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

Aitken, Maia R.; Southwood, Louise L.; Ross, Beth M.; Ross, Michael W.

doi:10.1111/j.1532-950x.2014.12286.x

Cited by 18 publications

(31 citation statements)

References 14 publications

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“…There are still few large‐scale, comprehensive studies investigating caecal disease. In recent studies of caecal impactions and intussusceptions, no breed predisposition was apparent, but also not explicitly investigated 26–31 . The results should therefore be interpreted with caution and larger studies are needed to determine whether horse type plays a role in the development of caecal disorders.…”

Section: Discussionmentioning

confidence: 96%

“…In recent studies of caecal impactions and intussusceptions, no breed predisposition was apparent, but also not explicitly investigated. [26][27][28][29][30][31] The results should therefore be interpreted with caution and larger studies are needed to determine whether horse type plays a role in the development of caecal disorders. The study suffered from several limitations, including the retrospective nature which is inherently associated with the problem of having to rely on the information written in the record.…”

Section: Papermentioning

confidence: 99%

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Differences in gastrointestinal lesions in different horse types

2017

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Clinical impression suggests that some gastrointestinal lesions are more common in certain horse types. The study tested the hypothesis that relative prevalence of acute gastrointestinal lesions differs between equid types. In a retrospective caseâ€"control study, records (2010â€"2015) were reviewed for equids with acute gastrointestinal disease. Signalment, details of gastrointestinal lesions and diagnoses were recorded. Animals were categorised as miniature type, pony, Arabian, light breed or draft type. Exclusion criteria were no recorded breed/size/diagnosis, age less than one year and donkeys. Using binary logistic regression the influence of type, sex and age on lesion location, nature and diagnoses were investigated. 575 animals (33 miniature types, 136 ponies, 335 light breed types, 17 Arabians and 54 draft types) were included. Using light breed types as reference, ponies (including miniatures) had decreased odds of colon displacements (OR 0.11; 95 per cent CI 0.05 to 0.24; P<0.001) and ponies alone had increased odds of strangulation of the small intestine by lipomas (OR 2.3; 95 per cent CI 1.3 to 4.1; P=0.004). Miniature types had decreased odds of strangulating small intestinal lesions (OR 0.1; 95 per cent CI 0.01 to 0.83; P=0.033) and draft types had increased odds of caecal conditions (OR 9.0; 95 per cent CI 2.3 to 34.8; P<0.001). In conclusion, equid type influences development of gastrointestinal lesions.

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Section: Discussionmentioning

confidence: 96%

Section: Papermentioning

confidence: 99%

Differences in gastrointestinal lesions in different horse types

2017

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“…There are few reports in the literature regarding the re-introduction of feed and water following resolution of caecal impactions, either with a typhlotomy or by-pass procedure. Aitken et al (2015) demonstrated in a single centre, retrospective case series that re-feeding did not differ between surgically or medically treated caecal impactions with the median time to first feed being 36 hours and median time to first hay being 72 hours [17]. There may be a variation of answers from respondents regarding reintroduction of feed and water for caecal impactions due to the sparse information in the reference texts [17].…”

Section: Accepted Articlementioning

confidence: 99%

Equine nutrition in the post‐operative colic: Survey of Diplomates of the American Colleges of Veterinary Internal Medicine and Veterinary Surgeons, and European Colleges of Equine Internal Medicine and Veterinary Surgeons

