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Basic Enema

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Megan Brashear, CVT, VTS (ECC), demonstrates how to administer a warm water/lubricant enema to one lucky little dog.

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Megan Brashear's picture
Megan Brashear

CVT VTS(ECC)

Enrolled: 07/2011

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Dee Taylor's picture

Poor puppy. Not a happy condition and not a happy solution.

Lauren Kent's picture

very helpful video, thanks for posting. How far do you feed the tubing into the colon? Is there a standard measurement for cats and dogs or a physical landmark that's used as a guide?
Thanks!

Megan Brashear's picture

Lauren, There isn't a predetermined length, the key is to get passed the obstruction which will vary patient to patient. There is not a 'too far' as long as you are not using excessive force to get the red rubber moving. Depending on the state of the patient it may take multiple tries to soften the feces enough to get the red rubber catheter by. Watch the deobstipation video for the next step!

Laura Edwards's picture

Long time listener, first time caller... Megan I just love your videos, thank you!

Is there any reason why y'all don't put Dawn (dish soap) in the enema? This is an additive at our clinic, but I want your input. Thanks! Laura

Chris Green's picture

Hi Laura,

The enema content is the choice of the DVM that orders it.  Many people do use dish soaps as enemas and the most important thing if people do choose to use dish soap is to use it judiciously and primarily for fairly small volume enemas.  In the event that large amounts of soap are used or soap makes it up to the stomach it can result in nausea.  

We do in fact use soap in our enemas quite frequently - we just use docusate sodium (DSS) which is more commonly known as a laxative but has its lubricating effects through its surfactant characteristics which are the same as soap.  The primary benefit to use of DSS instead of dish soap is that it does not have added fragrances or chemicals to which rare patients may be sensitive.  The use of obstetric lubricant is just a different form of enema and some veterinarians will choose a soapy additive for one type of enema and a lubricant enema for another depending on their prior experiences. I hope that answers your question.

Ariel Campos's picture

The video is very helpful. However, is it better to give the solution in small volumes repeatedly or a larger volume once? Why?

Sarah Harris's picture

We tend to use a larger volume at one time. This method helps to flush the feces out of the distal colon more effectively than multiple smaller infusions. Ideally, using a larger volume helps ensure that we only have to perform the enema one time, but it is not uncommon to have to repeat the procedure. I like to place the majority of the fluid past the problematic fecal ball and then infuse a small amount of the warm water as I am removing the red rubber catheter. Even when all these recommendations are performed, severely impacted animals may need further interventions such as subsequent enemas, IV fluid administration for rehydration, or in extreme situations, deobstipation.

Jacqueline Landin's picture

I would like to know how far should the catheter go in without injuring tha pet and how do you calculate how much of the enema solution to give? With this information added to the video it would definitely make it 100% excellent! Thanks!

Jessica Waters-Miller's picture

Hi Jacqueline,
Most of our doctors start with a 10mls/kg warm water/lube enema for deobstipation. The amount the colon can hold varies by patient size and depending on how giving the enema goes, we could end up giving more than that original 60mls. For example if I am giving an enema to a 6kg cat and the directions are to give 60mls of a warm water lube mix and while giving it roughly 40% of it comes back out immediately then I might give more. It depends if you are getting around the obstruction too. If the fecal ball is hard and you need to work the mixture around it most of it might come right back out.
The descending colon and transvers colon give you a good amount of distance to work with. The main thing to look out for is to not force it if you get a lot of resistance. Sometimes I will back out a little and infuse a small amount of solution and then try to shift slightly around the obstruction and infuse more. If there is a little resistance it may be the obstruction so do not force it but we also want to try to work that red rubber and enema past it. It may time some time and backing up but giving a little at a time and moving around it will help. Also paying attention to your patient, sometimes we have to do these with breaks in-between.
I hope that helps!