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  Discussion on Massive Impaction?
Author Message
Member:
Pirie

Posted on Tuesday, Jan 7, 2003 - 8:15 am:

Hi DrO,

I can't believe that another one of my horses is ill! This time it is the 4yo. She started with colic 2 days ago but seemed to settle with Buscopan and Bute (from the vet.) I stayed with her for 4 hours before being happy that all was well and left her at 10pm. She was eating, drinking and passing dung although she did seem a little unsettled.

The following morning I got a call saying she was down again with colic. This time when the vet came she did a rectal exam and wanted the mare to go to the local vet hospital for a second opinion. We did this and they wanted her referring to Liverpool vet hospital as they could feel a mass. Sigh! I know the road there soooo well now!!!

When we arrived at Liverpool they found an enormous mass on rectal and vaginal examination, extending back into the pelvis. Apparently it was 18" across in all directions, hard and tender. It was distorting her vagina so they could not find the cervix at all. On U/S it had very thick walls (the vet indicated about 2cm) and very few echoes coming from the centre of it. The thoughts were either an abscess or a cyst/tumour of some sort.

The mare was put in a stable for observation overnight and remained OK, interested in what was going on. This morning they have rung me to say that they now think the mass is an enormous pelvic flexure impaction. They are going to give her IV fluids and see if she manages to pass it without needing surgery.

Her bloods show a slightly raised white cell count (don't know the value, sorry) and her peritoneal fluid is normal.

I just wondered it you could tell me any more about this? How big can horse large intestine stretch before it becomes ischaemic? If she survives how likely is it that this could happen again?

With the benfit of hindsight 2 days before she colicked she got into her neighbour's stable and ate all of her barley straw bed, about a bale (?10-12 lbs). She is on ad lib hay so why she felt the need to eat so much straw I cannot imagine! Do you think this could have been the cause?

The only other recent change to her routine (out in a field with a friend during the day with access to shelter, quality round bale hay and water, in at night on shavings with 4 lbs hay and water and a small (1/4 lb) feed of pony nuts and chaff twice a day. She looks in good but not fat condition) was going from throwing a small bale of hay into the field every day (10-14 lbs) to putting a big round bale out for them instead. The farmer reckons a round bale = 15-20 small bales and they are getting through the round bale in 10 days. This change happened 3 weeks ago.

Thanks (again!!) for your help,

Michelle.

Moderator:
DrO

Posted on Wednesday, Jan 8, 2003 - 4:24 am:

Well, the story is a bit odd. While reading your description a pelvic flexure impaction seemed most likely, until I got to the ultrasound findings. I don't believe the wall would appear 2cm thick and why was the ingesta not picked up, I would have thought it to have a fairly characteristic ultrasound appearance.

How large before it becomes ischemic? I am not sure how to answer this question Michelle. Quite large? I can say that I have seen pelvic flexure impactions that filled the anterior pelvic inlet so that you cannot get around it to palpate anything else and they got well. No food for 5 days and tubing in several gallons of water 4 times daily was required but they eventually got it all passed. The tubing in of water, and I like to add a handful of Epsons to the gallon, is very important.
DrO
Member:
Suzym

Posted on Wednesday, Jan 29, 2003 - 10:23 pm:

Don't forget, DrO, my vets thought Indy's problem was an impaction at the pelvic flexure. They had to do a lot of examining at Purdue before they determined that it was an abscess.
Moderator:
DrO

Posted on Thursday, Jan 30, 2003 - 8:44 am:

I haven't Suzanne, Michelle's US sound findings certainly do not sound typical for PFI.
DrO
Member:
Pirie

Posted on Thursday, Jan 30, 2003 - 2:47 pm:

Hi,

sorry for not posting about what happened, life has been a bit hectic recently. The mare was on IV fluids to overhydrate her and no food for 4 days. She looked really well throughout but was not passing any DrOppings. Finally 4 1/2 days after first colicking the impaction began to move and she came home 6 days after she was admitted, looking a bit thin but sparklingly clean.

I'm unsure why the US findings were not typical for an impaction. Perhaps the horse or perhaps the interpreter? Still she did get better and is not thought to be any more likely to get colic than any other horse unless she has another bout. She better hadn't, much as I like and respect vets I've had quite enough vet visits (and bills) just recently! <g>

Thankyou as always for your wise words. Knowing I can post questions on here really helps. It is one of the best web sites around.

Michelle.
Moderator:
DrO

Posted on Friday, Jan 31, 2003 - 3:48 am:

Thanks for the update DrM, and the kind words. Hope you get over your injury soon.
DrO
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