Difference between revisions of "Caecal Impaction - Horse"

Revision as of 15:38, 10 August 2010

Description

Caecal impaction in horses occurs in two forms. In primary impactions the caecum contains dry, relatively solid ingesta which may be localised to the crainial part of the caecal base, or extend to fill the whole visera. The onset of clinical signs is 5-7 days and the associated signs are of low grade intermittent colic.

Secondary impactions are a result of caecal dysfunction, the caecal content is fluid and the vicera is distended and imotile. This syndrome usually occurs in the post-operative period and early signs may be missed, being attributed to discomfort following surgery or the concurrent condition. The

Signalment

Hospitalised horses are at greater risk, especially those with musculoskeletl conditions, often due to the reduction in activity and treatment with non-steroidal anti-inflammatory drugs.

Diagnosis

Clinical signs

Mild to moderate intermmitant colic signs
Marginal increase in heart rate
Reduced gut sounds

Diagnosis can be made on rectal examintion, the caecum is firmer and filled with ingesta and can be indented digitally. The caecal mass will be palpated in the right paralumbar area, identified by the taut ventral caecal band and the fat and blood vessels overlying the medial caecal band.

In most cases the impaction is not sufficiently severe or prolonged to cause cardiovascular compromise or changes in peritoneal fluid, but if the case is chronic or progresses to rupture then the condition is serious and the horse should be closely monitored for worsening clinical signs.

See Colic Diagnosis in Horses

Treatment

Medical Treatment of Colic in Horses

Prognosis

References

Blood, D.C. and Studdert, V. P. (1999) Saunders Comprehensive Veterinary Dictionary (2nd Edition) Elsevier Science
Edward Robinson, N and Sprayberry, K. A. (2009) Current Therapy In Equine Medicine Sixth edition Saunders Elsevier
Merck & Co (2008) The Merck Veterinary Manual (Eighth Edition) Merial
White, N.A., Edwards, G.B. (1999) Handbook of Equine Colic Reed Educational and Professional Publishing Ltd

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-{{OpenPagesTop}}
 ==Description==
-'''Caecal impaction''' in horses occurs in two forms. In '''primary impactions''' the caecum contains dry, relatively solid ingesta which may be localised to the cranial part of the caecal base, or extend to fill the whole viscera. The onset of [[Colic Diagnosis - Clinical Signs|clinical signs]] is typically 5-7 days and the associated signs are of low grade intermittent colic.
+'''Caecal impaction''' in horses occurs in two forms. In '''primary impactions''' the caecum contains dry, relatively solid ingesta which may be localised to the crainial part of the caecal base, or extend to fill the whole visera. The onset of clinical signs is 5-7 days and the associated signs are of low grade intermittent colic.
-'''Secondary impactions''' are a result of caecal dysfunction; the caecal content is fluid and the viscera is distended and immotile. This syndrome usually occurs in the post-operative period and early signs may be missed, being attributed to discomfort following surgery or the concurrent condition. The delayed diagnosis results in a serious situation where the caecum can become so distended that rupture is imminent.
+'''Secondary impactions''' are a result of caecal dysfunction, the caecal content is fluid and the vicera is distended and imotile. This syndrome usually occurs in the post-operative period and early signs may be missed, being attributed to discomfort following surgery or the concurrent condition. The
 ==Signalment==
-Hospitalised horses are at greater risk, especially those with musculoskeletal conditions, often due to inadequate analgesia, the reduction in activity and treatment with non-steroidal anti-inflammatory drugs.
+Hospitalised horses are at greater risk, especially those with musculoskeletl conditions, often due to the reduction in activity and treatment with non-steroidal anti-inflammatory drugs.
 ==Diagnosis==
 ===Clinical signs===
-* Mild to moderate intermmitent colic signs
+* Mild to moderate intermmitant colic signs
 * Marginal increase in heart rate
 * Reduced gut sounds
-* Dehydration
-Diagnosis can be made on [[Rectal Examination of the Horse|rectal examination]]; the caecum is firmer and filled with ingesta and can be indented digitally. The caecal mass will be palpated in the right paralumbar area, identified by the taut ventral caecal band and the fat and blood vessels overlying the medial caecal band.
+Diagnosis can be made on rectal examintion, the caecum is firmer and filled with ingesta and can be indented digitally. The caecal mass will be palpated in the right paralumbar area, identified by the taut ventral caecal band and the fat and blood vessels overlying the medial caecal band.
-[[Dehydration]] develops as the impaction becomes established; in most cases the impaction is not sufficiently severe or prolonged to cause cardiovascular compromise or changes in peritoneal fluid, but if the case is chronic or progresses to rupture then the condition is serious and the horse should be closely monitored for worsening clinical signs. There will be an increase in the protein content of peritoneal fluid as well as cardiovascular signs of shock as the caecum becomes grossly distended, ischemia of the viscera occurs and toxaemia develops as the caecum eventually ruptures.
+In most cases the impaction is not sufficiently severe or prolonged to cause cardiovascular compromise or changes in peritoneal fluid, but if the case is chronic or progresses to rupture then the condition is serious and the horse should be closely monitored for worsening clinical signs.
-See '''[[:Category:Colic Diagnosis in the Horse|Colic Diagnosis in Horses]]'''
+See <big>'''[[:Category:Colic Diagnosis in the Horse|Colic Diagnosis in Horses]]
 ==Treatment==
-Treatment depends on the severity and cause of the impaction. Mild impactions which are diagnosed early can be treated effectively with IV fluid therapy, oral fluid therapy with added magnesium sulphate by stomach tube and flunixin meglumate as analgesia. Food should be withheld and the horse should be monitored very closely to avoid the caecal distension progressing. Impactions which do not improve should be referred for surgical management.
+'''[[Colic, Medical Treatment|Medical Treatment of Colic in Horses]]'''</big>
-Caecal impactions can be corrected under general [[Equine Anaesthesia|anaesthesia]] by laparotomy. The caecum is decompressed and the ingesta is removed. In cases where the emptying function of the caecum has been lost, a by-pass surgery must be performed.
-The risk of secondary impactions developing post-operatively can be minimised by administering adequate analgesia and close monitoring of the patient. Feed intake, faecal output and gut sounds should be recorded while the patient is hospitalised, if they become reduced then rectal palpation is indicated to make an early diagnosis.
-See '''[[Colic, Medical Treatment|Medical Treatment of Colic in Horses]]'''
 ==Prognosis==
-The prognosis for horses with caecal impactions is guarded due to the number that progress to fatal rupture.
-{{Learning
-|literature search = [http://www.cabdirect.org/search.html?q=%28%28%28caecum%29+AND+%28obstruction%29+AND+od%3A%28horses%29%29%29+OR+%28%28%28%22caecal+impaction%22%29+AND+od%3A%28horses%29%29%29 Caecal Impaction in Horses]<br><br>
-}}
 ==References==
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 * Merck & Co (2008) '''The Merck Veterinary Manual (Eighth Edition)''' ''Merial''
 * White, N.A., Edwards, G.B. (1999) '''Handbook of Equine Colic''' ''Reed Educational and Professional Publishing Ltd''
-{{review}}
-{{OpenPages}}
 [[Category:Surgical Colic in the Horse]]
-[[Category:Medical Colic in the Horse]]
+[[Category:To_Do_-_lizzyk]]
-[[Category:Expert_Review]]
-[[Category:Impaction - Horse]]
-[[Category:Colic - Caecum Causes]]