Enemas

Question 1

what is an enema?

Answer 1

a liquid substance/preparartion placed in rectum and colon of a pateint to stimulate evacuation of faecal matter

Question 2

what an enema does?

Answer 2

not intended to flush colon
- lubricates and hydrates to help encourage evacuation

to distend the rectum and colon
to initiate normal expulsive reflexes
improve hydration
- as colon is highly absorbant

Question 3

reasons for giving an enema?

Answer 3

constipation/impaction

• dehydrated
• eaten something shouldn’t so can’t push through
• vomiting or diarrhoea
• common in older, sick or quieter animals as less likely to move

diagnostic or surgical procedures
- evacuate bowels pre-surgery

therapeutic purposes

• rectal medication
• easily absorbed through colon

Question 4

suitable enema products

Answer 4

water
saline
liquid paraffin
mineral oil
propriety agent (ready-made, eg. microlax)
contrast medium
- examination checking for growths, tumours and tears

Question 5

equipment for giving an enema?

Answer 5

PPE - gloves and apron 
bowl 
towels and inco pads 
lubricant
Higginson's syringe 
- one end in the rectum and other attached to enema/fluids 
- balloon works as pump 
enema solution 
easy access to animal's toilet area 
medication if required

Question 6

enema amounts?

Answer 6

water

• cats = 5-10ml/kg
• dogs = 20-40ml/kg
• every 20-30 minutes if necessary

liquid paraffin

• 2-10ml/kg
• every 1-2 hours

saline solution

• 1-2ml/kg
• do not repeat for 12 hours - can effect electrolyte balance

proprietary agent (microlax)
- as directed 

contrast medium

• 5-15ml/kg
• one off

Question 7

how to give an enema?

Answer 7

prepare all equipment and solution
- warm to body temperature so not effected and for comfort

give GA or sedation

restrain patient

lubricate tip of applicator

insert nozzle into anus, rotate and advance into rectum

introduce chosen solution

digitally remove faeces if necessary
- carefully to avoid prolapse and damage to mucosa

supply litter trays, take patient outside to defecate
- monitor amount and appearance

Question 8

foal enemas?

Answer 8

common due to meconium impaction

• first dropping - hard and painful
• plug which stops defecating in uterus
• not being passed can cause colic or tear to mucosa (can be fatal)

have in full view of or alongside mother
- mare may also be restrained as will be protective 
handle and restrain appropriately 
- standing or recumbent 
wear PPE 
use warm water and lube

Question 9

what is an aperient? examples?

Answer 9

a medicine or food that acts as a mild laxative

laxapet
katalax
liquid paraffin
docusol

Question 10

why use aperients?

Answer 10

given on a regular basis to long-haired cats
- prevent hairball impactions

can be used alongside enemas

used post-surgery to prevent straining

• GI, rectal or colonic surgery
• to prevent straining/pressure on surgery site

used for liver failure
- helps bing ammonia which liver isn’t able to do

care taken to avoid diarrhoea
- when passing normally = stop treatment

Question 11

other treatments for hydration/intestinal activity?

Answer 11

intravenous fluids if due to dehydration

nasogastric tubes

• equine procedure
• trickle water slowly into stomach
• via fluid bag and giving set

exercise to aid intestinal motility

dietary fibre

coca cola
- fizzieness break down stomach blockages

massaging

• stimulate guts
• avoid popping/moving blockage