An evaluation of the use of cisapride in horses with chronic grass sickness (equine dysautonomia)

A clinical trial was carried out to determine the effect of cisapride on rate of passage of digesta and clinical parameters in horses with chronic grass sickness. Sixteen horses were given intramuscular cisapride (0.1 mg kg-1 three times daily) (group I), and 15 received oral cisapride (0.8 mg kg-1 three times daily) (group O). A liquid-phase marker (cobalt-EDTA) and a solid-phase marker (polystyrene pellets) were given by stomach tube at the beginning of each of three consecutive 7 day periods, i.e., before, during and after cisapride therapy. Seven horses in each group completed the rate of passage trial; the remainder provided clinical data only. The rate of passage was found to be significantly faster after cisapride therapy than before. Comparison with data from 20 normal animals showed a trend towards normal rates of passage after therapy. In cases that died during the trial, the caecum and large colon were the main sites of pellet retention. Dry matter intake was significantly higher after therapy than before in group O and dry matter output was higher after treatment than before in both groups. Gut auscultation score increased in both groups in the periods during and after cisapride administration but heart rate was unaffected. Diarrhoea and colic occurred in each group but its occurrence was not associated with cisapride therapy. The results suggest that by increasing gut motility, cisapride is of benefit in the management of selected cases of chronic grass sickness.

An attempt to reproduce 'mal seco' in horses by feeding them Festuca argentina.

'Mal seco' is an almost invariably fatal disease of horses in Argentina and Chile, which resembles grass sickness, a dysautonomia of horses in Europe. The aetiology of mal seco remains unknown. An attempt to reproduce the disease was made by feeding horses with Festuca argentina, a plant considered to be toxic to animals and which was consistently found in the diet of nine horses suffering from mal seco. Three horses were fed with F argentina ad libitum for 28 days. The plant was infected with an endophytic fungus, whose morphological characteristics were in agreement with descriptions of Acremonium chlamydosporioides. No clinical abnormalities were observed in two of the horses, but one died on the fifth day of the trial after becoming incoordinated, unsteady and ataxic in the fore- and hindlimbs. No gross changes were observed post mortem in any of the horses, with the exception of a small number of Fasciola hepatica in the liver of the horse which died, and a moderate number of Gasterophilus species in the stomach of all three horses. No histopathological changes were observed in any of the organs examined, including several autonomic ganglia, brain including most brain stem nuclei, spinal cord, liver, kidney, stomach and small and large intestine. The results of this study suggest that F argentina is either not implicated in the aetiology of mal seco or produces its effects only when they are triggered by other unknown factors.

Small intestine and small colon neuropathy in equine dysautonomia (grass sickness).

The number of neurons in the coeliacomesenteric ganglia and the myenteric and submucosal plexuses of the jejunum, ileum and small colon, and the pathological changes induced in them, were studied in various types of equine dysautonomia. In all forms of dysautonomia, severe and extensive neuron loss and damage occurred in the ileum. In acute and subacute dysautonomia, jejunal neuron loss and damage were severe, but in chronic cases significantly less loss or damage occurred. The damage followed the same pattern in the small colon but it was always less obvious than in the jejunum. The distribution of the damage was uniform within a segment of the intestine. In fatal cases of dysautonomia, the clinical severity and duration of illness seems, in most instances, to be related to the amount of neuronal disruption occurring in the jejunum. Severe disruption results in acute/subacute dysautonomia, while milder damage leads to the chronic form. No case of dysautonomia was encountered in which enteric neuron loss and damage occurred without significant neuronal disruption also occurring in the coeliacomesenteric ganglia. Heal neuronal damage and loss are not invariably worse than that in the jejunum, and the possible reasons for this, together with the relationship between neuronal damage and possible causes of dysautonomia, are discussed.

Histopathology of the brain-stem nuclei of horses with "Mal seco", an equine dysautonomia.

"Mal seco" is a disease of unknown aetiology affecting horses in Argentina. It is similar to grass sickness, a primary dysautonomia of horses in Europe. A histopathological study of the brain stem nuclei of three horses with "mal seco" was performed. Changes were found that consisted of chromatolysis, cytoplasmic vacuoles, eosinophilic sphaeroids, and pyknotic and eccentric nuclei. These changes were most severe at the oculomotor, vestibular and abducent nuclei. The results provide further evidence to suggest that "mal seco" and grass sickness may be the same disease.

Use of clinical measurements to predict the outcome in chronic cases of grass sickness (equine dysautonomia).

Forty-five cases of chronic grass sickness were given scores for selected clinical measurements when they were first examined, to assess their value in predicting survival. Sixteen cases survived. The clinical scores for the degree of dysphagia, appetite, colic and the degree of reduction in gut sounds were significantly lower in the survivors than in the non-survivors. In addition, only the non-survivors had severe rhinitis. Ponies were significantly less likely to survive than cob types.

Cholinergic activity of intestinal muscle in vitro taken from horses with and without equine grass sickness.

Equine grass sickness (EGS) is a pan-dysautonomia of horses that involves central and peripheral neuronal degeneration and ultimately depletion. This is the first reported functional study on the motility of equine intestine taken immediately post mortem from horses with EGS. Strips of smooth muscle from the small intestine of healthy and EGS-affected horses were suspended in an organ bath and their motility was measured isometrically. The activity of the cholinergic system was studied. Physostigmine enhanced the motility of all muscle strips. Tissues taken from horses suffering from acute grass sickness (AGS) had the longest latency before a measurable response could be obtained (p < 0.05). The ileum appeared to be damaged by EGS to a greater extent than the duodenum. For the duodenal strips the enhanced rate of spontaneous contractions was significant (p < 0.05) for both normal tissue and that affected by grass sickness but this was not the case for the ileal strips. Muscarinic receptor sensitivity investigation using bethanecol suggested a hypersensitivity of receptors with AGS material.

Protozoan encephalomyelitis causing pelvic limb paresis in a yearling sheep.

A pelvic limb paresis of 6 weeks duration in a yearling sheep resulted from protozoan encephalomyelitis involving the spinal cord at the thoracolumbar junction. An elevated lumbosacral cerebrospinal fluid protein concentration but normal cisternal cerebrospinal fluid protein concentration indicated the presence of a thoracolumbar inflammatory lesion resulting in cord compression which obstructed the rostral flow of the cerebrospinal fluid. Under general anaesthesia, myelography at the lumbo-sacral site demonstrated blockage to the rostral flow of contrast medium at T13/L1. At necropsy, there were no gross pathological changes at T13/L1, but histopathology revealed non-tract specific lymphocytic perivascular cuffing, axonal swelling and oedema in the spinal cord, characteristic of a protozoal encephalomyelitis. No parasites were detected in the multiple spinal cord sections examined but immunocytochemistry identified antigens cross-reactive with Sarcocystis spp. antigens in glial cells in these lesions.