Colico en caballos

Case Report Rapport de cas
Chronic intestinal pseudo-obstruction in a horse: A case of myenteric
ganglionitis
Sonia Chénier, Susana M. Macieira, Doris Sylvestre, Daniel Jean
Abstract — An 11-year-old Quarter horse mare was presented for recurrent episodes of colic. A chronic intestinal
pseudo-obstruction was diagnosed. Medical treatment and surgical resection of the colon were performedbut the
condition did not improve and the horse was euthanized. Histopathological examination revealed a myenteric
ganglionitis of the small intestine and ascending colon.
Résumé — Pseudo-obstruction intestinale chronique chez une jument : un cas ganglionite myentérique. Une
jument Quarter Horse âgée de 11 ans a été présentée pour coliques récurrentes. Une pseudo-obstruction intestinalechronique a été diagnostiquée. Le traitement médical et la résection chirurgicale du côlon n’ont amené aucune
amélioration de la condition et l’animal a été euthanasié. L’examen histopathologique des tissus a révélé une
ganglionite des plexus myentériques de l’intestin grêle et du colon ascendant.
(Traduit par les auteurs)
Can Vet J 2011;52:419–422
C
hronic intestinal pseudo-obstruction (CIP)is a rare
syndrome characterized by impaired intestinal peristalsis
leading to clinical signs of obstruction (abdominal distension
and bowel dilation, dysphagia, vomiting, constipation) in
the absence of mechanical occlusion of the intestinal lumen
(1,2). Motility disorders of the gastrointestinal tract can be
either primary (familial or sporadic) or secondary to a systemic
disease.Four main etiopathogeneses underlie this syndrome:
neuropathies, myopathies, secondary neuromuscular disorders
and disorders of Cajal cells (2). Neural disorders appear to be far
more common than other causes in human cases of CIP, some
of which are characterized by a ganglionitis (2). In veterinary
medicine, CIP is mostly associated with muscular disorders of
the intestine (3–11).Chronic intestinal pseudo-obstruction due
to an intestinal ganglionitis is rare and has only been reported in
a dog, a horse, and a cow (12–14). The previous reported equine
case involved only the small colon and a mesenteric ganglion
(13). We describe a case of CIP in a horse with myenteric ganglionitis of the small intestine and ascending colon.
Case description
An 11-year-old femaleQuarter horse suffered over a 3-year
period from chronic recurrent colic and was examined for this
problem at the Equine Hospital of the Centre hospitalier universitaire vétérinaire de l’Université de Montréal. Apart from
gastric ulcers that were treated with cimetidine, there were
no significant findings on physical examination, laboratory
examinations, urinalysis, and abdominal palpationat its first
presentation to our hospital. Recurrent episodes of colic resolved
with medical treatments. Two years later, a second evaluation at
our hospital revealed a severe and firm impaction of the large
colon. Additional diagnostic tests included a complete blood
(cell) count (CBC), fecal flotation, serum biochemical analysis,
fecal culture for Salmonella, abdominalultrasonography, and
abdominocentesis which revealed no abnormalities. Medical
treatment was instituted for 3 d without improvement of the
large colonic impaction.
Considering the history of recurrent colic and the poor
response to medical treatment, surgical exploration was offered
to the owners. A ventral midline celiotomy was performed and
the large colonic impaction was resolved. After initialfeeding,
the impaction recurred; therefore, a complete pelleted diet was
instituted. The mare was discharged with routine post-operative
instructions and was fed a complete pelleted diet several times
a day. One year later, the mare was readmitted to the Equine
Hospital for recurrent episodes of colic, sometimes associated
with large colonic impaction. These signs were observed less...