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Kranenburg LC, Bouwmeester BF, van den Boom R. Findings and Prognosis in 149 Horses with Histological Changes Compatible with Inflammatory Bowel Disease. Animals (Basel) 2024; 14:1638. [PMID: 38891685 PMCID: PMC11171156 DOI: 10.3390/ani14111638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2024] [Revised: 05/27/2024] [Accepted: 05/29/2024] [Indexed: 06/21/2024] Open
Abstract
Inflammatory bowel disease (IBD) is a chronic disease characterized by different cell infiltrates in the intestine. The aims of this study were to report the clinical and clinicopathological findings in horses with histological changes compatible with IBD in the duodenum. Further, the clinical progression of IBD and survival were investigated. Patient records were reviewed for horses in which histological evidence of IBD was found in duodenal biopsies collected during endoscopy. The histological changes were classified as mild, moderate or severe and the predominant infiltrating cell type was recorded. Clinical improvement was assessed by the owner via a questionnaire at 6 weeks after biopsy, along with survival after one year. In total, 149 horses were included, and the most common clinical signs were weight loss, reduced performance and pain during abdominal palpation. Most horses showed partial malabsorption during an oral glucose absorption test, and the horses with severe IBD had lower serum protein concentrations. Lymphoplasmacytic enteritis was the most common type of IBD (78.5% of cases), while in six horses neutrophilic infiltration of the duodenum was present. Overall, 71% of the cases had improved clinically after six weeks, mostly following treatment with corticosteroids. The results of a second biopsy were a poor predictor of improvement, and the horses that improved after 6 weeks were more likely to be alive after one year.
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Affiliation(s)
| | | | - Robin van den Boom
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 112, 3584 CM Utrecht, The Netherlands; (L.C.K.)
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Timko K. Approach to Inflammatory Bowel Disease. Vet Clin North Am Equine Pract 2024:S0749-0739(24)00030-0. [PMID: 38789349 DOI: 10.1016/j.cveq.2024.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2024] Open
Abstract
Inflammatory bowel disease (IBD) in the horse encompasses a group of infiltrative gastrointestinal disorders resulting in malabsorption, maldigestion, weight loss, colic, and sometimes diarrhea. The type of IBD can be classified as granulomatous, lymphocytic-plasmacytic, or eosinophilic enterocolitis. The diagnosis of IBD in equids is based on consistent clinical signs and clinicopathologic findings in conjunction with confirmatory histopathology from a gastrointestinal biopsy. Treatment usually consists of a combination of immunosuppressive medications, anthelmintics, and dietary modifications. The prognosis of IBD in horses is variable and dependent on the horse's response to treatment; however, horses can show improvement or resolution of clinical signs.
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Affiliation(s)
- Kathryn Timko
- College of Veterinary Medicine, The Ohio State University, 601 Vernon L Tharp Street, Columbus, OH 43201, USA.
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Barrett JG, MacDonald ES. Use of Biologics and Stem Cells in the Treatment of Other Inflammatory Diseases in the Horse. Vet Clin North Am Equine Pract 2023; 39:553-563. [PMID: 37607855 DOI: 10.1016/j.cveq.2023.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/24/2023] Open
Abstract
Mesenchymal stem cells (MSCs) are powerful immunomodulatory cells that act via multiple mechanisms to coordinate, inhibit, and control the cells of the immune system. MSCs act as rescuers for various damaged or degenerated cells of the body via (1) cytokines, growth factors, and signaling molecules; (2) extracellular vesicle (exosome) signaling; and (3) direct donation of mitochondria. Several studies evaluating the efficacy of MSCs have used MSCs grown using xenogeneic media, which may reduce or eliminate efficacy. Although more research is needed to optimize the anti-inflammatory potential of MSCs, there is ample evidence that MSC therapeutics are worthy of further development.
