Colic equine: Indicators to consider on diagnosis.
The expression of visceral pain in horses varies according to the temperament of the animal, the site of injury and duration of the process. Not always an individual disease are the result of poor dietary management, housing, toxic or allergic, but before considering this possibility, we must make a good diagnosis, as there are many diseases that must be differentiated.
The following indicators should be taken into account:
Temperature: normal or slightly elevated. Slight increases were observed after a painful process or a state of excitement. The elevated temperature can be observed in case of rupture of organs or infectious diseases (colitis, pleurisy, etc.).. But in the presence or anteroom of shock, this parameter drops below the parameters considered as normal.
Behavior: usually manifest restlessness, constant position changes anguished glances toward the flanks.
Discoloration of the mucous membranes: Varies meet the following states: Bright red with vasodilation at the beginning of endotoxic shock, as this progresses, the mucous membranes acquire a deep red color due to vasoconstriction. Also it is possible to change the color of the mucous membranes at the head trauma caused by the intense pain or treatment in place to mask the effect of endotoxin.
Alteration of the coat and skin, is due to the presence of injuries that are evident at the level of bony protrusions (head, elbows, wrists, tarsi) or chest wall or abdominal pain as signs revealing perceived.
Stools: Consider the presence of undigested food, blood, parasites, mucus, sand, dirt or foreign matter such as strips to tie the bundles, wires, etc..
Urination: You have to take into account the quality and quantity of urine produced. Since anuria-oliguria are indications of severe dehydration, acute renal failure and shock. Also important is the way it makes urination, abdominal pain as perceived by the patient during the colic syndrome, can lead to urinary disorders.
Anorexia: No specific acute abdomen may be a better indicator of abdominal pain, high obstruction or digestive disorders of the upper digestive tract.
Respiratory rate: Varies, depending on the type of colic and the degree of symptoms. Pain can rise in the primary or secondary overload the stomach or the rupture of these organs. Under conditions of extreme pain, respiratory rate may reach levels of 80 to 100 per minute, and very dilated nostrils.
Heart rate: is increased, since it is observable in horses with colic it generates anxiety, pain and hypovolemia. As it is raised above 100 per minute, it is associated with a poor prognosis.
Peripheral arterial pulse: indicates the state of the cardiovascular and tissue perfusion. A weak pulse or changes in the extent of it reflected a decrease in systolic discharge. Usually associated with a very weak pulse a poor prognosis.
Capillary refill time: Usually is increased. This parameter indicates a decrease in tissue perfusion, usually due to hypovolemia, decreased cardiac output to increased peripheral resistance. In the dehydrated horse capillary refill time is increased (3 to 4 seconds) and the horse is severely dehydrated (5 to 6 seconds). If you stretch or twist the upper lip in a dehydrated animal, this test can extend your time. This type of test is a variation for the measurement of dehydration used by some clinicians. This should be timed carefully after observing the different membranes. These tests have proven to be one of the best indicators of the performance of perfusion and cardiovascular activity in relation to survival.
Dehydration is of fundamental importance with the presentation of clinical signs of shock. We consider the state of the mucous membranes (gum, conjunctiva among others). Note that the different types of lighting can change the color of light the same way (especially if the light is Tungsten). Simple dehydration produces a slightly pale whitish pink. Venous congestion or the release of endotoxins, membranes of red turn brick red. When oxygen transport is limited, the membranes are cyanotic. Before his death, perfusion and hypoxia are dramatically reduced, so the membranes are pale blue-gray. Swollen membranes are indicative of good perfusion.
Absence or presence of bowel sounds: auscultation with a stethoscope made at four sites, namely in the regions above and below paralumbares. The sounds are heard on both left and right sides and top and bottom on each side. Sounds typical of the colon are mixing and be heard on either side of the ventral surface. The sound produced by the interface and the mixing of gas from the colon and often blind. The small intestine may be moving soundlessly and this refers to the structure of the external abdominal wall. The sounds heard normally arise from the mixing of food with the gas.
The amplitude will vary greatly between horses. The mixing sounds normally occur regularly, 2 to 4 times per minute. The sounds you will hear a progression every 2 to 4 minutes when the horse has not eaten food recently. With the intake of these sounds increase in the amplitude and frequency and are characterized by the propulsive force along the intestine, listening to gurgling left side (colon) and right (blind) for 6 to 10 seconds. The sounds can be differentiated drive sound mixing for their cyclical pattern, intensity and longer duration. These sounds may stop after the administration of drugs such as atropine, xylazine, butorphanol, and detomidine. In almost all cases of abdominal pain, the sound of propulsion is reduced. In cases of severe intestinal disease (with or without myocardial strangulation) all sound will be absent. Peristalsis in the horse produced flows and sounds of bubbling gas interfaces and metallic.
These sounds should not be misinterpreted as progressive movements but rather must indicate the presence of ecstasy segment and dilatation of the intestinal wall, both the small intestine or the large intestine. Rarely increased sounds can be heard and are called as spasms or spasmodic colic. These sounds may be increased due to ischemia spasms, irritation of the parasite, or contraction against impaction. In these cases they are usually associated with pain. The increased frequency sounds can be heard also in the resolution of ileus tympanic or in the case of simple colic. These sounds are heard after treatment, after a walk or a spontaneous return to normal. Often the horse is seen as depressed or even tired but with a relaxation stay comfortable during this period of increased activity of the intestine. The sand can be heard during bowel movements by placing the stethoscope on the ventral abdomen. The sound of pouring sand over a mound of sand produces a sound similar to rubbing of the grains.
Most commonly used complementary methods:
1. Hematological parameters
2. Blood chemistry, electrolytes and functional tests and parasitological stool.
3. X-rays are the most commonly used chest.
5. Sampling for cytological, bacteriological and parasitological by: tracheal washings, endoscopy, colonoscopy and aspirations in the case of peritoneal effusions.
6. Skin tests: for determination of allergens from different sources.
7. Serological tests: to determine allergenic, bacterial and / or parasites.