Changes

==Treatment==

==Treatment==

[[Colic, Medical Treatment|'''Medical treatment''']] may be feasible if severe and persistent colic signs or progressive gaseous distension of the small intestine are not present.  In this situation, balanced electrolyte solutions (administered IV), nasogastric intubation and analgesia may suffice.  Liquid paraffin by nasogastric tube may prove useful but should only be attempted if gastric reflux has ceased.  The response to medical intervention will be evidenced in a reduction in: colic signs, the amount of gastric reflux, and small intestinal distension on repeated rectal exams; plus an improvement in cardiovascular status.<ref name="Hanson 2">Hanson, R.R, Schumacher, J, Humburg, J, Dunkerkley, S.C (1996) Medical treatment of horses with ileal impactions: 10 cases (1990-1994). ''J Am Vet Med Assoc'', 208(6):898-900.</ref>  Although medical treatment may resolve the impaction early on, surgery is typically required.

[[Colic, Medical Treatment|'''Medical treatment''']] may be feasible if the pain is manageable, if repeated abdominocentesis demonstrates no evidence of intestinal degeneration, if there is no nasogastric reflux and if multiple tightly distended loops of small intestine are not present on rectal examination.  In this situation, balanced electrolyte solutions (administered IV) and analgesia may suffice.  Substances via nasogastric tube are contraindicated, even if reflux is absent, because the small intestinal distension and reduced motility proximally will prevent these reaching the impaction.  The response to medical intervention will be evidenced by a reduction in colic signs and an improvement in cardiovascular status.<ref name="Hanson 2">Hanson, R.R, Schumacher, J, Humburg, J, Dunkerley, S.C (1996) Medical treatment of horses with ileal impactions: 10 cases (1990-1994). ''J Am Vet Med Assoc'', 208(6):898-900.</ref>  Although medical treatment may resolve the impaction early on, surgery is typically required.

'''Surgical treatment''' comprises celiotomy followed by reduction of the impaction via extraluminal massage aided by admixing of the intestinal fluid oral to the impaction or injection of fluids intraluminally.  The ingesta can then be moved into the caecum.  Infusions into the impaction may include saline, '''carboxymethylcellulose''' or '''dioctyl sodium sulfosuccinate (DSS)'''.  An '''enterotomy''' in the distal jejunum may be instigated to evacuate impacted contents and minimise intestinal manipulation.  Recurrent ileal impaction may demand a '''jejunocecostomy'''.<ref name="Hanson">Hanson, R.R, Wright, J.C, Schumacher, J, Baird, A.N, Humburg, J, Pugh, D.G (1998) Surgical reduction of ileal impactions in the horse: 28 cases. ''Vet Surg'', 27(6):555-60.</ref>

'''Surgical treatment''' comprises celiotomy followed by reduction of the impaction via extraluminal massage aided by admixing of the intestinal fluid oral to the impaction or injection of fluids intraluminally.  The ingesta can then be moved into the caecum.  Infusions into the impaction may include saline, '''carboxymethylcellulose''' or '''dioctyl sodium sulfosuccinate (DSS)'''.  An '''enterotomy''' in the distal jejunum may be instigated to evacuate impacted contents and minimise intestinal manipulation.  Recurrent ileal impaction may demand a '''jejunocecostomy'''.<ref name="Hanson">Hanson, R.R, Wright, J.C, Schumacher, J, Baird, A.N, Humburg, J, Pugh, D.G (1998) Surgical reduction of ileal impactions in the horse: 28 cases. ''Vet Surg'', 27(6):555-60.</ref>