title: Surgical reduction of ileal impactions in the horse: 28 cases.
abstract: OBJECTIVE
  To evaluate the seasonal influence, signalment, type of hay consumed, clinical examination findings, and outcome after surgery for horses with ileal impaction.
  
  
  METHODS
  A retrospective study.
  
  
  RESULTS
  Between 1988 and 1993, 28 horses had surgical correction of ileal impaction. There was a significantly higher rate of ileal impaction during the Fall (September-November, P = .0041 ). Mean duration of clinical signs of abdominal pain before referral was 15 hours. Transrectal palpation was used to localize the impaction in 11 horses. The ileal impaction was reduced by extraluminal massage aided by admixing of intestinal fluid oral to the impaction or injection of fluids intraluminally 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 reduction of the impaction. One horse initially treated by manual reduction required jejunocecostomy twice for management of recurrent ileal impaction. Follow-up information was obtained for 21 horses, of which 20 were alive 1 year or longer after surgery. A total of 27 of 28 horses were fed Coastal Bermudagrass hay as the primary type of hay consumed. A total of 9 horses continued to be fed Coastal Bermudagrass hay as the only roughage source, whereas 6 horses were fed Coastal Bermudagrass with at least 50% other hay, and in 6 horses, Coastal Bermudagrass hay was entirely eliminated from the diet.
  
  
  CONCLUSIONS
  Ileal impactions can be successfully reduced by celiotomy and extraluminal massage and injection techniques to soften the ingesta for passage into the cecum without enterotomy or bypass techniques in most horses. Changes in weather and feeding practices in the Fall may account for an increased risk of ileal impaction in horses in the southeastern United States at that time of year.
authors.affiliation: Department of Large Animal Surgery and Medicine, College of Veterinary Medicine, Auburn University, AL 36849-5522, USA.
authors.forename: R R
authors.initials: RR
authors.lastname: Hanson
authors.forename: J C
authors.initials: JC
authors.lastname: Wright
authors.forename: J
authors.initials: J
authors.lastname: Schumacher
authors.forename: A N
authors.initials: AN
authors.lastname: Baird
authors.forename: J
authors.initials: J
authors.lastname: Humburg
authors.forename: D G
authors.initials: DG
authors.lastname: Pugh
mesh_terms: D000818:Animals; D003085:Colic / Q000209:etiology / Q000601:surgery / Q000662:veterinary; D005260:Female; D006734:Horse Diseases / Q000453:epidemiology / Q000601:surgery*; D006736:Horses; D007077:Ileal Diseases / Q000453:epidemiology / Q000601:surgery / Q000662:veterinary*; D007415:Intestinal Obstruction / Q000453:epidemiology / Q000601:surgery / Q000662:veterinary*; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D012621:Seasons; D015144:Southeastern United States / Q000453:epidemiology; D016896:Treatment Outcome