Strangulating (Pedunculated) Lipomas in Horses
Key takeaways
A strangulating (or pedunculated) lipoma is a benign tumor that is suspended within the abdomen by a stalk of tissue.
- The lipoma moves behind or around the structures of the gastrointestinal tract, in some cases wrapping the stalk tightly enough to cut off the blood supply
- Causes of strangulating lipomas are currently unknown
- Symptoms range from mild to severe colic depending on disruption to intestinal function and blood supply
- Diagnostic tools include physical examination, rectal palpation, nasal intubation, and ultrasound
- Treatment is surgical removal of the lipoma and stalk, as well as any damaged portions of the intestine
- If treated early, the prognosis is good
- In cases where intestinal damage occurs, the prognosis is fair to poor
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A closer look: Strangulating (Pedunculated) Lipomas in Horses
Strangulating lipomas are uncommon in horses, but can quickly cause a life-threatening emergency due to death of intestinal tissue. Horses showing symptoms of severe colic require emergency veterinary attention to determine the cause and ensure prompt treatment.
Early detection is crucial to good outcomes. In cases where the strangulating lipoma is discovered and removed before damage to the intestine is permanent, the prognosis is good. For horses where portions of the intestine must be removed due to tissue death, the prognosis is guarded.
Risk factors
The severity of strangulating lipomas depends on the specific portion of the intestines affected, length of intestine involved, and the degree of strangulation that occurs. Signs of colic increase in severity as the severity of strangulation increases.
Horses over the age of 10 are more likely to have strangulating lipomas, as developing a lipoma and forming a stalk takes considerable time.
Possible causes
The causes of lipoma are not yet fully understood. They begin as localized plaques of fat within the abdomen that grow slowly over time. Eventually, the weight of the lipoma causes the supporting tissue to stretch, creating a stalk that the lipoma hangs from. In some cases, the lipoma moves over or around parts of the intestine, wrapping the intestine in the stalk, strangling the tissue in the process and cutting off blood supply. The pain associated with dying intestinal tissue results in severe colic.
Main symptoms
Most horses with strangulating lipomas show severe colic signs.
In some cases of strangulating lipomas, signs of pain are intermittent.
Testing and diagnosis
Diagnostic tools to identify a strangulating lipoma include:
- Physical examination
- Nasal intubation
- Rectal palpation
- Ultrasound
Note: nasal intubation should only be performed by a veterinarian. There is no safe way to intubate a horse at home.
Steps to Recovery
Treatment is surgical removal of the lipoma and pedicle. In cases tissue death has occurred, a portion of the intestine must be removed as well.
Prognosis depends on whether tissue death has occurred or not. The sooner the strangulating lipoma is identified and removed, the better the outcome.
Prevention
There are no proven preventative measures. Optimal intestinal health in horses requires a diet of many small meals throughout the day, access to plenty of fresh water, and daily exercise.
Are Strangulating (Pedunculated) Lipomas in Horses common?
Strangulating lipomas are uncommon in horses. They occur more frequently in older horses.
Typical Treatment
- Surgery
