Enteritis Equinos

Published in IVIS with the permission of the AAEP

Close this window to return to IVIS

Diagnosis and Treatment of Enteritis and Inflammatory Bowel Disease
Michelle Henry Barton, DVM, PhD, Diplomate ACVIM Author’s Address: College of Veterinary Medicine, The University of Georgia, Athens, Georgia 30602. mbarton@vet.uga.edu.

CASE ONE A 13-year-old Tennessee Walking Horse stallion developedacute onset of colic in central Georgia in October. He was found in his stall in the morning with numerous abrasions on his head. The grain and hay that he was offered the previous evening were only partially consumed. The owner witnessed him pawing at the ground. He then became recumbent and rolled. The local veterinarian was called and arrived approximately 45 minutes later. The owner reportedthat the stallion continued to intermittently paw, flank watch, and roll. His rectal temperature was 101.8oF, heart rate was 60 beats/minute, and respirations were 24 breaths/minute. Mucous membranes were tacky with a toxic line and the capillary refill time was 3 seconds. Gastrointestinal sounds were quiet. A nasogastric tube was passed and 8 liters of brown reflux were obtained. A rectalexamination was performed and several loops of mildly distended small intestine were palpable in the midabdomen. The local veterinarian administered 500 mg of flunixin meglumine IV and gave 3 liters of mineral oil and 3 liters of electrolyte solution via the nasogastric tube. The stallion immediately appeared more comfortable and seemed interested in grazing. However, three hours later, he resumespawing, flank watching, and rolling. He is referred to the Veterinary Teaching Hospital at the University of Georgia for further evaluation. At the time of presentation, the stallion appeared mildly to moderately uncomfortable, as evidenced by pawing and kicking at the abdomen. His rectal temperature was 99oF, heart rate was 64 beats/minute, and respirations were 32 breaths/minute. Mucous membranes weredry and diffusely toxic with a capillary refill time of 4 seconds. Extremities were cold to the touch. Gastrointestinal sounds were absent. Nasogastric intubation yielded 10 liters of oily brown reflux. Rectal examination revealed multiple loops of tightly distended small intestine. A catheter was placed in the jugular vein and isotonic polyionic fluids and 150 mg of xylazine were administered.Blood was submitted for a complete blood count and serum chemistry profile (Table 1). Abdominal fluid was collected and grossly appeared sanguineous (Table 1). The owner wants to know what is wrong with the horse, what is the treatment, and what is the prognosis? Etiology of Enteritis The presence of distended small intestine and gastric reflux are important clues that localize the problem to thesmall intestine. But what is the underlying etiology? Does this represent transient ileus, an inflammatory, an obstructive, or a strangulating obstructive lesion of the small intestine? The answer to this question is not always

straightforward. In fact, distinguishing between acute inflammatory lesions of small intestine i.e. enteritis and obstructive or strangulating small intestinal lesionscan be quite challenging. Enteritis is an acute inflammatory disease of the small intestine. Synonyms for enteritis include anterior or proximal enteritis, gastroduodenojejunitis, and proximal duodenitis-jejunitis. In adult horses, the exact etiology of proximal enteritis is not known. Although it is often speculated that the disease is infectious in nature, specific pathogens are infrequentlyisolated from affected horses and attempts at reproducing enteritis in adult horses by giving gastric or intestinal contents from affected individuals are largely unsuccessful.1 In some instances, Salmonella and Clostridium spp. can be isolated from the gastric reflux, intestine, or feces; however, outbreaks of enteritis are exceptionally rare in the mature horse.1,2 In contrast, enteritis in...