8/26 - Obstruction vs Strangulation

Obstruction

What SI problem will occur due to mechanical obstruction, when luminal obstructions impede the flow of digesta? There will be bowel dilation, simple ones will leave blood supply intact, and they are non-strangulating. There will be mild-moderate pain, good response to analgesia, minimal CV compromise, normal peritoneal fluid, and occasional gastric reflux.

Strangulation

What SI problem will be a mechanical obstruction, include compromise of both lumen and blood supply, and devitalized bowel, with endotoxemia, hemoconcentration, and dehydration? There will be moderate-severe pain, brief or no response to analgesia, CV deterioration, abnormal peritoneal fluid, and gastric reflux. This is a surgical emergency.

Obstruction

Will ascarid impaction, ileal impaction, and ileal hypertrophy cause obstruction or strangulation?

Strangulation

Will intussusception, SI volvulus, pedunculated lipomas, and abdominal incarcerations cause obstruction or strangulation?

P. equorum

What ascarid worm (first initial and species name) causes ascarid impactions and is also called the equine roundworm? It is an older foal and weanling disease, with immunity developing by 18-24 months. They will have a poor deworming history. Clinical signs include ill thrift, colic/depression, increased heart rate, increased respiratory rate, and fever. Diagnostics include history, FEC, gastric reflux with worms, and ultrasound of the abdomen. Treatment is via initial gastric decompression, anti-inflammatories, and usually surgery due to damage to the SI wall. Prognosis is poor with 10% long term survival due to adhesion formation.

Fenbendazole

In addition to proper protocol and pasture rotation, what benzimidazole drug is the appropriate choice to prevent ascarid impactions? If a large burden is suspected you can use a non-paralytic anthelcide, give mineral oil first through nasogastric tube to promote expulsion. FECRT should ideally be done first at 4-6 months of age.

2, 5

At which two months of age should foals be treated for ascarids? Fenbendazole or pyrantel pamoate can be used. At the second treatment, you should do the first FEC. You can treat strongyles with a ML at 6-9 months of age and praziquantel for tapeworms.

Ileal

What type of impaction (location) is most common in the southern US in June-November and is associated with coastal bermuda grass? It will present with colic, spasm of this area around the impaction, distention of the proximal SI, palpation of distention and/or impaction on rectal exam, and possible gastric reflux on NG intubation.

Yes

Can medical treatment using fluids, anti-inflammatories, oral laxatives, or gastric decompression (later) be used to treat acute ileal impaction?

No

Is enterotomy commonly needed for ileal impaction treatment? Manual massage is done to break it down.

Good

What is the prognosis for ileal impaction if it is treated medically? Post-operative ileus can occur. Prevention is by avoiding coastal bermuda grass, avoiding course fibrous feeds, and deworming for tapeworms.

Small

Ascarid impactions, ileum impaction/hypertrophy, IBD, adhesions, bastard strangles, and alimentary lymphoma can all be differentials for intestinal obstructions in which intestines?