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Module 16 > Management of Equine Acute Colic > Flashcards

Management of Equine Acute Colic Flashcards

1
Q

what does analgesia choice depend on (2)

A
  1. degree of pain
  2. duration of action
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2
Q

what are short acting analgesics (4)

A
  1. xylazine
  2. buscopan
  3. morphine
  4. ketamine
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3
Q

what are longer acting analgesics (3)

A
  1. detomidine
  2. butorphanol
  3. NSAIDs
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4
Q

what NSAIDs can be used (4)

A
  1. flunixin meglumine
  2. phenylbutazone
  3. meloxicam
  4. ketoprofen
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5
Q

what are side effects of NSAIDs (3)

A

1, renal injury

  1. right dorsal colitis
  2. delayed mucosal healing
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6
Q

what is the dose of flunixin megulmine

A

1.1 mg/kg IV

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7
Q

how long does flunixin last

A

up to 24 hours, dose q 12 hours max

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8
Q

how potent is flunixin

A

potent

take any signs of discomfort very seriously

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9
Q

how long before you refeed after a dose of flunixin

A

until 24 hours after last dose

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10
Q

what routes are used to administer flunixin

A

IV or oral

not IM –> clostridial myositis

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11
Q

what is the dose for phenylbutazone

A

4.4 mg/kg IV max

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12
Q

which is more potent flunixin or phenylbutazone

A

flunixine

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13
Q

what routes can phenylbutazone be given

A

IV only – perivascular tissue damage

oral

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14
Q

what is buscopan made of

A

butylscopolamine

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15
Q

what is the dose of buscopan

A

0.1-0.3 mg/kg IV

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16
Q

how does buscopan act

A

blocks muscarinic receptors

parasympatholytic

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17
Q

what are side effects of buscopan

A

tachycardia

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18
Q

how long acting is buscopan

A

short acting

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19
Q

what are a-2 adrenergic agonists

A

xylazine

detomidine

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20
Q

which is shorter acting xylazine and detomidine

A

xylazine is shorter acting

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21
Q

what is the dose of xylazine used

A

0.4mg/kg IV or IM

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22
Q

what dose of detomidine is used

A

0.01 mg/kg IV or IM

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23
Q

what dose of butorphanol is used

A

0.01-0.02 mg/kg IV or IM

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24
Q

what dose of morphine is used

A

0.12 mg/kg IV or IM

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25
Q

what dose of ketamine is used

A

0.5 mg/kg IM or IV

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26
Q

what is the maintanence amout of fluid for an adult horse

A

60 ml/kg/day

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27
Q

what is the maintanence amout of fluid for a foal

A

100 ml/kg/day

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28
Q

when would IV fluids be indicated

A

reflux or hypovolemia

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29
Q

what is an appropriate amount of enteral fluid

A

5L for 500kg horse

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30
Q

how often should you repeat enteral fluid

A

repeat every 30 mins to 2 hours

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31
Q

what is a recipe for enteral fluids to make them isotonic

A
  1. table salt (NaCl) and Lo salt (NaCl/KCl)

15ml tablesalt and 15 Losalt in 4L of water

  1. 5.27g NaCl, 0.37g KCl, 3.78g sodium bicarbonate
32
Q

what are the isotonic crystalloid fluids (4)

A
  1. hartmanns
  2. LRS
  3. Plasmalyte
  4. replacement fluids
33
Q

what are hypertonic crystalloid fluids

A

7.2% saline

34
Q

what are colloid fluids

A
  1. hetastarch
  2. plasma
35
Q

how do you assess IV therapy and how much fluid

A

goal directed based on mucus membranes, heart rate, urine output, jugular fill, PCV, lactate

36
Q

how much should you give in a bolus of IV fluids

A

10-20 ml/kg and re-assess

37
Q

what would 6% dehydration HR, CRT, PCV/TP and creatinine be

A

HR: 40-60

CRT: 2 secs

PCV/TP: 40/70

creatinine: 90-180 umol/l

38
Q

what would 8% dehydration HR, CRT, PCV/TP and creatinine be

A

HR: 60-80

CRT: 3

PCV/TP: 45/75

creatinine: 180-270 umol/l

39
Q

what would 10% dehydration HR, CRT, PCV/TP and creatinine be

A

HR: 80-100

CRT: 4

PCV/TP: 50/80

creatinine: 270-350

40
Q

what would 12% dehydration HR, CRT, PCV/TP and creatinine be

A

HR: >100

CRT: >4

PCV/TP: >50/>80

creatinine: >350

41
Q

how do you calculate the estimated fluid deficit

A

BW (kg) x % dehydration (decimal)

