Enema, Retention/High

Enema, Retention/High



Basic Information image



Synonym(S)


High enema, acetylcysteine enema



Overview and Goal(s)


Meconium impactions are the most common cause of colic in the neonatal foal. Routine enemas often resolve simple meconium impactions, whereas more aggressive therapy is warranted for cases that do not readily resolve with simple routine enemas.



Indications


Meconium impactions that have not resolved with routine enema administration



Contraindications


Cases of suspected bowel perforation



Equipment, Anesthesia




• Sedation: Diazepam (0.1–0.4 mg/kg IV), butorphanol (0.05 mg/kg IV), and/or xylazine (0.3–0.5 mg/kg IV)


• Equipment: 30 cm Foley catheter with 30 cc balloon, lubricant, hemostats, 60 mL catheter tip syringe, acetylcysteine, sodium bicarbonate



Anticipated Time


45 minutes



Preparation: Imporant Checkpoints




• Administration of glucose-containing intravenous fluids during the procedure is recommended (eg, lactated Ringer’s solution + 2.5% dextrose at 5 mL/kg/h)


• An appropriate location for a recumbent foal should be prepared. Ambient temperature should be considered as well as temperature of enema fluid to be used.


• Preparation of a 4% acetylcysteine solution by combining 40 mL of the 20% solution with 160 mL of sterile water or by combining 100 g of powdered N-acetylcysteine with 200 mL sterile water. The final solution (prepared either way) can be mixed with 20 g of sodium bicarbonate (4 tsp baking soda) to improve the efficacy of the acetylcysteine solution.

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Jul 24, 2016 | Posted by in SMALL ANIMAL | Comments Off on Enema, Retention/High

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