Colic Surgery Complications

Question 1

how frequently to monitor CBC/fibrinogen/lactate/electrolytes post colic sx

Answer 1

q24 hours

Question 2

prokinetics for post colic surgery?

Answer 2

• lidocaine CRI

- metoclopromide

Question 3

what electrolytes to add to fluids post colic surgery?

Answer 3

Ca, Mg, K

Question 4

when to discontinue meds post colic surgery?

Answer 4

• when eating
• afebrile
• normal CBC

Question 5

frequency of ileus post colic sx

Answer 5

10-20% of cases (accounts for 40% of deaths)

Question 6

how frequently to do PE post colic surgery

Answer 6

q1-3 hours

Question 7

how to give lidocaine CRI

Answer 7

-loading dose + CRI

NEVER bolus -> seizures

Question 8

adhesions: more common in foals or adults

Answer 8

foals

Question 9

anti-endotoxin therapy (5)

Answer 9

• flunixin meglumine
• biosponge during enterotomy
• polymixin B
• Plasma
• heparin in case of DIC

Question 10

how much K to add to fluids post colic surgery?

Answer 10

add 80 meq/5L bag

NEVER exceed 0.5 meq/kg/hr

Question 11

MOA of lidocaine CRI (5)

Answer 11

• decreases catecholamines and free radicals
• stimulates SM
• decreases afferent neurons
• inhibits PGs -> decreased inflammation
• decreases granulocyte migration

Question 12

NEVER exceed ______ K per hour

Answer 12

0.5 meq/kg/hr

Question 13

most important thing about fluid therapy post colic surgery

Answer 13

volume!! is most important

Question 14

what indicators at presentation tell you a patient is a greater risk for ileus post colic sx

Answer 14

• > 10 yo
• PCV > 45%
• high TP/albumin
• hyperglycemia
• anesthesia >2.5 hours
• sx>2 hours
• ischemic IS injury

Question 15

what to remember when dealing with hernias

Answer 15

• need belly band!

- wait 3 months to repair

Question 16

how frequently to monitor TP/PCV post colic surgery

Answer 16

q6 hours

Question 17

fluid maintenance for a horse

Answer 17

50 ml/kg/day

Question 18

most common lesion associated with post op ileus

Answer 18

strangulating SI lesion

Question 19

how to diagnose peritonitis

Answer 19

• blood-belly glucose difference >50 mg/dL OR
• peritoneal pH <7.2 + peritoneal glucose < 30 mg/dL

left shift, hypoproteinemia, thrombocytopenis, toxic WBCs

Question 20

decompress stomach how freuqently?

Answer 20

q2-3 hours as needed

Question 21

why are fluids so hard to maintain post colic sx?

Answer 21

mucosal damage -> increased capillary permeability -> fluid/protein loss to interstitium

Question 22

goal of fluid therapy post colic surgery

Answer 22

maintain vascular volume

HR <80 bpm; TP >4.1; PCV <50%

Question 23

what parameters suggest your fluid therapy post colic surgery is adequate?

Answer 23

HR <80 bpm; TP >4.1; PCV <50%

Question 24

adhesion prevetion (7)

Answer 24

• DMSO
• heparin
• CMC 3% (belly jelly/carboxyl methyl cellulose)
• HA
• NSAIDs, antibiotics
• omenectomy (REMOVE IT)
• peritoneal lavage (SUCTION)

Question 25

second most common cause of repeat surgery following colic surgery

Answer 25

adhesions

Question 26

side effects of lidocaine CRI and metoclopromide

Answer 26

seizures

Question 27

lidocaine CRI is used for _____(3) post colic surgery?

Answer 27

- pain management - anti-inflammatory - to treat post op ileus

Question 28

pain manangement post colic surgery?

Answer 28

- flunixin meglumine | - lidocaine CRI

Question 29

number one sequelae following incision issue

Answer 29

hernia

Question 30

signs of ileus

Answer 30

- reflux - decrease gut sounds - increased HR, TP, PCV - electrolyte derangement

Question 31

signs of endotoxemia

Answer 31

- edema - gi distension - reflux - thrombosis coag issue - tachycardia