy
15
Q
When you perform a pelvic flexure enterotomy, where do you make the incision?
A
At the pelvic flexure on the anti mesenteric border
16
Q
What parasite causes verminous arteritis?
A
Strongyles Vulgaris
17
Q
What anthelmintic is used to treat verminous arteritis caused by strongylus vulgaris?
A
Ivermectin
18
Q
What parasite causes ileocecal intussusception in horses?
A
Anoplocephala perforliata
19
Q
What is trichobezoar made of?
A
Hair
20
Q
What is a phytobezoar made of?
A
Fiber
21
Q
What are the most common enteroliths in horses?
A
MAP (magnesium, ammonium, phosphate)
22
Q
If an enterolith is round, what does it indicate? Likewise, if a enterolith is triangular, what does that indicate?
A
If an enterolith is round that indicates that it is alone while if an enterolith is triangular, that indicates that it has friends
23
Q
Bezoars/enteroliths most likely end up in which section of the GI tract?
A
Transverse colon
24
Q
Is SI colic more likely to be non-strangulating or strangulating?
A
Strangulating
25
What are the five types of strangulating SI lesions?
(1) lipoma
(2) EFE
(3) volvulus
(4) Mesenteric rent
(5) Developmental abnormalities
26
Describe the pathology of a strangulating lipoma
The lipoma becomes pedunculated and the pedicle wraps around the intestine and the mesentery
27
Where do the majority of lipomas occur and what is the avg age?
The small intestine
| 14-19 yrs old
28
What is the treatment for a strangulating lipoma?
Resection and anastomosis
29
What is an increasing risk factor for epiploic foramen entrapment?
Cribbing
30
What is another name for the epiploic foramen?
the Foramen of Winslow
31
What are the boundaries of the epiploic foramen?
(1) The caudate process of the liver
(2) Portal vein
(3) Gastropancreatic fold
32
What section of the GI tract is usually becomes entrapped in the epiploic foramen?
The ileum and distal jejunum
33
What is a major complication of epiploic foramen entrapment surgery?
portal vein tear
34
What are CS of LI torsion/volvulus?
Severe, unrelenting pain, acute colic and rapid CV compromise
35
What are risk factors of large colon torsion?
Post parturient mares, acute diet change, and lush pasture
36
What do you always do with a horse that is colicking?
Place an NG tube
37
What is the difference in reflux between SI colic and LI colic?
SI colic produces copious gastric reflux while LI colic produces only a few L of gastric reflux
38
If a horse has a fever >102 and is colicking, what does that indicate and what do you do?
It indicates that there is a medical cause and not a candidate for sx. Find the medical cause and treat it
39
What can be palpated on midline in a rectal exam?
The aorta is located dorsal midline, the inguinal rings are located on ventral midline, and the small colon as well
40
What can be palpated on the right side of the horse on a rectal exam?
The cecum, colon, and right ovary
41
What can be palpated on the left side of the horse on a rectal exam?
The left kidney, spleen and left ovary
42
What imaging device should be used as a routine part of a colic exam?
U/S
43
Should you administer medication through an NG tube if there is "net" or spontaneous reflux is present?
No
44
How can you tell if the NG tube is in the right location?
(1) You can see it on the left side of the neck
(2) There is neg pressure if you suck on the tube
(3) You can palpate the NG tube and the trachea separately
45
What sedative do you use on horse to place an NG tube?
Xylazine
46
If you are placing a NG tube and cause iotrogenic epistaxis, what structure did you run into?
The turbinates
47
T/F Spontaneous reflux is normal
F: spontaneous reflux is never normal
48
Why should you always record the amount of net reflux?
So that you can give replacement fluids
49
In what location do you perform an abdominocentesis?
Caudal to the xyphoid and on or to the right of ventral midline
50
What gauge needle do you use for an abdominocentesis?
18-20 g
51
What tubes do you use for (1) TP and culture, (2) cytology and lactate in a peritoneal fluid sample?
(1) red top
| 2) purple (EDTA
52
What are normal lactate levels in a horse? What lactate level indicates a 90% survival rate? What lactate levels indicate a reduction in prognosis?
<2
<6
>7
53
What is a normal WBC count in a foal? In an adult?
<5000
| <1500
54
Does a normal abdominocentesis r/o the need for sx?
No
55
What spasmolytics can you administer to a horse with colic?
Lidocaine and buscopan
56
What NSAID can you administer to a horse with colic, how often should you administer it and why?
Flunixin meglumine
| Q 12 hrs but no more bc of renal and GI implications
57
What alpha 2 agonists can you administer to a horse with colic?
