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*'''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.   
 
*'''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>
 
*'''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>
The preferred method of treatment
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consists of administration of multiple enemas, such as
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commercial phosphate enemas, soapy-water enemas, mineral
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oil, liquid paraffin and other home remedies. Additional
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proposed medical therapy includes pain control, administration
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of i.v. fluids and nasogastric administration of mineral oil and
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hydroxid solutions (Hanson 1999). Meconium retention that isrefractory to medical therapy requires surgical intervention.
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Based on the risk of developing post surgical complications,
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several treatment options have been developed in recent years
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that have reduced the number of foals requiring surgery. One
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of these options is the use of acetylcysteine retention
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enemas, which have been used successfully in human infants
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with meconium plug syndrome (Meeker and Kincannon 1964).
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Acetylcysteine use in foals has been described (Madigan and
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Goetzman 1990), but the evaluation of the outcome of
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treatment in a large group of foals has not been reported. The
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objectives of this study were to describe the clinical
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manifestations of meconium impaction in 44 foals and
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assess the therapeutic outcome of acetylcysteine
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retention enemas.(Pusterla)
      
==Prognosis==
 
==Prognosis==
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