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Equine Enterolithiasis

Equine Enterolithiasis. Accession # 114670 Erica Fields, DVM. Toby Henderson. 15 yo Appendix (no, really) gelding 9 day history of colic, unresponsive to Banamine Large colon impaction palpated by rDVM Presented to VTH – gas in cecum, tension in cecal bands, no impaction palpated.

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Equine Enterolithiasis

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  1. Equine Enterolithiasis Accession # 114670 Erica Fields, DVM

  2. Toby Henderson • 15 yo Appendix (no, really) gelding • 9 day history of colic, unresponsive to Banamine • Large colon impaction palpated by rDVM • Presented to VTH – gas in cecum, tension in cecal bands, no impaction palpated An Appendix horse

  3. Enterolithiasis Pathophysiology • Typically struvite (ammonium magnesium phosphate) • Need a nidus for formation (often a silicon dioxide stone, nail, or piece of rope) • Possible causes/predisposing factors • Increased magnesium diets • Geographic distribution (in CA, 28% of surgical colics have enteroliths!) • Breeds (Arab, Morgan, Am. Saddlebred, donkey) Blikslager 2002

  4. Enterolithiasis • Common sites – right dorsal colon and transverse colon • Clinical signs • Intermittent colic in mature horses (>4 yo) • Few rectal palpation abnormalities until large enough to occlude colon and cause severe pain/distension • Treatment • Generally, surgery is required – try to push toward pelvic flexure enterotomy • Prognosis – generally good (92% 1 year survival for surgically treated). Rupture occurred in 15%. Blikslager 2002

  5. Dorsal view of the colon Left dorsal colon Right dorsal colon Left ventral colon Right ventral colon Transverse colon Pelvic flexure Cecum Small colon http://www.vetmed.wsu.edu/Van308/_derived/equine.htm_txt_lgcolon.gif

  6. Alternative DDx • Colonic sand impaction • Common in horses on sandy soil • Ground fed • Sand accumulation usually in right dorsal colon and pelvic flexure • Clinical signs – diarrhea (irritates mucosa), colonic impaction signs, sand in feces, “sand rubs” • Treatment – medical initially (Psyllium), may need surgery Blikslager 2002

  7. Sly – Enterolith Toby – Sand impaction

  8. Reference • Blikslager AT. Surgical disorders of the large intestine. In Large Animal Internal Medicine, 3rd ed. 2002. pp 662-663.

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