SURGICAL REDUCTION OF ILEAL IMPACTIONS IN THE HORSE - 28 CASES

Objective-To evaluate the seasonal influence, signalment, type of hay consumed, clinical examination findings, and outcome after surgery for horses with ileal impaction. Study Design-A retrospective study. Resu lts-Between 1988 and 1993, 28 horses had surgical correction of ileal impaction. There was a significantly higher rate of ileal impaction du ring the Fall (September-November, P = .0041). Mean duration of clinic al signs of abdominal pain before referral was 15 hours. Transrectal p alpation was used to localize the impaction in 11 horses. The ileal im paction was reduced by extraluminal massage aided by admiring of intes tinal fluid oral to the impaction or injection of fluids intraluminall y and then movement of the ingesta into the cecum alone in 24 horses. A total of 26 horses recovered from surgery; 24 horses were discharged from the hospital and eventually returned to previous use. Two horses had fatal postoperative complications: jejunocecostomy dehiscence and development of extensive small intestine adhesions after manual reduc tion of the impaction. One horse initially treated by manual reduction required jejunocecostomy twice for management of recurrent ileal impa ction. Follow-up information was obtained far 21 horses, of which 20 w ere alive 1 year or longer after surgery. A total of 27 of 28 horses w ere fed Coastal Bermudagrass hay as the primary type of hay consumed. A total of 9 horses continued to be fed Coastal Bermudagrass hay as th e only roughage source, whereas 6 horses were fed Coastal Bermudagrass with at least 50% other hay, and in 6 horses, Coastal Bermudagrass ha y was entirely eliminated from the diet. Conclusion and Clinical Relev ance-Ileal impactions can be successfully reduced by celiotomy and ext raluminal massage and injection techniques to soften the ingesta for p assage into the cecum without enterotomy or bypass techniques in most horses. Changes in weather and feeding practices in the Fall may accou nt for an increased risk of ileal impaction in horses in the southeast ern United States at that time of year. (C) Copyright 1998 by The Amer ican College of Veterinary Surgeons.