Prevalence of Gastric Ulceration in Horses with Enterolithiasis Compared with Horses with Simple Large Intestinal Obstruction

SIMPLE SUMMARY: Enteroliths are stone-like concretions of salts that form in the large colon of some horses. The disease associated with their presence is known as enterolithiasis and may manifest itself as chronic or acute abdominal pain. Enterolithiasis particularly occurs in some geographic areas such as California and Florida, although it has also been occasionally reported elsewhere. Gastric ulceration, defined as lesions of the mucosal lining of the stomach, is a well-documented pathological condition that affects horses of all ages and breeds throughout the world. Many risk factors for the development of gastric ulcerations have been identified, and some others have been suspected but never proven. This paper documents the prevalence of gastric ulceration in horses affected by enterolithiasis and were surgically treated and compares it with the prevalence of gastric ulceration in horses affected by similar intestinal diseases that were also surgically treated. ABSTRACT: Enterolithiasis is a well-documented cause of colic in horses, especially in some geographic areas such as California and Florida. This retrospective case-control study aims at comparing the prevalence of gastric ulcers in horses affected by enterolithiasis to that in horses affected by other types of large intestinal obstruction. Two hundred and ninety-six horses were included in the study sample. Horses that had surgery for the removal of one or more enteroliths were included in the study as cases. Patients that had surgery for large intestinal simple obstructions other than enterolithiasis (large colon displacement, non-strangulating large colon torsion, and large and small colon impactions) were selected to match case horses for age, sex, and breed and included as controls. A total of 101/148 horses with enteroliths (68%) had gastric ulcers diagnosed during hospitalization, compared with 46/148 of matched controls (31%). There was a significant association between enterolithiasis and gastric ulceration (odds ratio 4.76, p < 0.0001), and a greater prevalence in Thoroughbreds as compared with other breeds (odds ratio 22.6, p < 0.0001). We concluded that enterolithiasis is significantly associated with gastric ulceration (p < 0.0001). The association is stronger in Thoroughbreds.