Medical colic

Question 1

What are medical colics?

Answer 1

can be resolvecd with medical treatment
“simple” colic
inflammatory conditions

Question 2

What can be causes of abdominal pain?

Answer 2

1. distension (fluid, gas, ingesta–obstruct)
2. pulling on root of mesentery
3. ischemia or infarction–strangulation
4. deep ulcers in stomach or intestine (right dorsal colitis)
5. peritoneal pain (peritonitis)

Question 3

Do obstructed horses have ischemia/infarction?

Answer 3

no, thus are often less systemically sick, no risk of reperfusion industry

Question 4

What is the name of distension in stomach? in cecum, which are most common (distention)

Answer 4

stomach–dilation
cecum–tympany
stomach and cecum most common

Question 5

What are the most common causes of colic in field?

Answer 5

spasm–gas colic

Question 6

What are the categories of disease (medical)

Answer 6

1. obstruction
2. distension
3. spasm
4. ulceration
5. inflammation (enteritis, colitis, peritonitis)

Question 7

Where do spams occur?

Answer 7

small intestine or large intestine

Question 8

What are important features of spasms?

Answer 8

no obstruction, no loss of perfusion

Question 9

Where are ulcers most common

Answer 9

in stomach and right dorsal colon

Question 10

What are causes of medical colic in teh stomach

Answer 10

1. gastroduodenal ulceration
2. distension
3. obstruction

Question 11

What are causes of medical colic in the small intestine

Answer 11

duodenitis-proximal jejunitis
ileus
spasm

Question 12

What are causes of medical colic in the large intestine?

Answer 12

gas accumulation (tympany)
impaction
colitis

Question 13

What are causes of medical colic in the peritoneum

Answer 13

peritonitis

Question 14

What are non-GI causes of “colic”

Answer 14

mesenteric abscess
ovarian tumor, abscess, hematoma
parturition
uterine artery rupture
liver disease
ruptured bladder (foal)
urinary tract, renal dz
pleural dz
laminitis

Question 15

What are causes of esophageal obstruction?

Answer 15

primary obstructions–in esophagus

secondary impactions–other masses

Question 16

What factors predispose to primary impactions?

Answer 16

simple choke
prior trauma
dental abnormalities
wolfing of food
diverticulum

Question 17

What is a big concern with choke?

Answer 17

the esophageal if damaged it tends to heal with strictures! or with diverticula–risk of recurrent chocke

Question 18

What are causes of secondary impactions?

Answer 18

foreign bodies
masses
acquired or congenital anomalies

Question 19

How is esophageal obstruction treated?

Answer 19

gentle lavage, endoscopy

Question 20

what is the biggest complication of choke?

Answer 20

aspiration pneumonia

Question 21

What can happen is esophageal obstruction not recognized in time?

Answer 21

esophageal rupture, causes swelling of the neck area

Question 22

What are signs of esophageal choke?

Answer 22

anxious
neck extended
gag, retch
forthy nasal discharge bilateral
look this up

Question 23

gastric ulcers in foals are caused by what?

Answer 23

poor perfusion of stomach

Question 24

What are risk factors for gastric ulcers?

Answer 24

1. stress
2. transportation
3. high grain diet
4. stall confinement
5. intermittent feeding
6. intense exercise
7. racing
8. illness
9. management changes
10. NSAID use

Question 25

What are clinical signs of gastric ulcers?

Answer 25

1. acute colic 2. recurring colic 3. excessive recumbency 4. poor BCS 5. partial anorexia 6. poor performance 7. attitude changes 8. frequent stretching to urinate 9. chronic diarrhea

Question 26

Where are the two big locations for gastric ulcers?

Answer 26

``` squamous mucosa pyloric region (NSAID) ```

Question 27

What causes pain with stomach distention?

Answer 27

the distention of the stomach

Question 28

What happens to the angle of the cardia with stomach distention?

Answer 28

the cardia angle gets more closed off. If have trouble getting into the stomach with NG tube, then consider that there is an issue with the stomach--severely gas distended or impacted e.g.

Question 29

Why would you tube a horse with a high heart rate/colic early on?

Answer 29

in case of stomach distension--tube to relieve and prevent rupture and if the heart rate decreases, then indicates the heart rate was high due to pain

Question 30

Is ileus usually a primary or secondary problem?

Answer 30

secondary

Question 31

What are the features of duodenitis-proximal jejunitis?

Answer 31

1. inflammation 2. distension and abdominal pain 3. gastric reflux NOT diarrhea

Question 32

Duodenitis--proximal jejunitis is difficult to disinguihs from what? Why is this important?

Answer 32

small intestinal strangulation, which needs sx!

Question 33

How can you differentiate DPJ and SI obstruction?

Answer 33

features that are more common in DPJ: 1. fever--inflam problem--often have inflammatory CBC 2. severe depression 3. thickened small intestinal wall on ultrasound, may see motility--different from surgical lesions--realy distended non-motile small intestine 4. in areas where this is common (SE USA) see disgusting dark red reflux. not seen in canada really

Question 34

What is the etiology of DPJ?

Answer 34

not really known salmonella? clostridium (difficile, perfringens) mycotoxins

Question 35

how could you possibly differentiate DPJ and small intestine strangulation on rectal?

Answer 35

small intestine strangulation--very distended obvious intestines DPj--thickened small intestine that can be felt but not as obvious (this is not always true)

Question 36

How can you differentiate SI strangulation and DPJ on U/S

Answer 36

find the right kidney, duodenum is right near it--assess wall thickness

Question 37

What are medical issues of the large intestine?

Answer 37

1. tympany 2. impaction (cecum, large, small colon) 3. colitis

Question 38

What are conditions where we worry about cecal impaction? Why do we worry?

Answer 38

1. ocular pain 2. stall rest--e.g. due to injury we worry because often few signs for cecal impaction then it ruptures! (the animal is still passing feces from the large colon)

Question 39

What do you notice on rectal with a cecal impaction or distension?

Answer 39

can find ventral cecal band more easily.

Question 40

Why can large colon impactions become surgical?

Answer 40

because it is the site of water reabsorption so the impaction becomes drier and drier and the mucosa becomes more friable. worry about rupture as well

Question 41

When does cecal tympany usually occur?

Answer 41

secondary due to large intestine impaction or volvolus etc | or primary cecal distension

Question 42

What is the most common colic after gas colic?

Answer 42

pelvic flexure impaction because associated with decreased water intake--e.g. fall/winter?

Question 43

How can you diagnose pevlic flexure impaction? What can you not figure out by this method

Answer 43

by rectal palpation but cannot figure out how far it extends

Question 44

Why might a horse appear painful when treating pelvic flexure impaction?

Answer 44

can feel pain as the impaction is moving (intermittent mild to moderate pain?)