Ponies, miniatures, and younger equids are at higher risk of fecalith obstruction compared to a general colic population.

OBJECTIVE: To determine breed, age, and sex predispositions for fecalith obstruction and to evaluate short-term survival and prognostic factors following surgical treatment of fecalith intestinal obstruction in equids. ANIMALS: 151 equids. METHODS: Medical records of equids undergoing surgery for fecalith obstruction from 2000 to 2020 were reviewed. Signalment, history, presenting clinicopathological data, surgical findings, complications, and short-term survival were recorded and compared between survivors and nonsurvivors. Signalment of the fecalith population was compared to a contemporaneous colic population. Clinical factors were assessed for association with outcome. RESULTS: 64 females, 53 castrated males, and 31 intact males were included. Three equids presented twice. Miniature horses, ponies, and miniature donkeys/mules represented 48% (71/148) of fecalith population and full-sized breeds represented 52% (77/148). Miniature horses and ponies were overrepresented and equids ≤ 1 year of age were overrepresented in the fecalith population compared to the colic population. One hundred thirty-nine equids (92%) survived to discharge, 6% (9/148) were euthanized intraoperatively, and 2% (3/148) were euthanized during hospitalization. Nonsurvivors showed more severe colic signs on admission, tachycardia on admission, and hyperlipemia. Equids with postoperative colic (P = .01) and complications (P = .002) were less likely to survive. CLINICAL RELEVANCE: Miniature horses and ponies were overrepresented compared to the colic population; however, full-sized breeds were also affected. Surgical treatment had an excellent short-term prognosis. Severe colic signs, tachycardia, hyperlipemia, postoperative colic, and surgical complications negatively affected short-term survival.

Acupuncture for Anaemia and Large Intestine Impaction Associated with Hind Limb Weakness in a Horse: A Case Report.

A 24-year-old horse was presented with a clinical history of anaemia, large intestine impaction and hind limb weakness. Loss of body weight was also reported. Hematocrit and hemoglobin levels were low and piroplasmosis test was negative. Nasogastric intubation with laxative agents was performed and 50 ml of a red blood-cell-supplement was given daily during a month. An assessment following Traditional Chinese Veterinary Medicine (TCVM) principles was performed after the last episode of large intestine impaction. A swollen, pale and wet tongue was observed. A superficial, weak pulse combined punctually with a slippery pulse was detected on the right side. The pulse on the left side was very thin. BL18, BL20 and BL23 were the most sensitive acupoints on the right side. BL18 and BL23 were the most sensitive on the left. TCVM diagnosis was Qi/Yang Kidney Deficiency, Spleen Qi Deficiency with Stagnation and Blood Deficiency. It received acupuncture at Bai-Hui, KI3, KI7, KI10, BL23, GB39, ST36, BL17 and acupressure at SP10. The client reported a significant improvement after treatment and hematocrit and hemoglobin levels were normal. KI3, ST36, BL39 acupoints were treated 14 days later. The outcome was favourable and one acupuncture session per month was recommended. No previous case reports in equines have been documented with a combination of blood, gastrointestinal and musculoskeletal problems in the same episode. This case is an example of an integrative approach to investigate the origin and the interdependent relation between body systems.

Effects of magnesium sulfate and dioctyl sodium sulfosuccinate on fecal hydration, output and systemic hydration in healthy horses / [Efeitos do sulfato de magnésio e do dioctil-sulfossuccinato de sódio na hidratação e eliminação fecal e sobre a hidratação sistêmica de cavalos saudáveis]

Magnesium sulphate (MS) and dioctyl sodium sulphosuccinate (DSS) are laxative drugs frequently used for the treatment of impactions. The aim of this study was to compare the effects of MS and DSS in fecal hydration, output and systemic hydration in healthy horses. Five healthy horses received 3 treatments with a 21-day interval. Treatment 1 was performed with administration of 4 liters of warm water; treatment 2: administration of 4 liters of warm water associated with 1g/kg of MS; and treatment 3: administration of 4 liters of warm water associated with 20mg/kg DSS. General and specific physical examination of the digestive system were performed, alongside with packed cell volume and total plasma protein measurement, abdominal ultrasonography and quantification of the amount and hydration of feces, before and 6, 12, 24, 36 and 48 hours after the treatments. No adverse effects were observed. The administration of laxatives promoted greater fecal output and hydration without resulting in systemic dehydration, yet no differences were observed between treatments. The absence of adverse effects of DSS demonstrates the safety of its use as a laxative drug at a dose of 20mg/kg. Studies comparing the effects of the laxative drugs in horses with large colon impaction are needed.(AU)

