Small intestinal volvulus in 115 horses: 1988-2000.
Authors: Stephen Jennifer O, Corley Kevin T T, Johnston Janet K, Pfeiffer Dirk
Journal: Veterinary surgery : VS
Summary
# Small Intestinal Volvulus in Horses: Clinical Presentation and Surgical Outcomes Small intestinal volvulus represents a surgical emergency with significant mortality risk, yet clinical presentation can be deceptively variable, making diagnosis challenging in practice. This retrospective analysis of 115 cases spanning 1988–2000 examined signalment, clinical signs, laboratory findings, and outcomes to clarify what practitioners might expect when managing these cases. The study revealed that affected horses were predominantly older (74% aged ≥3 years) and presented with inconsistent clinical signs—notably, elevated heart rate and severe pain were not universal features, whilst rectal examination identified distended small intestine in only 69% of cases, suggesting reliance on a single diagnostic approach risks missing the condition. Of 100 horses undergoing surgery, 84 recovered from anaesthesia and 67 survived to hospital discharge (80% post-operative survival, 58% overall survival), with 25 horses requiring small intestine resection. Nearly half of discharged horses developed post-operative complications, which significantly extended hospitalisation (11 days versus 8.9 days for uncomplicated cases). These findings indicate that whilst surgical prognosis is more favourable than previously reported, practitioners should counsel owners on the substantial likelihood of complications and prolonged recovery, and recognise that non-dramatic clinical presentation does not exclude volvulus, particularly in older horses.
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Practical Takeaways
- •Small intestinal volvulus can occur in horses of any age but was more common in horses ≥3 years; clinical signs alone are unreliable for diagnosis, so maintain high suspicion with any acute abdominal pain
- •Rectal examination findings are inconsistent for this condition (only 69% positive); don't rule out volvulus based on rectal palpation alone
- •Prognosis is reasonably good (80% post-operative survival), supporting aggressive surgical intervention in stable candidates; plan for 11-day average recovery with potential complications
Key Findings
- •80% of horses that underwent surgery for small intestinal volvulus survived to hospital discharge, with 84 of 100 surgical cases recovering from anesthesia
- •High heart rate and severe pain were not consistent clinical features at presentation, complicating early diagnosis
- •Rectal examination identified distended small intestine in only 69% of cases despite confirmed volvulus diagnosis
- •Post-operative complications occurred in 48% of discharged horses, extending average hospitalization from 8.9 to 11 days