Equine diarrhoea Flashcards
Define equine diarrhoea
Increased frequency and change in consistency - some use interchangably with colitis
Isolation important as difficult to differentiate
Causes of acute diarrhoea in the horse
Salmonella spp.
Clostridium difficile
Clostridium perfringens
Coronavirus
Cyathostominosis
Antimicrobial associated
Right dorsal colitis
Grain overload
Dietary
Clinical signs of equine diarrhoea
Clinical signs of chronic equine diarrhoea
Cow pat to high volume hosepipe D+++
Quiet to depressed
Colic
Fever
Hypovolaemia
SIRS
Laminits
Secondary infections
Significant risk of rapid deterioration
Chronic
- Ventral oedema
- Weight loss
- Electrolyte imbalances
Salmonella D+
Risk factors
Some are zoonotic
Nosocomial (from hospital)
Common large volume, watery D+
Bacteriaemia
Intermittent shedding
Risk factors
- Recent abdominal surgery
- GI disease (small colon impaction)
- immunosuppression
- Antimicrobials
- GA
- High ambient temperatures
- Prolonged hospital stay
- Horses actively shedding or carriers
Clostridiosis D+
Risk factors
Commonly - antimicrobial associated and nosocomial
Normal flora in all ages - low numbers do not produce toxins
Toxins produced - disease
Difficile and perfringens
Risk factors
- Dietary changes
- Hospitalisation
- Antimicrobials
- GI disease
- Not fully understood
Coronavirus D+
Enteric pathogen
Outbreaks
Risk factors not fully understood
Cyathostominosis D+
Risk factors
Treatment
Equine parasitic disease - high prevalence
Can have severe clinical signs
Pre-patent disease
Most commonly seen in spring - sudden mass emergence - clinical disease
Can remain encysted from weeks to 2 years
Encysted, hypobiotic larvae unaffected by most anthelmintics
Mass emergence in spring
- Mucosal injury
- Ulceration
- Inflammation
Risk factors
- Age
- Season
- Period since last anthelmintic
- Altered host immunity
- Stress
- Dietary changes
- Unknown factors
Moxidectin
Pre - treatment with steroids - dexamethasone or prednisolone
Antimicrobial colitis
Disruption of GI flora, no competition for nutrients, pathogenic bacteria proliferate, obligate anaerobe most important and antbiotics affecting these will cause D+
Right dorsal colitis
NSAID toxicity - often higher than licenced dose
Not always and not always long term use
Can occur in normovolamic
Misoprostal may be helpful
Psyllium may be helpful
Grain overload D+
Large quanity of hard feed
SI digestion overwhelmed and soluble CHO enters LI
Rapid fermentation by lactic acid producing bacteria lowers pH - gram negative bacteria die - endotoxin released
Other bacteria overgrow and gut wall compromised - bacteria and toxins enter circulation
Risk factors for D+
- gastrointestinal disease
- Immunosuppression
- Antimicrobials
- General anaesthesia
- Recent abdominal surgery
- Hospitalisation
- Other horses – could be acutely infected with shedding or silent carriers intermittent shed
- Dietary changes
Chronic diarrhoea causes
Chronic diarrhoea
Salmonella spp.
Cyathostomiasis
Right dorsal colitis
Sand enteropathy - often intestinal obstruction - treat with psyllium
Inflammatory bowel disease
Dietary
Young horse D+ causes
- Equine Proliferative Enteropathy
- Rhodococcus equi
- Salmonella spp.
- Clostridium difficile
- Clostridium perfringens
- Coronavirus
- Cyathostomiasis
- Antimicrobial Associated
- Right Dorsal Colitis
- Grain overload
- Dietary
Young horse D+ clinical signs
- Cow pat to high volume hosepipe D+++
- Quiet to depressed
- Colic
- Fever
- Hypovolaemia
- SIRS
- Laminitis
- Secondary infections
- Have a significant risk of deteriorating rapidly!
Equine proliferative enteropathy
Cause
Age
Lawsonia intracellularis
2-8months of age usually
Proliferative enteropathy of small intestine
Geographical
Severe hypoalbuminaemia
Weight loss +++
Farms with a history of disease and often annual reoccurrence in this age group
Treat - doxycycline
Rhodococcus equi
Usually get respiratory disease
Uncommon manifestation is D+
Common cause of pneumonia
Farms with a history of disease and often annual reoccurrence in this age group
Neonate diarrhoea causes - Foal 0-10 days
Infectious
Viral
Bacterial
Fungal
Protozoal
Virus
- Rotavirus
- Coronavirus
Bacterial
- Gram positive enterocolitis - clostridium
- Gram negative infections - E.coli, Salmonella, Actinobaccilus
Fungal - immunocompromised foals
- Cadida/mucor
Protozoal
- Cryptosporidium
Foal 0-10 days causes of diarrhoea
Non-infectious
Foal heat diarrhoea
Secondary to meconium infection
Errors in feeding - concentration or volume - orphaned foals
Gastroduodenal ulceration
Sand enterocolitis
Systemic disease - perinatal asphaxia, neonatal adjustment, sepsis
Congenital lactose intolerance
Foal diarrhoea 10 days - 6 weeks
Infectious
Virus
- Rotavirus
- Coronavirus - immunocompromised
Bacterial
- Gram positive enterocolitis - clostridium, rhodococcus equi (uncommon <6 weeks)
- Gram negative infections - E.coli, Salmonella, Actinobaccilus
Fungal - immunocompromised foals
- Cadida/mucor
Protozoal
- Cryptosporidium
Parasitic
- Strongyloides westerii
- Parascaris equorum
- Strongylus vulgaris
Foal diarrhoea 10 days - 6 weeks
Non infectious
Foal heat up to two weeks
Secondary to meconium impaction
Errors in feeding - post enteritis lactose intolerance
Gastric ulceration
Sand enterocolitis
Antibiotic induced diarrhoea - oral administration
Risk factors - neonatal foal D+
Pre-existing disease
Failure of passive transfer – predisposed to more
Poor hygiene in peripartum period
High stocking density
Antimicrobial administration
Milk replacer therapy
Aims of treatment of neonatal D+
- Treatment of underlying cause
- Treatment of the consequences of diarrhoea
- Fluid/electrolyte loss
- Bacterial translocation
- Albumin loss
- Nutrition – prevent from nursing to provide enteral rest – nutrition alternate way
Treatment of neonatal D+
First – history and physical exam
Second – Haematology and biochemistry
Third – Further diagnostics – ultrasound, faecal cultures, or PCR
In order of severity of sickness
Aims of diagnostic investigation for D+
- Determine likely cause for D+
- Determine need for supportive therapy
- Determine need to specific therapy
- Determine risk to in-contact horses and personnel
