Objective—To determine the clinical signs, treatment, and prognosis for horses with impaction of the cranial aspect of the base of the cecum (cecal cupula).
Design—Retrospective observational case series.
Animals—7 horses with colic attributed to cecal cupula impaction.
Procedures—Medical records were reviewed and horses that underwent exploratory celiotomy from 2000 through 2010 were identified. Horses with cecal cupula impaction and without other abdominal problems to which colic could be attributed were selected for inclusion in the study. Information regarding history, clinical findings, diagnostic testing, surgical findings and treatments, and treatments and complications after surgery was recorded. Rate of survival of horses to discharge from the hospital was determined. Long-term follow-up information was obtained with telephone questionnaires.
Results—Cecal cupula impaction without other cecal abnormalities was identified in 7 horses during exploratory celiotomy. Although clinical signs varied, horses typically had mild signs of colic and nondiagnostic rectal examination findings but were in systemically stable conditions at the time of the initial evaluation. Typhlotomies were performed and impactions were resolved by means of lavage and evacuation. All horses survived to discharge from the hospital and lived ≥ 2 years after surgery.
Conclusions and Clinical Relevance—Results of this study suggested cecal cupula impaction was a novel type of cecal impaction that was uncommon. Impactions did not involve the cecal body or apex and hypertrophy of the cecal wall was not grossly detected. Impactions were successfully treated with typhlotomy, lavage, and evacuation. Horses had a good prognosis after surgical treatment.
Case Description—A 7-year-old Quarter Horse gelding was evaluated because of sudden onset of severe left forelimb lameness of 4 days' duration.
Clinical Findings—Clinical evaluation and diagnostic perineural analgesia localized the lameness to the distal portion of the left forelimb. Radiography revealed a transverse fracture of the distal phalanx of the left forelimb.
Treatment and Outcome—The horse was treated conservatively with stall rest and stabilization of the hoof with fiberglass cast material and an elevated heel support. These treatments improved the lameness considerably. Over the following 4 months, the horse was exercised at an increasing level; external coaptation of the hoof was removed, and the horse was gradually shod in a flat shoe. At 6 months after injury, the horse had no signs of lameness when working at its previous performance level, but it was euthanized for reasons unrelated to orthopedic disease. Radiographically, the fracture was unapparent; however, results of magnetic resonance imaging and histologic examination of the cadaveric limb confirmed the presence of tissue changes consistent with a healing fracture.
Clinical Relevance—Conservative management of transverse fractures of the distal phalanx of a forelimb may be effective and enable affected horses to be returned to their intended use.