O sulfato de magnésio (SM) e o dioctil-sulfossuccinato de sódio (DSS) são drogas laxativas frequentemente utilizadas no tratamento da compactação. O objetivo deste estudo foi comparar os efeitos do SM e do DSS na hidratação e eliminação fecal, e na hidratação sistêmica de cavalos saudáveis. Cinco cavalos receberam três tratamentos, com intervalo de 21 dias. O tratamento 1 consistiu na administração de quatro litros de água morna; o tratamento 2: administração de quatro litros de água morna associada a 1g/kg de SM; e o tratamento 3: administração de quatro litros de água morna associada a 20mg/kg de DSS. Foram realizados exames físicos gerais e específicos do trato digestivo, hematócrito e proteína plasmática total, ultrassonografia abdominal e mensuração da quantidade e hidratação das fezes antes e após seis, 12, 24, 36 e 48 horas dos tratamentos. Não foram observados efeitos adversos. A administração de ambos os laxantes promoveu maior produção fecal e hidratação, sem resultar em desidratação sistêmica, entretanto não houve diferença entre os tratamentos. A ausência de efeitos adversos do DSS demonstra a segurança de seu uso como medicamento laxante na dose de 20mg/kg. São necessários estudos que comparem o efeito dos laxantes em equinos portadores de compactação de cólon.(AU)

Gastrointestinal impactions in backyard poultry.

In contrast to conventional commercial poultry, which are raised primarily in controlled indoor environments, backyard poultry are typically raised in less restricted settings, potentially exposing them to a greater variety of ingestible substances, including multiple types of forage. Consequently, problems such as gastrointestinal impactions caused by ingesta have been noted in backyard poultry. To determine the prevalence of these impactions in backyard poultry, we performed a retrospective database search for autopsy submissions to the California Animal Health and Food Safety laboratory system and found that gastrointestinal impaction was associated with the death of 42 backyard poultry cases (40 chickens, 1 turkey, and 1 goose) from January 2013 to July 2018. In 32 of these 42 (76%) cases, the impaction was caused by fibrous plant material, 7 (17%) by compacted feed, and 3 (7%) by miscellaneous ingesta (tortilla, plastic, and wood shavings). The large proportion of grass impactions indicate that foraging is the predominant source of impaction material in backyard poultry, and that long grasses may be a significant health hazard for poultry. Backyard, pasture-raised, and free-range poultry producers are advised to maintain short pastures, avoid feeds that may expand in the gastrointestinal tract, and provide adequate grit to prevent impactions.

Physical characteristics of free-living sea turtles that had and had not ingested debris in Microregion of the Lakes, Brazil.

The ingestion of detritus by sea turtles results in high mortality and morbidity. The objective of this study was to describe the characteristics of free-living sea turtles that ingested anthropogenic inorganic detritus in comparison to those that did not. A total of 186 necropsy files were analyzed in marine turtles from the beaches of the Microregion dos Lagos, Rio de Janeiro. Among the turtles that ingested detritus, the mean turtle was female and cachectic, with a carapace length of 36,6 cm, detritus accumulated in the large intestine, and fecal compaction. It seems most likely that's low food transit, combined with the multiplicity of ingestion, favored the accumulation of detritus. This ingestion resulted in cachexia associated with fecal compaction, since the greatest accumulation was in the large intestine. The intake of detritus by turtles was not punctual but continuous. These studies demonstrated the vulnerability of these animals to environmental pollution.

IMAGING DIAGNOSIS - RADIOGRAPHY, ULTRASONOGRAPHY, AND COMPUTED TOMOGRAPHY OF A GIANT FECALOMA CAUSING STERCORAL PERFORATION OF THE COLON IN A DOG WITH A PROSTATIC ABSCESS.

