Gastrointestinal — Equine

Refractory pain, tachycardia, significant reflux, and distended small intestine indicate a strangulating small intestinal lesion, classically a pedunculated lipoma in an aged horse, and warrant prompt surgical exploration. Mineral oil is contraindicated with reflux. Equine gastric ulcer syndrome is confirmed only by gastroscopy after a 12 to 18 hour fast so the squamous and glandular mucosa can be visualized and graded; fecal occult blood tests are unreliable in horses. This is esophageal obstruction (choke). Many cases resolve with sedation and esophageal relaxation; if not, careful NG tube lavage clears the obstruction. Oral fluids or oil risk aspiration, and horses cannot vomit.