Lipoma: A disease of old age in horses

Strangulating lipoma is of growing importance in the equine population as the number of aging horses increases.
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Q: I have a friend who lost her older gelding to a strangulated gut. The veterinarian said her horse had developed an internal fatty tumor that wrapped around the horse’s intestines. This came out of the blue: This gelding had been perfectly healthy until two days before, with no signs of illness. He was not overweight.

Since that happened, I’ve been terrified my 24-year-old gelding will develop a similar unseen tumor. Is there any way to keep these from developing? Or detect them before they wrap around a gut? My horse is generally doing well, aside from a little arthritis. I just want to make sure that I am doing everything I can for him. What can I do to prevent this problem?

Name withheld by request

A: Firstly, I am very sorry about your friend’s horse dying from a strangulating lipoma. Sadly, this disease is of growing importance in the equine population as the number of aging horses increases. Your concern for your own horse is understandable, but hopefully I can put your mind at ease.

The term colic refers to any pain in the gut.

Strangling lipomas are a more common cause of colic in older horses than their younger herdmates.

Unfortunately, we do not have a good system or a marker—other than advancing years—for identifying horses that have a pedunculated lipoma (a benign, fatty tumor on a stalk that is capable of strangulating the small intestine). Body weight and condition are not good indicators; even thin horses can get a strangulating lipoma. However, if we do develop a marker, the question then arises about how we use this information.

When performing surgery for colic for any reason in an old horse, we do prophylactically remove all pedunculated lipomas from the small intestine and small colon to prevent this problem in the future. Could we use a planned surgery specifically for removal of lipomas in old horses if we could identify those at greatest risk? This is currently not a practical approach.

Click here to learn about the most common types of colic. 

Nonetheless, if an older horse has severe colic, surgical treatment is a viable option. My philosophy in such situations is this: “An old horse with colic has a strangulating lipoma until proven otherwise.” My purpose here is not to scare you but to highlight an approach that could save your horse’s life. Old horses can get many different types of colic, as with any horse, and most are not caused by lipoma. However, old horses tend to be stoic so they might not display the expected signs of small intestinal strangulation and this lesion could then be missed.

This brings us to the most critical step in any horse with severe colic, lipoma or other disease, and that is to send the horse promptly to a referral hospital equipped for handling such cases, especially if there is any concern that surgery is needed. Of course, surgery is expensive and you need to decide ahead of time if that is the option for you. Your own veterinarian or a surgeon at a nearby equine hospital can tell you the cost of colic surgery in that hospital.

For your bookshelf:
Horse Owner's Veterinary Handbook
Storey's Barn Guide to Horse Health Care + First Aid
The Merck Veterinary Manual

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The next step is to debunk the myth that old horses do not handle colic surgery and anesthesia well. We have known for years—and it has been proven repeatedly—that old horses have just as good a chance of survival after colic surgery as younger horses. Colic surgery is expensive, as stated above, and might not be the best option for you or your horse for a number of reasons, but age alone need not be one of them.

I am sure that you have given your old horse a great life. Hopefully when the time comes, he leaves in peace, as most old horses do. Although much of what lies ahead for your horse is beyond your control, delays in referral to a hospital are easy to avoid if surgery is an option. The good news is that not all old horses have lipomas and, in general, the odds are in your favor against a need for surgery.

David E. Freeman, MVB, PhD,Dipl. ACVS

College of Veterinary Medicine
University of Florida
Gainesville, Florida

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