A mixed-breed dog presented with tenesmus, hematochezia, and abdominal distension of 2 weeks duration. Radiography showed a large round mass with a "soap-bubble" appearance and shell-like mineralization in the caudal abdomen. Computed tomography revealed a lamellate mineralized mass 8 cm in diameter and containing air in the descending colon and prostatic abscess. Heterogeneously contrast-enhanced, irregularly thickened colonic wall with intramural and peritoneal free gas indicated stercoral colonic perforation. Surgical intervention revealed a tumor-like giant fecaloma in the descending colon adjoining the prostate with extensive wall rupture and fecal peritonitis. Hypothetically, prostatic inflammation may affect colonic motility with resultant fecaloma formation.

Intra-abdominal fungal pseudomycetoma in two cats.

BACKGROUND: Pseudomycetomas are deep cutaneous to subcutaneous lesions caused by Microsporum canis mainly described in Persian cats, with few reports of intra-abdominal location. This report describes the clinical signs and lesions of intra-abdominal pseudomycetomas caused by M. canis in two Persian cats. CASE REPORT: Two Persian cats with a history of previous laparotomy (ovariohysterectomy and nephrostomy) and fecal impaction were examined. Cat #1 was euthanized and subjected to necropsy, histopathology and mycological evaluation. Cat #2 presented with chronic dermatophytosis, and an intra-abdominal mass, that was subjected to histopathology evaluation. Cat #1 presented at necropsy a white-grayish, firm mass (6cm×3.5cm×2.8cm) in the uterine cervix. Cat #2 presented a firm whitish mass (6.5cm×1.5cm×0.5cm) located close to the left kidney. Histologically, both masses contained multifocal granules with hyphae and spores surrounded by Splendore-Hoeppli reaction, with a pyogranulomatous inflammatory infiltrate and fibrous connective tissue proliferation in the periphery. Hyphae and spores exhibited marked Grocott and periodic acid-Schiff staining. M. canis was identified by fungal isolation in cat #1. CONCLUSIONS: Pseudomycetoma should be considered as a differential diagnosis in cats, especially in Persian cats presenting with an intra-abdominal mass. Entrance of the agent into the cavity can occur during laparotomy.

Outcome of Surgical and Medical Management of Cecal Impaction in 150 Horses (1991-2011).

OBJECTIVE: To evaluate short- and long-term outcome after medical and surgical management of horses with cecal impaction and to determine reasons for death or euthanasia. STUDY DESIGN: Retrospective case series. ANIMALS: Horses (n = 150). METHODS: Data collected from medical records (1991-2011) of horses with a diagnosis of cecal impaction, included signalment, history of recent disease/surgical procedure, admission data, management (medical, typhlotomy alone, jejunocolostomy), complications, and outcome. Short-term outcome (alive or dead at discharge) and long-term outcome (alive or dead at ≥1 year) were determined by telephone interview. Data were analyzed using a χ(2) or Fisher's exact test. Level of significance was P < .05. RESULTS: Of 150 horses hospitalized with a diagnosis of cecal impaction, 102 (68%) had a history of recent disease or a surgical procedure. Thirty-eight horses (25%) had cecal perforation at admission and 3 horses (2%) were euthanatized without treatment. Of 109 horses treated, 59 (54%) were managed medically and 50 (46%) surgically (typhlotomy [26]; jejunocolostomy [24]). The proportion of horses alive at hospital discharge was significantly lower for horses managed medically (61%) compared with surgically (82%; P = .02) but there was no difference between horses managed with typhlotomy alone (77%) or with jejunocolostomy (88%; P = .47). There were 57% of horses managed medically alive at 1 year. There was a similar proportion of horses alive at 1 year after typhlotomy alone (73%) and jejunocolostomy (70%; P = .86). CONCLUSIONS: Compared to the recent reports, the proportion of horses alive at hospital discharge was lower for both medically and surgically managed horses with cecal impaction. There was decreased survival for horses treated medically than those treated surgically; however, no significant difference was seen in survival between horses managed with typhlotomy alone versus jejunocolostomy.

