Abnormal Conditions of the Equine Large Intestine

R abdomen (coma shaped)

Where is the cecum located?

Water absorption and microbial digestion

What is the function of the cecum?

Base - most dorsal part

Body - 4 longitudinal bands

Apex - narrow blinded end directed cranially

What are the three parts of the cecum?

Cecal impactions (mild signs poor and rupture is possible)

What is the most common pathological condition of the cecum?

Poor dentition

feeding poor quality roughage

Parturition

Decrease water intake

Parasite induced thromboembolism

Sx/ hospitalization

What can cause a cecal impaction?

Laying down,

looking at flank,

Decreased appetite,

Depression

Borboygmi w/ decreased fecal production

What are signs of cecal impaction?

Rectal palpation revealing

-tentral on ventral cecal band

-Sacculations disappear and dissension

How is DX of cecal impaction confirmed?

Mechanical obstruction - firm dry and dough at the body or base - cecal wall not thickened and normal peritoneal fluid

What is type one cecal impaction?

Cecal disfunction - gass distension, painful, higher heart rate and poss endotoxic

What is type 2 cecal impaction?

Medicine

Sx - decompress

Type 1 cecal impaction can be tx w/ _____ but type 2 needs be tx w/ ____?

Could still rupture - no improvement aft 24-36hrs go to sx

What are risks of medical tx of cecal impactions?

R ventral colon

sternal flexure

L ventral colon

Pelvic flecture

L dorsal colon

Diaphragmatic flexure

R dorsal colon

From right to left name the structures of the colon?

Large colon tympany ( gas distension)

What is the most commonly reported colic in a horse?

Cribbing

More time stabled

Verminous

Lamness

Dental issues

Carb high diet

What are risk factors of large colon tympany?

Acute pain w/ abdominal distention

Rectal palpation - increased gas distention

How do you DX large colon tympany?

Withhold food

Analgesics (good prognosis)

How do you tx large colon tympany?

Mild to mod abdominal pain,

Decreased GI sounds

Decreased/ absent fecal production

Abdominal distension

Rare NG reflux

What will you see on PE of a large colon impaction?

Pelvic flexure

R dorsal colon

Transvers colon

In order what is the most common places to feel a large colon impaction?

Withhold fedd

Fluids

NSAIDS

Cathartics

What is the TX for Large Colon Impaction?

access to sand,

Insufficient roughage in diet

What are risk factors of sand impactions?

Ventral abdomen just caudal to typhoid

Where can sand be ascaltated?

Remove sand

Rehydrate

LAXITIVES

What is medical tx for Sand colic?

Pelvic flexure enterotomy

What are sx tx for sand colic?

Feed off ground,

Provide additional roughage

Psyllium

How do you prevent sand colic?

Large colon doesn't have mesenteric attachment to body wall,

pelvic flexure rhythmic is compromised

High carb diet results in gas distension

Why do large colon displacements occur?

Nonstrangulating - Left dorsal and ventral colons migrate to spleen in dorsal direction

What is a nephrosplenic entrapment/ left dorsal displacement?

US - gas occludes kidney

Rectal palpation

How do you dx nephrosplenic entrapment/ left dorsal displacement?

NPO

IV fluids

Phenylephrine

Rolling under Gen anesthesia

Trocharization then exercise the longe

How do you medically TX nephrosplenic entrapment/ left dorsal displacement?

Standing flank laparotomy

Ventral midline celiotomy

What are SX tx for nephrosplenic entrapment/ left dorsal displacement?

Retropulsive movement o pelvic lecture will push large colon between cecum and body wall.

What will you see in a R dorsal displacement?

Large colon volvulus - needs rapid referral and sx - Death in hrs w/out

What is one of the most painful and life threatening colics of the large colon?

The caudodorsal quadrant of the abdomen

Where we see the small colon reside?

Longitudinal teniae - contractile - form fecal balls

The anti mesenteric border will contain what in the small colon?

Enterolithiasis

What is the most common obstruction of the small colon?

Local necrosis

Not located in an exteriorizable part of the bowel

When would prognosis for an enterolith have a poor prognosis?

Life threatening - can be a malpractice claim - use lots of lube and sedation/ adequate restraint

Rectal tears are ___ injuries.

Dorsal aspect of rectum oriented parallel to longitudinal axis of rectum

Were will most rectal tears be located?

Reduce rectal activity

Gental fecal removal

Tx shock and peritonitis (Broad spec antibiotics and Flunixin meglumine)

Referral

What is tx for a rectal tear?

Diarrhea,

Dystocia

Intestinal parasites

Tumors

Colic

What are causes of rectal prolapse?

Females

Recal prolapse is more common in ___?

Purse string

Caudal epidermal

Mineral oil

What are tx for rectal prolapse?