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Equine veterinary journal2025; doi: 10.1111/evj.70104

Risk factors for equine strangulating lipoma colic: An international, case-control study.

Abstract: Obstruction by strangulating lipoma (SLO) is one of the most common causes of small intestinal strangulation in horses and is fatal without surgery. Current knowledge of risk factors for SLO is limited to horse signalment features. To date, other risk factors have not been investigated. Objective: To investigate horse- and management-level risk factors for SLO using a population of healthy horses as controls. Methods: Matched, case-control study. Methods: A prospective, international multicentre study was conducted in the UK and USA between January 2022 and May 2024. Cases were horses with SLO confirmed at exploratory laparotomy at the four participating hospitals. Three controls per case were randomly selected, matched on clinic and time. Conditional logistic regression was used to identify associations between variables and the risk of SLO. Results: Data from 55 SLO cases (UK, n = 42; USA, n = 13) and 167 matched controls were analysed. In a final multivariable model, increased age (odds ratio [OR]: 1.15; 95% confidence intervals [95% CI]: 1.04-1.28; p = 0.008) and particular breeds (Pony, Welsh Section D/Cob, American Quarter Horse/American Paint Horse/Appaloosa/Arabian) were at increased risk of SLO (OR: 1.53; 95% CI: 1.10-2.15; p = 0.012). SLO was more likely in horses with a prior history of laminitis (OR: 10.94; 95% CI: 2.21-54.13; p = 0.003) or increased stabling in the previous 4 weeks (OR: 6.79; 95% CI: 1.96-23.54; p = 0.003). Management strategies to maintain optimal weight and address equine metabolic syndrome were protective (OR: 0.19, 95% CI: 0.39-0.94; p = 0.041). Conclusions: Potential for selection and recall bias by horse owners. Conclusions: This study adds to knowledge of the epidemiology of SLO and has identified new risk factors which may be modifiable. Strategies to prevent endocrine-associated laminitis, including weight management in high-risk groups, should be considered to minimise SLO risk.
© 2025 The Author(s). Equine Veterinary Journal published by John Wiley & Sons Ltd on behalf of EVJ Ltd.
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Publication Date: 2025-10-08 PubMed ID: 41062921DOI: 10.1111/evj.70104Google Scholar: Lookup
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Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

Risk factors including age, breed, history of laminitis, and recent stabling conditions influence the likelihood of horses developing strangulating lipoma colic (SLO), a serious intestinal obstruction. Management practices that address weight and equine metabolic syndrome may reduce this risk.

Study Background and Objective

  • Strangulating lipoma obstruction (SLO) is a leading cause of intestinal strangulation in horses and requires surgical intervention for survival.
  • Prior research mainly focused on basic horse characteristics (signalment) without investigating other potential risk factors.
  • The goal of this study was to identify both horse-related and management-related risk factors for SLO by comparing affected horses with healthy controls.

Study Design and Methodology

  • The research was a prospective, international multicentre matched case-control study conducted between January 2022 and May 2024.
  • Cases: 55 horses diagnosed with SLO confirmed during exploratory surgery, recruited from four hospitals in the UK and USA.
  • Controls: 167 healthy horses matched by clinic location and time, selected randomly at a ratio of three controls per case.
  • Data Collection: Information was gathered about horse demographics, history (such as prior laminitis), stabling, and management practices.
  • Statistical Analysis: Conditional logistic regression was used to identify variables associated with increased or decreased risk of developing SLO.

Key Findings

  • Age: Older horses had a higher risk, with a 15% increase in odds of SLO per year of age.
  • Breed Risk: Certain breeds including Ponies, Welsh Section D/Cob, American Quarter Horse, American Paint Horse, Appaloosa, and Arabian showed significantly increased risk (53% higher odds).
  • History of Laminitis: Horses with prior laminitis had markedly higher SLO risk, approximately 11 times greater odds.
  • Recent Stabling: Increased time spent stabled in the preceding four weeks was associated with nearly 7-fold greater risk of SLO.
  • Protective Factors: Management approaches focused on maintaining optimal weight and controlling equine metabolic syndrome reduced SLO risk by about 81%.

Interpretation and Implications

  • The study advances understanding by identifying modifiable management factors beyond inherent horse characteristics.
  • The strong association with laminitis and stabling suggests endocrine health and exercise/movement may contribute to SLO development.
  • Weight management and preventive strategies against endocrine-linked laminitis could lower SLO occurrence, especially in high-risk breeds and older horses.
  • Clinicians and owners should consider these risk factors when developing preventive care plans.
  • There is recognition of potential biases such as selection and recall bias in owner-reported data, which could influence results.

Limitations and Recommendations for Future Research

  • Potential biases from owner recall and case selection may affect the generalizability of findings.
  • Further studies could explore causal mechanisms linking endocrine disease, stabling, and SLO.
  • Investigations into how modifications in management practices can effectively reduce SLO incidence are warranted.
  • More diverse geographical and larger sample studies could enhance understanding across different equine populations.

Conclusions

  • This study identifies older age, specific breeds, laminitis history, and recent increased stabling as risk factors for strangulating lipoma colic in horses.
  • Management targeting weight control and metabolic health shows promise in reducing SLO risk.
  • Preventative approaches tailored to high-risk horses should be considered to improve equine health outcomes.

Cite This Article

APA
Gillen A, Hassel D, Gonzalez S, Savage V, Bauck A, Freeman D, Archer DC. (2025). Risk factors for equine strangulating lipoma colic: An international, case-control study. Equine Vet J. https://doi.org/10.1111/evj.70104

Publication

Equine veterinary journal
ISSN: 2042-3306
NlmUniqueID: 0173320
Country: United States
Language: English

Researcher Affiliations

Gillen, Alexandra
  • Philip Leverhulme Equine Hospital, University of Liverpool, Cheshire, UK.
Hassel, Diana
  • Colorado State University Veterinary Teaching Hospital, Colorado State University, Fort Collins, Colorado, USA.
Gonzalez, Sam
  • Colorado State University Veterinary Teaching Hospital, Colorado State University, Fort Collins, Colorado, USA.
Savage, Victoria
  • Three Counties Equine Hospital, Gloucestershire, UK.
Bauck, Anje
  • College of Veterinary Medicine, University of Florida, Gainesville, Florida, USA.
Freeman, David
  • College of Veterinary Medicine, University of Florida, Gainesville, Florida, USA.
Archer, Debra C
  • Philip Leverhulme Equine Hospital, University of Liverpool, Cheshire, UK.

Grant Funding

  • Arden and Claudia Sims Lipoma Foundation

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Citations

This article has been cited 1 times.
  1. Nocera I, Cingottini D, Di Franco C, Sala G, Bindi F, Spadari A, Rinnovati R, Vitale V, Jose-Cunilleras E, Sgorbini M. In-Depth Analysis of the Prognostic Factors Associated with Short-Term Outcome in Equine Colic Patients: Multicentric Retrospective Study. Animals (Basel) 2026 Feb 5;16(3).
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