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What is an enema?
the introduction of fluid into the rectum
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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
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What is constipation?
- hard dry feces, small amounts passed less often than expected
- may be difficult to pass, may cause straining
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What is obstipation?
the passage of small amounts of watery feces around an impacted fecal mass
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Which is worse, constipation or obstipation?
obstipation
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What is the purpose of an enema?
- stimulate bowel activity
- evacuate the large intestines
- irrigate the colon
- soften feces
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What are some reasons we would use an enema?
- constipation and obstipation
- certain diagnostic procedures
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What are some diagnostic procedures we would use an enema for?
- colonoscopy
- abdominal radiographs
- lower GI series
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When would we not want to use an enema?
- perforation of bowel
- recent colon surgery
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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
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What are the different types of enemas?
- cleansing enema
- retention enema
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What is a cleansing enema used for?
designed to remove fecal material by the repeated administration of large volumes of enema solution
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What is a retention enema used for?
material administered stays in the colon until the desired effects are obtained
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What is an anti-inflammatory retention enema used for?
in a patient with inflammatory bowel disease
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What is a water retention enema used for?
constipated patient
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What materials do we need to use an enema?
- enema solution
- enema container
- tubing
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What temperature should the eneam solution be?
room temperature
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What can we use as an enema solution?
- tap water
- isotonic saline
- mild soap and water
- petroleum oils
- glycerin and water
- commercial enema preparations
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What type of enema solution should we avoid in dogs and cats?
phosphate enemas (Fleet)
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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)
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What do we need for an enema container?
- bucket or bag for large animals
- 60 - cc syringe for cats and small dogs
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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
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What can we attach to the end of the tube to use for large volumes in dogss?
funnel
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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
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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
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How far to we insert the enema tube?
at least 5 cm cranial to anal sphincter
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What might an obstipated patient require?
frequent small enemas
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When we are giving an enema for treatment of poisoning, when do we stop?
when the fluid runs clear
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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
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