Lecture 36 4/22/25 Flashcards by Danika Boltz

What is the significance of colic?

-occurs in around 4% of horses
-case fatality rate of 11%
-second most common cause of death in horses 30 days or older; behind old age
-more than 90% of cases are uncomplicated

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What is colic?

visceral abdominal pain

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What are the possible etiologies of colic?

-gut distention with fluid, gas, or ingesta
-pulling at the root of the mesentery
-ischemia or infarction
-inflammation of viscera or peritoneum
-endotoxemia
-choleliths

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What are the anatomical predisposing factors for colic?

-long mesentery and moveable GI tract
-“bottlenecks” and “sacks”; pelvic flexure, transverse colon, small colon, ileum, stomach, cecum
-inability to actively vomit

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What are the possible signs of colic?

-diminished appetite
-stretching
-pawing/restlessness
-turning to look at flank
-getting up and down or rolling
-bruxism
-sweating

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What are possible risk factors for colic?

-mares used for breeding
-arabians
-cared for by manager/trainer
-turned out without water
-history of previous colic or surgery
-higher grain content in diet

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What are possible protective factors against colic?

-regular access to pasture
-consistent feed and exercise schedule
-appropriate dental care
-consistent access to water
-appropriate deworming
-minimal exposure to sand in feeding areas

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What should be determined in the first steps to approaching a colic?

-medical vs surgical
-small intestine vs large intestine
-strangulating vs non-strangulating

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How does signalment change the approach to a colic?

-post-partum mares experience colon displacements, colon torsions, and small colon impactions
-stallions experience inguinal hernia
-older animals develop lipomas
-minis get lots of impactions

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Which aspects of a horse’s history are important for assessing colic?

*preventive care
-deworming
-vaccines
-dental care
*diet and exercise
-changes
*environmental/weather
-sand
-water source/freezing
-geographic location
*medical history
-past colic +/- surgery
-medications
*history of cribbing

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Which aspects of the colic episode are important to determine from an owner/manager?

-duration of the episode
-last defecation
-clinical signs and progression
-treatments; often given NSAIDs at home

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What are the characteristics of physical exam in colic cases?

-need to do a good general physical exam
-want to get a heart rate before medicating if safe

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What should be assessed regarding pain in colic horses?

-severity
-duration
-response to analgesics

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What are the characteristics of heart rate in colic cases?

-rate generally increases with degree of pain
-want to assess strength and rhythm
-HR greater than 70 to 80 BPM indicates need to pass nasogastric tube

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What are the characteristics of perfusion assessment in colic cases?

-assessment of MM, CRT, and extremity temp.
-can assess for endotoxemia and shock

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What are the characteristics of gastric auscultation iin colic cases?

-want to listen to each quadrant for 30 to 60 seconds; should hear sounds in this timeframe
-gut can be hypomotile, normal, or hypermotile
-want to listen ventrally to try and detect sand

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What are the potential risks of doing rectal palpation on a colic horse?

-rectal tear
-fatality due to over-stressing horse

How can rectal palpation be made safest for both horse and vet?

-sedation +/- twitch
-buscopan for relaxation
-epidural if needed

What are possible findings when doing rectal palpation?

-impactions
-gas distention
-“bands”
-nephrosplenic space

What are the characteristics of nasogastric tubing in colic cases?

-want to check for the presence of reflux; indicates obstruction or proximal enteritis/ileus
-tube should be left in place if greater than 4 to 6 L is returned

What are the characteristics of normal abdominocentesis fluid?

-yellow or clear
-TP less than 2.5 g/dL
-nucleated cells less than 5000/microliter
-lactate less than 2 mmol/L

What are the components of clinicopathologic assessment for colic horses?

-PCV/TP
-lactate
-serum chem; hyperglycemia and azotemia
-CBC; endotoxemia

What findings can be seen on abdominal ultrasound?

*small intestine
-distention
-motility
-wall thickness
*abdominal fluid
-amount
-echogenicity
*bowel wall thickness
-mesenteric vessels

Which other diagnostics can be done in colic cases?

-endoscopy
-radiography
-laparoscopy

What are the indications for colic surgery?

-persistent or uncontrollable pain -abnormal rectal findings -large volumes of reflux -deterioration of clinical and/or metabolic parameters

What are poor prognostic indicators for colic?

-heart rate greater than 80 BPM -weak pulse -PCV greater than 60% -blood glucose greater than 300 mg/dL -significantly elevated lactate -profound neutropenia with left shift -abnormal blood pressure

What are the general causes of colic?

-idiopathic (most common) -simple, non-strangulating obstruction -strangulating obstruction -non-strangulating infarctions -inflammatory dz

Which types of simple obstruction can cause colic?

*impactions *displacements -right dorsal displacement -left dorsal displacement

What are the general treatment considerations for colic?

-control pain/analgesia -prevent/control endotoxemia -maintain/restore metabolic homeostasis -correct primary cause

Which sedatives/analgesics are commonly used in colic cases?

-xylazine -butorphanol -detomidine -NSAIDs -N-butylscopalammonium bromide

What are the characteristics of GI motility modification?

-commonly used drugs decrease GI motility -management of post-op ileus is commonly done with lidocaine

Which treatments are used as lubricants/cathartics?

-possibly diet changes -fluids and electrolytes (oral best) -mineral oil -DSS -magnesium sulfate/epsom salts -psyllium

What are the characteristics of endotoxemia management?

-risk depends on type of colic -correct primary problem -provide supportive care -specific therapy for some causes

What are common treatments for simple gas/spasmodic colic?

-flunixin meglumine -oral fluids -possibly xylazine

What determines whether an impaction is medical or surgical?

-location -severity -typically try medical management first

What are the findings in gastric impactions?

-variable pain -normal rectal exam -stomach may be enlarged on US -endoscopy shows large amounts of ingesta -may only be found at surgery

What are the treatments for gastric impaction?

-gastric lavage -diet coca cola (dissolves impactions)

Where do impactions often occur besides the stomach?

-pelvic flexure -cecum -small colon -transverse colon -ileum

How are impactions in the intestines diagnosed?

-history of feed change and/or decreased water consumption -decreased fecal output -mild to moderate pain -palpation

What is the treatment for intestinal impaction?

-pain management -fluids; oral are most effective -laxatives