Prospective survey of veterinary practitioners' primary assessment of equine colic: clinical features, diagnoses, and treatment of 120 cases of large colon impaction.

BACKGROUND: Large colon impactions are a common cause of colic in the horse. There are no scientific reports on the clinical presentation, diagnostic tests and treatments used in first opinion practice for large colon impaction cases. The aim of this study was to describe the presentation, diagnostic approach and treatment at the primary assessment of horses with large colon impactions. METHODS: Data were collected prospectively from veterinary practitioners on the primary assessment of equine colic cases over a 12 month period. Inclusion criteria were a diagnosis of primary large colon impaction and positive findings on rectal examination. Data recorded for each case included history, signalment, clinical and diagnostic findings, treatment on primary assessment and final case outcome. Case outcomes were categorised into three groups: simple medical (resolved with single treatment), complicated medical (resolved with multiple medical treatments) and critical (required surgery, were euthanased or died). Univariable analysis using one-way ANOVA and Tukey's post-hoc test, Kruskal Wallis with Dunn's post-hoc test and Chi squared analysis were used to compare between different outcome categories. RESULTS: 1032 colic cases were submitted by veterinary practitioners: 120 cases met the inclusion criteria for large colon impaction. Fifty three percent of cases were categorised as simple medical, 36.6% as complicated medical, and 9.2% as critical. Most cases (42.1%) occurred during the winter. Fifty nine percent of horses had had a recent change in management, 43% of horses were not ridden, and 12.5% had a recent / current musculoskeletal injury. Mean heart rate was 43 bpm (range 26-88) and most cases showed mild signs of pain (67.5%) and reduced gut sounds (76%). Heart rate was significantly increased and gut sounds significantly decreased in critical compared to simple medical cases (p<0.05). Fifty different treatment combinations were used, with NSAIDs (93%) and oral fluids (71%) being administered most often. CONCLUSIONS: Large colon impactions typically presented with mild signs of colic; heart rate and gut sounds were the most useful parameters to distinguish between simple and critical cases at the primary assessment. The findings of seasonal incidence and associated management factors are consistent with other studies. Veterinary practitioners currently use a wide range of different treatment combinations for large colon impactions.

Hospital-based study of dental pathology and faecal particle size distribution in horses with large colon impaction.

The aim of the study was to determine if horses with large colon impaction were more severely affected by oral pathology than control cases and to relate faecal particle size distribution to dental pathology in both study groups. A prospective study included 39 horses with large colon impaction and 72 control horses from a hospital-based population. An oral pathology score (OPscore) and periodontal disease index (PDI) were assigned to all horses and faecal samples were collected for estimating faecal particle size and analysis of particle size distribution. Horses with large colon impactions were not more severely affected by oral pathology than control horses for both OPscore (P = 0.2) and PDI (P = 0.3). Faecal particle size estimates were significantly higher in control animals (P <0.001). No significant association was found between faecal particle size estimates and OPscores in horses with large colon impaction or control horses. In horses with large colon impaction, faecal particle size estimates increased with increasing PDI (P = 0.05). No associations were found between dental pathology and faecal particle size estimates. Horses developing large colon impaction did not have worse dentition than control horses.

Constipation associated with brumation? Intestinal obstruction caused by a fecalith in a wild red diamond rattlesnake (Crotalus ruber).

This report describes the fecalith-induced intestinal obstruction of a free-ranging red diamond rattlesnake (Crotalus ruber) and the snake's subsequent history following surgical removal of the fecalith. The captured snake exhibited an abnormally distended abdomen and an extremely hard mass, detected via palpation, near its vent. Coeliotomy yielded a 2.5-cm, 5-g fecalith from the large intestine. Microscopic dissection of the fecalith revealed no evidence of gastrointestinal parasitic worms. Subsequently, we implanted a radio-transmitter that allowed us to track the snake's movements for 7 months (until the radio signal vanished), indicating normal behaviour, complete recovery and good health apart from the obstruction. This observation suggests that fecalith development and intestinal obstruction represent potential risks of long-term faecal retention, an unusual physiological trait well documented among rattlesnakes and other stout, heavy-bodied terrestrial viperid snakes. Dehydration and decreased gut motility associated with brumation (≈hibernation) may predispose temperate snakes to fecalith formation. Regional drought and a small mammal diet with indigestible hairs might have also promoted fecalith formation in this specimen.

