Noninvasive hydrostatic reduction of an ileocecocolic intussusception in a puppy.

A 5-week-old male intact Golden Retriever puppy was presented for a history of vomiting and diarrhea with hematochezia. Ultrasound findings confirmed the presence of an ileocecocolic intussusception. Surgical correction was declined because of financial concerns. Based on a pediatric procedure used in humans, an ultrasound-guided hydrostatic reduction (USGHR) was performed. This procedure consisted in injecting saline rectally under controlled pressure to mechanically reduce the intussusception. Reduction of the intussusception and evaluation of potential complications were concurrently evaluated by ultrasound during the procedure. No recurrence was observed the next day and the puppy was discharged. Follow-up indicated that the dog was still doing well 6 months later. This case report describes a new technique in veterinary medicine allowing successful nonsurgical reduction of an ileocecocolic intussusception in a dog. This procedure is innovative, simple, and substantially decreases the cost and minimizes morbidity potentially associated with surgical management.

Nonsurgical reduction of prolapsed colocolic intussusception in 2 puppies.

OBJECTIVE: To describe the nonsurgical management of prolapsed colocolic intussusception in 2 puppies. CASE SUMMARY: Two 3-month-old male intact puppies (Pug and Labrador Retriever) developed intussusceptions that had prolapsed from the anus after they had suffered from tenesmus with soft feces or diarrhea. Reduction of the prolapsed tissue was performed and colocolic intussusception was diagnosed ultrasonographically in 1 dog. Rectal manipulation and saline enema were performed in both dogs, and reduction of the intussusception was confirmed endoscopically or ultrasonographically. Bupivacaine and prednisolone foam enemas were administered to reduce tenesmus. Abdominal ultrasonography the following day in 1 dog confirmed a normal appearing colon. No further tenesmus was noted in 1 dog; the other had a brief rectal prolapse after an episode of tenesmus that was manually reduced. Intussusception had not recurred 4 months and 1 year following manual reduction procedures. NEW OR UNIQUE INFORMATION PROVIDED: This is the first report of successful nonsurgical management of colocolic intussusception in a companion animal. Nonsurgical management is a first-line treatment of intussusception in children and could be considered in dogs with colocolic intussusception. Further investigation is required to define specific aspects, including rectal manipulation, saline enema, or anesthesia, that aid in resolution of this type of intussusception.

EFFECT OF A NUTRIENT ENEMA ON SERUM NUTRIENT CONCENTRATIONS IN WHITE-SPOTTED BAMBOO SHARKS (CHILOSCYLLIUM PLAGIOSUM).

Ill and anorectic captive sharks present a unique challenge for husbandry and veterinary staff. Providing adequate fluid and nutritional support to sharks while minimizing handling remains difficult. This study aimed to evaluate the ability of a nutrient enema to alter blood analyte concentrations. Thirty-six healthy, fasted white-spotted bamboo sharks (Chiloscyllium plagiosum) were enrolled in the study with 18 sharks receiving a nutrient enema and 18 sharks receiving a non-nutrient saline enema. The metabolic state of sharks was evaluated via measurement of blood glucose, blood urea nitrogen, and ß-hydroxybutyrate as well as other serum biochemistry parameters. Changes in sodium, chloride, calcium, ß-hydroxybutyrate, glucose, total protein, and triglyceride concentrations were seen across time in both groups. Blood glucose absolute concentrations and changes over time differed between the nutrient and nonnutrient groups. This pilot study indicates that it is possible to influence the glucose metabolism of healthy sharks via nutrient enema. Further study is needed to better understand potential therapeutics for ill and anorectic sharks.

