Surprise discovery of enteroliths wedged in colon of American paint horse

Companero, a 26-year-old American paint horse, was referred to the Equine Medical Center for emergency colic evaluation. The gelding’s primary care veterinarian, Kate Baldwin of TreeHorse Veterinary Services in Biglerville, Pennsylvania, had treated Companero at home for a suspected colon impaction, but due to his continued discomfort, referred him to the Equine Medical Center for further diagnostics and treatment.

Led by Emily Schaefer, clinical assistant professor of equine medicine, the center’s medicine team completed an abdominal ultrasound. The procedure did not identify significant abnormalities. An abdominocentesis, normal in color, returned a slightly elevated white cell count, and rectal palpation revealed a transverse colon obstruction.

Medical management with intravenous fluids and enteral fluids was started, and Companero initially remained quiet with no overt signs of colic. By the second day of hospitalization, Campanero had not passed any manure and again began showing signs of moderate abdominal discomfort. A second abdominal ultrasound was performed, but no abnormalities were found. A second abdominocentesis revealed changes in the gelding’s peritoneal fluid, indicating that surgical intervention would be necessary to relieve the obstruction.

During surgical exploration of Companero’s abdomen, Maureen Kelleher, clinical assistant professor of sports medicine and surgery, discovered three large enteroliths in the transverse and right dorsal colon. An enterotomy was performed, and the enteroliths were removed.

Enteroliths are intestinal “stones” or mineral deposits that form in thin layers over a small piece of foreign matter ingested by the horse, such as a sliver of wood, a pebble, or grains of sand. Enteroliths may remain in the colon for variable periods of time, but result in obstructive colic when the normal gastrointestinal motility moves the enterolith from a larger-diameter colon structure to a smaller-diameter structure. Some breeds of horses are predisposed to enteroliths, which are also caused by certain diets and are more prevalent in horses in North America’s Western states. Unusual for a horse with enteroliths, Companero has lived his entire life on the East Coast.

Companero needed a little assistance from the center’s large animal lift during his recovery from surgery. Once back in his stall, he remained bright and comfortable during his post-operative care, which included fluid therapy, antibiotics, and analgesia. The gelding was started on a careful refeeding schedule shortly after surgery.

After seven days in the hospital, Companero and his companion Diablo were transported home. Detailed instructions for an adjusted diet were provided to his owner, Sally Alexander, who will continue his rehabilitation care at home.

Sally, who has been riding for more than 50 years, describes Companero as her “fun” horse! She has spent the past 11 years trail-riding through woods and fields and in the mountains with her husband, Steve, on his off-the-track thoroughbred, Diablo. Steve and Diablo enjoy jumping, and they travel from their home in Gettysburg, Pennsylvania, to Virginia on a regular basis for jumping lessons. Of course, Diablo accompanied Companero to the hospital to provide moral support during his treatment.

“Everyone at the hospital was so caring and took Companero’s problems into account, and that made all the difference in his great outcome. He has bad knees and has trouble getting up when he is down, so extra planning and effort were needed to get him up after surgery,” said Sally, who was very concerned about her gelding because of his age and physical challenges. “It was also great that Dr. Kelleher had experience in this type of problem, which I understand is unusual for this area. We can't thank everyone at the hospital enough for the great care both horses received during their stay.”