Rectal palpation is an important and common diagnostic procedure in equine veterinary practice. It is one of the only ways to access organs that are otherwise difficult to visualize or reach. This diagnostic provides extremely useful information in diagnosing a number of disease processes, especially those that result in signs of abdominal pain (colic), weight loss, diarrhea or any other observation that may result from a gastrointestinal abnormality.
A vet carefully inserts a lubricated, gloved arm into the rectum. Through the rectal wall, normal structures are felt for their position and characteristics. Organs regularly palpated include the female reproductive organs, bladder, left kidney, back edge of spleen, parts of large and small colon, parts of small intestine, the inguinal rings and others. Some of these can be felt only when they are abnormal. In cases of colic, the rectal exam may provide valuable information that contributes to the diagnosis.
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Although the results of this test should be evaluated in conjunction with other diagnostics, a complete history, and physical exam, it is an extremely important tool for diagnosing a wide range of gastrointestinal problems or narrowing the list of possible diagnoses.
Great care must be taken in performing a rectal exam and in interpreting the results. The examiner can usually only reach the back (caudal) 1/3 of the abdomen, so there are structures and parts of structures that cannot be felt. Experienced practitioners are much more accurate in their assessment, but there is always room for error and misinterpretation.
Rectal exam cannot be used effectively in horses that are too small to accommodate their hand and arm. In foals, a finger can be inserted rectally to aid in detection of some meconium impaction cases.
There is a small risk of rectal tear, a potentially fatal injury.
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