Enemas are given to relieve meconium impaction as well as constipation in foals. Because enemas are not innocuous, they should be administered only to foals demonstrating evidence of fecal retention; clinical signs include tail flagging, rolling, straining to defecate, and abdominal distention.

Materials

See FIGURE 1 .

• An enema bucket
• Warm water
• Mild soap (~1 tsp soap in 1 L of water; if mild soap [e.g., Ivory, a liquid organic soap] is not used, mucosal irritation may occur)
• A catheter (if not part of the enema bucket)
            • A red-rubber urethral catheter (~24 French)
            • A Foley catheter (for retention enema; ~12 to 14 French)
• Several diapers or disposable towels for cleaning the area during the enema
• Cloth towels for cleaning the foal after the enema
• A bucket of warm water for cleaning the foal’s hind end after the procedure
• Lubricant
• Sample cups (if a sample is requested)
• An antispasmodic (e.g., hyoscine butylbromide [Buscopan, Boehringer Ingelheim] administered as directed by the veterinarian) may be warranted to decrease straining
• Hemostats

Method

Enemas may be given to help relieve fecal retention only with the permission of the veterinarian in charge of the case.

1. Attach the rubber catheter to the enema bucket, and place a small amount of lubricant on the end of the tube. Insert the catheter into the foal’s rectum. Allow an appropriate amount of soapy water (based on the foal’s size; usually ≤1 L) to enter the rectum by gravity.
2. Watch the area closely for signs of defecation, and catch a sample if the veterinarian requested one. Foals are often permitted to move around the stall to encourage defecation. Diapers may be used to catch manure.
3. When the enema is complete, clean the foal’s soiled areas with warm water and a cloth towel.

Comments

• If a foal will receive more than one or two soapy enemas within 12 to 24 hours, mixing an electrolyte solution (according to the veterinarian’s instructions) into the soap can help prevent hyponatremia and hypochloremia.
• Retention enemas (FIGURE 2) using acetylcysteine may be required in foals that fail to respond to routine enemas.
• Manipulations should be gently performed by the veterinarian or technician (under the veterinarian’s instruction) to prevent rectal trauma.