VCP 411: Medicine Section

Clinical significance of rectal examination

CLINCIAL SIGNIFICANCE OF RECTAL EXAMINATION

• Rectal exploration of abdomen is a vital part of the complete examination of the abdomen of large animals especially in cattle and horse.
• Special care is necessary to avoid injury to the patients and causing stress. Suitable lubrication is essential and force should be avoided.
• It enables the observation of alimentary tract, urinary and genital tract, vessels, peritoneum and pelvic structures.
• Amount and nature of feces in the rectum should be observed.
• Palpation for paralysis, ballooning of the rectum, distension of the loops of the intestine with fluid or gas, presence of hard masses of ingesta as in cecal and colonic impaction in horse.
• Intestinal obstruction due to volvulus, intussusception or strangulation.
• Detection of tight bands of mesentery – in displacement of segments.

Cattle

• Palpation of caudal sacs of rumen is possible when rumen is distended e.g bloat or vagus indigestion – push well into the pelvis.
• When empty – it is within the reach.
• Distended abomasums may be palpable in the right half of the abdomen when there is abomasal torsion and occasionally in vagus indigestion. Left kidney in the cow can be felt.
• Distinct lobulation is evident. It is also possible in horses.
• Abnormality in size of the kidney – Eg. i) Pyelonephritis ii) Hydronephrosis iii) Amyloidosis
• Pain on pressure – in pyelonephritis.
• Ureter and Empty bladder – not palpable.
• Distended bladder and in Chronic cystitis the bladder is palpable at the anterior end of the pelvic cavity.
• Abnormalities of bladder and ureters – in cattle are palpable to the ventral aspects of the vagina.
• Stone like hardness – large calculi in horses (occasionally)
• Pain with spasmodic jerk of the penis on palpation of the urethra occurs in urinary obstruction due to small calculi, cystitis, urethritis.
• Enlarged, thickened ureters occur in pyelonephritis.
• Peritoneum Grape like lesion in tuberculosis.
• Large, hard, irregular masses - fat necrosis
• Enlarged Lymph nodes - lymphomatosis

Abdominal aorta is palpable

• In horses, anterior mesenteric artery examination is important, if verminous aneurysm is suspected. Vessels are thickened, rough uneven surfaces with pain, but still pulsate. It is possible to palpate the inguinal ring from inside the abdomen in horses.
• Some of the specific abnormalities of the digestive tract which are commonly palpable on rectal examination
  • L-shaped rumen (vagus indigestion)Cecal torsion – palpable as long distended organ and movable.
  • Abomasal torsion – palpable as tense viscous in late pregnancy.
  • Abomasum impaction – not usually palpable in late pregnancy.
  • Left side displacement of abomasums (cannot palpate the displaced abomasums but often feel the rumen which is usually smaller than normal)
  • Intussusception – not always palpable, depend upon location of intussusception and size of the animal.
  • Mesentinal torsion – usually palpable.
  • Intestinal incarceration.
  • Peritonitis – only palpable if peritoneum of posterior aspect of abdomen is affected.
  • Lipomatosis – Commonly palpable as lumps in the abdomen and pelvic cavity.
• Rectal paralysis – In cows nearing parturition, the pressure by the fetus on pelvic nerves resulting in aberrant rectal paralysis causing constipation.
• Rectal prolapse: causes – Enteritis with profuse diarrhoea, Violent straining, Coccidiosis in young cattle, Rabies, Spinal cord abscess, When pelvic organs are engorged
• Rectal stricture: Inherited