Management of Equine Acute Colic Flashcards
(76 cards)
1
Q
what does analgesia choice depend on (2)
A
- degree of pain
- duration of action
2
Q
what are short acting analgesics (4)
A
- xylazine
- buscopan
- morphine
- ketamine
3
Q
what are longer acting analgesics (3)
A
- detomidine
- butorphanol
- NSAIDs
4
Q
what NSAIDs can be used (4)
A
- flunixin meglumine
- phenylbutazone
- meloxicam
- ketoprofen
5
Q
what are side effects of NSAIDs (3)
A
1, renal injury
- right dorsal colitis
- delayed mucosal healing
6
Q
what is the dose of flunixin megulmine
A
1.1 mg/kg IV
7
Q
how long does flunixin last
A
up to 24 hours, dose q 12 hours max
8
Q
how potent is flunixin
A
potent
take any signs of discomfort very seriously
9
Q
how long before you refeed after a dose of flunixin
A
until 24 hours after last dose
10
Q
what routes are used to administer flunixin
A
IV or oral
not IM –> clostridial myositis
11
Q
what is the dose for phenylbutazone
A
4.4 mg/kg IV max
12
Q
which is more potent flunixin or phenylbutazone
A
flunixine
13
Q
what routes can phenylbutazone be given
A
IV only – perivascular tissue damage
oral
14
Q
what is buscopan made of
A
butylscopolamine
15
Q
what is the dose of buscopan
A
0.1-0.3 mg/kg IV
16
Q
how does buscopan act
A
blocks muscarinic receptors
parasympatholytic
17
Q
what are side effects of buscopan
A
tachycardia
18
Q
how long acting is buscopan
A
short acting
19
Q
what are a-2 adrenergic agonists
A
xylazine
detomidine
20
Q
which is shorter acting xylazine and detomidine
A
xylazine is shorter acting
21
Q
what is the dose of xylazine used
A
0.4mg/kg IV or IM
22
Q
what dose of detomidine is used
A
0.01 mg/kg IV or IM
23
Q
what dose of butorphanol is used
A
0.01-0.02 mg/kg IV or IM
24
Q
what dose of morphine is used
A
0.12 mg/kg IV or IM
25
what dose of ketamine is used
0.5 mg/kg IM or IV
26
what is the maintanence amout of fluid for an adult horse
60 ml/kg/day
27
what is the maintanence amout of fluid for a foal
100 ml/kg/day
28
when would IV fluids be indicated
reflux or hypovolemia
29
what is an appropriate amount of enteral fluid
5L for 500kg horse
30
how often should you repeat enteral fluid
repeat every 30 mins to 2 hours
31
what is a recipe for enteral fluids to make them isotonic
1. table salt (NaCl) and Lo salt (NaCl/KCl)
15ml tablesalt and 15 Losalt in 4L of water
2. 5.27g NaCl, 0.37g KCl, 3.78g sodium bicarbonate
32
what are the isotonic crystalloid fluids (4)
1. hartmanns
2. LRS
3. Plasmalyte
4. replacement fluids
33
what are hypertonic crystalloid fluids
7.2% saline
34
what are colloid fluids
1. hetastarch
2. plasma
35
how do you assess IV therapy and how much fluid
goal directed based on mucus membranes, heart rate, urine output, jugular fill, PCV, lactate
36
how much should you give in a bolus of IV fluids
10-20 ml/kg and re-assess
37
what would 6% dehydration HR, CRT, PCV/TP and creatinine be
HR: 40-60
CRT: 2 secs
PCV/TP: 40/70
creatinine: 90-180 umol/l
38
what would 8% dehydration HR, CRT, PCV/TP and creatinine be
HR: 60-80
CRT: 3
PCV/TP: 45/75
creatinine: 180-270 umol/l
39
what would 10% dehydration HR, CRT, PCV/TP and creatinine be
HR: 80-100
CRT: 4
PCV/TP: 50/80
creatinine: 270-350
40
what would 12% dehydration HR, CRT, PCV/TP and creatinine be
HR: \>100
CRT: \>4
PCV/TP: \>50/\>80
creatinine: \>350
41
how do you calculate the estimated fluid deficit
BW (kg) x % dehydration (decimal)
42
what is the goal for treating impactions (3)
1. soften impaction/ease passage
2. increase motility
3. maintain comfort
43
what are 3 ways you could soften an impaction
1. repeated high volume gastric lavage: 1-2L of water in
2. coke administration (1-2L)
3. CRI isotonic enteral fluids
44
what are ways the owner can manage an impaction
