Colic Diagnosis - Abdominal Auscultation

Auscultation

Auscultation of the abdomen of the horse can be a useful tool in the diagnosis of colic. It is performed in a four quadrant approach over 4 to 5 minutes. The abdomen can be divided into left and right, dorsal and ventral sections. The examination begins by placing the stethoscope onto the paralumbar fossa and moving it to the middle and ventral abdomen. Normal intestinal sounds (borborygmi) are that of "splashing," "rumbling" and "bubbling." The caecum can be auscultated in the right paralumbar fossa. Cecal sounds occur one to three times a minute in the normal horse. Cecal sounds are like water flushing down a drainpipe. When assessing these sounds, the veterinarian should assess the tone, duration and intensity. Large intestinal sounds are deeper than small intestinal sounds. If the horse has been fasted or is anorexic, these sounds will be reduced. Repeat auscultation is vital when monitoring a horse with colic. There is a worse prognosis associated with cases where there is a progressive decrease in intensity and frequency of intestinal sounds.

Auscultation of the abdomen for intestinal borborygmi, usually performed in a four quadrant approach, can be a useful tool. Increased borborygmi are not usually associated with major changes, and may be indicative of spasmodic colic, or impending diarrhea. Increased borborygmi can be found early on in cases of enteritis, colitis and intestinal obstruction. Later in the progression of the disease there is decreased borborygmi due to the pain and inflammation associated with the gastrointestinal tract. Decreased borborygmi, or a sustained absence, may be suggestive of serious and potentially irreversible changes to the intestine. Trapped gas (tympany), particularly in the caecum and colon, can often be heard as a high pitched "pinging" during concurrent auscultation and percussion of the right (caecal) and left (colonic) flanks. Auscultation of the ventral abdomen over a 5 minute period can also be useful in regions where sand impaction is common. Auscultation reveals a sound similar to that of an ocean wave in these patients.

References

• Edwards B. (2009), Diagnosis and Pathophysiology of Intestinal Obstruction, in Equine Gastroenterology courtesy of the University of Liverpool, pp 9
• Meuller E, Moore J. N, (2008) Classification and Pathophysiology of Colic, Gastrointestinal Emergencies and Other Causes of Colic, in Equine Emergencies- Treatments and Procedures, 3rd Edition, Eds Orsini J. A, Divers T.J, Saunders Elsevier, pp 108 - 109
• Rose R.J, Hodgson D.R (2000) Examination of the Alimentary Tract, Alimentary Tract, Manual of Equine Practice, 2nd Edition, Saunders Elsevier, pp 293