Ileal impaction in the horse: 75 cases.

This research paper examines a collection of 75 cases of horses suffering from ileal impaction, noting correlations related to breed, gender, and age. The study also explores the impact of certain factors on survival outcomes, including clinical signs, type of surgery, postoperative complications, and biochemical tests such as rectal temperature, plasma protein concentration, and the anion gap.

Case overview and symptoms

• The paper reviews 75 instances of horses suffering from ileal impaction, an obstruction of the ileum (part of the small intestine). Instances were documented retrospectively from hospital records.
• It was found that there existed a predisposition towards mares, and Arabian horses were observed to be over-represented in comparison to other breeds.
• The horses were on average around 8.3 years old and the primary symptom that was prevalent among almost all cases (96%) was abdominal pain. Other significant findings were nasogastric reflux and small intestinal distention.
• On rectal palpation, it was observed that ileal impaction was physically evident in 25% of cases.

Therapeutics and prognosis

• The investigation reports that exploratory surgery, known as celiotomy, was performed on 69 horses. Despite the fact that two of these horses required removal of the ingested material via enterotomy (surgical incision into the intestines), in most cases, the mass could be reduced using techniques such as extramural massage.
• A jejunocecostomy (creating a connection between the jejunum and the cecum) was performed for 47 horses.
• Post-surgery complications included ileal impaction or blockage in 25 horses, and 11 developed laminitis, a painful condition affecting the horse’s feet.
• Out of all the cases, only 27 horses survived, indicating a high fatality rate.

Analysis of survival factors

• Significant variations were noted between survivors and non-survivors regarding rectal temperature, plasma protein concentration, and anion gap, which implies that these factors might influence the prognosis.
• For example, survivors had an average rectal temperature of 37.7 degrees Celsius, plasma protein concentration of 7.8 g/dl, and an anion gap of 15 mEq/l, whereas non-survivors had values of 38.2 degrees Celsius, 8.9 g/dl, and 21.3 mEq/l respectively.
• The research found that the chances of survival decreased with the increasing duration of clinical symptoms.
• The type of surgical procedure also played a role with more invasive treatments such as enterotomy or jejunocecostomy reported to have a negative impact on survival.