Risk factors for epiploic foramen entrapment colic in a UK horse population: A prospective case-control study

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Reasons for performing study:

Epiploic foramen entrapment (EFE) is a common cause of small intestinal strangulation in the horse and its epidemiology requires further investigation.


To identify horse- and management-level risk factors for EFE and to explore reasons for the apparent seasonality of this condition.


Horses exhibiting certain behaviours and those exposed to particular management practices that vary seasonally are at increased risk of EFE.


A prospective unmatched, multicentre case-control study was conducted over 24 months in the UK. Data on 77 cases and 216 control horses were obtained from 9 collaborating clinics and logistic regression was used to identify associations between horse and management variables and the likelihood of EFE.


In a final multivariable model crib-biting/windsucking behaviour was associated with the largest increase in likelihood of EFE. A history of colic in the previous 12 months, increased stabling in the previous 28 days and height of the horse also increased the likelihood of EFE. Horses with access to a mineral/salt lick, those easily frightened and horses not fed at the same time as others were at reduced risk of EFE.


Horses exhibiting certain behaviours, those with a previous history of colic and horses of greater height appear to be at inherently greater risk of EFE. The increase in likelihood of EFE with increased duration of stabling may explain the apparent seasonality of this condition.

Potential relevance:

These findings assist identification of horses at high-risk of EFE and provide information on management strategies that may reduce this risk. If the observed associations are causal, avoiding sudden increases in duration of stabling, not feeding horses in the same group at the same time and providing a mineral/salt lick may reduce the likelihood of EFE. The risk factors identified in this study provide important clues to the aetiology of EFE.

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