Rectal Tear
Basic Information 
Definition
Partial- or full-thickness tear through the wall of the rectum (or occasionally the small colon)
Clinical Presentation
Disease Forms/Subtypes
Grading system used to classify tears:
• Grade 1: Only the mucosa and submucosa are torn.
• Grade 2: The muscularis is torn, but the mucosa and submucosa remain intact.
• Grade 3a: The mucosa, submucosa, and muscularis are torn, but the serosa remains intact.
• Grade 3b: The mucosa, submucosa, and muscularis are torn dorsally, and the mesorectum remains intact.
Physical Exam Findings
• Temperature variable depending on severity of compromise
• Possibly tachycardia depending on the severity
• Depression, lethargy, and colic signs
• Mucous membranes variable depending on the severity; pale pink and moist to toxic and purple
• Possibly abdominal distension and secondary ileus
• Possibly reduced fecal output, tenesmus, and blood-tinged feces
Diagnosis 
Initial Database
• Complete blood count: Leukopenia or leukocytosis are common; occasionally normal
• Bare arm rectal examination with the horse sedated and restrained and under the effects of medications to prevent further straining (see initial treatment): Identify blood on retraction of the arm and palpate the defect.
• Peritoneal fluid: Normal in grades 1 and 2, variable increases in total protein (TP) and white blood cell counts seen in grades 3a and 3b, marked elevations in TP and white blood cell counts and gross fecal contamination seen in grade 4 tears.
• Transabdominal ultrasonography: May see peritoneal effusion in horses with grade 3a, 3b, and 4 tears and may see gas artifacts caused by pneumoperitoneum in horses with grade 4 tears
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