Cecal perforation in the horse.

The case records of 23 horses with cecal perforation (CP) were reviewed. The horses averaged 4.5 years of age (6 weeks to 13 years) and included 9 intact males, 12 mares, and 2 geldings. Twelve of the horses were Standardbreds, 9 were Thoroughbreds, and 1 each, a Belgian and Morgan. The horses were allotted to 2 groups: group I-13 hospitalized horses in which CP occurred unexpectedly, and group II-10 horses with CP at the time of admission. The horses characteristically had been sick or affected with disease unrelated to the cecum. Sixteen horses had been given nonsteroidal anti-inflammatory drugs before the onset of CP. Twelve of the 13 hospitalized patients (group I) had vague, scarcely recognizable clinical signs of gastrointestinal disease before CP. The clinical signs and clinical laboratory changes that appeared in affected horses were identifiable with severe endotoxin shock, secondary to peritoneal contamination with ingesta and bacteria. All horses died. At necropsy of the horses, the cecum was large and firm and was filled with ingesta, and the colon was empty; however, in 1 postpartum mare, the cecum and colon contained the usual amount of ingesta and were normal in size. In all horses, a single perforation was present, which appeared at various sites. The most common was a transverse perforation along the ventral aspect of the cecal body. Gross and microscopic examinations uncovered no existing disease near the perforation site or in other areas of the cecal wall or cecocolic orifice.(ABSTRACT TRUNCATED AT 250 WORDS)