42
Q

what is the goal for treating impactions (3)

A
  1. soften impaction/ease passage
  2. increase motility
  3. maintain comfort
43
Q

what are 3 ways you could soften an impaction

A
  1. repeated high volume gastric lavage: 1-2L of water in
  2. coke administration (1-2L)
  3. CRI isotonic enteral fluids
44
Q

what are ways the owner can manage an impaction

A

stimulate motility

hand walking

45
Q

what is bethanechol

A

pro kinetic

for impaction

46
Q

what is the most common type large colon impaction

A

pelvic flexure impaction

47
Q

what are 4 methods of softening a large colon impaction

A
  1. isotonic enteral fluids
  2. cathartic MgSO4/epsom salt - ONCE
  3. (liquid paraffin/mineral oil)
  4. IV fluids: requires 3x maintenance
48
Q

how much isotonic enteral fluids can you give to soften a large colon impaction

A

5L every 1 hr until resolved

49
Q

what analgesic can you give for a large colon impaction

A

flunixin 1.1 mg/kg

50
Q

how long does flunixin last

A

except to last 12 hours

51
Q

how do you treat a cecal impaction

A

surgery

52
Q

how do you medically manage a cecal impaction (3)

A
  1. soften through enteral fluids
  2. increase motility: hand walking
  3. maintain comfort: usually not very painful –> if painful surgery is indicated
53
Q

how do you treat a small colon impaction

A

soften

or if not surgery and guarded prognosis

54
Q

how do you soften a small colon impaction

A

enema –> gravity admin using stomach tube

IV fluids 1-3x maintenance

mineral oil/liquid paraffin

(enteral fluids are less effective)

55
Q

why are enteral fluids less effective in managing a small colon impaction

A

because most of the fluids are absorbed by the colon

56
Q

what is phenylephrine

A

a-1 adrenergic agonist

peripheral vasoconstriction and splenic contraction

57
Q

what is phenylephrine used for

A

nephrosplenic entrapment to induce vasoconstriction and splenic contraction

58
Q

what is the dose of phenylephrine

A

20ug/kg IV over 15 mins

59
Q

what are the risks of phenylephrine

A

fatal hemorrhage in older horses (>15 years)

bradycardia –> slow infusion or walk

lunge horse for 15 mins after admin

60
Q

what can rolling the horse be used to treat

A

nephrosplenic entrapment

61
Q

how is rolling procedure performed when treating a nephrosplenic entrapment

A

phenyephrine admin and general anesthesia induced

dorsal recumbency and agitated

assess by US and repeat transrectal palpation

62
Q

what is a percutaneous cecal trocharization

A

performed to reduce gas distention of the cecum in large colon impaction or displacement

63
Q

what are the risks of percutaneous cecal trocharization

A

risk of peritonitis (potentially fatal)

64
Q

what is seen with enteritis on US

A

distended SI on rectal and US with large volumes of reflux

only mild pain once stomach decompressed

65
Q

how is enteritis treated

A

frequent gastric decompression

IV fluids (can have significant losses)

anti endotoxemic therapy

lidocaine

antimicrobials

66
Q

how is sand impaction diagnosed

A

fecal test

mix with water in glove, sand sediments

diagnosis confirmed by rads

67
Q

how are sand impactions treated

A

psyllium by NGT

surgery

68
Q

what is the prognosis of colic surgery related to (4)

A
  1. heart rate
  2. PCV
  3. type of surgery
  4. length of resection
69
Q

what are postoperative complications of colic surgery (7)

A
  1. anesthesia
  2. ileus
  3. peritonitis
  4. incisional infection/hernia
  5. laminitis
  6. jugular vein thrombosis
  7. adhesion formation
70
Q

what increases the risk of post operative ileus

A

SI lesions esp resection and anastomosis

71
Q

how is postoperative ileus managed (4)

A
  1. frequent gastric decompression (1-4 hours)
  2. IV fluid therapy
  3. prokinetics
  4. partial parenteral nutrition?
72
Q

what are prokinetics that can be used to treat postoperative ileus (4)

A
  1. lidocaine
  2. metaclopramide
  3. erythromycin
  4. bethanechol
73
Q

how is lidocaine administered as a pro kinetic to treat post op ileus

A

bolus then CRI

74
Q

how is metaclopramide administered as a pro kinetic to treat post op ileus

A

CRI

75
Q

what is a side effect of metaclopramide

A

side effect is severe aggression

76
Q

how is erythromycin administered as a pro kinetic to treat post op ileus

A

intermittent bolus q 6 hours

expensive

Module 16 (26 decks)

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