The large colon in horses is a significant component of the equine digestive system, responsible for the fermentation and absorption of nutrients from fibrous plant material. It is a part of the hindgut and consists of several segments, including the right and left ventral colon, the left dorsal colon, and the right dorsal colon. The large colon's design facilitates the breakdown of cellulose through microbial fermentation, enabling horses to extract energy from forage-based diets. Anatomical features, such as flexures and sacculations, contribute to its function but also predispose it to common health issues like impaction and displacement. This page compiles peer-reviewed research studies and scholarly articles that explore the anatomy, physiology, and clinical conditions associated with the large colon in horses.
Knudsen AR, Marsh JS, Pye JL.To describe reproductive performance in Thoroughbred broodmares post-large colon resection and to compare to performance post-colopexy. Methods: A single-institution retrospective study. Methods: A total of 29 client-owned horses: post-large colon resection (LCR) n = 19, post-colopexy: n = 10. Methods: Thoroughbred broodmares that survived until discharge following LCR (Group R) or colopexy (Group P) between 2006 and 2023 were included. Clinical data were collected from clinical records. Breeding and foaling data were collected from the Australian and New Zealand Studbooks. Statistical...
Kramer AJ, Meziara Wilson T, Kimura S, Groover E, DeLeon-Carnes M, Neto RLALT.A 23-y-old gelding was presented to a veterinary teaching hospital with a history of chronic, refractory diarrhea. Clinically, the horse was in poor body condition, with a thickened and corrugated large intestine identified by transcutaneous abdominal ultrasonography. At postmortem examination following euthanasia, the large colon and cecum had segmental thickening of the intestinal wall with innumerable mucosal ulcers and prominent polypoid mucosal masses. Many mesenteric and hepatic lymph nodes were enlarged. Histology revealed granulomatous and ulcerative typhlocolitis and granulomatous lym...
Watrobska N, Gough R, Hallowell G, Haugaard S, McGovern KF.Post-operative reflux (POR) is rare following large colon volvulus (LCV) but does occur despite the absence of a small intestinal lesion. The prevalence, risk factors and association with survival of POR after LCV are currently unknown. Objective: To determine the prevalence of POR in horses with an LCV and its association with survival. A further objective was to assess factors which may predict POR. The hypothesis was that horses with POR following LCV surgery have a worse outcome for survival compared to those without POR. Methods: A retrospective cross-sectional study. Methods: Clinical da...
Scilimati N, Cerullo A, Nannarone S, Gialletti R, Giusto G, Bertoletti A.Small colon impaction can result in accumulation of ingesta, gas, and fluid orally to the impaction site in horses. Large colon tympany, which is caused by ingesta fermentation, can be a predisposing factor for intestinal displacement. The aim of this study is to report the history, clinical, and surgical findings of horses and ponies referred for abdominal pain not responsive to drugs where a right dorsal displacement (RDD) or large colon volvulus (LCV), together with a small colon faecalith (SCF), were diagnosed during surgery. This study included a total of five horses and five ponies. Base...
Haardt H, Romero AE, Boysen SR, Tan JY.Abdominal ultrasonography is valuable in the diagnosis of equine colic. Fast localized abdominal sonography of horses (FLASH) enables practitioners with limited experience to perform ultrasonography in emergency settings. However, many practitioners only possess rectal format linear array transducers (RFLT). The hypotheses are: (a) A low frequency curvilinear transducer (LFCT) and RFLT will detect free abdominal fluid and abnormal small intestinal loops with similar frequency during FLASH, and (b) there will be a difference between the transducers for detection of gastric abnormalities and nep...
Tommasa SD, Roth SP, Triebe T, Brehm W, Lohmann KL, Stöckle SD.Granulosa cell tumors (GCTs) are the most common ovarian tumors in mares. The classical presentation of a GCT is a unilaterally enlarged ovary appearing as a multicystic honeycomb mass. In rare cases, GCTs cause hemoperitoneum as a result of the rapid growth of the tumor. The clinical diagnosis of GCT is usually based on history, rectal examination, ultrasonographic examination, and serum hormone analysis, and surgical removal of the affected ovary is the treatment of choice. The different surgical approaches are based on the dimension of the GCT. A 7-year-old mare was referred to the departme...