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Affiliation(s)
- Jennifer G Barrett
- Marion duPont Scott Equine Medical Center, Virginia-Maryland College of Veterinary Medicine, Virginia Tech, Leesburg, VA, USA.
| | - Elizabeth S MacDonald
- Marion duPont Scott Equine Medical Center, Virginia-Maryland College of Veterinary Medicine, Virginia Tech, Leesburg, VA, USA
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Hostetter JM, Uzal FA. Gastrointestinal biopsy in the horse: overview of collection, interpretation, and applications. J Vet Diagn Invest 2022; 34:376-388. [PMID: 35354416 DOI: 10.1177/10406387221085584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Evaluation of gastrointestinal (GI) biopsies is a multistep process that includes reviewing an appropriate history, determining sample quality, and evaluating histologic sections. Selected diagnostic parameters that, in combination with intestinal histopathology, can be useful to localize disease to the intestinal tract in the horse include hypoproteinemia and hypoalbuminemia, ultrasound evidence of increased thickness of the small intestinal wall, and alterations in glucose or D-xylose absorption tests. Biopsies may be acquired either endoscopically, or via laparoscopy or standing flank incisional approaches. GI sections should be evaluated using a systematic approach that includes both architectural changes and inflammatory cell infiltrates. Although strategies have been developed for assessment of GI biopsies from the dog and cat, a standardized approach to interpretation of the equine GI biopsy has yet to be developed. GI biopsies pose several challenges to the pathologist, especially for endoscopic biopsies in which the quality of the specimen and its orientation may vary greatly. Architectural changes are arguably the most critical changes to evaluate. In a horse with chronic GI inflammation, such as occurs in idiopathic inflammatory bowel disease (IBD), the cell types encountered frequently are macrophages, eosinophils, lymphocytes, and plasma cells. Increased numbers of these cell types are categorized loosely as mild, moderate, and severe. Specific forms of idiopathic IBD have been further classified by this infiltrate as granulomatous enteritis, eosinophilic enteritis, and lymphoplasmacytic enteritis; there is limited information on microscopic changes with each. Unfortunately, microscopic GI lesions are usually nonspecific, and determination of etiology requires further investigation.
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Affiliation(s)
- Jesse M Hostetter
- Department of Pathology, College of Veterinary Medicine, University of Georgia, Athens, GA, USA
| | - Francisco A Uzal
- California Animal Health and Food Safety Laboratory System, University of California-Davis, San Bernardino, CA, USA
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Jarvis N, McKenzie HC. Nutritional Considerations when Dealing with an Underweight Adult or Senior Horse. Vet Clin North Am Equine Pract 2021; 37:89-110. [PMID: 33820611 DOI: 10.1016/j.cveq.2020.12.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Weight loss occurs when the supply of energy is insufficient to meet the energy needs of an individual. The energy supply may be reduced by inadequate provision of feed, inadequate consumption, reduced digestion and absorption, or disruption in metabolic processing. Increased energy expenditure occurs with exercise and during cold temperatures, pregnancy, and lactation. Underlying clinical disease, particularly chronic inflammation, neoplasia, and protein-losing conditions, can cause weight loss or exacerbate existing weight loss. A methodical approach to weight-loss investigation and treatment is necessary, because of the often multifactorial nature of this condition.
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Affiliation(s)
- Nicola Jarvis
- Redwings Horse Sanctuary, Hapton, Norwich, Norfolk NR15 1SP, UK
| | - Harold C McKenzie
- Department of Large Animal Clinical Sciences, Virginia Maryland College of Veterinary Medicine, Virginia Tech, 215 Duckpond Drive, Blacksburg, VA 24061, USA.
