Chronic severe pyloric lesions in horses: 47 cases.

BACKGROUND: The clinical findings and outcome associated with chronic severe equine pyloric lesions have not been well described previously. OBJECTIVES: To describe the history, clinical signs, endoscopic and ultrasound results, laboratory data, treatment, pathological findings and survival of horses with chronic severe pyloric lesions. STUDY DESIGN: Retrospective case series. METHODS: Medical records from horses treated at clinics in Czech Republic and Germany in which chronic severe pyloric lesions were confirmed endoscopically and/or on post-mortem examination were reviewed. RESULTS: Forty-seven horses were identified, median age 3 years (range 0.8-16 years). There were 3 geldings, 23 mares and 19 stallions and the majority were Warmbloods (60%). The most common presenting signs were poor body condition (40; 87%), slow eating (39; 83%), recurrent colic (35; 74%) and selective appetite (30; 64%). The most consistent laboratory abnormality was hypoalbuminaemia (10; 36%). Slow gastric emptying was confirmed in 29 individuals during gastroscopy and/or ultrasonography. Endoscopy revealed distal oesophagitis in 9 of 47 horses, and severe equine squamous gastric disease in all cases. Pyloric lesions were depressed, flat or raised fibrinosuppurative pyloric ulcers and were seen in 45 (2 pylori were not seen endoscopically). Thirty-two cases were treated, with 28 responding well initially. All treated cases received anti-ulcer medication and four underwent gastrojejunostomy. Clinical signs recurred after medical treatment in at least 11 cases. Only 18 of 44 cases (41%) survived long term (3 were lost to follow-up). Horses diagnosed at 3 years of age or younger were significantly less likely to survive more than 6 months than older horses (27.8% vs. 72.2%, P<0.001). MAIN LIMITATIONS: The study is retrospective, some records were incomplete and case identification was subjective. CONCLUSIONS: Chronic severe pyloric lesions can be associated with delayed gastric emptying identified with ultrasonography and/or endoscopy. The prognosis is poor in young horses.

Guttural pouch mycosis in horses: a retrospective study of 28 cases.

The medical records of 28 horses with guttural pouch mycosis were reviewed. The most commonly observed clinical signs were nasal discharge, epistaxis, dysphagia and/or cough. All 28 horses had the disease unilaterally, however, in five of them, it had spread into the contralateral pouch via the mesial septum. Three horses were treated medically, 11 horses underwent surgery and seven horses were treated both medically and surgically. Fifty percent of horses (14/28) were euthanased or died, fifty percent of horses (14/28) survived. There was no significant correlation between treatment method (medical, surgical, combination) and survival rate. The most common reason for euthanasia was dysphagia due to pharyngeal dysfunction. There was a highly significant correlation between the presence of dysphagia and non-survival (p=0.008).

Equine granulocytic anaplasmosis in the Czech Republic.

Twelve confirmed cases of equine granulocytic anaplasmosis (EGA) and five additional suspected cases, showing a compatible clinical history and specific IgG titres of 1280 or above, were recorded in the Czech Republic during the period 2002 to 2008. The diagnosis was based on clinical signs, the detection of Anaplasma phagocytophilum morulae in neutrophils in blood smears, serology and molecular methods. Pyrexia (39.8 to 41.3 degrees C), depression, partial or total anorexia, limb oedema and icterus were the most frequently observed clinical abnormalities. Haematological examination revealed thrombocytopenia in all the horses, and mild anaemia and leucopenia in five of them. Several horses showed high titres of specific antibodies immediately after onset of the disease, suggesting that they had previously been exposed to A phagocytophilum. Genotyping of the A phagocytophilum strains distinguished two genetic variants, with divergence in the sequence of the ank gene of the bacterium, circulating in the Czech Republic.