Colic in horses Flashcards Preview

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Flashcards in Colic in horses Deck (34):
1

Causes of colic - 2

-GI viscus (usually; spasmodic/gas, impaction, displacement, strangulation)
-Other (liver, urogenital)

2

How horses express pain

Laminitis - recumbency
Neurologic - recumbency
Botulism - recumbency
MSK - tying up and severe lameness

3

Clinical signs - colic

incessant pawing, trying to go down, rolling incessantly, abrasions on head (suggests recumbency/rolling), recumbency (sternal to lateral the more severe it gets), muscle fasiculations, looking back at flanks, restlessness, kicking at abdomen, sweating

4

Causes of colic and %

Over 100 reported:
72% spasmodic and undiagnosed
14.5% pelvic flexure and other impactions
5-7% surgical
5.5% gas
1% colitis

5

Broad causes of colic - 5

Spasmodic/gas - motility, diet, parasites
Impaction - usually large colon
Displacement - usually large colon
Strangulation
Ulcers

6

Aim of examining a horse with colic - 2

-Does it need referral or can it be treated in the field (majority)?
-Make a diagnosis

7

3 most important features of a colic work-up

History, PE and NGT

8

Other features of a colic work-up 4

Rectal exam, abdominocentesis, ultrasound, clinical pathology

9

History to obtain during PE 7

age, time of colic onset, degree of colic shown, any treatments given, previous colic, last passed faeces, managment (diet, exercise, worming regime)

10

In what age of horses are strangulating lipomas more commonly seen?

Older horses (teenagers)

11

What should you focus on during the PE? 5

Demeanor (signs of pain), TPR, GI borborygmi, CV status (MM, CRT, pulse quality, turgor, jugular fill, limb temperature) and abdominal distension

12

Signs of mild colic pain - 7

occasionall pawing, looking at flanks, strectching out, intermittent recumbency, inappetence, backing up to wall, playing with water

13

Signs of severe colic pain - 4

sweating, violent rolling, dropping to ground, extreme rolling

14

Important information from TPR

T = take before rectal exam (introduces air): febrile = colitis/peritonitis/enteritis/rupture
P=may be increased due to anxiety/pain/hypovolaemia (higher suggests more severe colic)
R=may be increased due to anxiety/pain/abdominal distension

15

Where to listen for borborygmi?

4 quadrants (left dorsal, left ventral and vice versa)

16

What does a high pitched ping suggest?

Gas distension of a viscus (LI)

17

How do you assess abdominal distension?

Difficult, look at paralumbar fossa, ask owner if it appears different to normal

18

When should you pass a NGT?

All colics (opinion varies) as horses cannot vomit and gastric rupture may occur. This is the only way to relieve gastric distension.

19

What is an abnormal NGT finding?

NORMAL = 2L fluid (suggests SI dysfunction)
If you get any reflux, don't give anything by the tube

20

Steps after initial PE

Monitor, medical treatment (analgesia, laxatives, fluids),monitor response to Tx, further diagnostics, refer

21

When to give medical treatment

Only if mild abnormalities on PE, no reflux, analgesia possibly even if horse appears comfortable, oral fluids if no reflux

22

Aims of a rectal exam

Identify normal structures, identify distension (SI/LI and type), identify displacements, identify abnormal structures (masses etc.)

23

Do you reach a diagnosis from rectal exam?

Often no. But it can raise your index of suspiscion

24

4 points to remember when doing a rectal exam

Restraint, sedation, spasmolytic and lubrication

25

How do you identify large intestine?

Wide diameter, sacculation and taenial bands (except pelvic flexure which is smooth with mesenteric band only

26

How do you identify small colon? 3

sacculations, 2 taenial bands and faecal balls are normally palpable. SI not normally palpable.

27

What can you feel during a rectal exam?

Large intestine, small colon, caecum (on RHS), left kidney, spleen (on LHS), bladder (midlines), reproductive organs, inguingal rings, mesenteric root, aorta

28

Where does large colon impaction often occur?

Pelvic flexure

29

What might you feel in SI distension?

'bicycle tyres'

30

Why (not) perform rectal?

WHY: diagnosis, prognosis
NOT: risk to you and horse

31

Method of abdominocentesis. Why?

Teat cannula and needle. To assess bowel health (compromised intestine leaks cells and proteins)

32

Distinguish a normal and abnormal peritoneal fluid sample (4)

NORMAL: clear/straw colour, 5000cells/UL, >25G/L, cytology (bacteria, feed material

33

What does rectal/transcutaneous ultrasound allow evaluation of?

peritoneal fluid, size of SI, position of LI, also look at liver, kidneys and spleen

34

Why do clinical pathology?

-Unlikely to help make specific diagnosis
-helps assess severity of colic (circulatory and eletrolyte status)
-PCV and plasma total solids(important baseline data)
-haematology and biochemistry (useful to differentiate some conditions e.g. enteritis and cholangiohepatitis).