A 13-year-old Morab mare, 4-5 months pregnant, presented with a chief complaint of colic less than a day in duration. An exploratory celiotomy was performed, which relieved a small intestine volvulus. She was transferred to the Internal Medicine Service for post-operative ileus and endotoxemia. Five days after her first surgery, she underwent a second celiotomy for resolution of her persistent ileus. Following the second surgery, the mare's endotoxemia resolved and small intestine motility improved. Ten days after the second surgery she developed severe ileus once more and was euthanized.

The definitive cause of post-operative ileus in equidae is currently unknown. What is clear is that there are many contributing elements that result in this condition. The risk factors, phases of ileus and pharmacological and therapeutic interventions will be reviewed. There is no gold standard treatment for post-operative ileus but a multimodal therapy approach is currently the best plan to resolve this complicated condition.