Repeated manual evacuation for treatment of rectal tears in four horses.

This research focuses on the treatment of serious rectal tears in horses through repeated manual evacuation, presenting a non-surgical intervention that was successful in four examined cases, with horses discharged within two weeks demonstrating full resolution of the rectal tear.

Introduction

• The research primarily discusses four cases of horses suffering from Grade-IIIb rectal tears. These tears, which involve all layers of the rectum excluding the mesocolon, often lead to a poor prognosis for the horse’s survival due to their propensity to transform into full perforations and the difficulty in treating these injuries.
• Traditional treatments for this type of rectal tear usually involve surgical intervention. However, the study indicates that not all Grade-IIIb tears necessitate this kind of treatment, proposing a non-surgical method of care via repeated manual evacuation of the rectum and terminal part of the small colon.

Methodology

• Four horses with Grade-IIIb rectal tears were evaluated through rectal palpation and endoscopy.
• Among the four horses, two showed signs consistent with shock and endotoxemia, illustrating a severe reaction to harmful substances in the blood. Additionally, all horses exhibited nonseptic peritonitis, an inflammation of the peritoneum that is not caused by bacterial infection, as indicated by the evaluation of peritoneal fluid samples.

Treatment

• The horses were treated by administering antibiotics and anti-inflammatory drugs, combined with repeated manual evacuation of the terminal portion of the small colon and rectum.
• The main objective of the treatment was to prevent further enlargement of the rectal tear by eliminating the storage function of the terminal part of the small colon and rectum.

Results

• None of the treated horses experienced worsening of the original rectal injury, highlighting the effectiveness of the treatment method.
• All horses were discharged within a duration of two weeks from admission. The rectal tear was fully resolved in each case, demonstrating a successful outcome of the repeated manual evacuation technique in treating Grade-IIIb rectal tears.