(E39) Clinical Presentation and Outcome of Gastric Impactions with or Without Concurrent Intestinal Lesions in Horses

Abstract:

Background: Gastric impactions (GI) have been identified as primary lesions (lone GI; LGI) or during investigation of other intestinal lesions (concurrent GI; CGI). Anecdotally, CGI resolve faster and carry a better prognosis than LGI.

Objectives: To determine clinical, laboratory and ultrasonographic findings, short- and long-term survival in horses with GI, hypothesizing that LGI carry a worse prognosis than CGI.

Animals: 71 horses from two referral hospitals (2007-2022).

Methods: Retrospective cohort study. GI were defined as feed extending to the margo plicatus after ≥ 24h fasting. Clinical parameters, diagnostic findings, and outcome were compared between LGI and CGI. Long-term survival was determined by questionnaire.

Results: Twenty-seven horses had LGI, 44 had CGI. Large intestinal lesions (32/44) were more common than small intestinal lesions (12/44). CGI resolved more slowly than LGI (LGI mean 4 days, range 1-10; CGI mean 2 days, range 0-8; P = .003). Short- (LGI 63%, 17/27; CGI 59%, 26/44; P = .74) and long-term survival (LGI 3.5 ± 1.9 years; CGI 2.3 ± 2.3 years; P = .42) were not significantly different. However, LGI was more likely to experience gastric rupture (LGI 29.6%, 8/27; CGI 11.4%, 5/44; P = .05). LGI was 8.7 times more likely to require dietary changes (LGI 72.7%, 8/11; CGI 25%, 4/16; 95% confidence interval, 1.53-49.22; P = .01). GI recurred in 21.7% (LGI, 6/20; CGI, 4/26; P = .23) of affected horses.

Conclusions and Clinical Importance: LGI and CGI present similarly with a comparable prognosis, but LGI are more likely to rupture. Long-term dietary changes are often necessary for horses with LGI.