Changes

==Treatment==

==Treatment==

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

If gastric impaction is suspected, the horse should be trasnported with a nasogastric tube in place to a clinic with surgical facilities.(Mair)  '''Medical treatment''' might include gastric lavage with water(BLiks) to remove as much impacted ingesta as possible, which may take several attempts.  100-200ml of an 8% solution of '''dioctyl sodium sulfosuccinate (DSS)''' may help to hydrate the dessicated material.  IV fluid therapy and analgesia should be commenced, although IV fluids are unlikely to resolve the impaction.(Mair)  Owing to the risk of gastric rupture, gastric motility stimulants shold be avoided if the extent of the impaction is undetermined.(Mair)  At surgery the following should be performed:

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

*Infusion of balanced polyionic fluids such as saline(Bliks) either directly into the impaction through the gastric wall (adjacent to the greater curvature) or via a nasogastric tube

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

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

*Impactions diagnosed at surgery may benefit from bethanechol at 0.2mg/kg SC every 8 hours to stimulate gastric motility.(Mair)

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

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

*Gastroscopy is indicated to confirm resolution of the impaction and to identify any underlying causes in stomach.(mair)

Medical treatment includes nasogastric intubation, and frequent attempts at softening the ingesta with water, followed by refluxing the fluid contents. (BLiks)

feltextending back to midway between the xiphisternum and the umbilicus and istherefore readily accessible via a midline

celiotomy.As much as 30 - 40 kg have been removed via a gastrotomy but postoperativelynormal gastric motility was not

In dorsal recumbency, the impacted stomach can be felt extending back to midway between the xiphisternum and the umbilicus and is therefore readily accessible via a midline celiotomy. As much as 30 - 40 kg have been removed via a gastrotomy but postoperatively normal gastric motility was not restored and impaction recurred (Edwards 1997). Reduction of stomach volume by partial resection of its flaccid wall was

restoredand impaction recurred (Edwards 1997). Reduction of stomach volume by partialresection of its flaccid wall was

similarly unsuccessful (Huskamp et al 2000). (Edwards)

similarlyunsuccessful (Huskamp et al 2000). At post mortem examination there is markedtransmural hypertrophy of the

Themost recently ingested food passes directly from the cardia to the pylorus. (Edwards)

 

In addition to analgesia, gastrric lavage via NGT or massage and injection of fluid to soften the impaction during laparotomy (151-3 in Sanchez)

==References==

==References==