Uso de cetamina pela via cólon-retal para contenção química de jiboias Boa constrictor Linnaeus, 1758 com teste de influência da droga sobre o sistema renal / Use of ketamine by colon-rectal route for chemical restraint in Boa constrictor Linnaeus, 1758 with test of influence of the drug on renal system

Por serem frequentes na clínica de animais silvestres, faz-se necessária a manipulação de jiboias e para isso, indispensável o conhecimento sobre as manobras precisas para o tratamento das possíveis afecções. Quando se opta pela contenção química, ou pela realização de procedimentos cirúrgicos, um dos fármacos utilizados na anestesia de serpentes é a cetamina. Viu-se a necessidade de buscar uma via alternativa, semelhante em eficácia às tradicionais para a contenção química, porém que minimizasse os riscos e efeitos adversos encontrados na sua execução. O presente trabalho sugere que a via retal seja esta alternativa, por isso, treze jiboias foram submetidas à administração de 70mg/kg de cloridrato de cetamina, com sonda uretral, através da cloaca até o cólon-reto. Foram avaliados, nos tempos 0, 10, 20, 30, 40, 50, 60, 70, 80, 90 e 120 minutos, a partir da administração do fármaco, os seguintes parâmetros: frequência cardíaca, relaxamento muscular e mobilidade, resistência à contenção ou manipulação e reação postural de endireitamento. Foi realizada coleta de 0,5mL de sangue por punção do seio venoso paravertebral cervical, antes da administração do fármaco, no dia seguinte e após nove dias. Foram dosadas as concentrações plasmáticas de cálcio, fósforo e ácido úrico de todos os exemplares a fim de verificar o perfil bioquímico renal e avaliar a influência do fármaco neste sistema. Não foram observadas alterações bioquímicas plasmáticas durante o período de avaliação. Foi possível promover a contenção química das jiboias Boa constrictor, utilizando cloridrato de cetamina pela via cólon-retal.(AU)

It is necessary to deal with Boa constrictor snakes because they are frequently treated in wild and exotic animal clinics and the knowledge about the required procedures in the treatment of the possible affections becomes imperative. When the choice for chemical restraint or sedation for surgical procedures is made, one of the drugs used in snakes is ketamine. We believed it was necessary to look for an alternative route of drug administration as effective as the regular ones, but with minimum risks and less adverse effects in its execution. Therefore thirteen snakes were submitted to the administration of 70mg/kg of ketamine hydrochloride, with an urethral tube, through the cloaca into the colon-rectum. After this, they were evaluated during the 0, 10, 20, 30, 40, 50, 60, 70, 80, 90 and 120 next minutes from the administration time using the following parameters: heart rate, muscle relaxation and mobility, handling or restraint resistance and righting reflex. Blood samples were collected from each snake by cervical paravertebral venous sinus punction, before the drug administration, on the next day and nine days after. Serum concentrations of calcium, phosphorus and uric acid were measured in order to check the renal biochemical profile and the possibility of influence of the drug on this system. It was possible to provoke chemical restraint in Boa constrictor snakes, with ketamine hydrochloride administered by the colon-rectal route.(AU)

Imaging assessment of the modified double contrast barium enema using carboxymethylcellulose on radiography and ultrasonography in dogs.

A modified double contrast barium enema using carboxymethylcellulose was evaluated in beagle dogs and compared with dogs receiving a conventional barium enema. The experimental group was divided into three groups (1, 2, and 3) and given 30 ml/kg of different volume ratios of a barium vs. carboxymethylcellulose mixture. Each group underwent sonography following radiography. The volume ratio of one part barium to three parts carboxymethylcellulose was judged to be the optimal mixture, resulting in a general distribution of contrast and bowel radiolucency on radiographs and adequate postradiography sonography. The modified barium enema using carboxymethylcellulose is useful for assessing the general morphology and mucosal layers of the colon simultaneously on radiographs and ultrasonographs.

Inadvertent transvaginal administration of sodium phosphate enemas in 2 alpaca crias.