Gillen A, Kottwitz J, Munsterman A.A variety of treatment strategies for nephrosplenic entrapment of the large colon are reported, with conflicting evidence in the published literature as to the preferred treatment option. The aim of this study is to provide a systematic meta-analytical assessment of the efficacy of different treatment strategies in horses with confirmed or suspected nephrosplenic entrapment. This study involves meta-analysis including nonrandomized studies. A comprehensive literature search was performed from January 1970 to January 2017. Inclusion criteria were retrospective studies involving horses with conf...
Kaufman JM, Nekouei O, Doyle AJ, Biermann NM.Medical records of equine patients presented for signs of abdominal pain to the Atlantic Veterinary College Teaching Hospital between 2000 and 2015 were reviewed. A total of 575 patients were enrolled, and the most common clinical findings, diagnoses, and outcomes are described. Potential predictors of survival to discharge were assessed. The most common diagnosis was large colon impaction (18.4%), followed by large colon volvulus (6.2%). Overall survival to discharge was 69%. The survival rates for horses were 82.9% for those with no diagnosis, 74.6% for those with large intestine lesions, an...
Petersen JL, Lewis RM, Embertson R, Valberg SJ, Holcombe SJ.Large colon volvulus (LCV) is a life-threatening form of colic that occurs when the large colon rotates 360° or more on its axis, resulting in colonic distention and ischaemia. Any horse can suffer from LCV, but the risk is greatest for periparturient Thoroughbred broodmares; the objective of this study was to estimate the heritability of LCV in these horses. The criteria for classification as an LCV case were being a Thoroughbred broodmare from one of three farms in central Kentucky and having had surgical correction for LCV. Controls were identified as Thoroughbred broodmares present on the...
Whyard JM, Brounts SH.This study compared post-operative complications and survival in horses with right dorsal displacement of the large colon (RDD) and horses with other non-strangulating large colon (NSLC) lesions. Data were obtained from medical records of horses undergoing exploratory laparotomy from 2000 to 2016 and from owner questionnaire. Of 137 horses that fitted the inclusion criteria, 67 (49%) had RDD and 70 (51%) had NSLC lesions. Twenty-eight horses with RDD (42%) and 27 horses with NSLC (39%) experienced ≥ 1 complication after surgery. The RDD group showed more severe complications than the NSLC gr...
Blikslager AT.Management factors associated with colic, particularly related to stall confinement and nutrition, have been linked to alterations in gastrointestinal mucosal transport, motility, and microbiome, which in turn creates conditions that induce colic. In particular, meal feeding creates large changes in water movement in and out of the colon and alters the microbiome. These conditions may in turn result in colic conditions such as large colon impaction or large colon volvulus. In addition, a range of management and nutritional factors have been found to place horses at risk of select colic conditi...
Robinson E, Carmalt JL.To report inguinal herniation of the ascending colon in a Standardbred colt. Methods: Case report. Methods: A 6-month-old Standardbred colt. Methods: The colt underwent surgical exploration of the hernia with large colon resection and anastomosis. Results: A successful large colon resection and anastomosis was completed, however, the colt was euthanatized at the end of surgery upon owner request. Conclusions: Although uncommon, indirect inguinal herniation of the ascending colon can occur in young horses.
Pease AP, Scrivani PV, Erb HN, Cook VL.Large-colon torsion is a common cause of colic in horses and has a worse prognosis and higher cost than other causes of surgical colic of the large colon. During large-colon torsion, the colon wall becomes thick due to vascular occlusion. Therefore, we hypothesized that detecting increased colon wall thickness during ultrasonography would be an accurate preoperative test for large-colon torsion. The sample population consisted of 42 horses that were admitted for surgical treatment of colic localized to the large colon. The diagnosis was confirmed at surgery or necropsy examination. Twelve (29%...
Ruohoniemi M, Kaikkonen R, Raekallio M, Luukkanen L.This retrospective study consisted of 14 horses (age 6 weeks-12 years) with radiographically evident sand accumulations cranioventrally in the abdomen and clinical signs suggestive of sand enteropathy. The horses were treated medically and resolution of sand was monitored radiographically. Routine treatment consisted of psyllium mucilloid, combined with magnesium sulphate and/or mineral oilif needed. Initially, the number, size and shape of the sand accumulations showed large variation and the response to therapy was not predictable based on the initial appearance of the accumulation. In 2 foa...
