Gastric and Large Colon Impactions Combined With Aggressive Enteral Fluid Therapy May Predispose to Large Colon Volvulus: 4 Cases.

The research paper discusses the potential risks related to the aggressive use of large volumes of water for the treatment of large colon impactions in horses, suggesting a connection with the onset of large colon volvulus. The study also suggests changes to the treatment strategy for large colon impactions to prevent such complications.

Objective of the Research

• The primary objective of this research was to investigate the correlation between the aggressive enteral fluid therapy used for the treatment of large colon impactions in horses and the onset of large colon volvulus.
• The study further aimed to offer an alternative treatment strategy to tackle large colon impactions while preventing complications such as large colon volvulus and gastric impaction.

Methodology

• The researchers reviewed the records of horses that underwent exploratory laparotomy at the Veterinary Teaching Hospital of Turin from 2012 to 2019.
• From these records, cases where horses initially diagnosed with large colon impaction eventually developed a large colon volvulus after the administration of large volumes of fluids were identified and thoroughly analyzed.

Findings

• Four cases were identified where horses with an initial diagnosis of large colon impaction developed large colon volvulus post enteral administration of large volumes of water.
• All these cases reported a sudden surge in pain, unresponsive to analgesics, shortly after the administration of large volumes of water. This led to referral and subsequent detection of large colon volvulus during exploratory laparotomy.
• Moderate gastric impaction was also observed intraoperatively in each of these cases, and the condition was confirmed postoperatively via gastroscopy.

Conclusion and Recommendation

• The results hinted at a potential correlation between aggressive enteric fluid treatment and the onset of colon volvulus. The researchers proposed that this could be due to the reduction of available space in the abdominal cavity caused by administration of large fluid volumes amidst pre-existing gastric and colon impaction.
• As an alternative treatment strategy, the researchers suggest more frequent administration of smaller fluid volumes to treat large colon impactions, without predisposing horses to potentially fatal complications such as colon volvulus.