OBJECTIVE: To describe the clinical presentation and resultant metabolic disturbances following retroperitoneal administration of hyperphosphate enemas in alpaca crias. CASE OR SERIES SUMMARY: Two crias presented to the Colorado State University Veterinary Teaching Hospital after inadvertent transvaginal retroperitoneal hyperphosphate enema administration. The first cria developed an acute onset of neurologic signs, severe hypernatremia, and died soon after presentation. The second cria developed severe hyperphosphatemia, hypocalcemia, and acidemia. The metabolic derangements normalized within 24 hours of intensive treatment with calcium supplementation and IV crystalloid fluid diuresis. The cria was discharged after 1 week in the hospital. NEW OR UNIQUE INFORMATION PROVIDED: This report provides a description of electrolyte disturbances secondary to inadvertent transvaginal retroperitoneal administration of hyperphosphate enemas in 2 crias and attendant clinical signs of these disturbances. Management of hyperphosphatemia and hypocalcemia in 1 cria via aggressive fluid therapy with calcium supplementation led to a rapid and sustained normalization of phosphorus, calcium, and acid-base balance.

Efeito de diferentes soluções de enema sobre os parâmetros clínicos de eqüinos / Effect of different enema solutions on clinical parameters of equines

Avaliou-se o efeito de diferentes soluções de enema sobre os parâmetros clínicos de eqüinos hígidos. Foram utilizados 15 eqüinos adultos, distribuídos em três grupos de cinco animais cada: grupo 1 - tratados com água de torneira mais sabão neutro; grupo 2 - tratados com solução isotônica e grupo 3 - tratados com água de torneira mais vaselina. O efeito das soluções de enema sobre os parâmetros clínicos variou em função do tipo de solução infundida. A solução com menor efeito sobre os parâmetros clínicos foi a isotônica. A solução de água de torneira e sabão neutro desencadeou um aumento da temperatura retal e edema da mucosa retal. Embora as três soluções tenham se mostrado efetivas em hidratar e amolecer as fezes, a solução de água com sabão foi a que apresentou o melhor efeito.

The effect of three different enema solutions on clinical parameters of equines was studied using 15 healthy adult animals. They were alloted into three groups of five animals each: group 1 - treated with tap water associated with neuter soap; group 2 -treated with isotonic solution; and group 3 - treated with tap water associated with vaseline. Effects of enema solutions on clinical parameters were observed. Isotonic solution caused less alteration on clinical parameters. Tap water and soap enema induced inflammatory reaction on colon mucosa. Even though all three solutions showed effectiveness in hydrating and softening the feces, the treatment with water plus soap showed the best results.

Rectal instillation of butyrate provides a novel clinically relevant model of noninflammatory colonic hypersensitivity in rats.

BACKGROUND & AIMS: The treatment of irritable bowel syndrome (IBS), characterized by abdominal pain and bloating, is empirical and often poorly efficient. Research lacks suitable models for studying the pathophysiologic mechanisms of the colonic hypersensitivity and new pharmacologic targets. The present study aimed to develop a novel model of colonic hypersensitivity possessing several of the characteristics encountered in patients with IBS. METHODS: Rats received enemas of a butyrate solution (8-1000 mmol/L) twice daily for 3 days. A time course was determined for colonic hypersensitivity (colorectal distention test) and referred cutaneous lumbar hyperalgesia (von Frey hairs). Macroscopic and histologic analyses were performed on colonic mucosa. The efficacy of morphine, U50488H (a kappa opioid agonist), and trimebutine on the 2 pain parameters was determined. Finally, the involvement of peptidergic C-fibers was evaluated using capsaicin-pretreated animals and treatments with calcitonin gene-related peptide (CGRP) and neurokinin 1 receptor antagonists. RESULTS: Butyrate enemas induced a sustained, concentration-dependent colonic hypersensitivity and, to a lesser extent, a referred cutaneous mechanical hyperalgesia, particularly in female rats, but no macroscopic and histologic modifications of the colonic mucosa, as observed in patients with IBS. Both pain parameters were sensitive to morphine, U50488H, trimebutine, neonatal capsaicin treatment, and the CGRP receptor antagonist but not to the neurokinin 1 receptor antagonist. CONCLUSIONS: These results present our noninflammatory model of chronic colonic hypersensitivity as a useful novel tool for studying IBS. The CGRP receptor antagonist-induced reduction of colonic hypersensitivity suggests that CGRP receptors may provide a promising target for treatment of IBS.

Phosphate enema toxicosis in a pygmy goat wether.