Kooreman K, Babbs C, Fessler J.To evaluate and compare oxidative processes during ischemia and reperfusion of the equine large colon and jejunum. Methods: 2 groups of 6 anesthetized horses undergoing a terminal procedure. Methods: Isolated loops of large colon and jejunum were subjected to 2 hours of ischemia, followed by 2 hours of reperfusion. Tissue specimens were taken after 105 minutes of ischemia and 10, 30, 60, and 120 minutes of reperfusion. Mesenteric arterial and venous blood samples were collected for blood gas analysis at the same times to evaluate ischemia and reoxygenation. Oxidative processes in tissues were ...
Bristol DG.Enterocutaneous fistulae are rare in horses and occur most commonly as a complication of umbilical hernias or their treatment. Horses with enterocutaneous fistulae may be successfully treated by en bloc resection of the body wall and intestine or by allowing second intention healing. Complications associated with surgical intervention include fever, colic, incisional problems, and recurrence of the fistula. Nonsurgical management of two horses with presumptive large colon fistulae resulted in resolution of the fistulae without complications.
Bertone AL, Ralston SL, Stashak TS.Each of 3 digestion trials (3 forage diets) was performed on 2 groups of horses 6 to 12 months after sham operation (group 1; n = 3) or large-colon resection (group 2; n = 5). Diets were alfalfa pellets, alfalfa hay, and grass hay. Feed and fecal analyses were performed to determine apparent digestion of dry matter, organic matter, and crude protein and true digestion of dry matter, organic matter, crude protein, total plant cell wall, hemicellulose, cellulose, and lignin. Additional fecal and metabolic variables determined were percentage of fecal water, total fecal water, metabolic organic m...
Livesey MA, Arighi M, Ducharme NG, Horney FD, Hurtig MB.Incarceration of the large colon by the suspensory ligament of the spleen was diagnosed and surgically corrected on exploratory celiotomy in 76 horses exhibiting abdominal pain. The condition was diagnosed most frequently during the winter months in mature males of mean age 4.7 years. Clinical signs progressed slowly and included mild to moderate abdominal pain and distension with moderate tachycardia. The mean duration of colic prior to surgical intervention was 20.7 hours. The mild nature of the colic, the findings on palpation per rectum, and the continued passage of feces in 40% of horses,...
Ralston SL, Sullins KE, Stashak TS.The effect of 60% resection of the large colon vs ischemic insult without resection on the ability of horses to digest grass hay was investigated. Digestion trials were performed on 9 horses before surgery (base line) and 3 weeks, 6 weeks, and 6 months after surgery. The percentage of apparent digestion of crude protein, crude fiber, nitrogen-free extract, calcium, phosphorus, magnesium, manganese, copper, and zinc was calculated. Horses that had resection (n = 5) had decreased apparent digestion of crude protein, crude fiber, and phosphorus 3 weeks after surgery, compared with those in horses...
Sellers AF, Lowe JE, Cummings JF.Some support for both serotonin and substance P as biotransmitters in the equine large colon is presented. Close arterial injections of small quantities of each of these were effective, respectively, in stimulating marked increases in coordinated pressure peaks in the vicinity of the pelvic flexure, with modest (serotonin) or marked (substance P) increase in colon artery blood flow. Both the acaricide, amitraz, and the tranquilizer xylazine appeared to act on the equine large colon via yohimbine-sensitive alpha 2-adrenergic receptors.
Cummings JF, Sellers AF, Lowe JE.The distribution of the putative motor excitatory neurotransmitter, substance P, was studied immunocytochemically in the left dorsal colon of four normal control ponies and three ponies with amitraz-induced impaction colic. Substance P-like immunoreactivity in the control ponies was observed in nerve fibres in all layers of the bowel wall and in the nerve cell bodies of the enteric ganglia. The substance P-like immunoreactivity was clearly more intense in the cell bodies of submucosal ganglia than in those of the myenteric ganglia. The internodal nerve strands of the myenteric plexus were very...
