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LAS > Rectal Tears in Horses > Flashcards

Rectal Tears in Horses Flashcards

1
Q

most rectal tears are ____ cm from anus

A

4-60 cm

<30 cm more common secondary to foaling

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2
Q

bypass techniques for rectal tears

A
  • temporary indwelling rectal liner via celiotomy (passes in feces in 9-12 days)
  • colostomy performed standing: double incision loop technique is GS
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3
Q

indications for bypass procedures for rectal tears (4)

A
  • prevents fecal impaction
  • prevents worsening
  • allow grade 3 to heal without direct repair
  • can protect sutures post direct repair
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4
Q

signalment for rectal tears

A
  • ARABIANS
  • miniature horses
  • males > females
  • fractious horses
  • horses with previous tears
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5
Q

rectal tears are most commonly in ____ aspect of rectum (unless secondary to foaling)

A

dorsal aspect

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6
Q

grade 2 rectal tears

A

ONLY muscularis (mucosa and submucosa intact and bulge out) -> diverticulum where feces can get trapped

Do NOT bleed -> often go unnoticed

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7
Q

this type of rectal tear can ONLY be treated via conservative management

A

Grade 2

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8
Q

do you need to mention the risk of rectal tear to clients?

A

NO

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9
Q

treatment for grade 2 rectal tears

A

NOT surgery

ONLY conservative

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10
Q

surgical treatment options for rectal tears

A
  • direct suture repair

- bypass procedures (temporary indwelling rectal liner vs. colostomy

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11
Q

_____ allows grade 3 to heal without direct repair

A

bypass procedures

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12
Q

main cause of rectal tears in horses

A

transrectal palpation (usually as wall contracts)

can also occur during foaling

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13
Q

survival rate for grade 4 rectal tears

A

6% survival; usually only those that happen secondary to foaling (therefore fixed immediately) survive

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14
Q

abdominocentesis with WBCs >_____ = peritonitis

A

50,000

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15
Q

ways to minimize risk for rectal tears in horses

A
  • lots of lube
  • clean feces out
  • relax arm when horse strains
  • busocpan (decreases rectal pressure by 70%)
  • lidocaine enemas (does NOT decrease rectal pressure)
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16
Q

which direction do you close rectal tears?

A

transversely

17
Q

conservative management is only used for which type of rectal tears

A
  • usually used for grade 1
  • ONLY treatment for grade 2
  • can be used for grade 3 BUT surgery is GS
18
Q

in this type of rectal tear, rectal material is contained within the mesocolon

A

3b: occurs be 11’clock and 1’clock -> rectal material is contained within the mesocolon

involves all layers except serosa

19
Q

______ drug decreases rectal pressure by 70%

A

buscopan

20
Q

grade 1 rectal tears

A

ONLY mucosa and submucosa

bleeds

21
Q

only type of rectal tear that does NOT bleed

A

grade 2

22
Q

treatment for grade 4 rectal tears

A

ONLY surgery

6% survival; usually only those that happen secondary to foaling (therefore fixed immediately) survive

23
Q

true or false: do not commit to covering referral cost for rectal tears

A

true

24
Q

GS technique used for colostomy

A

double incision loop technique

25
Q

what size should your bites be for rectal tear repair

A

<1.5 cm

26
Q

first aid measures for rectal tears (8)

A
  • NEVER wait and see = negligence
  • stop horse from straining: xylazine and lidocaine epidural C1-C2
  • assess severity
  • antibiotics
  • NSAIDs
  • fluids
  • rectal tampon
  • REFER ALWAYS
27
Q

chronic fecal impactions are sometimes seen secondary to this type of rectal tear

A

grade 2

28
Q

this rectal tear ONLY involves the muscularis (mucosa and submucosa intact and bulge out) -> diverticulum where feces can get trapped

Do NOT bleed -> often go unnoticed

A

grade 2

29
Q

conservative management for rectal tears entails….

A
  • antibiotics, NSAIDs, fluids
  • laxatives (oral fluids + MgSO4/epsom salt) + low bulk diet (pellets, mash)
  • daily removal of feces from rectum q1-2 hours for 5 days then q6 hours until healed

**mineral oil is NOT a laxative

30
Q

grade 4 rectal tear

A

full thickness

can lead to herniation of viscera

31
Q

treatment for grade 1 rectal tears

A

-conservative: survival 90%

can do surgery if want faster healing

32
Q

treatment for grade 3 rectal tears

A

surgery is G.S.

conservative management can be used (40-70% survival; must prevent conversion to grade 4)

33
Q

grade 3 rectal tear

A

ALL layers EXCEPT serosa

bleeds

3a: occurs anywhere EXCEPT from 11 ‘clock to 1 ‘clock
3b: occurs be 11’clock and 1’clock -> rectal material is contained within the mesocolon

34
Q

approaches used for direct suture repair of rectal tears

A
  • speculum and long handled instruments
  • non-visual
  • prolapse through anus (common for tears secondary to foaling)
  • laparoscope with hand assistance in rectum
  • ventral midline celiotomy for Grade 4 with evisceration (so you can assess blood supply)

LAS (51 decks)

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