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Gastric impaction can occur as a primary condition but is often diagnosed at surgery as a finding secondary to other disturbances in the intestinal tract.  In some cases there be predisposing causes such as ulceration or fibrosis at the pylorus, whereas in other cases it ma occur spontaneously.  Predisposing factors:

Gastric impaction can occur as a primary condition but is often diagnosed at surgery as a finding secondary to other disturbances in the intestinal tract.  In some cases there be predisposing causes such as ulceration or fibrosis at the pylorus, whereas in other cases it may occur spontaneously.   

 

==Predisposing factors==

*Ingestion of certain feedstuffs including beet pulp, bran, straw, wheat and barley - beet pulp and bran can become dessicated within the stomach and may not become rehydrated by water or gastric secretions

*Ingestion of certain feedstuffs including beet pulp, bran, straw, wheat and barley - beet pulp and bran can become dessicated within the stomach and may not become rehydrated by water or gastric secretions

*Dental disorders - roughage may be incompletely masticated

*Dental disorders - roughage may be incompletely masticated

*Feeding a horse that has signs of colic - there may be poor gastric emptying associated with generalised decreased gastrointestinal motility

*Feeding a horse that has signs of colic - there may be poor gastric emptying associated with generalised decreased gastrointestinal motility

Clinical signs

==Clinical signs==

Abdominal discomfort

Abdominal discomfort

If the signs are mild and resolve spontaenosuly or with analgesics, owners often inclined to feed the horse, worsening the imapction

If the signs are mild and resolve spontaneously or with analgesics, owners often inclined to feed the horse, worsening the impaction

 

   

   

Diagnosis

==Diagnosis==

Suspected if cannto pass NGT, with gastric disytension the gastoroesophageal junction can become distoreted makingit difficutl to pass an NGT

Suspected if cannot pass NGT, with gastric distension the gastoroesophageal junction can become distorted making it difficult to pass an NGT

If poorly macerated r digested feed material is recvered form the NGT when the horse has been starved for several hrs

If poorly macerated or digested feed material is recovered from the NGT when the horse has been starved for several hrs

On rectal, spleen may be dispalced caudally andmedially (not specific)

On rectal, spleen may be displaced caudally and medially (not specific)

Endoscopy (not diagnostic for impaction and diffcult to assess gastric distnsion)

Endoscopy (not diagnostic for impaction and difficult to assess gastric distension)

Rads may help, will show diaphragm displaced crnaially

Rads may help, will show diaphragm displaced cranially

If suspected, horse should be tranferred with NGT in place to a faciltiy where surgery can be perfomed if necessary

If suspected, horse should be tranferred with NGT in place to a faciltiy where surgery can be perfomed if necessary

Medical tx can include gastric lavage to remove as much imcpated material as possible - may need to dne repeatedly

Medical tx can include gastric lavage to remove as much impacted material as possible - may need to be done repeatedly

100-200ml 8%DSS may facilittae hydration of dessicated ingesta

100-200ml 8%DSS may facilitate hydration of dessicated ingesta

IV fluid and anlagesics sould also be given, altogh unliukely that IV fluids will resovle the imapction

IV fluid and anlagesics should also be given, although unlikely that IV fluids will resolve the impaction

Gastric motility stimulants hsould be avpoided if the extent of the impaction is unkown to prvent gastrci rupture

Gastric motility stimulants should be avoided if the extent of the impaction is unkown to prevent gastric rupture

Those diagnosed at sx ay be treated iwth bethanoecol at 0.2mg/kg SC every 8hrs

Those diagnosed at sx may be treated with bethanecol at 0.2mg/kg SC every 8hrs

Direct infusion of balanced polyionic fluids into the i,maopction through the stomach wall

Direct infusion of balanced polyionic fluids into the impaction through the stomach wall

Stomach massaged to brea down oimapction and facilitate movement of lfuid into the ingesta

Stomach massaged to break down impaction and facilitate movement of fluid into the ingesta

Or fluid may be infused via NGT followed by massage of the sotmach

Or fluid may be infused via NGT followed by massage of the stomach

Post-op starve for 48-72hrs

Post-op starve for 48-72hrs

Gastrocpsy indicated to cofnrum resolution of impaction and identyo any undelryign cuases in stomach

Gastroscopy indicated to confirm resolution of impaction and identify any underlying causes in stomach

==References==

==References==

Mair, T.S, Divers, T.J, Ducharme, N.G (2002) '''Manual of Equine Gastroenterology''', ''WB Saunders''.

Mair, T.S, Divers, T.J, Ducharme, N.G (2002) '''Manual of Equine Gastroenterology''', ''WB Saunders''.