Phosphate enema toxicity was diagnosed in a 7-month-old, castrated male, pygmy goat. On presentation, clinical findings included mild depression, tachycardia, tachypnea, rumen stasis, muscle tremors, hypocalcemia, hypokalemia, hypochloremia, hyperphosphatemia, azotemia, and metabolic acidosis. Fluid diuresis and parenteral antimicrobial therapy resulted in recovery after 3 d of treatment.

Surgical removal of a seminoma from a black sea bass.

An adult black sea bass was examined because of abdominal distention and decreased appetite. A large abdominal swelling was evident and was firm on palpation. Differential diagnoses included neoplasia, abscess or granuloma, hematoma, or swim bladder abnormality. Diagnostic tests included survey radiography, positive-contrast radiography, and computed tomography. The sea bass was anesthetized with tricaine methanesulfonate. A ventral midline abdominal incision was made, and adhesions to the mass were gently dissected. The fish recovered without complications. Radiography was repeated 8 weeks after surgery, and there was no evidence of mass regrowth. To the authors' knowledge, this is the first report of a barium enema being performed in a fish. Although surgical procedures are performed more commonly on fish for research, a few reports of clinical surgical cases have been described. Our experience supports the conclusions of other reports that certain surgical procedures can be performed safely in fish.

[Life threatening metabolic disorders after application of a sodium phosphate containing enema in the dog and cat]. / Lebensbedrohliche Stoffwechselstörungen nach Applikation eines Natriumphosphat-haltigen Klistiers bei Hund und Katze.

Application of a sodium phosphate containing enema caused life-threatening metabolic disorders in a Dachshund and two cats. Clinical signs were characterised by dehydration and various neurological deficits including seizures. Most striking laboratory abnormalities were hypernatremia, hypocalcemia, hyperphosphatemia, and polycythemia. Despite intensive treatment the dog died, whereas the cats recovered completely. In face of possible severe and potentially fatal metabolic abnormalities sodium phosphate enemas, such as Practo-Clyss, should be used with caution or not at all in cats and small dogs.

Treatment of calcium, phosphorus, and magnesium balance disorders.

In food animal practice, the majority of the calcium, phosphorus, and magnesium balance disorders are due to low blood concentrations of one or more of these minerals. The purpose of this article is to review methods that can be used to restore normal blood concentrations of these minerals. Low plasma calcium is often accompanied by changes in plasma phosphorus and magnesium. Initial discussions will consider each mineral separately, followed by pros and cons of combined therapies. In all cases the doses of the treatments described in this article are those appropriate for the 600-kg cow.

Suspected herbicide toxicosis in a dog.

An 8-year-old 38-kg spayed female Golden Retriever was admitted for vomiting, signs of abdominal pain on palpation, ataxia, anorexia, and generalized weakness of 2 days' duration. Ten hours prior to onset of clinical signs, the dog was found standing in and drinking from large pools of an accidentally spilled herbicide that contained an octanoic acid ester of bromoxynil (3,5-dibromo-4-hydroxybenzonitrile) and an isooctyl ester of (2-methyl-4-chloro) phenoxyacetic acid (MCPA). Appendicular muscles were firm on palpation and persistent muscle contraction (myotonia > 1 minute duration) was found on muscle percussion, using a reflex hammer. Electrical activity indicative of myotonia was identified on electromyographic evaluation. With supportive treatment, the dog eventually recovered from suspected MCPA toxicosis. Although rare, MCPA toxicosis should be considered as a cause of acquired myotonia in dogs.

Acute thallium toxicosis in a dog.

A Doberman Pinscher was evaluated for acute onset of gastroenteritis, characterized by anorexia, hematemesis, and hematochezia. The dog had ingested mole bait containing thallium 2 days prior to admission. Thallium toxicosis was confirmed by detection of thallium in the urine, using colorimetric analysis. The dog responded well to administration of antibiotics, fluids administered IV, warm-water enemas, and oral administration of activated charcoal slurries.

Comparison of an orally administered gastrointestinal lavage solution with traditional enema administration as preparation for colonoscopy in dogs.

