Colic surgery - Freeman

Question 1

Normal vitals 1000lb (450 kg) adult horse

Answer 1

Temp: 99.5-100.5
HR: 36-40 bpm
Resp rate: 8-20 breaths/min
CRT: 2s
PCV: 36%
TP: 6-7 gm/dl

Question 2

Apparently high PCV with normal plasma protein

Answer 2

Splenic contraction or

Dehydration

Question 3

Increase in PCV and Plasma protein

Answer 3

dehydration

Question 4

Increase in PCV and decrease in plasma protein

Answer 4

Dehydration with protein loss

• severe mucosal ischemia or inflammation
• peritonitis

Question 5

Horses >/= 10 yrs old

Answer 5

Strangulating lipoma until proven otherwise

Question 6

Strangulating lipoma features

Answer 6

1. +/- small intestinal distentoin
2. elevated heart rate
3. +/- reflux
4. Pain can be very mild
5. Thin horses can also develop it

Question 7

90% of lipomas in

Answer 7

small intestine

Question 8

2nd most common strangulating lesion

Answer 8

Epiploic Foramen Entrapment

Question 9

Bad habit with strong association of epiploic foramen entrapment

Answer 9

Cribbing

Question 10

Young and ribby with a pot belly

Answer 10

Ascarid impaction

Question 11

Peripartum colic in mares

Answer 11

Mesenteric defect

-Can be repaired laparoscopically

Question 12

Risk factors for fecaltih

Answer 12

Small ponies

Foals

Question 13

Pregnant mare think

Answer 13

Uterine torsion

Question 14

Postpartum mare with extreme pain and worsening abdominal distention think

Answer 14

Large Colon Volvulus

-PROMT REFERRAL

Question 15

Cecal impaction

Answer 15

Usually a horse in the hospital for some reason

Question 16

Intussusception vocab

Answer 16

Itussusceptien receives the intussusceptiens

Question 17

Blood in peritoneal fluid means

Answer 17

Small intestinal strangulation, I think

Question 18

Thick walled small intestinal loops sign of

Answer 18

strangulation, I think

Question 19

A colon wall thickness >/= 9mm can accurately predict

Answer 19

large-colon torsion

Question 20

Ultrasonic dx of right dorsal displacement of large colon

Answer 20

Visualization of mesenteric vessels along right lateral abdomen, dorsal to costochondral junction in at least 2 intercostal spaces, distinct from cecal vessels

Question 21

Nephrosplenic ligament entrapment

Answer 21

Phenylephrine and rolling-better
Phenylephrine and lunging
-won’t be able to see resolution immediately on U/S

Question 22

How much small intestine can be removed?

Answer 22

70%, small intestine is 50-70 feet long

-Strangulation increases length by 25%

Question 23

5 critical steps in SI resection and anastomosis

Answer 23

1. Arrange SI and mesentary in anatomically correct manner
2. Resect and partly close mesentary
3. Decompress all distended intestine
4. Create a large, anatomically and physiologically correct stoma
5. Complete closure of mesentary

Question 24

Side-to-side jejunocecostomy has a

Answer 24

larger stoma and fewer postoperative problems than end-to-side.

Question 25

Lembert patterns

Answer 25

1. Interrupted 3-0 PDS 2. Minimal inversion 3. < 1 mm from edge 4. Bites 6mm wide 5. Bites 6 mm apart

Question 26

Enterotomy sites

Answer 26

1. Pelvic flexure (colotomy) 2. Small colon 3. Cecum (typhlotomy) 4. Small intestine (rare)

Question 27

Indications of enterotomies

Answer 27

remove impaction with feed, foreign body, enterolith

Question 28

Extensive large colon resection has

Answer 28

- improved survival in horses with volvulus | - prevents recurrence of LCV in high risk cases

Question 29

Post op care

Answer 29

1. Water at 12 hours +/- 2. Small handfuls of hay at 18-24 hours - at 4 hour intervals 3. Monitor HR, attitude, motility 4. Full feed by 72-96 hours