and then abruptly crashed, went into shock and became recumbent. An
abdominal ultrasound was performed and a massive, soupy caecal
impaction was diagnosed. Exploratory laparotomy was advised, but
declined on financial grounds. The donkey was euthanased. A
necropsy confirmed the diagnosis of soupy caecal impaction.
Impaction of the caecum with ingesta is unique when compared to
impactions in other regions of the gastrointestinal tract. Caecal
impactions may consist of firm dehydrated ingesta or fluid ingesta that
fails to empty due to caecal dysfunction. The clinical distinction,
however, may not always be apparent. Clinical signs of caecal
impaction may be subtle, including reduced fecal output, altered fecal
consistency, decreased intestinal motility on auscultation (particularly in
the right flank region), reduced appetite, dull demeanor, and mild
abdominal pain. Nasogastric reflux may occur with compression of the
duodenum by a markedly distended caecum.
Medical treatment of caecal impactions is used in horses considered to
be at low risk of perforation based on examination per rectum and with
mild signs of colic. Treatment includes fasting, analgesia, laxatives, as
well as IV and enteral fluid therapy. The consequences of failure of
medical therapy can be fatal; therefore, veterinarians treating horses
with caecal impactions may often recommend surgical treatment.
Spontaneous perforation is a risk, especially in cases where the cecum
is tightly distended with fluid ingesta. Surgical treatment for cecal
impaction involves typhlotomy with evacuation of ingesta.
In all likelihood, the caecal impaction was present prior to the scrotal
ablation, and was probably responsible for the clinical signs of colic
and depression. Due to their mild nature, the clinical signs were
ascribed to complications of the castration, and further diagnostics
were not pursued. In retrospect, it may have been indicated to perform
a more exhaustive diagnostic workup on this donkey, prior to surgery.
Septic joints in foals need to be radiographed
Septic arthritis is a common orthopedic condition in equine stud
practice. As it is a potentially life-threatening condition, horses
suspected of having an infected joint should be considered an
emergency patient. Joint infection in horses most commonly is
generally rapidly progressive and may quickly become non-weight
bearing. Lameness may be less severe if examination is performed
close to onset of the infection, if the affected joint is open and draining
or if analgesic treatment has been given. In the author’s experience
commonly used analgesics such as NSAIDS and butorphanol do not
markedly improve lameness from septic arthritis.
If pain is severe, elevated heart and respiratory rates may be present.
Foals are usually febrile. Marked joint effusion, periarticular heat and
15-‐18
February
2016
East
London
Convention
Centre,
East
London,
South
Africa
76