Difference between revisions of "Rectal Tear - Horse"
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| − | Rectal tears are classified according to the layers of the bowel wall | + | [[Category:To Do - SophieIgnarski]] |
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| + | ==Description== | ||
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| + | Rectal tears are serious injuries in the horse, most commonly occurring as a result of rectal examination by veterinarians. Other less common causes include dystocia, ruptured haematomas, spinal fractures, strictures and thromboembolism. Rectal tears may occur in horses of all ages although nervous or young horses are more often affected. Arabaians and small horses are also more prone to developing tears. | ||
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| + | Rectal tears are classified according to the layers of the bowel wall. | ||
* Grade 1) Involves the mucosa only. | * Grade 1) Involves the mucosa only. | ||
| − | * Grade 2) Mucosal and submucosal tears | + | * Grade 2) Mucosal and submucosal tears |
| − | * Grade 3) Tears involving the muscularis. Only the serosa is intact | + | * Grade 3) Tears involving the muscularis. Only the serosa is intact |
| − | * Grade 4) Complete tear with leakage of faecal material into the abdomen | + | * Grade 4) Complete tear with leakage of faecal material into the abdomen |
==Clinical signs== | ==Clinical signs== | ||
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==Diagnosis== | ==Diagnosis== | ||
| − | If a rectal tear is suspected, it is important to establish its extent as this dictates the treatment required and the prognosis for recovery. The horse should be sedated before further examination is carried out and an epidural should be performed in order to prevent straining | + | If a rectal tear is suspected, it is important to establish its extent as this dictates the treatment required and the prognosis for recovery. The horse should be sedated before further examination is carried out and an epidural should be performed in order to prevent straining. |
==Treatment== | ==Treatment== | ||
| − | Grade 1 and 2 tears are best managed conservatively with a combination of non-steroidal anti-inflammatory drugs, broad-spectrum antibiotics and laxatives such as mineral oil. A moist diet such as bran mash or grass should be provided in order to aid defecation. The horse should be closely monitored for signs of colic, haematochezia, dyschezia, pyrexia and tenesmus. Repeated rectal examination should be avoided unless unavoidable. Tears less that two to three centimetres in length usually heal without causing further problems and rarely require | + | Grade 1 and 2 tears are best managed conservatively with a combination of non-steroidal anti-inflammatory drugs, broad-spectrum antibiotics and laxatives such as mineral oil. A moist diet such as bran mash or grass should be provided in order to aid defecation. The horse should be closely monitored for signs of colic, haematochezia, dyschezia, pyrexia and tenesmus. Repeated rectal examination should be avoided unless unavoidable. Tears less that two to three centimetres in length usually heal without causing further problems and rarely require treatmemnt. |
| − | Grade 3 and 4 tears are acute, life-threatening emergencies and should be referred to a surgical facility. Before transportation it is essential that appropriate emergency care is provided and measures are | + | Grade 3 and 4 tears are acute, life-threatening emergencies and should be referred to a surgical facility. Before transportation it is essential that appropriate emergency care is provided and measures are performed to prevent faecal contamination. The rectum should be packed with an antiseptic tampon; a length of stocking filled with betadine-soaked cotton has been recommended for this. A purse-string suture should be placed in the rectum to prevent expulsion of the tampon. Broad-spectrum antibiotics, flunixin meglumine and appropriate tetanus prophylaxis should also be administered. |
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==Prognosis== | ==Prognosis== | ||
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==References== | ==References== | ||
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* Knottenbelt, D. C., Pascoe, R. R. (2003) '''Diseases and Disorders of the Horse''' ''Elsevier Health Sciences'' | * Knottenbelt, D. C., Pascoe, R. R. (2003) '''Diseases and Disorders of the Horse''' ''Elsevier Health Sciences'' | ||
* Robinson, N. E., Sprayberry, K. A. (2009) '''Current Therapy in Equine Medicine''' ''Elsevier Health Sciences'' | * Robinson, N. E., Sprayberry, K. A. (2009) '''Current Therapy in Equine Medicine''' ''Elsevier Health Sciences'' | ||
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Revision as of 14:28, 14 August 2010
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This article is still under construction. |
Description
Rectal tears are serious injuries in the horse, most commonly occurring as a result of rectal examination by veterinarians. Other less common causes include dystocia, ruptured haematomas, spinal fractures, strictures and thromboembolism. Rectal tears may occur in horses of all ages although nervous or young horses are more often affected. Arabaians and small horses are also more prone to developing tears.
Rectal tears are classified according to the layers of the bowel wall.
- Grade 1) Involves the mucosa only.
- Grade 2) Mucosal and submucosal tears
- Grade 3) Tears involving the muscularis. Only the serosa is intact
- Grade 4) Complete tear with leakage of faecal material into the abdomen
Clinical signs
Many rectal tears occur unknown to the examiner. The first indication that a tear has occurred may be the presence of fresh blood on the rectal sleeve following rectal examination. The veterinarian may be aware of a sudden release in pressure or increase in space when performing rectal examination. If the tear is complete, abdominal viscera may be easily palpable. Other clinical signs indicative of a rectal tear may include passage of haemorrhagic faeces, straining to defecate and signs of colic.
Diagnosis
If a rectal tear is suspected, it is important to establish its extent as this dictates the treatment required and the prognosis for recovery. The horse should be sedated before further examination is carried out and an epidural should be performed in order to prevent straining.
Treatment
Grade 1 and 2 tears are best managed conservatively with a combination of non-steroidal anti-inflammatory drugs, broad-spectrum antibiotics and laxatives such as mineral oil. A moist diet such as bran mash or grass should be provided in order to aid defecation. The horse should be closely monitored for signs of colic, haematochezia, dyschezia, pyrexia and tenesmus. Repeated rectal examination should be avoided unless unavoidable. Tears less that two to three centimetres in length usually heal without causing further problems and rarely require treatmemnt.
Grade 3 and 4 tears are acute, life-threatening emergencies and should be referred to a surgical facility. Before transportation it is essential that appropriate emergency care is provided and measures are performed to prevent faecal contamination. The rectum should be packed with an antiseptic tampon; a length of stocking filled with betadine-soaked cotton has been recommended for this. A purse-string suture should be placed in the rectum to prevent expulsion of the tampon. Broad-spectrum antibiotics, flunixin meglumine and appropriate tetanus prophylaxis should also be administered.
Prognosis
References
- England, G. C. W. (2005) Fertility and Obsetrics in the Horse Wiley-Blackwell'
- Knottenbelt, D. C., Pascoe, R. R. (2003) Diseases and Disorders of the Horse Elsevier Health Sciences
- Robinson, N. E., Sprayberry, K. A. (2009) Current Therapy in Equine Medicine Elsevier Health Sciences