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Home / Equine Research Bank / Equine Vet J / Risk factors for strangulating lipoma obstruction and lipoma...
Equine veterinary journal2025; doi: 10.1111/evj.70107

Risk factors for strangulating lipoma obstruction and lipomata in horses.

Abstract: Strangulating lipoma obstruction (SLO) is the most common cause of equine small intestinal strangulation and is fatal without surgery. Currently, epidemiological information is primarily limited to signalment-related risk factors and requires further investigation. Objective: To identify horse-level risk factors for SLO and/or abdominal lipoma(s) (LP) formation in horses with acute colic that underwent surgery or post-mortem examination at participating equine clinics. Methods: Prospective, international, multicentre, epidemiological study. Methods: An epidemiological study was conducted over 27 months (January 2022-April 2024) in 8 clinics (UK n = 4, USA n = 4) to identify variables associated with altered likelihood of SLO and/or LP. Horses presenting with acute colic signs that underwent surgery or post-mortem examination were eligible. Those (i) that had SLO as the primary cause of colic, or (ii) those that had mesenteric and/or omental lipoma(ta) (LP) were compared to horses without lipomata. Signalment, adiposity, endocrine status, and lipomata deposition data were analysed using univariable and multivariable logistic regression models. Results: Data from 392 horses was obtained (108 SLO; 190 LP). Increasing age (odds ratio [OR] 1.23) for every year increase in age 95% CI (95% CI: 1.17-1.30, p < 0.001), male sex (OR 1.78, 95% CI: 1.08-2.95, p = 0.02) and clinical indicators of Equine Metabolic Syndrome (EMS) (OR 4.77, 95% CI: 2.93-7.77, p < 0.001) were significantly associated with increased likelihood of SLO. Increasing age, clinical indicators of EMS, indicators of previous/current laminitis (hoof growth ring score), jejunal mesenteric fat score and omental fat scores were significantly associated with increased likelihood of LP. Conclusions: Population restricted to horses with acute colic signs admitted to collaborating clinics. Conclusions: Measures to prevent adiposity and EMS development appear important to reduce the likelihood of LP and SLO. Further investigation of differential adipose tissue deposition between male and female horses is warranted.
© 2025 The Author(s). Equine Veterinary Journal published by John Wiley & Sons Ltd on behalf of EVJ Ltd.
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Publication Date: 2025-10-04 PubMed ID: 41045447DOI: 10.1111/evj.70107Google Scholar: Lookup
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Summary

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Overview

  • This study investigated factors that increase the risk of strangulating lipoma obstruction (SLO) and lipoma formation in horses experiencing acute colic, aiming to identify horse-level variables linked to these conditions.
  • Data from multiple international equine clinics were analyzed to understand how age, sex, adiposity, and metabolic health influence the likelihood of SLO and abdominal lipomas.

Background and Importance

  • Strangulating lipoma obstruction (SLO) is the leading cause of small intestinal strangulation in horses, which can be fatal without surgical intervention.
  • Despite its severity, detailed epidemiological information on SLO risk factors remains limited, with prior research mainly focusing on basic signalment details like age and breed.
  • Identifying risk factors could help in preventive strategies and improve clinical outcomes for horses with acute colic associated with lipomas.

Study Design and Methods

  • The study was a prospective, international, multicenter epidemiological investigation conducted over 27 months from January 2022 to April 2024.
  • Eight equine clinics participated—four from the UK and four from the USA.
  • Horses presenting with acute colic that underwent surgery or post-mortem examination were included.
  • Researchers compared horses with:
    • SLO as the primary cause of colic, and/or
    • Presence of mesenteric and/or omental lipomas (lipomata, LP)
    • to horses without lipomata.
  • Variables collected included:
    • Signalment (age, sex, breed)
    • Adiposity measures (fat scores in different regions)
    • Indicators of endocrine status (clinical signs of Equine Metabolic Syndrome, EMS)
    • History/evidence of laminitis (hoof growth ring score)
  • Data was analyzed using univariable and multivariable logistic regression models to identify associations between these variables and the likelihood of SLO or LP.

Key Results

  • Data was obtained from 392 horses; 108 had SLO and 190 had lipomata.
  • Significant risk factors for increased likelihood of SLO included:
    • Increasing age (Odds Ratio [OR] 1.23 per year increase; p < 0.001)
    • Male sex (OR 1.78; p = 0.02)
    • Clinical indicators of Equine Metabolic Syndrome (EMS) (OR 4.77; p < 0.001)
  • Factors significantly associated with lipoma formation (LP) were:
    • Increasing age
    • Clinical signs consistent with EMS
    • Indicators of previous or current laminitis (hoof growth ring score)
    • Higher fat scores in the jejunal mesentery and omentum (abdominal fat deposits)

Conclusions and Implications

  • The study population was restricted to horses presenting with acute colic at specialized clinics, so findings apply primarily to this clinical subset.
  • Results suggest a strong link between metabolic health (especially EMS), adiposity, and both lipoma formation and the risk of SLO.
  • Male horses and older horses are at higher risk for these conditions.
  • Preventative measures should focus on reducing adiposity and the development or progression of EMS in horses to lower the risk of lipomata and SLO.
  • The observed sex difference points to a need for further research on how fat distribution differs between male and female horses and how this influences lipoma risk.

Overall Significance

  • This research highlights the importance of metabolic health management in horses to prevent life-threatening intestinal complications related to lipomas.
  • Veterinarians and horse owners can use these findings to guide monitoring strategies, dietary management, and medical interventions aimed at controlling EMS and obesity.
  • The study adds valuable epidemiological insight into the risk factors behind SLO and lipoma development, helping to improve preventive care and prognosis in equine colic cases.

Cite This Article

APA
Gillen A, Hassel D, Gonzalez SW, Savage V, Mudge M, Wood A, Barnes H, Bauck A, Freeman D, Dembek K, Gonzalez LM, Archer DC. (2025). Risk factors for strangulating lipoma obstruction and lipomata in horses. Equine Vet J. https://doi.org/10.1111/evj.70107

Publication

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

Researcher Affiliations

Gillen, Alex
  • Philip Leverhulme Equine Hospital, University of Liverpool, Neston, Cheshire, UK.
Hassel, Diana
  • College of Veterinary Medicine & Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA.
Gonzalez, Sam W
  • New Bolton Centre, University of Pennsylvannia, Kennett Square, Pennsylvannia, USA.
Savage, Victoria
  • Three Counties Equine Hospital, Tewkesbury, Gloucestershire, UK.
Mudge, Margaret
  • College of Veterinary Medicine, The Ohio State University, Columbus, Ohio, USA.
Wood, Andrew
  • Liphook Equine Hospital, Liphook, Hampshire, UK.
Barnes, Hattie
  • Bourton Vale Equine Clinic, Cheltenham, 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.
Dembek, Katarzyna
  • College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, USA.
Gonzalez, Liara M
  • College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, USA.
Archer, Debra C
  • Philip Leverhulme Equine Hospital, University of Liverpool, Neston, Cheshire, UK.

Grant Funding

  • The Arden and Claudia Sims Lipoma Foundation

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