FREE SHIPPING over $40
OVER 10000 FIVE-STAR REVIEWS
5% OFF ALL SUBSCRIPTIONS
100% HAPPINESS GUARANTEE
Analyze Diet
0
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.
Get Full Text
Publication Date: 2025-10-04 PubMed ID: 41045447DOI: 10.1111/evj.70107Google 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.
LinkedInCopy
  • Journal Article

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.

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

References

This article includes 33 references
  1. Blikslager AT, Bowman KF, Haven ML, Tate LP, Bristol DG. Pedunculated lipomas as a cause of intestinal obstruction in horses: 17 cases (1983‐1990).. J Am Vet Med Assoc 1992;201:1249–1252.
  2. Edwards GB, Proudman CJ. An analysis of 75 cases of intestinal obstruction caused by pedunculated lipomas.. Equine Vet J 1994;26:18–21.
  3. Abutarbush SM, Carmalt JL, Shoemaker RW. Causes of gastrointestinal colic in horses in western Canada: 604 cases (1992 to 2002).. Can Vet J 2005;46:800–805.
  4. Phillips TWJ. Retrospective analysis of the results of 151 exploratory laparotomies in horses with gastrointestinal disease.. Equine Vet J 1993;25:427–433.
  5. Mair TS, Smith LJ. Survival and complication rates in 300 horses undergoing surgical treatment of colic. Part 1: short‐term survival following a single laparotomy.. Equine Vet J 2005;37:303–309.
  6. Garcia‐Seco E, Wilson DA, Kramer J, Keegan KG, Branson KR, Johnson PJ. Prevalence and risk factors associated with outcome of surgical removal of pedunculated lipomas in horses: 102 cases (1987‐2002).. J Am Vet Med Assoc 2005;226:1529–1537.
  7. Freeman DE, Schaeffer DJ. Age distributions of horses with strangulation of the small intestine by a lipoma or in the epiploic foramen: 46 cases (1994‐2000).. J Am Vet Med Assoc 2001;219:87–89.
  8. Dart AJ, Snyder JR, Pascoe JR, Farver TB, Galuppo LD. Abnormal conditions of the equine descending (small) colon: 102 cases (1979‐1989).. J Am Vet Med Assoc 1992;200:971–978.
  9. Newkirk K, Chameroy K, Tadros EM. Pituitary lesions, obesity, and mesenteric lipomas in insulin‐resistant horses.. Open J Vet Med 2014;04:190–196.
  10. Morrison PK, Harris PA, Maltin CA, Grove‐White D, Argo CMG. EQUIFAT: a novel scoring system for the semi‐quantitative evaluation of regional adipose tissues in Equidae.. PLoS One 2017;12:e0173753.
    doi: 10.1371/journal.pone.0173753google scholar: lookup
  11. Carslake HB, Pinchbeck GL, McGowan CM. Equine metabolic syndrome in UK native ponies and cobs is highly prevalent with modifiable risk factors.. Equine Vet J 2021;53:923–934.
  12. Carter RA, Geor RJ, Burton Staniar W, Cubitt TA, Harris PA. Apparent adiposity assessed by standardised scoring systems and morphometric measurements in horses and ponies.. Vet J 2009;179:204–210.
  13. British Horse Society. Fat Scoring.. 2024.
  14. Schott HC. Pituitary pars intermedia dysfunction: equine Cushing's disease.. Vet Clin North Am Equine Pract 2002;18:237–270.
  15. Gillen AM, Ireland JR, Rocchigiani G. Characterising equine abdominal lipomata: can histologic features improve the understanding of pathogenesis and risk?. Equine Vet J 2025.
    doi: 10.1111/evj.14483google scholar: lookup
  16. Hosmer DWL. Applied logistic regression. 2nd ed. Hoboken, NJ: John Wiley & Sons; 2000.
  17. Statement TStRoOSiE [cited 2015 Jan 17]. Available from: https://www.equator-network.org/reporting-guidelines/strobe/
  18. Archer DC, Proudman CJ. Epidemiological clues to preventing colic. Vet J 2006;172:29–39.
  19. O'Neill DG, Corah CH, Church DB. Lipoma in dogs under primary veterinary care in the UK: prevalence and breed associations. Canine Genet Epidemiol 2018;5(9):1–13.
  20. Farkas N, Wong J, Bethel J, Monib S, Frampton A, Thomson S. A systematic review of symptomatic small bowel lipomas of the jejunum and ileum. Ann Med Surg (Lond) 2020;58:52–67.
  21. Vrshni Menaka R, Siva Nathan MMR. A large mesenteric lipoma: an uncommon etiology of small bowel obstruction. Malaysian J of Med and Health Sci 2020;16:319–321.
  22. Senmaru T, Fukui M, Okada H, Mineoka Y, Yamazaki M, Tsujikawa M. Testosterone deficiency induces markedly decreased serum triglycerides, increased small dense LDL, and hepatic steatosis mediated by dysregulation of lipid assembly and secretion in mice fed a high‐fat diet. Metabolism 2013;62:851–860.
  23. Frank N. Equine metabolic syndrome. Vet Clin North Am Equine Pract 2011;27:73–92.
  24. Reynolds A, Keen JA, Fordham T, Morgan RA. Adipose tissue dysfunction in obese horses with equine metabolic syndrome. Equine Vet J 2019;51:760–766.
  25. Le Duc D, Lin CC, Popkova Y. Reduced lipolysis in lipoma phenocopies lipid accumulation in obesity. Int J Obes (Lond) 2021;45:565–576.
  26. Morgan R, Keen J, McGowan C. Equine metabolic syndrome. Vet Rec 2015;177:173–179.
  27. Gandini M, Freeman DE, Giusto G. Hypothesis on the pathophysiology of small intestinal strangulation by a pedunculated lipoma. Equine Vet Educ 2021;37(4):207–213.
  28. Furtado T, Perkins E, Pinchbeck G, McGowan C, Watkins F, Christley R. Exploring horse owners' understanding of obese body condition and weight management in UK leisure horses. Equine Vet J 2021;53:752–762.
  29. Charifa A, Azmat CE, Badri T. Lipoma Pathology. StatPearls Vol. Treasure Island (FL). 2023.
  30. Superchi P, Vecchi I, Beretti V, Sabbioni A. Relationship among BCS and fat thickness in horses of different breed, gender and age. Ann Res and Review in Biol 2013;4:354–365.
  31. Robin CA, Ireland JL, Wylie CE, Collins SN, Verheyen KLP, Newton JR. Prevalence of and risk factors for equine obesity in Great Britain based on owner‐reported body condition scores.. Equine Vet J 2015;47:196–201.
  32. Song JW, Chung KC. Observational studies: cohort and case‐control studies.. Plast Reconstr Surg Glob Open 2010;126:2234–2242.
  33. Esdaile JA. Bias in case‐control studies. A review.. J Epidemiol Community Health 1990;44(3):179–186.

Citations

This article has been cited 0 times.
Subscribe to our newsletter
Join 99,970 horse owners like you who receive our email updates on horse health and nutrition.