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  • Author or Editor: Douglas L. Langer x
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Objective

To identify breed, age, sex, physical findings, history, and outcome of treatment in horses and other equids with enterolithiasis.

Design

Retrospective study.

Animals

900 equids with enterolithiasis.

Procedure

Medical records from equids with enterolithiasis admitted between 1973 and 1996 were reviewed. Data on signalment, history, physical examination and clinicopathologic findings, surgical findings, and outcome were compiled from records and from telephone interviews with owners. Sex and breed predilections were determined by comparison of the study population with the general hospital population of equids during the same time period.

Results

Equids with enterolithiasis represented 15.1% of patients admitted for treatment of colic, and 27.5% of patients undergoing celiotomy for treatment of colic. Arabian and Arabian crosses, Morgans, American Saddlebreds, and donkeys were significantly overrepresented, and Thoroughbreds, Standardbreds, warmbloods, and stallions were significantly underrepresented in the study population, compared with the hospital population. The mean age of equids with enterolithiasis was 11.4 years. The most common historic findings were signs of intermittent colic (33.3%) and passage of enteroliths in the feces (13.5%). Physical examination findings were similar to those found in equids with other forms of nonstrangulating large colon obstructive disease. Fifteen percent (131) developed gastrointestinal tract rupture caused by an enterolith that necessitated euthanasia. Short-term and 1-year survival rates for equids undergoing celiotomy for treatment of enterolithiasis and recovering from anesthesia were excellent (96.2 and 92.5%, respectively), and postoperative complications were uncommon. Recurrence of enterolithiasis was identified in 7.7% of the study population.

Clinical Implications

Results indicated that short-term and 1-year survival rates for equids undergoing surgery for enterolithiasis are excellent. Identification of signalment, history, and management factors may help identify equids with a high risk for development of enterolithiasis. (J Am Vet Med Assoc 1999;214;233–237)

Free access
in Journal of the American Veterinary Medical Association

Summary

Medical records of 245 horses that had been evaluated by use of abdominal radiography between January 1990 and December 1992 were reviewed. One hundred forty-one horses subsequently had a postmortem examination or surgical exploration performed for definitive lesion diagnosis. The signalment, diagnosis, site, and number of enteroliths were obtained from the medical records. Radiographs were evaluated individually by 3 reviewers for the presence of enteroliths, preferred diagnostic view, evidence of large colon tympany, and film quality. Of the 141 cases reviewed, 66.7% (94/141) had confirmed enterolithiasis. Enteroliths were identified in the right dorsal colon of 59 horses, in the transverse colon of 28, in the small colon of 24, and in the ventral colon of 1 (enteroliths were detected in multiple sites in 12 horses). For the 3 reviewers, mean sensitivity was 76.9% and specificity was 94.4%. Mean positive-predictive value was 96.4%, and negative-predictive value was 67.5%. Cases involving only large colon enteroliths were correctly diagnosed 83.2% of the time, compared with 41.6% of the time for cases involving small colon enteroliths. Enteroliths were evident in 54.8% of the horses with radiographic signs of large colon distention. Fifteen horses had enteroliths in the small colon, 4 in the transverse colon, and 4 in the dorsal colon.

Radiographic quality was evaluated and scored as adequate (0), underexposed (−1), overexposed (1), or incomplete. Mean score was −0.5, and there were 21 (14.9%) incomplete studies. For the 75 cases correctly diagnosed via abdominal radiography, there were 14 (18.7%) incomplete studies and a mean score of −0.43. Of the 19 false-negative evaluations, there were 3 (15.8%) incomplete studies and a mean score of −0.69. The most common error leading to the missed diagnoses seemed to be inadequate penetration of the abdomen.

Free access
in Journal of the American Veterinary Medical Association