Changes

==Diagnosis==

==Diagnosis==

Early rectal examination may reveal the impaction low in the right caudal abdominal quadrant.  Subsequent distention of the jejunum will be palpable ''per rectum'' but may preclude palpation of the impaction, thus the definitive diagnosis is often made at surgery.  Many horses with ileal impaction are delayed in their referral because initially their colic is mild and their condition deceptively stable.  Abdominocentesis may show an elevated protein concentration if the impaction has persisted for more than about 18 hours.(Merck)  The most likely differential diagnosis is proximal jejunitis, which can be challengin to rule out.

Early rectal examination may reveal the impaction low in the right caudal abdominal quadrant.  Subsequent distention of the jejunum will be palpable ''per rectum'' but may preclude palpation of the impaction, thus the definitive diagnosis is often made at surgery.  Many horses with ileal impaction are delayed in their referral because initially their colic is mild and their condition deceptively stable.  Abdominocentesis may show an elevated protein concentration if the impaction has persisted for more than about 18 hours.</ref>Impaction may also develop secondary to spastic contractions of the ileal musculature against ingesta.<ref name="Merck">Merck & Co (2008) '''The Merck Veterinary Manual (Eighth Edition)''', ''Merial''.</ref> The most likely differential diagnosis is proximal jejunitis, which can be challengin to rule out.

==Treatment==

==Treatment==