Xylazine
Detomidine
Romifidine
58
What opioid is best to administer for colic pain?
butorphanol
59
What level of IgG indicates failure of passive transfer?
<800
60
In a colicky foal, what should you U/S
The umbilicus and abdomen
61
What should the umbilical vein measure below on an U/S of a foal? The umbilical artery? The aa./urachus combo just cranial to the bladder?
<1 cm
<1.3 cm
<2.5 cm
62
What are common causes of newborn colic?
(1) Meconium impaction
(2) Gastric ulceration
(3) Enteritis
(4) Inguinal hernia w/ruptured tunic
(5) Sepsis
63
A 3 day old foal presents to you with colic. What is most common cause and what is the most common age for this to occur?
Ruptured bladder
| 2-5 days old
64
Besides a ruptured bladder, what are two other causes of colic in a 2-5 day old foal with colic?
Gastric ulcers
| Enteritis
65
What are common causes of colic in foals <5 days?
```
Gastroduodenal ulcers (gastric outflow obstruction)
Enteritis
SI volvulus
Intussusception
Impaction (ascarid)
```
66
What causes of colic are more typical in colts?
Meconium impaction
| Inguinal hernia
67
What causes of colic are more typical in fillies?
```
Ruptured bladder (at the urachus)
Ureteral abnormalities
```
68
A foal is stretched out on their back and has been seen straining. What is most likely causing this presentation?
Pain from colic
69
What can you give as a sedative for colic in a foal?
Diazepam (benzo)
70
What can't you give foals less than 2 weeks of age and why?
xylazine
| Because it decreases CV output and HR. The formula for CO is CO = HR x SV. Foals can't adjust their SV
71
What NSAID can you administer to a foal with colic and what is the recommended dosage?
Banamine
| TID
72
What gastroprotectant can you use on a foal with colic and what is its MOA?
Ranitidine
| H2 antagonist
73
What gastroprotectant is not effective in a foal <1 month and what is its MOA?
omeprazol
| PPI
74
What type of colic does an inguinal hernia cause?
Acute, severe colic
75
What type of approach is used to correct a foal with an inguinal hernia?
An inguinal approach
76
What is a cystorrhexis?
A ruptured bladder
77
Where are male foals more likely to suffer a cystorrhexis?
The dorsal aspect of the bladder
78
Where are female foals more likely to suffer a cystorrhexis?
a urachal rupture
79
What is the most common bloodwork abnormality in a 2-5 day old foal with cystorrhexis?
electrolyte derangement
80
T/F A foal with cystorrhexis can still urinate
T
81
What would you see on U/S in a foal with cystorrhexis?
Free fluid in the abdomen
| No or very small bladder
82
What would you see in a serum sample for the peritoneal creatinine ratio in a foal with cystorrhexis?
a ratio >1:2
83
Is a cystorrhexis a surgical emergency?
No
84
How do you treat a foal with cystorrhexis?
You medically stabilize first. If the K+ is >5.5 mEq/L you'll see muscle tremors and arrhythmias. Treat those first and then perform sx only after stable
85
What is your approach and what kind of incision do you make to correct a ruptured bladder?
Ventral midline elliptical incision around the umbilicus
86
In a ruptured bladder surgery, what do you do?
You remove the brachial remnants, double ligate the umbilical arteries (2) and vein, and then administer broad spectrum antibiotics
87
What parasite causes ascarid impaction in foals?
Parascaris equorum
88
When does ascarid impaction usually occur in the foal?
~24 hrs after deworming
89
What is the surgical intervention for ascarid impaction?
SI enterotomy
90
Why do foals have a guarded prognosis for ascarid impaction treated with SI enterotomy?
Because foals and GI sx don't do well together
91
In an older foal with acute severe colic, what may be the cause?
Sliding intussusception
92
What is an intussuscipien and intussusceptum?
The intussuscipien is the telescoping part of the intussusception and the intussusceptum is the telescoped part of the intestine
93
What surgical intervention is required for an intussusception?
Manual reduction, resection and anastomosis
94
What happens if there is excessive mesenteric shortening with reduction and anastomosis of intussusception?
Predisposition to volvulus
95
Parasites cause what kind of intussusception?
Ileocecolic
96
What is the prognosis for intussusception in a foal?
Fair to guarded
97
SI volvulus in a foal causes what kind of formation?
Corkscrew
98
Gastric outflow obstruction in a foal is secondary to what?
pyloric stenosis from ulceration
99
What surgical intervention is used to treat gastric outflow obstruction and what is the prognosis?
Bypass - gastroduodenostomy
| Guarded
