All colics are not created equal
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Thorough and timely assessment play a significant role in successful treatment of the critical colic
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Making a decision for referral early can significantly influence the outcome
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Survival is directly correlated to early diagnosis and treatment
Field diagnostics
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Components of the colic examination
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Physical exam
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Rectal
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Abdominocentesis (belly tap)
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Ultrasound
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Nasogastric intubation
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Physical exam
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Pain status
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Heart rate
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Normal = 36-44
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Temperature
• Normal = 99.5-101
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Respiratory rate
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Normal = 12-16
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Mucous membranes
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Normal = pink, moist, CRT <2 sec
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Gastro-intestinal sounds
• Present? Not present? Increased? Decreased? Gas?
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Evidence of pain
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Abdominal distention
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Examination per rectum
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Slow initial entry into rectum
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Left dorsal quadrant to find the spleen
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Clockwise examination
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Detect all fixed structures
o Buscopan (0.3 mg/kg) can facilitate rectal
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Rectal examination
o What you are feeling for:
• Abnormal distention.
• Abnormal position.
• Abnormal mass.
• Abnormal peritoneal surface.
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Abdominal ultrasound
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Can be performed in the field
o Preferable a 5-10 MHz microconvex probe or 2.5-5 MHz sector scanner
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Can sometimes use linear probe percutaneously if it is at lease a 5 MHz, but is more difficult
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Can use reproduction probe transrectally sometimes to evaluate SI distention and motility palpated rectally
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Abdominal ultrasound
• The sweet spots:
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Inguinal region
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Just abaxial to midline
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Identify position of spleen and locate left kidney (for nephrosplenic rule-out)
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Abdominocentesis
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Can be performed in the field
• Teat cannula or 18 gauge – 1.5" needle
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Aseptic prep
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At most dependent portion of the abdomen
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Just abaxial to midline
• Gross analysis of fluid – serosanguinous or not?
o Can carry refractometer – evaluate protein (normal = < 1.0 g/dl)
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Nasogastric intubation
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Reflux and gastric lavage
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Fluid obtained should be less than 2 L
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Perform lavage if significant feed material obtained – gastric impaction??
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If > 2 L net back – do not give oil, H2O or electrolytes
