Unit 2 - GI Colic

Question 1

What is colic?

Answer 1

abdominal pain most likely localized to the GI tract

Question 2

Is mortality associated with colic higher in horses less than a year of age or greater?

Answer 2

greater

Question 3

What percentage of colic are simply medical and not surgical?

Answer 3

80-85% are medical - 30% resolve without treatment

Question 4

What are the influencing factors for survival of colic?

Answer 4

Delay of treatment, underlying disease, shock and endotoxemia, improvements in anesthesia, and fluid therapy

Question 5

What are the risk factors to developing colic?

Answer 5

Previous colic episodes, round bale feeding, course or poor-quality hay, high concentrate diets, acute decrease in exercise, cribbing, late pregnancy to 150 days post-partum, possibly weather changes

Question 6

What clinical signs are associated with colic?

Answer 6

Rolling, pawing, looking at flank, abnormal behavior, grinding teeth, lifting the upper lip, not passing manure, sweating, abnormal posture, and anorexia

Question 7

What information should you get about a horses history in a colic case?

Answer 7

signalment, recent changes, duration of colic, medical history, previous episodes of colic

Question 8

What should you examine during physical examination in a colic case?

Answer 8

Attitude, abdominal distension, fecal consistency, TPR, MM, CRT, GI auscultation

Question 9

What is the normal T for horses?

Answer 9

99-101 F

Question 10

What is the normal HR for horses?

Answer 10

30-42 bpm

Question 11

What is the normal RR for horses?

Answer 11

12-20 bpm

Question 12

What may increased HR indicate?

Answer 12

pain, endotoxemia, and decreased vascular volume

Question 13

What are signs of endotoxemia in the mm?

Answer 13

brick red color, blue or purple, toxic line

Question 14

How do you check hydration status on a horse?

Answer 14

CBC/chemistry panel, mucus membranes, and a skin tent (neck or upper eyelid)

Question 15

What is a normal PCV in horses?

Answer 15

30-40%

Question 16

What is a normal TS in horses?

Answer 16

6-7 g/dl

Question 17

What is the prognosis for survival if a patient has a PCV of greater than 60%?

Answer 17

Poor prognosis for survival

Question 18

Where should GI auscultation be done?

Answer 18

4 quarants - dorsal and ventral in the right and left flank

Question 19

In 1 minute, how many ‘episodes’ of sounds should you hear on GI auscultation?

Answer 19

1-2 episodes of sounds

Question 20

What behavior is associated with pain?

Answer 20

Violent, uncontrollable, continous and older horses are stoic

Question 21

What are signs of mild pain?

Answer 21

laying down, looking at abdomen, occasionally rolls

Question 22

What can cause mild GI pain?

Answer 22

large colon impactions or displacements

Question 23

What are signs of moderate pain?

Answer 23

active rolling, continuous discomfort

Question 24

What can cause moderate GI pain?

Answer 24

large colon displacements and gas distension

Question 25

What are signs of severe pain?

Answer 25

violently throwing self on ground and very little awareness of surroundings

Question 26

What are the causes of severe pain?

Answer 26

Vascular compromise to bowel, large colon torsion, and small intestinal strangulating lesion

Question 27

What diagnostics should be done for colic?

Answer 27

Blood work, nasogastric tube, rectal examination, abdominocentesis, and ultrasound

Question 28

What bloodwork should be done in colic cases?

Answer 28

PCV/TS, lactate, CBC, and serum chemistry

Question 29

Why do you want to pass a NG tube early on in treatment?

Answer 29

Because they cannot vomit, it will help releive pressure in the stomach that will ultimately make them more comfortable

Question 30

What volume of reflux is normal?

Answer 30

1-2 liters

Question 31

What volume of reflux is significant?

Answer 31

>4 liters - don't give mineral oil

Question 32

Can a rectal examination aid in colic diagnosis?

Answer 32

It may aid in determining where and if the distension is gas or solid, but determining a definitive diagnosis is rare

Question 33

What complication is associated with rectal examination?

Answer 33

rectal tears

Question 34

Why would you want to do a fecal assessment in colic cases?

Answer 34

For gross evaluation, fecal flotation to determine if parasites are the cause, and to determine if there is sand sediment

Question 35

Where should you do an abdominocentesis?

Answer 35

at the right of midline

Question 36

What does normal periotoneal fluid look like?

Answer 36

clear, yellow peritoneal fluid

Question 37

What are some abnormal fluid consistencies from abdominocentesis?

Answer 37

Cloudy, serosanguinous, or reddish brown +/- plant material

Question 38

What does serosanguinous fluid indicate?

Answer 38

there is blood in the peritoneal fluid

Question 39

What does reddish brown +/- plant material fluid indicate?

Answer 39

There is a rupture or you accidently went into the GI tract

Question 40

What diagnostic tool is helpful for evaluation of colic?

Answer 40

ultrasound

Question 41

Why is ultrasound a good diagnostic tool?

Answer 41

Abdominal effusion and character, evaluate bowl wall thickness, SI distension, and nephrosplenic space

Question 42

Bare with me here, there are a lot. What are the indications for referral in colic cases?

Answer 42

``` Persistent HR > 60 bpm Red, injected, purple mucus membranes Increasing severity of clinical signs Marked abdominal distension Unrelenting pain Chronic, intermittent pain >2 days duration Distended small intestine Spontaneous reflux/large volumes of reflux Large colon palpable in the pelvic inlet Serosanguinous abdominocentesis Thickened intestinal walls ```

Question 43

What is the medical treatment for colic?

Answer 43

Pain control, hand walking, fluid therapy (they will need a lot), gastric decompression, laxatives, restrict food intake, and prokinetics

Question 44

What can be used for pain control in colic cases?

Answer 44

NSAIDs, sedatives, and analgesia

Question 45

What type of fluid do you want to use for IV fluid therapy?

Answer 45

isotonic replacement fluid - LRS, Plasmalyte A, and Normasol-R

Question 46

What electrolyte deficits can you correct with IV fluid therapy?

Answer 46

Calcium, potassium, magnesium

Question 47

What is the most common NSAID used for colic treatment?

Answer 47

Flunixin meglumine (Banamine)

Question 48

Does Flunixin meglumine mask surgical colic pain?

Answer 48

no

Question 49

What other NSAIDs can be used to treat colic pain?

Answer 49

Phenylbutazone, ketoprofen, Dipyrone

Question 50

What sedatives can be used in colic cases?

Answer 50

Xylazine, Detomidine, and Romifidine

Question 51

What sedative can mask surgical colic pain?

Answer 51

Detomidine

Question 52

Why would you want to give N-butylscopolammonium bromide to a colic patient?

Answer 52

It is a parasympatholytic that provides temporary ileus to relax the intestine

Question 53

What analgesic is the most commonly used in colic patients?

Answer 53

Butorphanol tartrate

Question 54

What drug is butorphanol often given with?

Answer 54

Xylazine, Detomidine, and Romifidine

Question 55

What laxatives do you want to give to colic patients?

Answer 55

mineral oil, magnesium sulfate, dioctyl sodium sulfosccinate (DSS), water, and Psyllium

Question 56

What does mineral oil do in the GI tract?

Answer 56

it lubricates it

Question 57

What type of laxative is magnesium sulfate?

Answer 57

it is an osmotic

Question 58

What type of laxative is DSS?

Answer 58

it is a detergent

Question 59

When is it good to use Psyllium as a laxative?

Answer 59

It is bulk forming so it is good for particulate colic (sand, gravel)