Summary Reasons for performing study : Idiopathic focal eosinophilic enteritis (IFEE) and diffuse eosinophilic enteritis (DEE) are primary eosinophilic intestinal conditions without a known cause that are associated with an increasing number of surgical colic cases. Histology may be helpful in defining disease aetiology and pathogenesis. Objectives : To characterise further the inflammatory infiltrate in equine IFEE and to compare the condition with DEE. Methods : Twenty‐three IFEE cases and 5 DEE cases were examined by light microscopy including immunohistology to identify infiltrating leucocytes. Inflammatory infiltrates in mucosa and submucosa were characterised in IFEE lesions ( Group 1 ), the intestine distant from the lesions in IFEE ( Group 2 ) and DEE ( Group 3 ). Results and conclusions : IFEE lesions represented an accumulation of leucocytes in submucosa and muscularis , with dominance of eosinophils and macrophages and smaller numbers of lymphocytes, plasma cells and neutrophils. T cells represented the dominant lymphocytes. The mucosa overlying the lesion and both mucosa and submucosa in IFEE nonlesion sites and in DEE exhibited a similar composition, with different prevalence of various cell types. Macrophages were significantly more prevalent in the mucosal and submucosal infiltrates in IFEE nonlesion sites than in DEE, and lymphocytes significantly more prevalent in the mucosa in DEE than in IFEE nonlesion sites. The findings confirm IFEE as a primary eosinophilic intestinal disorder and indicate that IFEE represents a focally exacerbated inflammatory reaction in horses with DEE, possibly due to functional changes in the macrophage and T cell components, with subsequent excessive recruitment of both eosinophils and macrophages. Potential relevance : This characterisation of the inflammatory reaction in IFEE and DEE represents the first comparative report on primary eosinophilic intestinal disorders in horses. It provides a starting point for more detailed investigations into the factors promoting these conditions.
Background: Surgical site infection (SSI) is a frequent complication following emergency equine laparotomy. It negatively impacts equine welfare, increases treatment costs and is a hospital biosecurity risk justifying investigations of ways to reduce SSI incidence. Objectives: To determine if a sutured-on stent dressing for anaesthetic recovery reduces SSI in horses following emergency laparotomy. Study design: Randomised controlled trial. Methods: Eligible horses undergoing emergency exploratory laparotomy were enrolled. Horses were randomised to have a sutured-on stent dressing (intervention) or standard adhesive textile dressing (control) placed for incisional protection during anaesthetic recovery. Horses were followed up to 90 days postoperatively. Data were analysed according to intention-to-treat principles. Time to SSI (primary outcome) for each group was analysed using a Cox proportional hazard model. Secondary outcomes (SSI during hospitalisation, pyrexia during hospitalisation, days hospitalisation and incisional hernia formation at 90 days) were analysed using Chi-squared tests and a univariable logistic regression model (categorical data) or by comparing means between groups (continuous data). Results: The study included 352 horses (167 intervention group, 185 control group). SSI developed in 101 horses (28.7%) at a mean of 9.7 days (SD 4.6 days). Rate of SSI was not significantly different between intervention and control groups unadjusted (Hazard Ratio [HR] 0.83, 95% CI 0.56 - 1.23, P=0.36) or adjusted for variables significantly associated with rate of SSI (HR 0.88, 95% CI 0.59 – 1.30, P=0.51). There were no significant differences in secondary outcomes between intervention and control groups. Main limitations: This study was performed at a single centre and only evaluated incisional protection for anaesthetic recovery. Conclusions: Use of a sutured-on stent dressing for anaesthetic recovery did not reduce the rate of SSI compared to a textile adhesive dressing. Further RCT are required to investigate efficacy of other interventions on reduction of SSI following emergency laparotomy
