Rectal tears in the horse: an analysis of 35 cases.

This research study explores the treatment and survival rates of 35 horses that had severe rectal tears and were treated at the Veterinary Medical Center at Texas A & M University over five years. It highlights how survival rates varied depending upon the grade of tear, initial first aid, and different treatment methods applied.

Study Details and Methodology

• The study analysed the medical records of 35 horses which were presented to the Veterinary Medical Center at Texas A & M University over a 5-year period. Each horse had experienced severe rectal tears, specifically Grade 3 or 4.
• Grade 3 tears were subdivided into two categories: Grade 3a (remaining tissue was serosa) or Grade 3b (remaining tissue was mesorectum).
• Five horses were euthanised upon arrival due to the severity of their injuries. The remaining 30 horses underwent various treatment methods:
• Primary suture closure (8 horses)
• Faecal diversion alone (9 horses)
• Faecal diversion in combination with suture closure (11 horses)
• Packing of the tear with medicated gauze sponges (2 horses)
• Faecal diversion was achieved with a temporary indwelling rectal liner (TIRL) in 19 horses and a colostomy in one.

Findings and Conclusion

• The study found the survival rate was directly related to the grade of the rectal tear, the efficiency of the first aid provided at the time of injury and the specific treatment method utilized.
• The survival rates were disaggregated by tear grade: 74% of the horses with Grade 3a tears survived while 44% with Grade 3b tears survived. Grade 4 tears had the least favourable prognosis.
• Furthermore, prompt and effective first aid provided prior to professional treatment significantly improved the survival rate.
• In terms of treatment techniques, primary closure of the tear using sutures showed excellent results when the patient was suitably selected. For horses which were not ideal candidates for suture closure only, combining faecal diversion and suturing provided better outcomes than just faecal diversion alone.
• The temporary indwelling rectal liner (TIRL) was particularly useful in managing faecal diversion and improved treatment results.
• Even in critical cases, some horses were successfully treated by solely packing the rectal tear with gauze sponges.

Implications of the Study

• This research has significant implications for the veterinary treatment of severe rectal tears in horses. It advises on the most effective techniques for different scenarios, stressing the importance of quick and effective first aid, and the benefits of a TIRL and suture closure.
• It helps vet practitioners improve the prognosis of such conditions and choose the most appropriate treatment method based on the severity of the tear and the general condition of the horse.