Medical Treatment of Colic in Horses
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Description
A pedunculated lipoma is a common cause of small intestinal strangulation or obstruction in horses older than fifteen years of age. It is seen in all types of horses but most commonly in ponies and cob-type horses. Geldings appear to be at higher risk compared to mares and stallions. It is unclear whether the risk of lipoma formation is associated with body condition.
Lipomas are the most-common intra-abdominal tumour of geriatric horses. They are often multiple in number and attach to the mesentery of the intestine via a stalk or pedicle of varying length. The stalk becomes wrapped around a segment of small intestine, causing compression of the intestinal lumen and corresponding mesenteric vessels. Longer stalks are associated with more severe and complete intestinal strangulation. More rarely, broad-based tumours can occur causing periodic restriction of ingesta without intestinal compromise. Lipomas may also be incidental findings at post mortem or exploratory laparotomy.
Clinical signs
Due to the varying vascular compromise associated with lipomas, clinical signs may range from intermittent signs of colic to severe abdominal discomfort.
- Acute onset abdominal pain (flank-watching, rolling, kicking, pawing)
- Decreased borborygmi
Other clinical findings include the production of large volumes of gastric reflux following nasogastric intubation, although this may be absent in the early stages of disease.
Diagnosis
Nasogastric decompression may reMultiple distended loops of small intestine may be palpable on rectal examination or visible on ultrasonographic examination. Occasionally the lipoma may be felt per rectum.
Treatment
The only treatment available for this disease is surgery to remove the tumour and, if necessary, any compromised intestine.
Prognosis
The long term survival following surgery varies from 38% to 50%. If surgery is not performed until signs of cardiovascular compromise have occurred the prognosis is poor.
References
- Bertone, J. (2006) Equine Geriatric Medicine and Surgery Elsevier Health Sciences
- Orsini, J. A., Divers, T. (2007) Equine Emergencies: Treatment and Procedures Elsevier Health Sciences