Glade MJ.Twelve adult horses were fed a corn-oats-timothy hay diet containing 2.87% nitrogen (N) for 4 wk and were then killed. Fresh digesta samples were immediately harvested from the stomach, duodenum, jejunum, ileum, cecum, large colon, small colon, rectum and feces. Total N content of the digesta (on a dry matter basis) increased from the stomach (2.74%) to the duodenum (5.58%; P less than .01), decreased in the cecum (3.10%, P less than .01), remained constant through the large intestine and decreased in the feces (2.10%; P less than .01). High-speed centrifugation of wet digesta and low-speed ce...
Blikslager AT.Management factors associated with colic, particularly related to stall confinement and nutrition, have been linked to alterations in gastrointestinal mucosal transport, motility, and microbiome, which in turn creates conditions that induce colic. In particular, meal feeding creates large changes in water movement in and out of the colon and alters the microbiome. These conditions may in turn result in colic conditions such as large colon impaction or large colon volvulus. In addition, a range of management and nutritional factors have been found to place horses at risk of select colic conditi...
Pease AP, Scrivani PV, Erb HN, Cook VL.Large-colon torsion is a common cause of colic in horses and has a worse prognosis and higher cost than other causes of surgical colic of the large colon. During large-colon torsion, the colon wall becomes thick due to vascular occlusion. Therefore, we hypothesized that detecting increased colon wall thickness during ultrasonography would be an accurate preoperative test for large-colon torsion. The sample population consisted of 42 horses that were admitted for surgical treatment of colic localized to the large colon. The diagnosis was confirmed at surgery or necropsy examination. Twelve (29%...
Ruohoniemi M, Kaikkonen R, Raekallio M, Luukkanen L.This retrospective study consisted of 14 horses (age 6 weeks-12 years) with radiographically evident sand accumulations cranioventrally in the abdomen and clinical signs suggestive of sand enteropathy. The horses were treated medically and resolution of sand was monitored radiographically. Routine treatment consisted of psyllium mucilloid, combined with magnesium sulphate and/or mineral oilif needed. Initially, the number, size and shape of the sand accumulations showed large variation and the response to therapy was not predictable based on the initial appearance of the accumulation. In 2 foa...
Kooreman K, Babbs C, Fessler J.To evaluate and compare oxidative processes during ischemia and reperfusion of the equine large colon and jejunum. Methods: 2 groups of 6 anesthetized horses undergoing a terminal procedure. Methods: Isolated loops of large colon and jejunum were subjected to 2 hours of ischemia, followed by 2 hours of reperfusion. Tissue specimens were taken after 105 minutes of ischemia and 10, 30, 60, and 120 minutes of reperfusion. Mesenteric arterial and venous blood samples were collected for blood gas analysis at the same times to evaluate ischemia and reoxygenation. Oxidative processes in tissues were ...
Glade MJ.Twelve adult horses were fed a corn-oats-timothy hay diet containing 2.87% nitrogen (N) for 4 wk and were then killed. Fresh digesta samples were immediately harvested from the stomach, duodenum, jejunum, ileum, cecum, large colon, small colon, rectum and feces. Total N content of the digesta (on a dry matter basis) increased from the stomach (2.74%) to the duodenum (5.58%; P less than .01), decreased in the cecum (3.10%, P less than .01), remained constant through the large intestine and decreased in the feces (2.10%; P less than .01). High-speed centrifugation of wet digesta and low-speed ce...
Cummings JF, Sellers AF, Lowe JE.The distribution of the putative motor excitatory neurotransmitter, substance P, was studied immunocytochemically in the left dorsal colon of four normal control ponies and three ponies with amitraz-induced impaction colic. Substance P-like immunoreactivity in the control ponies was observed in nerve fibres in all layers of the bowel wall and in the nerve cell bodies of the enteric ganglia. The substance P-like immunoreactivity was clearly more intense in the cell bodies of submucosal ganglia than in those of the myenteric ganglia. The internodal nerve strands of the myenteric plexus were very...
Bristol DG.Enterocutaneous fistulae are rare in horses and occur most commonly as a complication of umbilical hernias or their treatment. Horses with enterocutaneous fistulae may be successfully treated by en bloc resection of the body wall and intestine or by allowing second intention healing. Complications associated with surgical intervention include fever, colic, incisional problems, and recurrence of the fistula. Nonsurgical management of two horses with presumptive large colon fistulae resulted in resolution of the fistulae without complications.
