A strangulating lipoma is a common cause of surgical colic in horses, particularly older horses (often >15 years of age). A lipoma is a benign fatty tumor that develops within the abdominal cavity and forms a long stalk (pedicle). Over time, this stalk can wrap around a portion of the intestine, cutting off blood supply and causing a strangulating obstruction.
Although the tumor itself is not cancerous, the resulting loss of blood flow to the intestine is life-threatening and requires emergency surgical treatment. Delay in diagnosis or referral significantly worsens the prognosis.
Clinical signs are consistent with acute, severe colic and may progress rapidly.
Signs may include:
- Sudden onset of abdominal pain
- Pawing, flank watching
- Repeatedly lying down and getting up
- Violent rolling
- Depression
- Inappetence
- Sweating
- Elevated heart rate (often >60 beats per minute)
- Decreased or absent gastrointestinal sounds
- Reduced to absent manure production
- Progressive worsening of pain despite medical treatment
Pain may temporarily improve with sedation or analgesics but typically returns quickly.
Your veterinarian will perform a thorough physical examination and obtain a history.
Questions may include:
- Age and sex of the horse
- Previous colic episodes
- Recent management or feed changes
Physical examination may include:
- Heart rate, respiratory rate, rectal temperature
- Mucous membrane color
- Gastrointestinal sounds
- Assessment for abdominal distention
- Rectal examination (may reveal distended small intestine)
Based on initial findings, your veterinarian may recommend:
- Passing a nasogastric tube to evaluate for reflux
- Blood work to assess hydration and systemic compromise
- Abdominal ultrasound
- Abdominocentesis (sampling abdominal fluid)
A serosanguinous abdominal fluid sample (blood tinged) combined with an elevated abdominal lactate is often suggestive of a strangulating lesion of the intestine. A definitive diagnosis of a strangulating lipoma is often made during exploratory abdominal surgery.
If a strangulation of the intestines is suspected, surgical treatment is required. There is no effective medical (non-surgical) management for a strangulating lipoma.
Surgical treatment includes:
- Exploratory abdominal surgery under general anesthesia
- Identification and removal of the lipoma
- Release of entrapped intestine
- Evaluation of the affected intestine
- Resection and anastomosis may be required if a portion of intestine is non-viable
Horses undergoing surgery typically require:
- Hospitalization for 5–7 days
- Intravenous fluids, antibiotics, and analgesics (pain control)
- Gradual reintroduction of feed
- Monitoring for postoperative complications such as ileus (delayed transit of gastrointestinal content) or infection
After discharge, horses generally require:
- A period of strict stall rest based on incisional healing
- Gradual increase in turnout
- At least 2–3 months before returning to riding or training
Prognosis depends on:
- Duration of intestinal strangulation
- Degree of intestinal damage
- Whether intestinal resection was required
- Speed of referral and surgical intervention
Horses treated early, before irreversible intestinal damage occurs, have a fair to good prognosis. Prognosis becomes more guarded if extensive intestine must be removed or if the horse is systemically compromised at the time of surgery.
Key Points for Horse Owners:
- Strangulating lipomas most commonly affect older horses and geldings
- Sudden, severe colic is an emergency
- Lack of response to medical treatment is a warning sign
- Early referral to a surgical facility improves survival
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