1,406
edits
Changes
Created page with " {{unfinished}} {| cellpadding="10" cellspacing="0" border="1" | Also known as: |'''Meconium Retention<br> '''Colic in foals<br> '''Impaction<br> '''Simple Obstruction<br> '''..."
{{unfinished}}
{| cellpadding="10" cellspacing="0" border="1"
| Also known as:
|'''Meconium Retention<br>
'''Colic in foals<br>
'''Impaction<br>
'''Simple Obstruction<br>
'''Large Intestinal Simple Obstruction<br>
'''Small Colon Impaction<br>
'''Descending Colon Impaction'''
|}
==Description==
Meconium impaction or retention is the most common cause of colic in the first 24 hours of life.
==Signalment==
Newborn foals. More common in colts than fillies, particularly if they are overdue. This may be related to a narrower pelvic inlet.
==Aetiology==
Meconium is composed of glandular secretions, swallowed amniotic fluid and cellular debris. It is dark brown to black and cement- or pellet-like in texture. Most foals defaecate shortly after their first meal, within 24 hours of birth. Once meconium has been passed, the faeces become a dark yellow, reflecting milk digestion. Meconium retention may result from a lack of colostrum ingestion, since colostrum is a natural laxative. Thus foals with meconium retention should also be checked for failure of passive transfer (FPT). Intestinal dysmotility may also be an indication of perinatal asphyxia.
==Clinical Signs==
*Colic (due to gas accumulation within the bowel)
*Continuous straining
*Classic 'arched back' stance
*Foal depressed or remains bright
*Normal or reduced level of suckling
*Tail swishing and elevation
*Restlessness
==Diagnosis==
*'''CAREFUL''' digital examination ''per rectum'' (for diagnosis only)
*Abdominal palpation (meconium may be palpable if abdominal tympany is not too advanced)
*Abdominal ultrasound
*Abdominal radiography
==Differential Diagnoses==
*'''Uroperitoneum''': the foal may assume a more extended stance (NB: a ruptured bladder may occur simultaneously with meconium retention)
*[[Gastric Ulceration - Horse|Gastrodudodenal ulceration]]
*Impending enteritis
*Obstructive gastrointestinal lesions
**Small intestinal intussusception
**Torsion
**[[Atresia|''Atresia coli'']]
==Treatment==
*'''Enema:''' warm soapy water made with a mild soap that can be administered through soft rubber tubing by gravity.
*'''Liquid praffin:''' 300ml by nasogastric tube for foals that do not respond rapidly to an enema
*'''Muzzling and maintenance rate fluids IV:''' for persistent meconium retention resulting in significant abdominal distension. A constant rate infusion of 5-10% dextrose will provide some calories in addition to the free water needs. Dextrose should NOT be given as a bolus.
*'''Retention enema:''' a more aggressive treatment may be required using acetylcysteine which is an irritant and increases secretion. 20g baking soda and 8g acetylcysteine are added to 200ml water to create a 4% acetylcysteine solution of pH7.6. A 30-french Foley catheter is inserted 2.5 to 5cm into the rectum and the bulb slowly inflated to occlude the rectum. 100-200ml of the solution is adminstered under gravity and retained for 30-45mins by occluding the catheter.<ref>Pusterla, N, Magdesian, K, Maleski, K, ''et al.'' (2004) Retrospective evaluation of the use of acetylcysteine enemas in the treatment of meconium retention in foals: 44 cases (1987-2002). ''Equine Vet J'', (6):170-174. In: Wilkins, P.A (2010) 'Diseases Of The Gastrointestinal Tract' in Reed, S.M, Bayly, W.M. and Sellon, D.C (2010) '''Equine Internal Medicine''' (Third Edition), Saunders, Chapter 21.</ref>
*'''Surgery:''' may be required for extreme cases
*'''Analgesia:''' may be needed for some foals. NSAIDs have deleterious effects on renal function and gastric mucosal blood flow, so they should be avoided if possible. '''Butorphanol''' given IM at 0.05 to 0.1mg/kg<ref>Arguedas, M.G, Hines, M.T, Papich, M.G ''et al.'' (2008) Pharmacokinetics of butorphanol and evaluation of physiologic and behavioural effects after intravenous and intramuscular administration to neonatal foals. ''J Vet Intern Med'', 22(6):1417-1426. In: Wilkins, P.A (2010) 'Diseases Of The Gastrointestinal Tract' in Reed, S.M, Bayly, W.M. and Sellon, D.C (2010) '''Equine Internal Medicine''' (Third Edition), Saunders, Chapter 21.</ref> may help to prevent straining. '''Hyoscine''' (Buscopan-Boehringer) may alleviate the colic.
*'''Intranasal oxygen:''' is useful for foals with significant abdominal distension.<ref>Wilkins, P.A (2004) Respiratory distress in foals with uroperitoneum: possible mechanisms. ''Equine Vet Educ'', 16(6):293-295. In: Wilkins, P.A (2010) 'Diseases Of The Gastrointestinal Tract' in Reed, S.M, Bayly, W.M. and Sellon, D.C (2010) '''Equine Internal Medicine''' (Third Edition), Saunders, Chapter 21.</ref>
==Prognosis==
Most cases resolve with medical management within 12-24hrs.
==Complications==
Foals with meconium retention may be at risk of sepsis because bacterial translocation may occur across the disrupted intestinal mucosa. Blood cultures are thus advisable and foals should be monitored closely for clinical signs of sepsis. Continuous straining may lead to patent urachus.
==References==
Wilkins, P.A (2010) 'Diseases Of The Gastrointestinal Tract' in Reed, S.M, Bayly, W.M. and Sellon, D.C (2010) '''Equine Internal Medicine''' (Third Edition), Saunders, Chapter 21.
<references/>
[[Category:Medical_Colic_in_the_Horse]]
[[Category:To_Do_-_Nina]]
[[Category:To_Do_-_Review]]
[[Category:Intestine_-_Mechanical_Obstruction]]