Colicky horses that undergo exploratory surgery and are ultimately diagnosed with an ileal impaction appear to benefit from a single injection of carboxymethylcellulose (CMC) into the ileum to resolve the problem, according to veterinarians from Auburn University’s College of Veterinary Medicine.

"Impactions of the ileum, the last part of the small intestine, are a relatively common occurrence in certain geographic regions and are associated with the ingestion of Coastal Bermudagrass hay," explained Christopher G. Alford, DVM, who with R. Reid Hanson, DVM, Dipl. ACVS, ACVECC (emergency and critical care), reviewed the use of CMC in ileal impactions at the 2010 American Association of Equine Practitioners Convention, held Dec. 4-8 in Baltimore, Md.

He noted that many horses presenting with ileal impactions can be managed medically, but sometimes surgery is performed to resolve the impaction–surgery that has its own associated risks. "A large variety of complications can occur in horses undergoing abdominal surgery, especially if the intestines are cut into or a section of intestine is removed," noted Alford.

Finding alternate ways to breakdown the impaction other than cutting into the ileum would decrease the postoperative complications and increase the horse’s chance for survival, he noted. "Using the ‘lubricant’ CMC is a simple way to reduce the impaction with a minimal effect on the small intestine," he said. "CMC penetrates and rehydrates the impaction, but its primary mechanism of action is lubricating the impaction, making it easier (for the ingesta) to pass into the cecum