Equine Top Topic - Colic

Question 1

what is the most important factor in differentiating surgical from medical colics?

Answer 1

pain

Question 2

T/F: horses that are repeatedly refractory to routine analgesics need colic surgery

Answer 2

TRUE

Question 3

how is serum vs peritoneal lactate used to decide if a colicking horse needs to go to surgery?

Answer 3

lactate will be significantly higher in peritoneal fluid vs serum in surgical colic cases

Question 4

proximal enteritis causing colic in a horse affectes what part of their gi tract?

Answer 4

small intestines

Question 5

what is the classic case presentation of proximal enteritis in a horse?

Answer 5

mild colic/depression, fever, copious red-brown smelly nasogastric reflux

Question 6

how is proximal enteritis in a horse diagnosed?

Answer 6

ultasound shows thick-waled hypomotile small intestines with some distension, peritoneal fluid has increased protein with normal WBC count

Question 7

how is proximal enteritis in a horse treated?

Answer 7

iv fluids, analgesics, nasogastric decompression, laminitis, prophylaxis, and maybe surgical decompression

Question 8

proximal enteritis as a cause of colic is more common in what horses? what clinical sign is very common with this type?

Answer 8

eastern US & europe, horses more depressed than colicky

Question 9

what is the etiology of proximal enteritis?

Answer 9

unknown

Question 10

what is the classic case presentation of large colon impaction?

Answer 10

mild intermittent colic with fairly normal PE parameters

Question 11

how is large colon impaction diagnosed?

Answer 11

palpate impaction on rectal

Question 12

how is large colon impaction treated?

Answer 12

enteral fluids & laxatives, analgesics as needed, & IV fluids if indicated

Question 13

how is large colon impaction prevented?

Answer 13

maintain good dental care & appropriate parasite control, provide fresh water, & provide good quality hay

Question 14

what are the most common sites of large colon impaction?

Answer 14

pelvic flexure, transverse colon, & base of cecum

Question 15

how are sand impactions diagnosed? how are they treated?

Answer 15

radiographs - psyllium

Question 16

what are cecal impactions associated with in colicky horses?

Answer 16

sudden decrease in activity level

Question 17

what part of the gi tract is affected by spasmodic/tympanic colic in horses?

Answer 17

affects large colon

Question 18

what is the classic case presentation of spasmodic/tympanic colic in horses?

Answer 18

acute onset of mild to severe colic, heart rate normal to increased, mucus membranes WNL, & typically, minimal gi sounds

Question 19

how is spasmodic/tympanic colic diagnosed?

Answer 19

presentation, lack of significant findings on rectal/nasogastric intubation, systemically stable, & responds to first round of medical therapy

Question 20

how is spasmodic/tympanic colic treated?

Answer 20

analgesics, sedatives, anti-spasmodics (buscopan), enteral fluids, & laxatives

Question 21

how is spasmodic/tympanic colic prevented?

Answer 21

maintain a consistent diet/management, maintain good dental care, & appropriate parasite control

Question 22

what is the most common cause of colic in horses?

Answer 22

spasmodic/tympanic

Question 23

what are three key surgical colics?

Answer 23

large colon volvulus, small intestinal incarceration or strangulation, & large colon displacement (left dorsal or right dorsal displacement)

Question 24

what is the classic case presentation of large colon volvulus?

Answer 24

acute severe pain with abdominal distension, often non-responsive to analgesics, significant tachycardia, varying degrees of systemic compromise depending on duration

Question 25

how is large colon volvulus diagnosed?

Answer 25

presentation, extremely gas filled intestines on rectal exam, & ultrasound shows diffusely significantly thickened large colon wall

Question 26

how is large colon volvulus treated?

Answer 26

surgery and potentially resection of the large colon

Question 27

what is the prognosis of large colon volvulus?

Answer 27

guarded

Question 28

how is large colon volvulus prevented?

Answer 28

unknown

Question 29

T/F: large colon volvulus are most often clockwise, & may or may not involve the cecum

Answer 29

TRUE

Question 30

T/F: the classic case of large colon volvulus is a broodmare just after foaling

Answer 30

TRUE

Question 31

what is the classic case presentation of small intestinal incarceration/strangulation?

Answer 31

progressively painful,copious nasogastric reflux, & deteriorating metabolic status

Question 32

how is small intestinal incarceration diagnosed?

Answer 32

distended loops of small intestines on rectal, copious nasogastric reflux, serosanguinous peritoneal fluid with increased lactate

Question 33

how is small intestinal incarceration treated?

Answer 33

surgery, & potentially resection of the small intestines

Question 34

how is small intestinal incarceration prevented?

Answer 34

unknown except for decreasing cribbing (can decrease risk of epiploic foramen entrapment)

Question 35

what is the most common cause of a strangulating colic in older, obese horses?

Answer 35

pedunculated lipomas

Question 36

where can incarceration of the small intestines occur in the body?

Answer 36

epiploic foramen, mesenteric rents, inguinal orifice, & umbilical orifice

Question 37

what is the classic case presentation of large colon displacement?

Answer 37

mild then progressive pain with progressive abdominal distension or recurrent bouts of colic & metabolic status is slow to deteriorate

Question 38

how is left dorsal colon displacement diagnosed?

Answer 38

can't feel nephrosplenic space on palpation, on ultrasound, left kidney not visible & the spleen is displaced ventrally

Question 39

how is right dorsal colon displacement diagnosed?

Answer 39

may feel tight taenia coursing near base of the cecum, & on ultrasound, may see colonic mesenteric vessels coursing along right lateral body wall in an abnormal location

Question 40

how is left dorsal colon displacement treated?

Answer 40

phenylephrine to shrink spleen & lunge the horse, roll horse under GA, or surgical correction

Question 41

how is right dorsal colon displacement treated?

Answer 41

IV fluids, withhold feed, analgesics, & often, surgery if pain is progressive or metabolic status is deteriorating

Question 42

how is left dorsal colon displacement prevented? what about right dorsal displacement?

Answer 42

nephrosplenic ablation for LDD - unknown for RDD

Question 43

why is the large colon prone to excessive movement/displacement?

Answer 43

only attached to the body wall at the base of the cecum