Equine SI Diseases

Overview of Colic in Horses

• Importance of recognizing signs of colic in equine patients.

• Key symptoms include pain, changes in behavior, and signs of distress.

Case Presentation

• Initial observation: darkish pink, tacky mucous membranes, indication of pain.

• Patient sedation initiated due to severity of discomfort.

• No net reflux observed upon passing a nasogastric tube.

Diagnostic Findings

• Rectal Examination:

  • No significant abnormalities detected.

• Blood Lactate Level:

  • Measured at 3.2 millimoles, indicating moderate elevation (normal <1.5).

• Peritoneal Fluid Tap:

  • Fluid characterized as serosanguineous with lactate of 7.2, significantly elevated.

• Abdominal Ultrasound:

  • Notable findings include dilated, thickened loops of small intestine on the right lateral wall.

  • Moderate movement detected in the left-sided small intestine but signs of fluid distension.

Differential Diagnosis

• Consider differential diagnoses based on findings:

  • Epiploic Foramen Entrapment:

    • Characteristics present: left to right entrapment, history aligned with typical features.

    • Risk factors: tall, deep-chested horses, geldings, and thoroughbreds, particularly at age 10.

    • Cribbing identified as a leading risk factor for this condition, often causing dental wear.

  • Strangulating Lipoma:

    • Another potential diagnosis based on experienced symptoms.

  • Gastric Feed Impaction:

    • Considered less likely given ultrasound results and overall health status.

  • DPJ (Distention of the Small Intestine):

    • Insidious onset, moderate fluid distension, may provide differential insight.

Anatomy and Complications

• Epiploic Foramen:

  • Approximately two fingers wide, critical for understanding strangulation risk.

  • Important surrounding structures:

    • Portal vein.

    • Caudal vena cava.

    • Right lobe of the pancreas.

  • Surgical interventions are risky due to potential large blood loss if the vena cava is torn during reduction attempts.

Case Conclusion

• Recap of 11-year-old Thoroughbred gelding risking colic episodes.

• Signs of moderate colic, tachycardia, and possible gastric reflux due to prior decompression.

• Further reflection on classic characteristics for possible DPJ diagnosis.

Study Objective

• Encourage formation of clinical reasoning questions related to small intestinal disease in horses.

• Importance of understanding both clinical signs and anatomical considerations for better examination performance.