Lawson

Sherlock

Ireland

et al. 2021

Equine Veterinary Journal

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Background Evidence is lacking concerning re‐introduction of feed and water following colic surgery. Objectives To describe current approaches of European and American specialists to re‐introduction of feed and water in adult horses following surgical treatment of common intestinal lesions, assuming an uncomplicated recovery. Study design Cross‐sectional survey. Methods Electronic invitations, with a link to the online survey, were sent to 1,430 large animal specialists, including Diplomates of the ECVS, ACVS, ECEIM and ACVIM colleges. Results The response rate was 12.6% including partial respondent data. Responses for each multiple‐choice question were between 123 and 178. Results are expressed as the percentage of the total number of responses and as a range where specific lesions are grouped together. Respondents reported that horses with large intestinal displacements were offered free choice water (63%‐65%) within 3 hours (55%‐63%), whereas horses with a small intestinal strangulating lesion were offered < 2 L water (64%‐74%) 12‐24 hours (28%‐34%) post‐operatively. Horses with a large colon displacement were offered feed within 3 hours of surgery (16%) with the majority offered feed 6‐12 hours (35%‐36%) post‐operatively. Horses with small intestinal strangulating lesions and small colon lesions were offered feed 24‐48 hours (34%‐42%) after surgery. Following small intestinal, small colon or caecal lesions, horses were re‐introduced feed in handfuls (79%‐93%) and initially with grass (41%‐54%). Horses with large colon displacements were mostly fed handfuls (49%‐50%) of forage initially, but a number of respondents would offer larger quantities such as a small bucket (35%‐37%) and predominantly of hay (50%‐51%). Main limitations Low response rate. This study did not take into account common post‐operative complications that may alter the clinical approach. Conclusions This post‐operative colic nutrition survey is the first to describe current clinical practice. Further research is required to investigate nutritional strategies in post‐operative colic cases.

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“…2012; Aitken et al . 2015). Caecal impaction in hospitalised horses can go unrecognised if the horse’s mentation is altered because of the problem that required hospitalisation.…”

Section: Risk Factorsmentioning

confidence: 99%

“…1984; Moore and Hardy 2017), and as low as 25% (Aitken et al . 2015). Multiple classifications (primary or secondary, acute or chronic and type I or II) have been applied to caecal impactions (Sherlock 2019).…”

Section: Introductionmentioning

confidence: 99%

Caecal impactions: Diagnosis, management and prognosis

Álvarez

Hanson

Schumacher

2020

Equine Veterinary Education

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Summary A caecal impaction can be caused by an accumulation of dry ingesta (type I) or abnormal caecal motility resulting in a feed impaction of fluid consistency (type II). Horses that develop a caecal impaction have often been administered a nonsteroidal anti‐inflammatory drug (NSAID) during hospitalisation for treatment of a painful condition such as an ocular or orthopaedic disease. Clinical signs of caecal impaction can be mild, and progress to more moderate to severe signs of abdominal pain as the impaction enlarges. Since an impacted caecum has a high risk of rupture, early diagnosis and treatment are important. Horses with a caecal impaction can be treated medically or surgically, and treatment decisions are based on clinical signs, results of transrectal palpation, character of peritoneal fluid and response to medical management. For type I caecal impaction, medical management consists of aggressive fluid therapy, both intravenous and enteral, to soften ingesta. Fluid therapy can be combined with laxatives, motility‐enhancing drugs and analgesic drugs. Surgery is indicated if results of transrectal abdominal examination indicate that the impaction is unchanged or has enlarged, signs of abdominal pain increase, or if there is cardiovascular deterioration. Horses with type II caecal impaction have a greater chance of survival if managed surgically. Using a ventral mid‐line celiotomy approach, a caecal impaction can be resolved via a typhlotomy. When caecal motility is poor, or there are signs of chronic caecal dysfunction, a caecal bypass procedure (jejunocolostomy or ileocolostomy) should be considered. Although the prognosis for horses with a caecal impaction is claimed to be fair to good, choice of treatment is controversial and may influence prognosis. If the affected horse survives to discharge from the hospital, the long‐term prognosis is generally good. Many retrospective studies of cases of caecal impaction are weakened by failure to distinguish between types I and II.

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

Cited by 18 publications

References 14 publications

Differences in gastrointestinal lesions in different horse types

Differences in gastrointestinal lesions in different horse types

Equine nutrition in the post‐operative colic: Survey of Diplomates of the American Colleges of Veterinary Internal Medicine and Veterinary Surgeons, and European Colleges of Equine Internal Medicine and Veterinary Surgeons

Caecal impactions: Diagnosis, management and prognosis

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