Diagnosis, management and prognosis of small colon impactions

Summary Common causes of obstruction of the small colon and rectum include diffuse faecal impaction, enterolithiasis, faecalithiasis, phytobezoar, trichobezoar, phytotrichobezoar, phytoconglobate, foreign body, intramural haematoma and retained meconium. Poor dentition, poor‐quality hay, lack of adequate water, parasite damage and lack of exercise are risk factors for the development of small colon impactions. Clinical signs of small colon obstruction develop slowly because a large space proximal to the obstruction allows ingesta, gas and fluid to accumulate. Medical management of horses with faecal impaction of the small colon involves improvement of hydration, stimulation of colonic motility, softening the impaction by the administration of osmotic laxatives or lubricants, and control of pain. Surgical intervention is indicated when medical management fails to resolve the impaction or when intractable pain and a deteriorating cardiovascular status ensues.