Equis ISSN 2398-2977

Rectum: meconium impaction

Contributor(s): Prof Derek Knottenbelt, Prof Jonathon Naylor

Introduction

  • Retention of meconium (fetal feces) after birth can result in a bowel impaction and consequent colic.
  • Most common form of colic in foals.
  • Signs: lack of passage of feces in peri-parturient period, straining and colic.
  • Cause: unknown, although the disease is more common in male foals due to their narrower pelvis.
  • Diagnosis: clinical examination of a foal, combined with digital rectal examination.
  • Treatment: involves the use of analgesics, laxatives, and enemas. Surgery is occasionally indicated.
  • Prognosis: good, as long as treatment is undertaken promptly and the foal is not anorexic and hypoglycemic for too long.

Pathogenesis

Etiology

  • Failure of passage of meconium feces.

Predisposing factors

General
  • Male.
  • Weakness.
  • Diminished nursing.
  • Presence of concurrent disease.

Pathophysiology

  • Failure of passage of meconium after birth   →   abdominal pain, reduced appetite and failure to suck.
  • This is a vicious circle since failure of passage of meconium can be due to lack of prompt feeding after birth since milk has a laxative effect.
  • The longer a meconium impaction is present, the more concreted it becomes and the more intensive treatment is necessary.
  • Failure of passage of meconium after birth   →   impaction   →   abdominal pain, lack of appetite and failure to suck.
  • This is a vicious circle since failure of passage of meconium can be due to lack of prompt feeding after birth since milk has a laxative effect.
  • The longer a meconium impaction is present, the more concreted it becomes and the more intensive treatment is necessary.

Timecourse

  • Occurs within 3-4 days of birth, it is the commonest cause of colic at this age. The severity of signs is related to the extent of the impaction.

Diagnosis

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Treatment

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Prevention

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Outcomes

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Pusterla N, Magdesian K G, Maleski K, Spier S J & Madigan J E (2004)Retrospective evaluation of the use of acetylcysteine enemas in the treatment of meconium retention in foals: 44 cases (1987-2002).Equine Vet Educ16(3), 133-136 VetMedResource.
  • Scarratt W K, Wallace M A, Pleasant R S, Sysel A M, Feldman B & Jones J C (1997)Chylothorax and meconium impaction in a neonatal colt.Equine Vet J29(1), 77-79 PubMed.
  • Cohen N D & Chaffin M C (1994)Intestinal obstruction and other causes of abdominal pain in foals.Comp of Cont Educ16(6), 780-790 VetMedResource.

Other sources of information

  • Rose R J & Hodgson D R (1993)Manual of Equine Practice.Saunders. ISBN 0 7216 3739 6.
  • Madigan J E (1992)use of acetylcysteine solution enema for meconium retention in the neonatal foal.Proceedings of the 14th Bain-Fallon Memorial Lectures. Australia.
  • Madigan J E & Goetzman B W (1990)Use of acetylcysteine solution enema for meconium retention in the neonatal foal.Proceedings of the AAEP.
  • Spurlock S L & Furr M (1990)Fluid therapy.In:Equine Clinical Neonatology. Eds: A M Koterba, W H Drummond & P C Kosch. Philadelphia: Lea & Febiger, USA. pp 671-700.


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