Forty dogs were randomly assigned to be given either multiple enemas (group A) or orally administered lavage solution (group B) before colonoscopy. Dogs of group A (n = 20) were given 3 large-volume warm-water enemas 6 hours apart, with the last enema given 9 to 15 hours before colonoscopy. Dogs of group B (n = 20) were given a total dose of 50 ml of the lavage solution/kg of body weight through an orogastric tube. The lavage solution was administered in 2 doses of 25 ml/kg given 1 hour apart, 12 to 18 hours before colonoscopy. Dogs were monitored for changes in body weight and in serum sodium, potassium, chloride, calcium, phosphate, urea nitrogen, creatinine, and total CO2 concentrations. Colonoscopy was performed on dogs under general anesthesia by an investigator blinded as to the method of preparation, and the quality of preparation was subjectively evaluated. The quality of colon preparation was significantly (P less than 0.005) better after administration of oral lavage solution, compared with that after multiple enemas. There were minimal changes in laboratory values, side-effects were minimal, and biopsy specimen artifacts were not seen. Because proper patient preparation is necessary for complete colonoscopic examination, results suggested that an orally administered polyethylene glycol-containing electrolyte solution is preferable to administration of multiple enemas in preparing dogs for colonoscopy.

Rectal resection in the dog. A new surgical approach and the evaluation of its effect on fecal continence.

Thirteen healthy mixed breed dogs (6 female and 7 male) underwent rectal transection and resection of 0 to 6 cm using a dorsal approach. Rectoanal sphincter pressure studies were performed preoperatively and 6 weeks after surgery using a double balloon manometer device. Sphincter pressure profiles were altered in the 6 cm resection dogs. Clinical observations of defecation and degree of continence were made over a 10 week period postoperatively. The transection only and 4 cm resection dogs defecated normally. All dogs in the 6 cm resection group involving the peritoneal reflection were incontinent but retained some normal posturing behavior. Surgical complications included minor infection in two dogs, rectocutaneous fecal leakage in four dogs, breakdown of the anastomotic site in four dogs, and incontinence in all of the dogs that underwent 6 cm resections. Barium enemas were performed on the rectums postmortem to ascertain the degree of stricturing induced by the surgery. The index of stenosis measured did not correlate well with the extent of straining in each group. Histopathologic findings on dogs in the transection only and 4 cm resection groups without dehiscence showed mild granulomatous proctitis with normal myenteric plexi seen. Dogs suffering dehiscence had suppurative proctitis, necrosis, and obliteration of the myenteric plexi.

Electrolyte abnormalities induced by hypertonic phosphate enemas in two cats.

Severe electrolyte disturbances developed after the administration of hypertonic phosphate enemas in 2 chronically obstipated cats. Hyperphosphatemia, hypernatremia, and hypocalcemia were detected in both cats. Physical findings included weakness, anxiety, tachycardia, hypothermia, and dehydration. Intravenous fluid and electrolyte therapy led to prompt, dramatic improvement in both cats. Although well tolerated by most healthy animals, hypertonic phosphate enemas should be avoided in small animals, especially those that are dehydrated, severely obstipated, or suffering from renal or colonic disease.

Clinical, biochemical, acid-base, and electrolyte abnormalities in cats after hypertonic sodium phosphate enema administration.

Ten clinically healthy cats were allotted into 2 groups. Group A was given the low (60 ml), and group B was given the high (120 ml) recommended dose of a commercial hypertonic sodium phosphate enema. Enema retention was enforced. All cats developed clinical and/or laboratory abnormalities, with group B cats being more severely affected. Clinical signs that occurred rapidly included depression, ataxia, vomition, bloody diarrhea, mucous membrane pallor, and stupor; tetany was not seen. One cat in group B died. Laboratory abnormalities included hypernatremia, hyperphosphatemia, hypocalcemia, hyperglycemia, calculated hyperosmolality, and metabolic acidosis with high anion gap probably due to hyperlacticacidemia. There were no significant gross or microscopic lesions associated with enema administration. Therefore, the use of hypertonic sodium phosphate enema at recommended doses is potentially dangerous to cats.