Risk factors for epiploic foramen entrapment colic: an international study.
Authors: Archer D C, Pinchbeck G K, French N P, Proudman C J
Journal: Equine veterinary journal
Summary
# Epiploic Foramen Entrapment: Identifying at-Risk Horses Epiploic foramen entrapment (EFE) ranks among the most common causes of small intestinal strangulation in horses, yet little was known about which animals or management practices predispose horses to this life-threatening condition. Using a matched case-control design across UK, Irish and American equine hospitals, Archer and colleagues analysed questionnaire data from 109 EFE cases and 310 controls to identify significant risk associations through conditional logistic regression. Crib-biting and windsucking emerged as the strongest predictors, increasing EFE risk 67-fold, whilst previous colic history (4.4-fold increased risk) and greater height (1.05-fold per centimetre) were also significant; notably, horses displaying reactive behavioural traits—including nervousness, excitability and inquisitiveness—showed reduced risk, suggesting a distinct "at-risk personality" characterised by calm, potentially stress-responsive temperaments. The findings indicate that some horses may have inherent anatomical or physiological predisposition to EFE, making this research particularly valuable for risk stratification and management planning in practice; identifying high-risk candidates early could inform targeted preventive strategies, though further work is needed to clarify whether behavioural modification or other interventions can meaningfully reduce incidence in susceptible populations.
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Practical Takeaways
- •Horses exhibiting crib-biting or windsucking should be considered high-risk for EFE colic; management strategies to eliminate these behaviours may reduce colic incidence
- •Monitor horses with previous colic episodes closely, particularly taller horses, as they have inherent predisposition to EFE
- •Consider behavioural profiling as part of colic risk assessment; horses with calm, food-responsive dispositions may have lower EFE risk
Key Findings
- •Crib-biting/windsucking behaviour was strongly associated with increased risk of EFE (OR 67.3, 95%CI 15.3-296.5)
- •Previous colic history in 12 months increased EFE risk (OR 4.4, 95%CI 1.5-12.7)
- •Greater horse height was associated with increased EFE risk (OR/cm 1.05, 95%CI 1.01-1.08)
- •Specific behavioural traits including easy frightening, sweating up easily, and inquisitiveness were protective against EFE