title: Outcome of Surgical and Medical Management of Cecal Impaction in 150 Horses (1991-2011).
abstract: OBJECTIVE
  To evaluate short- and long-term outcome after medical and surgical management of horses with cecal impaction and to determine reasons for death or euthanasia.
  
  
  METHODS
  Retrospective case series.
  
  
  METHODS
  Horses (n = 150).
  
  
  METHODS
  Data collected from medical records (1991-2011) of horses with a diagnosis of cecal impaction, included signalment, history of recent disease/surgical procedure, admission data, management (medical, typhlotomy alone, jejunocolostomy), complications, and outcome. Short-term outcome (alive or dead at discharge) and long-term outcome (alive or dead at ≥1 year) were determined by telephone interview. Data were analyzed using a χ(2) or Fisher's exact test. Level of significance was P < .05.
  
  
  RESULTS
  Of 150 horses hospitalized with a diagnosis of cecal impaction, 102 (68%) had a history of recent disease or a surgical procedure. Thirty-eight horses (25%) had cecal perforation at admission and 3 horses (2%) were euthanatized without treatment. Of 109 horses treated, 59 (54%) were managed medically and 50 (46%) surgically (typhlotomy [26]; jejunocolostomy [24]). The proportion of horses alive at hospital discharge was significantly lower for horses managed medically (61%) compared with surgically (82%; P = .02) but there was no difference between horses managed with typhlotomy alone (77%) or with jejunocolostomy (88%; P = .47). There were 57% of horses managed medically alive at 1 year. There was a similar proportion of horses alive at 1 year after typhlotomy alone (73%) and jejunocolostomy (70%; P = .86).
  
  
  CONCLUSIONS
  Compared to the recent reports, the proportion of horses alive at hospital discharge was lower for both medically and surgically managed horses with cecal impaction. There was decreased survival for horses treated medically than those treated surgically; however, no significant difference was seen in survival between horses managed with typhlotomy alone versus jejunocolostomy.
authors.affiliation: Department of Clinical Studies, New Bolton Center, University of Pennsylvania School of Veterinary Medicine, Kennett Square, Pennsylvania.
authors.forename: Maia R
authors.initials: MR
authors.lastname: Aitken
authors.affiliation: Department of Clinical Studies, New Bolton Center, University of Pennsylvania School of Veterinary Medicine, Kennett Square, Pennsylvania.
authors.forename: Louise L
authors.initials: LL
authors.lastname: Southwood
authors.affiliation: Department of Clinical Studies, New Bolton Center, University of Pennsylvania School of Veterinary Medicine, Kennett Square, Pennsylvania.
authors.forename: Beth M
authors.initials: BM
authors.lastname: Ross
authors.affiliation: Department of Clinical Studies, New Bolton Center, University of Pennsylvania School of Veterinary Medicine, Kennett Square, Pennsylvania.
authors.forename: Michael W
authors.initials: MW
authors.lastname: Ross
mesh_terms: D000714:Anastomosis, Surgical / Q000662:veterinary; D000818:Animals; D002429:Cecal Diseases / Q000601:surgery / Q000628:therapy / Q000662:veterinary*; D005244:Fecal Impaction / Q000401:mortality / Q000601:surgery / Q000628:therapy / Q000662:veterinary*; D005260:Female; D006734:Horse Diseases / Q000601:surgery / Q000628:therapy*; D006736:Horses; D007421:Intestine, Small / Q000601:surgery; D008297:Male; D010414:Pennsylvania / Q000453:epidemiology; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome