Changes

The faecal output and character of the faeces should be assessed. Donkeys with large intestinal impactions may have little or no faecal output. Hyperlipaemic donkeys frequently have dry, mucus covered faecal balls and the dry rectal mucosa is more prone to tearing. Coprological examinations can be carried out as a possible indicator of problems. Faecal samples may also be cultured for organisms such as ''Salmonella''.

The faecal output and character of the faeces should be assessed. Donkeys with large intestinal impactions may have little or no faecal output. Hyperlipaemic donkeys frequently have dry, mucus covered faecal balls and the dry rectal mucosa is more prone to tearing. Coprological examinations can be carried out as a possible indicator of problems. Faecal samples may also be cultured for organisms such as ''Salmonella''.

Displacement or distension of the intestines should be assessed. The practitioner should try to decide if the distension is due to ingesta, fluid or gas. Even if it is not possible to palpate the abdomen thoroughly, abnormal structures may be palpable at the pelvic inlet. 53% of all impactions have been found to be pelvic flucture (Cox ''et al'', 2007).

Displacement or distension of the intestines should be assessed. The practitioner should try to decide if the distension is due to ingesta, fluid or gas. Even if it is not possible to palpate the abdomen thoroughly, abnormal structures may be palpable at the pelvic inlet. 53% of all impactions have been found to be at the pelvic flexure (Cox ''et al'', 2007).

<u>Normal structures</u> which may be palpable include the following, although this is not always the case:

<u>Normal structures</u> which may be palpable include the following, although this is not always the case:

When considering surgery in the geriatric donkey in the early stages of an abdominal crisis, additional factors have to be considered

When considering surgery in the geriatric donkey in the early stages of an abdominal crisis, additional factors have to be considered

before severe circulatory compromise has occurred. If there is severe dental disease present this may have been a contributing factor to the development of the impaction and may impair recovery post surgery, due the decreased ability to masticate long fibres. Dental disease may also increase the likelihood of the recurrence of any impaction. Concurrent conditions, such as liver disease, renal disease, pancreatitis, anaemia, immune responses to infection, or hypoalbuminaemia, will all heavily influence the decision to go to surgery. The presence of chronic [[Musculoskeletal Disorders - Donkey|musculo-skeletal conditions]] such as [[Laminitis - Donkey|laminitis]] and arthritis should also be considered, as medical or surgical treatment of the colic may exacerbate such conditions.

before severe circulatory compromise has occurred. If there is severe dental disease present this may have been a contributing factor to the development of the impaction and may impair recovery post surgery, due to the decreased ability to masticate long fibres. Dental disease may also increase the likelihood of the recurrence of any impaction. Concurrent conditions, such as liver disease, renal disease, pancreatitis, anaemia, immune responses to infection, or hypoalbuminaemia, will all heavily influence the decision to go to surgery. The presence of chronic [[Musculoskeletal Disorders - Donkey|musculo-skeletal conditions]] such as [[Laminitis - Donkey|laminitis]] and arthritis should also be considered, as medical or surgical treatment of the colic may exacerbate such conditions.

==Treatment==

==Treatment==

'''Correcting dehydration'''

'''Correcting dehydration'''

Rapid infusion of a '''balanced electrolyte solution''' via an intravenous catheter will restore circulating blood volume and improve tissue perfusion. It will also help to correct shock caused by the absorption of endotoxin through a compromised intestinal wall. Intravenous infusion of fluids is useful when rehydration via the oral route is inappropriate, ''i.e.'' when there is gastric reflux, ileus or an intestinal obstruction. If perfusion is very poor, '''hypertonic saline''' may help in the short term but must be

Rapid infusion of a '''balanced electrolyte solution''' via an intravenous catheter will restore circulating blood volume and improve tissue perfusion. It will also help to correct shock caused by the absorption of endotoxins through a compromised intestinal wall. Intravenous infusion of fluids is useful when rehydration via the oral route is inappropriate, ''i.e.'' when there is gastric reflux, ileus or an intestinal obstruction. If perfusion is very poor, '''hypertonic saline''' may help in the short term but must be

followed up quickly by large volumes of isotonic fluids.  

followed up quickly by large volumes of isotonic fluids.  

'''Feeding'''

'''Feeding'''

When a lesion requiring surgical corrrection has been diagnosed, feeding may be contra-indicated until post surgery. However, a source of nutrition is needed as soon as possible in order to '''maintain a positive energy balance''' and prevent the development of hyperlipaemia. Rectal findings should be monitored, and in horses with caecal or colon impactions it is believed that feed should only be given once the impaction is no longer palpable. However, H. Duffield's experience, if the impacted donkey wants to eat and there are normal borborygmi present and a good faecal output, then small amounts of high calorie feed with a high water content may be useful to prevent hyperlipaemia. Mineral oil or glucose powder may also be added to the feeds to avoid using a nasogastric tube.  

When a lesion requiring surgical corrrection has been diagnosed, feeding may be contra-indicated until post surgery. However, a source of nutrition is needed as soon as possible in order to '''maintain a positive energy balance''' and prevent the development of hyperlipaemia. Rectal findings should be monitored, and in horses with caecal or colon impactions it is believed that feed should only be given once the impaction is no longer palpable. However, in H. Duffield's experience, if the impacted donkey wants to eat and there are normal borborygmi present and a good faecal output, then small amounts of high calorie feed with a high water content may be useful to prevent hyperlipaemia. Mineral oil or glucose powder may also be added to the feeds to avoid using a nasogastric tube.  

Blood parameters need to be monitored closely, especially glucose levels which need checking every four hours'.

Blood parameters need to be monitored closely, especially glucose levels which need checking every four hours'.