Gastrointestinal Rupture Clinical Signs (AAEP 2003)

A study to determine the clinical signs of gastrointestinal rupture during colic was done by researchers at the University of California, Davis, and results were presented by Diana Hassel, DVM, of UC Davis at the 2003 American Association of Equine Practitioners' convention. Results of the study could help veterinarians know what signs to look for to make a definitive diagnosis of intestinal rupture, thus allowing them to prevent prolonged suffering of the affected horse and additional expense to the horse owner, as euthanasia for a horse with a ruptured intestine is inevitable.

The medical records of 149 horses with gastrointestinal rupture admitted to the UC Davis veterinary teaching hospital from 1990 through 2002 were examined. Common clinical findings associated with acute intestinal rupture included depression, sweating, reluctance to walk, tachycardia (rapid heartbeat), fever, an increase in the concentration of red blood cells in the blood, an abnormally low number of white blood cells, abnormal mucous membranes, elevated peritoneal (abdominal cavity) fluid protein concentration, and abnormal peritoneal fluid color, said Hassel.

She said that four of those signs were key in determining colic severity--heart rate, peritoneal protein concentration, blood lactate concentration, and mucous membrane appearance. "Heart rate and mucous membrane color are important indicators of cardiovascular status, are signs of endotoxemia, and have prognostic value regarding subsequent survival," Hassel said.

She said that on physical exam, 47.8% of horses had an elevated temperature (above 101.5°F, or 38.6°C), 92% had an increased heart rate, 67.2% had rapid and shallow breathing, 69.7% had an increased capillary refill time (longer than two seconds), and 85.5% had abnormal mucous membrane color. In addition, 65.6% were "shocky" or "depressed" and 17.6% had severe pain. Hassel also reported that upon rectal examination, a gritty feeling was found on the connective tissue that lines the abdominal cavity or there was the palpable presence of free gas within the abdomen in 48.4% of those cases which underwent rectal examination.

When horses underwent abdominocentesis (surgical puncture of the abdomen), the peritoneal fluid was found to be abnormal in color in 85.5% of cases. When the total protein concentration of the peritoneal fluid was analyzed, it was found to be elevated in 86.4% of cases with the presence of bacteria in 95.7% of cases.

"Abdominocentesis is an important diagnostic test in the assessment of colic cases and can be definitive in cases of rupture," said Hassel. Abdominocentesis can be accomplished in the field.

If abdominal ultrasound was used for diagnosis, veterinarians found peritoneal fluid accumulation, sometimes with echogenic debris. In addition, Hassel recommended the use of abdominal radiography, if available, for the diagnosis of free abdominal air.

With these results in mind, veterinarians have a clearer picture of what signs to look for when gastrointestinal rupture is suspected. If a rupture is diagnosed, then the horse will likely require euthanasia.

About the Author

Sarah Evers Conrad

Sarah Evers Conrad has a bachelor’s of arts in journalism and equine science from Western Kentucky University. As a lifelong horse lover and equestrian, Conrad started her career at The Horse: Your Guide to Equine Health Care magazine. She has also worked for the United States Equestrian Federation as the managing editor of Equestrian magazine and director of e-communications and served as content manager/travel writer for a Caribbean travel agency. When she isn’t freelancing, Conrad spends her free time enjoying her family, reading, practicing photography, traveling, crocheting, and being around animals in her Lexington, Kentucky, home.

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