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17 Cards in this Set
- Front
- Back
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What are causes of medical colic?
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gas colic: auscult gas, animal may look bloated
spasmodic colic: ↑ gut sounds impaction: dx by rectal palpation sand: put feces in palpation sleeve, add H2O to separate out sand; gut sounds sound like ocean parasites unknown |
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What are risk factors for developing colic?
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recent change in diet, recent change in stabling, recent change in activity level, previous colic or colic sx (highest risk w/in 2 mo.), other (inadequate deworming, dental care)
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What are important hx & PE findings in patients w/ colic?
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history
-duration & severity of colic (most important), any tx already instituted, adverse medication rxns -other (may be taken after PE): housing/environment, parasite control, diet, other illnesses, prior colic sx PE -abdominal contour, TPR, pulse quality, gum color, CRT, skin tent for dehydration, auscultated chest & abdomen |
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What are some ancillary diagnostics used in colic patients?
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rectal palpation: bladder, ventral band of cecum, aorta, L kidney, nephrosplenic ligament, spleen, pelvic flexure
-abnormalities: tight band, distended bowel, impaction, mass nasogastric intubation -quantity important (> 2 L is abnormal) -gas, color of fluid, pH less significant abdominocentesis: color, TP < 2.5 g/dl, TNCC < 10K cells/µl fecal sand U/S: nephrosplenic entrapment, bowel thickness rads: foals; horses w/ enteroliths |
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What are the 4 main indications for referral of a colic patient?
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refractory or unrelenting pain
lack of response to therapy (2nd colic exam is major indication for referral) evidence of endotoxemia: tachycardia, congested gums, prolonged CRT finding inconsistent w/ simple colic: excessive reflux, abnormal rectal fiding, serosanguinous abdominal fluid |
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For the following exam parameters, what are the ranges for a "normal" colic & one that should be referred:
a. colic b. pulse c. mm color d. CRT |
a. normal: none, refer: recurrent, unresponsive
b. normal: < 48 bpm, refer: 60-80 bpm c. normal: pink, refer: congested d. normal: < 2 s., refer: 3 s. |
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For the following exam parameters, what are the ranges for a "normal" colic & one that should be referred:
a. gut sounds b. rectal exam c. nasogastric reflux d. abdominocentesis |
a. normal: gurgle q 4-5 s., refer: no sounds
b. normal: cecal band, pelvic flexure; refer: distended intestine c. normal: < 2 L, refer: > 2 L d. normal: light yellow, TP < 2.5 g/dl, TNCC < 10K cells/ul; refer: serosanguinous, TP > 2.5 g/dl, TNCC > 10K cells/ul |
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What is the pain management protocol for colic?
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mild to moderate pain
-brief exam: HR, mm, CRT -tx w/ short duration analgesic (~40 min): xylazine, +/- butorphanol IV -if no response, repeat tx response to initial analgesic -perform remainder of exam -tx w/ long duration analgesic: flunixin no response or severe pain -briefer exam: HR -analgesia: detomidine -if no response, repeat tx |
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What is the fluid therapy protocol for colic?
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determine fluid deficit: % dehydration x body wt. (kg) = deficit (L)
bolus ½ of fluid deficit rapidly: up to 100 ml/kg/hr (ex. 15 L) replace remainder at a slower rate: 2-3x maintenance/hr (ex. 2 L/hr) maintenance = 50 ml/kg/day |
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What is the medical tx for colic?
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laxatives
-mineral oil: for large intestinal dz only -DSS: detergent, penetrates impaction better than mineral oil -MgSO4: Epsom salts, pulls fluid into intestines have owner walk horse withhold feed for several hours gradual return to regular diet: start next day w/ hay |
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What are some causes of:
a. nasogastric reflux b. abnormal abdominocentesis findings c. tight bands on rectal exam |
a. pyloric or small intestinal obstruction (#1), anterior enteritis (#2), some large colon displacements
b. small intestinal compromise, enteritis, large intestinal compromise, splenic tap c. large colon displacement or volvulus (#1), distended cecum (cecal impaction: refer ASAP), mesentery under tension, uterine torsion |
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simple SI obstruction
a. clinical signs b. causes c. tx d. px |
a. consistently painful, mild tachycardia, reflux, 2-3 distended SI loops, normal abdominal tap
b. ascarid impaction, ileal impaction c. trace lesion via ileum, correct lesion, infuse obstruction, decompress SI into cecum d. short term 85%, long term 75% |
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simple LI obstruction
a. clinical signs b. causes c. tx d. px |
a. consistent mild pain, normal mm color, tachycardia, distended or impacted colon, normal abdominal tap
b. pelvic flexure feed impaction, R dorsal sand impaction, enteroliths, cecal impaction, neophrosplenic entrapment, meconium impaction (foals), fecal impaction (miniature horses) c. correct displacement or exteriorize pelvic flexure, enterotomy, lavage colonic lumen d. short term 90%, long term 85% |
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SI strangulating obstruction
a. clinical signs b. causes c. tx d. px |
a. consistent moderate pain, congested gums, tachycardia, reflux, multiple distended SI loops, serosanguinous tap
b. mesenteric lipoma (#1), epiploic foramen entrapment (#2), inguinal hernia, intussusception c. trace lesion via ileum, correct lesion, decompress SI into cecum, resect SI d. short term 75%, long term 50% |
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LI strangulating obstruction
a. clinical signs b. tx c. px |
a. consistent severe pain, pale mm, normal pulse or tachycardia, markedly distended colon, inconsistent tap results
b. exteriorize pelvic flexure, enterotomy, lavage colonic lumen, detorse colon, decision on viability c. short term 50%, long term 35% |
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What are the clinical signs of anterior enteritis?
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depression/mild pain, congested gums, tachycardia, copious reflux, several mildly distended SI loops, serosanguinous tap (slight ↑ in TP, normal TNCC)
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What are some indications for surgery in colic patients?
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simple SI obstruction: ascarid impaction, ileal impaction
simple LI obstruction: pelvic flexure feed impaction, R dorsal sand impaction, enteroliths, cecal impaction, neophrosplenic entrapment, meconium impaction (foals), fecal impaction (miniature horses) SI strangulating obstruction: mesenteric lipoma, epiploic foramen entrapment, inguinal hernia, intussusception LI strangulating obstruction anterior enteritis infarction |