Clinical signs, treatment, and prognosis for horses with impaction of the cranial aspect of the base of the cecum: 7 cases (2000-2010).

OBJECTIVE: To determine the clinical signs, treatment, and prognosis for horses with impaction of the cranial aspect of the base of the cecum (cecal cupula). DESIGN: Retrospective observational case series. ANIMALS: 7 horses with colic attributed to cecal cupula impaction. PROCEDURES: Medical records were reviewed and horses that underwent exploratory celiotomy from 2000 through 2010 were identified. Horses with cecal cupula impaction and without other abdominal problems to which colic could be attributed were selected for inclusion in the study. Information regarding history, clinical findings, diagnostic testing, surgical findings and treatments, and treatments and complications after surgery was recorded. Rate of survival of horses to discharge from the hospital was determined. Long-term follow-up information was obtained with telephone questionnaires. RESULTS: Cecal cupula impaction without other cecal abnormalities was identified in 7 horses during exploratory celiotomy. Although clinical signs varied, horses typically had mild signs of colic and nondiagnostic rectal examination findings but were in systemically stable conditions at the time of the initial evaluation. Typhlotomies were performed and impactions were resolved by means of lavage and evacuation. All horses survived to discharge from the hospital and lived ≥ 2 years after surgery. CONCLUSIONS AND CLINICAL RELEVANCE: Results of this study suggested cecal cupula impaction was a novel type of cecal impaction that was uncommon. Impactions did not involve the cecal body or apex and hypertrophy of the cecal wall was not grossly detected. Impactions were successfully treated with typhlotomy, lavage, and evacuation. Horses had a good prognosis after surgical treatment.

Subclinical cecal impaction in a dog.

A 7-year-old, bichon frise dog was incidentally diagnosed with cecal impaction. Typhlectomy was performed as cecal rupture and resultant septic peritonitis appeared to be imminent. Histopathological evaluation did not identify an underlying cause for impaction and cecal dysmotility was suspected. Subclinical cecal impaction has not previously been reported in dogs.

Impaction cæcale subclinique chez un chien. Un diagnostic fortuit d'impaction cæcale a été posé chez un chien Bichon frisé âgé de 7 ans. Une typhlectomie a été réalisée, car une rupture cæcale et une péritonite septique résultante semblaient imminentes. L'évaluation histopathologique n'a pas identifié une cause sous-jacente pour l'impaction et la dysmotilité était soupçonnée. L'impaction cæcale subclinique n'a pas été précédemment signalée chez les chiens.(Traduit par Isabelle Vallières).

Spiral colon impaction in juvenile alpacas: 12 cases (2006-2010).

OBJECTIVE: To describe clinical signs and treatment outcomes for juvenile alpacas with spiral colon impaction (SCI). DESIGN: Retrospective case series. Animals-12 juvenile (< 6 months old) camelids with SCI. PROCEDURES: Crias with SCI were identified by searching the medical records database of the Cornell University Equine and Farm Animal Hospital. A keyword-based search method was used. Inclusion required confirmation of SCI on the basis of surgical or necropsy findings. History, signalment, examination findings, diagnostic test results, medical treatments, and surgical reports as well as short- and long-term outcomes were reviewed. Peritoneal fluid parameters were compared with those of age-matched comparison crias in which SCI was suspected but ruled out at necropsy or exploratory celiotomy. RESULTS: 12 crias with confirmed SCI were identified. Common clinical signs included lethargy and diarrhea. Abdominal distention was observed in 9 crias. In 3 crias, a mass in the region of the spiral colon was palpated. Seven crias underwent peritoneal fluid analysis; compared with age-matched comparison crias, SCI-affected crias had higher peritoneal fluid nucleated cell counts and nucleated cell count-to-total protein concentration ratios. A ventral midline celiotomy was performed in 9 crias; 7 underwent an enterotomy, and 2 underwent transmural infusion of saline (0.9% NaCl) solution with manual breakdown of ingesta; 3 of these crias survived for at least 6 months. CONCLUSIONS AND CLINICAL RELEVANCE: Crias with SCI that were not resolved by medical management had a poor prognosis. During celiotomy, transmural infusion of saline solution with manual breakdown of ingesta provided a less invasive alternative to enterotomy.

