Medical treatment of horses with ileal impactions: 10 cases (1990-1994).

OBJECTIVE: To evaluate clinical and laboratory findings for horses treated medically for ileal impactions. DESIGN: Retrospective case series. ANIMALS: 10 horses with primary ileal impaction that were treated successfully with medical treatment alone. PROCEDURE: Medical records were reviewed for all horses with naturally developing ileal impaction seen at our hospital between 1990 and 1994. RESULTS: Transrectal palpation revealed an impaction in the midabdominal area in all horses. Generalized distention of the small intestine was evident in 6 horses, whereas 4 horses were examined early in the course of the condition and did not have intestinal distention. Treatment consisted of intravenous administration of a balanced electrolyte solution, nasogastric intubation and siphonage, and administration of analgesics. Mineral oil was administered after gastric reflux had ceased. Mean time for resolution of ileal impaction was 11.7 hours. CLINICAL IMPLICATIONS: Medical treatment may be a viable alternative for horses that cannot have surgery, provided persistent signs of severe pain or progressive gaseous distention of the small intestine are not features of the condition. Improvement of cardiovascular status, reduction in signs of abdominal pain, decrease in distention of loops of small intestine during repeated transrectal examination, softening of the impaction, and decreases in amounts of gastric reflux were indicative of a response to medical treatment.