Fasciola hepatica (liver fluke) affects grazing animals including horses but the extent to which it affects UK horses is unknown.To define how liver fluke affects the UK horse population.Descriptive, cross-sectional, observational study.An F. hepatica excretory-secretory antibody detection ELISA with a diagnostic sensitivity of 71% and specificity of 97% was validated and used to analyse serum samples. An abattoir study was performed to determine prevalence. A case-control study of 269 horses compared fluke exposure between horses with liver disease and controls. Data on clinical signs and blood test results were collected for sero-positive horses. Genotyping of adult fluke was used to produce a multilocus genotype for each parasite.Four (2.2%) of 183 horses registered in the UK, sampled in the abattoir, had adult flukes in the liver, and the sero-prevalence of F. hepatica was estimated as 8.7%. In the case-control study, horses showing signs consistent with liver disease had significantly higher odds of testing positive for F. hepatica on ELISA than control horses. In 23 sero-positive horses, a range of non-specific clinical signs and blood test abnormalities was reported, with a third of the horses showing no signs. Genotypic analysis of liver flukes from horses provided evidence that these came from the same population as flukes from sheep and cattle.Bias could have arisen in the prevalence and case-control studies due to convenience sampling methods, in particular the geographic origin of the horses. Only a small number of horses tested positive so the data on clinical signs are limited.Exposure to liver fluke occurs frequently in horses and may be an under-recognised cause of liver disease. Flukes isolated from horses are from the same population as those found in ruminants. When designing and implementing parasite control plans, fluke should be considered, and horses should be tested if appropriate.
Summary This report describes the likely development and growth of bilateral granulosa cell tumours (GCTs) in a Warmblood pony mare, during the first trimester of pregnancy after artificial insemination. The GCTs were initially suspected to be ovarian haematomas and were managed conservatively. However, they ultimately led to life‐threatening haemoperitoneum (HP) and were later diagnosed as GCTs with histopathology. The case was successfully managed with emergency standing laparoscopic‐assisted bilateral ovariectomy after haemodynamic supportive therapy. The mare made a full recovery and delivered a live filly foal at term. GCTs can be a rare cause of life‐threatening HP and can be successfully managed with haemodynamic support and standing laparoscopic‐assisted removal. Bilateral ovariectomy in a pregnant mare after 70 days of gestation can result in successful delivery of a live foal.
A horse which had had a caecal impaction for 10 days was treated by means of an ileocolostomy [corrected] but failed to respond satisfactorily. Before a second laparotomy was performed it was observed to have dislodged the extension set from a jugular catheter and air was heard being sucked into the vein. It became very agitated but was anaesthetised again and the impaction was removed through an incision in the apex of the colon [corrected] After recovering from the anaesthesia it developed severe signs of pruritus which subsided only after 12 hours. These signs were considered most likely to have resulted from a venous air embolism.
Summary African horse sickness ( AHS ) is an arboviral disease of equids transmitted by Culicoides biting midges. The virus is endemic in parts of sub‐Saharan Africa and official AHS disease‐free status can be obtained from the World Organization for Animal Health on fulfilment of a number of criteria. AHS is associated with case fatality rates of up to 95%, making an outbreak among naïve horses both a welfare and economic disaster. The worldwide distributions of similar vector‐borne diseases (particularly bluetongue disease of ruminants) are changing rapidly, probably due to a combination of globalisation and climate change. There is extensive evidence that the requisite conditions for an AHS epizootic currently exist in disease‐free countries. In particular, although the stringent regulations enforced upon competition horses make them extremely unlikely to redistribute the virus, there are great concerns over the effects of illegal equid movement. An outbreak of AHS in a disease free region would have catastrophic effects on equine welfare and industry, particularly for international events such as the Olympic Games. While many regions have contingency plans in place to manage an outbreak of AHS , further research is urgently required if the equine industry is to avoid or effectively contain an AHS epizootic in disease‐free regions. This review describes the key aspects of AHS as a global issue and discusses the evidence supporting concerns that an epizootic may occur in AHS free countries, the planned government responses, and the roles and responsibilities of equine veterinarians.
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