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Updated: Feb 16, 2026

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An update on equine post-operative ileus: Definitions, pathophysiology and management.

Z M Lisowski1, R S Pirie1, A T Blikslager2

  • 1The Roslin Institute and Royal (Dick) School of Veterinary Studies, University of Edinburgh, Easter Bush, Midlothian, UK.

Equine Veterinary Journal
|December 28, 2017
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Summary

Post-operative ileus (POI) in horses is a common surgical complication. Understanding its inflammatory triggers, like macrophage activation, is key to developing better treatments for this multifactorial condition.

Keywords:
POIabdomencolicgastrointestinal motilityhorsesurgery

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Area of Science:

  • Veterinary Surgery
  • Equine Medicine
  • Gastroenterology

Background:

  • Post-operative ileus (POI) significantly impacts horses after abdominal surgery, increasing recovery time and costs.
  • Current understanding of equine POI relies heavily on human and rodent models, identifying manipulation-induced inflammation and macrophage activation as key factors.

Purpose of the Study:

  • To review the current understanding of equine post-operative ileus pathophysiology.
  • To highlight the role of inflammation and macrophage activation in POI development.
  • To emphasize the need for multimodal treatment strategies.

Main Methods:

  • Literature review of equine, human, and rodent studies on post-operative ileus.
  • Analysis of inflammatory pathways and cellular mechanisms involved in POI.
  • Evaluation of current and potential therapeutic approaches.

Main Results:

  • Inflammation, particularly involving muscularis externa macrophages, is a critical component in POI development.
  • Existing pharmacological treatments for POI have shown limited success across species.
  • POI is recognized as a complex, multifactorial condition.

Conclusions:

  • Effective management of equine POI requires a comprehensive, multimodal approach.
  • Further research into equine-specific inflammatory mechanisms is needed.
  • Minimizing POI incidence necessitates addressing its diverse contributing factors.