Treatment and Prognosis for Horses with Rectal Tears: 83 Cases (1986–1998)

1. Introduction

Rectal tears continue to be a major source of malpractice suits for veterinarians. Successful management of rectal tears relies on proper first-aid, prompt referral, and selection of appropriate therapy. The purpose of this paper is to provide insight on prognosis of horses with various grades of rectal tears and discuss treatment of cases seen at the Texas Veterinary Medical Center (TVMC).

2. Materials and Methods

Case records of all horses presented to the TVMC between January 1, 1986 and July 1, 1998 and diagnosed with rectal tears were retrieved. Signalment, etiology, grade of tear, and treatment selected was recorded. A grade 1 tear involves just mucosa. Only the muscular layer is disrupted with a grade 2 tear. Grade 3 tears are subclassified into 3a if only serosa is intact, or 3b if they occur dorsally into the mesorectum, while grade 4 tears are full thickness.^1,2 Treatments included conservative therapy, temporary indwelling rectal liner (TIRL), colostomy, and direct suture per rectum. When direct suture was elected, it was performed blindly, under epidural anesthesia using a one-handed technique. No specialized instrumentation was utilized. Conservative therapy included some combination of manual evacuation, antibiotics, NSAIDs, and peritoneal lavage. Follow-up information was obtained by telephone interview with owners or referring veterinarians. […]