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What is an enema?
the introduction of fluid into the rectum
What do we use an enema for?
evacuation of feces, or as a means of administering nutrients, or medicinal substances, or opaque material in radiological examination of the lower GI tract
What is constipation?
- hard dry feces, small amounts passed less often than expected
- may be difficult to pass, may cause straining
What is obstipation?
the passage of small amounts of watery feces around an impacted fecal mass
Which is worse, constipation or obstipation?
What is the purpose of an enema?
- stimulate bowel activity
- evacuate the large intestines
- irrigate the colon
- soften feces
What are some reasons we would use an enema?
- constipation and obstipation
- certain diagnostic procedures
What are some diagnostic procedures we would use an enema for?
- abdominal radiographs
- lower GI series
When would we not want to use an enema?
- perforation of bowel
- recent colon surgery
What are some complications when using an enema?
- perforation of colon, causing leakage of fluid into abdomen
- vomiting if administered too fast
- hemorrhage if colon is irritated
What are the different types of enemas?
- cleansing enema
- retention enema
What is a cleansing enema used for?
designed to remove fecal material by the repeated administration of large volumes of enema solution
What is a retention enema used for?
material administered stays in the colon until the desired effects are obtained
What is an anti-inflammatory retention enema used for?
in a patient with inflammatory bowel disease
What is a water retention enema used for?
What materials do we need to use an enema?
- enema solution
- enema container
What temperature should the eneam solution be?
What can we use as an enema solution?
- tap water
- isotonic saline
- mild soap and water
- petroleum oils
- glycerin and water
- commercial enema preparations
What type of enema solution should we avoid in dogs and cats?
phosphate enemas (Fleet)
What can happen if we use a phosphate enema in a dog and cat?
- can cause severe electrolyte disturbance which can cause hypernatremia, hypocalcemia, hypomagnesemia
- can cause acid-base imbalance (metabolic acidosis)
What do we need for an enema container?
- bucket or bag for large animals
- 60 - cc syringe for cats and small dogs
What kind of tubing can we use?
- soft red rubber urinary or feeding catheter
- old IV tubing with flamed, rounded ends may be used for cats
- soft rubber tubing up to 1 cm diameter with flamed end may be used for dogs
What can we attach to the end of the tube to use for large volumes in dogss?
What is the two-person procedure?
- one person restrains by holding the patient's head and collar
- the other person holds the tail and administers the enema
How do we do an enema?
- with patient in standing position, insert lubricated tube into rectum
- administer enema solution slowly
- remove tubing from rectum
- allow patient to evacuate
How far to we insert the enema tube?
at least 5 cm cranial to anal sphincter
What might an obstipated patient require?
frequent small enemas
When we are giving an enema for treatment of poisoning, when do we stop?
when the fluid runs clear
What can we use to break up hard feces, and who is responsible for doing this?
- sponge forceps
- veterinarian, vet tech should not do this