Flashcards in Sept 23 Deck (18)
What are signs that a colic is surgical?
1. refractory pain
2. persistently elevated heart rate
3. nasogastric reflux
4. distended loops of small intestine on rectal examination
5. abdominal distension/distended large colon
6. tight bands on rectal palpation
7. abnormal abdominocentesis
What are the goals of fluid therapy?
1. resuscitation-increase cardiac output
2. correct dehydration-esp impaction
3. keep up with ongoing losses
4. correct acid base and electrolyte disturbances
What are things to consider with fluid therapy?
1. type of fluid
2. rate of administration
3. route of administration
4. patient monitoring--adjust as needed
What are types of IV fluids?
crystalloids (maintenance or resuscitation)
hypertonic saline (quick restoration of volume, follow with isotonic)
colloids--hetastarch, pentastarch or plasma
What are types of colloids?
hetastarch, pentastarch or plasma
What level of dehydration does an animal have to be at to detect it on a clinical exam?
What is maintenance level of fluid?
If an animal is dehydrated, over what period of time should you correct it?
How much fluid do you give to an animal that is dehydrated?
2x maintenance (5ml/kg/hr) plus losses
What are two sources of fluid loss?
relfux or diarrhea
What is the benefit of ranitidine in a refluxing horse?
it can be given IV, the others cannot be given IV
What is an issue with omeprazole?
it is expensive and the compounded formulation is no good
How do you prevent gastric ulcers?
1. dietary management (appropriate diet, quality roughage-alfalfa-high Ca, constant access to roughage)
2. omeprazole at a preventative dose
HOw is DPJ treated?
1. fluid therapy
2. analgesic and anti-inflammatory drugs
3. gastric decompression
4. anti-endotoxin support
5. nutritional support!!!--e.g. parenteral if refluxing for several days
6. lidocaine CRI--prokinetic, anti-inflammatory
7. +/- antimicrobials
8. +/- surgery
What are two features of lidocaine CRI?
How are impactions treated?
1. surgery if severe
2. control abdominal pain
3. oral laxatives
4. oral or intravenous fluid therapy
What are the rules of oral fluid therapy?
1. no more than 8-10L at a time
2. at least 20 min between doses
3. check for reflux before each administration
4. ideally isotonic