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Risk factors for epiploic foramen entrapment colic: an international study.
Abstract: Epiploic foramen entrapment (EFE) is one of the most common causes of small intestinal strangulation in the horse. Identification of risk factors would generate hypotheses about causation and may suggest preventive strategies. Objective: Horses exhibiting certain behavioural patterns and those exposed to particular management practices are at increased risk of EFE. Methods: A matched case-control study was conducted on EFE cases admitted to hospitals in the UK, Ireland and USA. Data on 109 cases and 310 control horses were obtained by telephone questionnaire and conditional logistic regression was used to identify associations between horse- and management-level variables and the risk of EFE. Results: Crib-biting/windsucking behaviour was strongly associated with increased risk of EFE (OR 67.3, 95%CI 15.3-296.5). A history of colic in the previous 12 months (OR 4.4, 95%CI 1.5-12.7) and horses of greater height (OR/cm 1.05, 95%CI 1.01-1.08) were also at increased risk. The person(s) responsible for horses' daily care (nonowner/relative/spouse OR 5.5, 95%CI 2.3-13.3) and a number of behavioural features, including response to a stimulus causing fright (easily frightened OR 0.4, 95%CI 0.1-1.0) or excitement (sweats up easily/occasionally OR 0.3, 95%CI 0.1-0.8), reaction to their surroundings (inquisitive OR 0.4, 95%CI 0.2-0.8) and feeding behaviour when stressed (goes off food in full/part OR 0.3, 95%CI 0.1-1.0) were also associated with altered risk of EFE. Conclusions: The association between horses of greater height and those with a previous history of colic and increased risk of EFE suggests that some horses may be inherently predisposed to EFE. Furthermore, a behavioural pattern has been characterised that is common to horses at increased risk of EFE. Further research is required to investigate the causal pathway linking behavioural traits with gastrointestinal dysfunction and to determine whether behavioural modification reduces the risk of EFE. Conclusions: The findings of the present study have relevance to horses in the UK, Ireland and USA.
Publication Date: 2008-02-13 PubMed ID: 18267890DOI: 10.2746/042516408X266079Google Scholar: Lookup The Equine Research Bank provides access to a large database of publicly available scientific literature. Inclusion in the Research Bank does not imply endorsement of study methods or findings by Mad Barn.
- Journal Article
- Multicenter Study
- Research Support
- Non-U.S. Gov't
Summary
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The researchers carried out an international study on the risk factors associated with epiploic foramen entrapment (EFE), a common cause of small intestinal strangulation in horses. They found that certain behaviours and management practices increased the risk. Key identified risk factors included crib-biting/windsucking behaviour, a history of colic, and greater height in horses.
Research Design and Methods
- The team used a matched case-control study design, focusing on EFE cases in horse hospitals across the UK, Ireland, and USA.
- They collected data on 109 cases and 310 control horses through telephone questionnaires. Conditional logistic regression was then applied to discover associations between risk of EFE and a variety of horse- and management-level variables.
Research Findings and Associations
- Crib-biting/windsucking behaviour was found to have a very strong association with an increased risk of EFE with an odds ratio (OR) of 67.3.
- Horses that had a history of colic in the previous 12 months were also at high risk (OR 4.4) as were taller horses (OR/cm 1.05).
- The person in charge of the horse’s care if they were a non-owner/relative/spouse also increased the risk (OR 5.5).
- Interestingly, certain behavioural features such as the horse’s response to a frightening stimulus, its reaction to its surroundings, and changes in feeding behaviour under stress also correlated with altered risk of EFE.
Conclusion and Further Research
- The study concluded that some horses might be inherently predisposed to EFE, especially those of greater height or with a history of colic.
- Behavioural elements were recognised that are commonly related to horses at a higher risk of EFE. Thus, the paper suggests that further research is needed to explore the causal link between these behaviours and gastrointestinal dysfunction. Additionally, it would be valuable to investigate if modifying these behaviours could reduce the risk of EFE.
- The findings of this study are relevant for horses and horse management practices in the UK, Ireland, and the USA.
Cite This Article
APA
Archer DC, Pinchbeck GK, French NP, Proudman CJ.
(2008).
Risk factors for epiploic foramen entrapment colic: an international study.
Equine Vet J, 40(3), 224-230.
https://doi.org/10.2746/042516408X266079 Publication
Researcher Affiliations
- Division of Veterinary Clinical Studies, University of Liverpool, Leahurst, Neston, The Wirral CH64 7TE, UK.
MeSH Terms
- Animals
- Behavior, Animal
- Case-Control Studies
- Colic / epidemiology
- Colic / etiology
- Colic / veterinary
- Confidence Intervals
- Female
- Horse Diseases / epidemiology
- Horse Diseases / etiology
- Horses / anatomy & histology
- Intestinal Obstruction / epidemiology
- Intestinal Obstruction / etiology
- Intestinal Obstruction / veterinary
- Intestine, Small / pathology
- Logistic Models
- Male
- Odds Ratio
- Risk Factors
- Stereotyped Behavior
Citations
This article has been cited 10 times.- Asin J, Nyaoke AC, Samol MA, Arthur RM, Uzal FA. Clostridioides (Clostridium) difficile-associated disease, epiploic foramen entrapment, and gastric rupture in a Thoroughbred racehorse: case report and literature review. J Vet Diagn Invest 2022 Sep;34(5):913-917.
- Curtis L, Burford JH, England GCW, Freeman SL. Risk factors for acute abdominal pain (colic) in the adult horse: A scoping review of risk factors, and a systematic review of the effect of management-related changes. PLoS One 2019;14(7):e0219307.
- Schork IG, de Azevedo CS, Young RJ. Personality, abnormal behaviour, and health: An evaluation of the welfare of police horses. PLoS One 2018;13(9):e0202750.
- Grzeskowiak RM, Barrett EJ, Rodgerson DH. Cecal entrapment within the epiploic foramen in a mare. Can Vet J 2017 Aug;58(8):842-844.
- Archer DC, Costain DA, Sherlock C. Idiopathic focal eosinophilic enteritis (IFEE), an emerging cause of abdominal pain in horses: the effect of age, time and geographical location on risk. PLoS One 2014;9(12):e112072.
- Escalona EE, Okell CN, Archer DC. Prevalence of and risk factors for colic in horses that display crib-biting behaviour. BMC Vet Res 2014;10 Suppl 1(Suppl 1):S3.
- Schork IG, Young RJ. Rapid animal welfare assessment: an archaeological approach. Biol Lett 2014 Sep;10(9).
- Tharwat M, Al-Sobayil F. Equine colic: A comprehensive overview of the sonographic evaluation, diagnostic criteria, and management of different categories. Open Vet J 2025 Mar;15(3):1116-1139.
- Fikri F, Hendrawan D, Wicaksono AP, Purnomo A, Khairani S, Chhetri S, Purnama MTE, Çalışkan H. Colic incidence, risk factors, and therapeutic management in a working horse population in Tuban, Indonesia. Vet World 2024 May;17(5):963-972.
- Matthews LB, Sanz M, Sellon DC. Long-term outcome after colic surgery: retrospective study of 106 horses in the USA (2014-2021). Front Vet Sci 2023;10:1235198.
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