Sellers AF, Lowe JE, Cummings JF.Some support for both serotonin and substance P as biotransmitters in the equine large colon is presented. Close arterial injections of small quantities of each of these were effective, respectively, in stimulating marked increases in coordinated pressure peaks in the vicinity of the pelvic flexure, with modest (serotonin) or marked (substance P) increase in colon artery blood flow. Both the acaricide, amitraz, and the tranquilizer xylazine appeared to act on the equine large colon via yohimbine-sensitive alpha 2-adrenergic receptors.
Gillen A, Kottwitz J, Munsterman A.A variety of treatment strategies for nephrosplenic entrapment of the large colon are reported, with conflicting evidence in the published literature as to the preferred treatment option. The aim of this study is to provide a systematic meta-analytical assessment of the efficacy of different treatment strategies in horses with confirmed or suspected nephrosplenic entrapment. This study involves meta-analysis including nonrandomized studies. A comprehensive literature search was performed from January 1970 to January 2017. Inclusion criteria were retrospective studies involving horses with conf...
Bertone AL, Ralston SL, Stashak TS.Each of 3 digestion trials (3 forage diets) was performed on 2 groups of horses 6 to 12 months after sham operation (group 1; n = 3) or large-colon resection (group 2; n = 5). Diets were alfalfa pellets, alfalfa hay, and grass hay. Feed and fecal analyses were performed to determine apparent digestion of dry matter, organic matter, and crude protein and true digestion of dry matter, organic matter, crude protein, total plant cell wall, hemicellulose, cellulose, and lignin. Additional fecal and metabolic variables determined were percentage of fecal water, total fecal water, metabolic organic m...
Robinson E, Carmalt JL.To report inguinal herniation of the ascending colon in a Standardbred colt. Methods: Case report. Methods: A 6-month-old Standardbred colt. Methods: The colt underwent surgical exploration of the hernia with large colon resection and anastomosis. Results: A successful large colon resection and anastomosis was completed, however, the colt was euthanatized at the end of surgery upon owner request. Conclusions: Although uncommon, indirect inguinal herniation of the ascending colon can occur in young horses.
Ralston SL, Sullins KE, Stashak TS.The effect of 60% resection of the large colon vs ischemic insult without resection on the ability of horses to digest grass hay was investigated. Digestion trials were performed on 9 horses before surgery (base line) and 3 weeks, 6 weeks, and 6 months after surgery. The percentage of apparent digestion of crude protein, crude fiber, nitrogen-free extract, calcium, phosphorus, magnesium, manganese, copper, and zinc was calculated. Horses that had resection (n = 5) had decreased apparent digestion of crude protein, crude fiber, and phosphorus 3 weeks after surgery, compared with those in horses...
Livesey MA, Arighi M, Ducharme NG, Horney FD, Hurtig MB.Incarceration of the large colon by the suspensory ligament of the spleen was diagnosed and surgically corrected on exploratory celiotomy in 76 horses exhibiting abdominal pain. The condition was diagnosed most frequently during the winter months in mature males of mean age 4.7 years. Clinical signs progressed slowly and included mild to moderate abdominal pain and distension with moderate tachycardia. The mean duration of colic prior to surgical intervention was 20.7 hours. The mild nature of the colic, the findings on palpation per rectum, and the continued passage of feces in 40% of horses,...
Whyard JM, Brounts SH.This study compared post-operative complications and survival in horses with right dorsal displacement of the large colon (RDD) and horses with other non-strangulating large colon (NSLC) lesions. Data were obtained from medical records of horses undergoing exploratory laparotomy from 2000 to 2016 and from owner questionnaire. Of 137 horses that fitted the inclusion criteria, 67 (49%) had RDD and 70 (51%) had NSLC lesions. Twenty-eight horses with RDD (42%) and 27 horses with NSLC (39%) experienced ≥ 1 complication after surgery. The RDD group showed more severe complications than the NSLC gr...
Petersen JL, Lewis RM, Embertson R, Valberg SJ, Holcombe SJ.Large colon volvulus (LCV) is a life-threatening form of colic that occurs when the large colon rotates 360° or more on its axis, resulting in colonic distention and ischaemia. Any horse can suffer from LCV, but the risk is greatest for periparturient Thoroughbred broodmares; the objective of this study was to estimate the heritability of LCV in these horses. The criteria for classification as an LCV case were being a Thoroughbred broodmare from one of three farms in central Kentucky and having had surgical correction for LCV. Controls were identified as Thoroughbred broodmares present on the...
