Martin B B, Freeman D E, Ross M W, Richardson D W, Johnston J K, Orsini J A
Department of Clinical Studies, New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Kennett Square 19348, USA.
J Am Vet Med Assoc. 1999 Jan 1;214(1):80-4.
To determine the prognosis in horses with cecocolic or cecocecal intussusception.
Retrospective study.
30 horses with cecocolic intussusception or cecocecal intussusception.
Information on history, physical examination findings, and laboratory values was summarized from the medical records. Laboratory data included results of hematologic examination, serum biochemical analysis, and peritoneal fluid color, total nucleated cell count, and total protein concentration. A one-year follow-up via the telephone was used to determine long-term survival.
Horses ranged from 7 months to 30 years old, but 63% were < or = 3 years. Standardbred horses were significantly overrepresented. Twenty-six horses had acute-to-subacute disease, and 4 had a chronic wasting disease. Cecal intussusceptions were suspected on the basis of finding a mass on abdominal palpation per rectum (14 of 24 horses) and positive ultrasonographic findings (2 of 3 horses). Thirteen horses with colic for > 1 day had scant, soft feces. Six horses died or were euthanatized without undergoing surgery, and 24 were treated surgically. Six of the latter horses were euthanatized during surgery because of peritonitis, rupture of the cecum, and irreducible intussusception. All 4 horses with a chronic disease were euthanatized because of irreversible changes in the cecum. Of the 18 horses allowed to recover from surgery, 15 survived long-term. Surgical treatments were reduction, with or without partial typhlectomy (6 horses), partial typhlectomy through a colotomy and reduction (6), reduction through a colotomy and partial typhlectomy (3), partial typhlectomy for a cecocecal intussusception (1) and an ileocolostomy (2).
Cecal intussusception has a good prognosis with surgical correction without delay. Reduction through colotomy has a high success rate. Bypass by ileocolostomy should be used as a last resort.