Ileal impaction and jejunal enterotomy in a 4-month-old Arabian filly.

A 4-month-old Arabian filly was treated by surgical correction of an ileal impaction. The impaction was resolved through a distal jejunal enterotomy. One-year follow-up showed no post-operative complications secondary to the enterotomy. Jejunal enterotomy may be a surgical option for resolution of an ileal impaction.

Is there a statistical correlation between ultrasonographic findings and definitive diagnosis in horses with acute abdominal pain?

REASON FOR PERFORMING STUDY: Abdominal ultrasonography has become a part of the diagnostic investigation for the acute abdomen in many equine clinics. There is limited information on the correlation between abnormalities detected on abdominal ultrasonography and the specific category of small intestine (SI) and large intestine (LI) diseases. OBJECTIVES: To investigate the relationship between abdominal ultrasonographic findings and disease categories that cause abdominal pain requiring surgery. METHODS: Medical records were reviewed for horses undergoing surgery or post mortem examination for colic. The ultrasound examination was performed to assess free peritoneal fluid, the left kidney, stomach, appearance and motility of the duodenum, identification, appearance, motility and thickness of small intestine loops, and the appearance and motility of the colon. Logistic regression analysis was used to identify associations between disease categories and ultrasonographic findings; a Chi-squared test was used to test for associations between each variable and disease categories. RESULTS: The study included 158 horses. Distended and nonmotile SI loops were associated with strangulated obstruction (n = 45); increased free peritoneal fluid, completely distended SI loops with abnormal motility and thickened loops were associated with definitive diagnosis involving SI (n = 58). Failure to visualise the left kidney was associated with renosplenic entrapment (n = 16); thickened large colon (LC) was associated with LC strangulating volvulus (n = 9). CONCLUSION: The use of abdominal ultrasonography can be used for the accurate definitive diagnosis involving SI and LI diseases. POTENTIAL RELEVANCE: This retrospective study may be used as a basis for prospective studies to assess the ultrasonographic findings in horses with medical colic and to compare these with surgical findings.

Sand impactions in a Saskatchewan beef cow-calf herd.

Forty beef cows were reported to show signs of abdominal pain and discomfort over a period of 1 wk. Two of the affected animals died and on postmortem examination were found to be impacted with sand in their abomasum and small intestines. Sand-laden barley silage was found to be the cause of these impactions.

Complete caecal bypass without ileal transection for caecal impaction in horses: seven clinical cases (1997-2007).

OBJECTIVES: To report the clinical outcome in seven horses following use of a newly described surgical technique for treating caecal impaction. METHODS: The medical records of seven horses with caecal impaction treated surgically using a stapling technique to create a complete caecal bypass without ileal transection were reviewed. Data were obtained from the records and through telephone interviews with case-associated personnel. RESULTS: The mean age was 10 years (range 2-22 years) and duration of colic ranged from 24 h to 2 weeks. Five horses had type II motility dysfunction and the remaining two had type I. Mean surgical time was 185 min (range 146-245 min) and the horses were hospitalised for a mean of 12.4 days (range 9-22 days); 71% (5/7) were discharged from hospital and all five were alive 60 days from the surgery date. One horse was lost to follow-up. The four (66.7%) available remaining horses were alive ≥ 1 year (long-term survivors). CONCLUSIONS: Complete caecal bypass without ileal transection for clinical cases of caecal impaction had comparable outcomes to complete bypass with ileal transection. The technique is easy to perform, has the potential to reduce surgical time, compared with traditional bypass techniques, and may reduce the risk of intraoperative abdominal contamination. It is recommended for use in clinical cases in which caecal bypass is desirable.