Kaufman JM, Nekouei O, Doyle AJ, Biermann NM.Medical records of equine patients presented for signs of abdominal pain to the Atlantic Veterinary College Teaching Hospital between 2000 and 2015 were reviewed. A total of 575 patients were enrolled, and the most common clinical findings, diagnoses, and outcomes are described. Potential predictors of survival to discharge were assessed. The most common diagnosis was large colon impaction (18.4%), followed by large colon volvulus (6.2%). Overall survival to discharge was 69%. The survival rates for horses were 82.9% for those with no diagnosis, 74.6% for those with large intestine lesions, an...
Tommasa SD, Roth SP, Triebe T, Brehm W, Lohmann KL, Stöckle SD.Granulosa cell tumors (GCTs) are the most common ovarian tumors in mares. The classical presentation of a GCT is a unilaterally enlarged ovary appearing as a multicystic honeycomb mass. In rare cases, GCTs cause hemoperitoneum as a result of the rapid growth of the tumor. The clinical diagnosis of GCT is usually based on history, rectal examination, ultrasonographic examination, and serum hormone analysis, and surgical removal of the affected ovary is the treatment of choice. The different surgical approaches are based on the dimension of the GCT. A 7-year-old mare was referred to the departme...
Haardt H, Romero AE, Boysen SR, Tan JY.Abdominal ultrasonography is valuable in the diagnosis of equine colic. Fast localized abdominal sonography of horses (FLASH) enables practitioners with limited experience to perform ultrasonography in emergency settings. However, many practitioners only possess rectal format linear array transducers (RFLT). The hypotheses are: (a) A low frequency curvilinear transducer (LFCT) and RFLT will detect free abdominal fluid and abnormal small intestinal loops with similar frequency during FLASH, and (b) there will be a difference between the transducers for detection of gastric abnormalities and nep...
Scilimati N, Cerullo A, Nannarone S, Gialletti R, Giusto G, Bertoletti A.Small colon impaction can result in accumulation of ingesta, gas, and fluid orally to the impaction site in horses. Large colon tympany, which is caused by ingesta fermentation, can be a predisposing factor for intestinal displacement. The aim of this study is to report the history, clinical, and surgical findings of horses and ponies referred for abdominal pain not responsive to drugs where a right dorsal displacement (RDD) or large colon volvulus (LCV), together with a small colon faecalith (SCF), were diagnosed during surgery. This study included a total of five horses and five ponies. Base...
Watrobska N, Gough R, Hallowell G, Haugaard S, McGovern KF.Post-operative reflux (POR) is rare following large colon volvulus (LCV) but does occur despite the absence of a small intestinal lesion. The prevalence, risk factors and association with survival of POR after LCV are currently unknown. Objective: To determine the prevalence of POR in horses with an LCV and its association with survival. A further objective was to assess factors which may predict POR. The hypothesis was that horses with POR following LCV surgery have a worse outcome for survival compared to those without POR. Methods: A retrospective cross-sectional study. Methods: Clinical da...
Kramer AJ, Meziara Wilson T, Kimura S, Groover E, DeLeon-Carnes M, Neto RLALT.A 23-y-old gelding was presented to a veterinary teaching hospital with a history of chronic, refractory diarrhea. Clinically, the horse was in poor body condition, with a thickened and corrugated large intestine identified by transcutaneous abdominal ultrasonography. At postmortem examination following euthanasia, the large colon and cecum had segmental thickening of the intestinal wall with innumerable mucosal ulcers and prominent polypoid mucosal masses. Many mesenteric and hepatic lymph nodes were enlarged. Histology revealed granulomatous and ulcerative typhlocolitis and granulomatous lym...
Knudsen AR, Marsh JS, Pye JL.To describe reproductive performance in Thoroughbred broodmares post-large colon resection and to compare to performance post-colopexy. Methods: A single-institution retrospective study. Methods: A total of 29 client-owned horses: post-large colon resection (LCR) n = 19, post-colopexy: n = 10. Methods: Thoroughbred broodmares that survived until discharge following LCR (Group R) or colopexy (Group P) between 2006 and 2023 were included. Clinical data were collected from clinical records. Breeding and foaling data were collected from the Australian and New Zealand Studbooks. Statistical...
