Small colon, rectum and anus

Question 1

What horses commonly get small collon impaction?

ie Foreign Bodies, Dry feed and Enteroliths

Answer 1

Miniature ponies.

Question 2

Clinical signs of small colon impaction.

Answer 2

No faeces

Low-grade chronic pain

Depressive, inappetant

+/- diarrhoea

Abdominal distension

Abnormal rectal

Peritonitis, secondary to ischemia

Question 3

What are the 4 grades of rectal tears?

Answer 3

1. Mucosa and submucosa
2. Mucosa, submucosa and muscular layer prolapse
3. All layers except serosa (subtype a) or mesentary (subtype b)
4. Full thickness tear.

Question 4

How is a small colon impaction treated?

Question 5

How is a rectal tear assessed acutely?

Answer 5

Blood on rectal glove.

1. Sedate horse: epidural, spasmolytic, +/- topical lignocain
2. Carefully evaluate tear (manually, endoscopically)

Question 6

How is a rectal prolapse managed?

Question 7

How is a rectal tear managed?

Answer 7

1. Carefully evacuate colon and pack defect (ALL grades of tear).

Cotton wall soaked in benedine; prevents ingesta filling defect.

2. Grades 1 & 2: Conservative management - immediately start ABxs

• BSAB’s
• flunixin
• Supportive care i.v. fluids
• Send to surgical hospital where it can be managed intensely.

Grades 3 & 4: Refer to surgical facilit

Question 8

What are the 4 types of surgical rectal tear repairs?

Answer 8

Caudal laporotomy - locate where the tear is.

1. In-dwelling rectal liner
2. Direct closure of the tear (primary closure)
3. Diverting colostomy
4. Laparoscopic repair

Question 9

What are the 3 grades of rectal prolapse?

Answer 9

1. Simple prolapse
2. Complex prolapse
3. Small colon intussusception