stimulate motility
hand walking
45
what is bethanechol
pro kinetic
for impaction
46
what is the most common type large colon impaction
pelvic flexure impaction
47
what are 4 methods of softening a large colon impaction
1. isotonic enteral fluids
2. cathartic MgSO4/epsom salt - ONCE
3. (liquid paraffin/mineral oil)
4. IV fluids: requires 3x maintenance
48
how much isotonic enteral fluids can you give to soften a large colon impaction
5L every 1 hr until resolved
49
what analgesic can you give for a large colon impaction
flunixin 1.1 mg/kg
50
how long does flunixin last
except to last 12 hours
51
how do you treat a cecal impaction
surgery
52
how do you medically manage a cecal impaction (3)
1. soften through enteral fluids
2. increase motility: hand walking
3. maintain comfort: usually not very painful --\> if painful surgery is indicated
53
how do you treat a small colon impaction
soften
or if not surgery and guarded prognosis
54
how do you soften a small colon impaction
enema --\> gravity admin using stomach tube
IV fluids 1-3x maintenance
mineral oil/liquid paraffin
(enteral fluids are less effective)
55
why are enteral fluids less effective in managing a small colon impaction
because most of the fluids are absorbed by the colon
56
what is phenylephrine
a-1 adrenergic agonist
peripheral vasoconstriction and splenic contraction
57
what is phenylephrine used for
nephrosplenic entrapment to induce vasoconstriction and splenic contraction
58
what is the dose of phenylephrine
20ug/kg IV over 15 mins
59
what are the risks of phenylephrine
fatal hemorrhage in older horses (\>15 years)
bradycardia --\> slow infusion or walk
lunge horse for 15 mins after admin
60
what can rolling the horse be used to treat
nephrosplenic entrapment
61
how is rolling procedure performed when treating a nephrosplenic entrapment
phenyephrine admin and general anesthesia induced
dorsal recumbency and agitated
assess by US and repeat transrectal palpation
62
what is a percutaneous cecal trocharization
performed to reduce gas distention of the cecum in large colon impaction or displacement
63
what are the risks of percutaneous cecal trocharization
risk of peritonitis (potentially fatal)
64
what is seen with enteritis on US
distended SI on rectal and US with large volumes of reflux
only mild pain once stomach decompressed
65
how is enteritis treated
frequent gastric decompression
IV fluids (can have significant losses)
anti endotoxemic therapy
lidocaine
antimicrobials
66
how is sand impaction diagnosed
fecal test
mix with water in glove, sand sediments
diagnosis confirmed by rads
67
how are sand impactions treated
psyllium by NGT
surgery
68
what is the prognosis of colic surgery related to (4)
1. heart rate
2. PCV
3. type of surgery
4. length of resection
69
what are postoperative complications of colic surgery (7)
1. anesthesia
2. ileus
3. peritonitis
4. incisional infection/hernia
5. laminitis
6. jugular vein thrombosis
7. adhesion formation
70
what increases the risk of post operative ileus
SI lesions esp resection and anastomosis
71
how is postoperative ileus managed (4)
1. frequent gastric decompression (1-4 hours)
2. IV fluid therapy
3. prokinetics
4. partial parenteral nutrition?
72
what are prokinetics that can be used to treat postoperative ileus (4)
1. lidocaine
2. metaclopramide
3. erythromycin
4. bethanechol
73
how is lidocaine administered as a pro kinetic to treat post op ileus
bolus then CRI
74
how is metaclopramide administered as a pro kinetic to treat post op ileus
CRI
75
what is a side effect of metaclopramide
side effect is severe aggression
76
how is erythromycin administered as a pro kinetic to treat post op ileus
intermittent bolus q 6 hours
expensive
