Changes

==Diagnosis==

==Diagnosis==

Suspected if cannot pass NGT, with gastric distension the gastoroesophageal junction can become distorted making it difficult to pass an NGT.  If poorly macerated or digested feed material is recovered from the NGT when the horse has been starved for several hrs.   

*Gastric impaction is suspected if a '''nasogastric tube''' cannot be passed or if poorly macerated or digested feed material is recovered from the tube when the horse has been starved for several hours.  With gastric distension, the gastoroesophageal junction can become distorted making it difficult to pass the tube.(Mair)

On rectal, spleen may be displaced caudally and medially (not specific)(Mair)

*On '''rectal examination''', the spleen may be displaced caudally and medially (but this is not specific for gastric impaction).(Mair)

Endoscopy (not diagnostic for impaction and difficult to assess gastric distension) would be indicated in a chronic case(Mair, Blisk)

*'''Endoscopy''' would be indicated in a chronic case(Mair, Blisk) and may show a full stomach after a fast of 18-24hrs.(Sanchez)  However it is not diagnostic for impaction as it is difficult to assess gastric distension by endoscopy.(MAir)

Rads may help, will show diaphragm displaced cranially(Mair)

*In a small horse or pony, a lateral '''radiograph''' of the cranial abdomen may show the diaphragm displaced cranially(Mair)

*'''Ultrasonography''' may reveal a markedly enlarged gastric echo extending over six or more intercostal spaces on the left side of the abdomen.  A marked increase in the thickness of the wall of the stomach may also be imaged. (Edwards)

However, the diagnosis of stomach impaction is usually made at surgery on horses that have had uncontrollable colic or poor response to medicaltherapy.  (Bliks)

'''However, if the horse suffers from acute severe colic, a diagnosis is often made at surgery'''.

 

 

If the horse sufferes from acute severe colic, a diagnosis os often made during exploratory celiotomoy.  If signs do not warrant surgical intervnetion, endocosocpy showing a full stomahc after a norally adeqaute fast of 18-24hrs can often confirm the diagnosis.  Abdominal rads are resrved for smaller horses and ponies.

==Treatment==

==Treatment==