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MacDonald ES, Barrett JG. The Potential of Mesenchymal Stem Cells to Treat Systemic Inflammation in Horses. Front Vet Sci 2020; 6:507. [PMID: 32039250 PMCID: PMC6985200 DOI: 10.3389/fvets.2019.00507] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Accepted: 12/20/2019] [Indexed: 12/13/2022] Open
Abstract
One hallmark of mesenchymal stem cells (MSCs) is the ability to differentiate into multiple tissue types which assists in tissue regeneration. Another hallmark of MSCs is their potent anti-inflammatory and immunomodulatory properties and the potential to treat inflammatory, immune-mediated, and ischemic conditions. In equine practice, MSCs have shown efficacy in the treatment of musculoskeletal disorders such as tendinopathy, meniscal tears and cartilage injury. However, there are many equine disease processes and conditions that may benefit from the immunomodulatory properties of MSCs. Examples include conditions associated with overwhelming acute inflammatory response such as systemic inflammatory response syndrome to chronic diseases characterized by a prolonged low level of inflammation such as equine asthma and recurrent uveitis. For the acute inflammatory response processes, there is often high morbidity and mortality with no effective immunomodulatory treatment to prevent the overwhelming synthesis of proinflammatory mediators. For chronic inflammatory disease processes, frequently long-term corticosteroid treatment is the therapeutic mainstay, with serious potential complications. Thus, there is an unmet need for alternative anti-inflammatory treatments for both acute and chronic illnesses in horses. While MSCs show promise for such conditions, much research is needed before a clinically safe and effective treatment will be available. Optimal MSC tissue source, patient vs. donor source (autologous vs. allogeneic) and cell growth conditions need to be determined for each problem. For immediate use, allogeneic MSC treatments is preferable, but immune tolerance and adequate safety require further study. MSC collection and cryopreservation from horses before they are injured or ill, whether from umbilical cord tissue, bone marrow or adipose might become more widespread. Once these fundamental approaches to treating specific diseases with MSCs are determined, the route of administration, dose and timing of administration also need to be studied. To provide a framework for development of MSC immunomodulatory treatments, this article reviews the current understanding of equine MSC anti-inflammatory and immunomodulatory properties and proposes how MSC therapy may be further developed to treat acute onset systemic inflammatory processes and chronic inflammatory diseases.
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Affiliation(s)
- Elizabeth S MacDonald
- Marion duPont Scott Equine Medical Center, Virginia Maryland College of Veterinary Medicine, Virginia Tech, Leesburg, VA, United States
| | - Jennifer G Barrett
- Marion duPont Scott Equine Medical Center, Virginia Maryland College of Veterinary Medicine, Virginia Tech, Leesburg, VA, United States
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Galinelli NIC, Wambacq W, Lefère L, Paulussen E, Hesta M. Can the outcome of an impaired oral glucose absorption test in horses be improved with fat supplementation and dietary modifications? VETERINARY RECORD CASE REPORTS 2019. [DOI: 10.1136/vetreccr-2019-000844] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
| | - Wendy Wambacq
- Laboratory of Animal NutritionFac. Vet SciencesGhent UniversityGentBelgium
| | - Laurence Lefère
- Department of Internal Medicine and Clinical Biology of Large AnimalsUniversiteit GentMerelbekeBelgium
| | - Ellen Paulussen
- Department of Internal Medicine and Clinical Biology of Large AnimalsUniversiteit GentMerelbekeBelgium
| | - Myriam Hesta
- Laboratory of Animal NutritionFac. Vet SciencesGhent UniversityGentBelgium
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Biscoe EW, Whitcomb MB, Vaughan B, Dechant JE, Magdesian KG. Clinical features and outcome in horses with severe large intestinal thickening diagnosed with transabdominal ultrasonography: 25 cases (2003–2010). J Am Vet Med Assoc 2018; 253:108-116. [DOI: 10.2460/javma.253.1.108] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Diagnostics and Treatments in Chronic Diarrhea and Weight Loss in Horses. Vet Clin North Am Equine Pract 2018; 34:69-80. [DOI: 10.1016/j.cveq.2017.11.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Boshuizen B, Ploeg M, Dewulf J, Klooster S, Bruijn MD, Picavet MT, Palmers K, Plancke L, Cock HD, Theelen M, Delesalle C. Inflammatory bowel disease (IBD) in horses: a retrospective study exploring the value of different diagnostic approaches. BMC Vet Res 2018; 14:21. [PMID: 29351774 PMCID: PMC5775604 DOI: 10.1186/s12917-018-1343-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Accepted: 01/11/2018] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Diagnosing IBD in horses is challenging and requires a multimodal approach, since no conclusive diagnostic test is available. The objectives of this study were to provide an overview of population characteristics, results of applied diagnostic tests, treatment modalities and outcome in a large group of horses thought to have IBD and that were presented to four large equine referral hospitals, and to provide an exploratory investigation of possible associations between results of applied diagnostic tests, applied treatment modalities and outcome. A retrospective case series was performed across four large equine referral hospitals. Seventy-eight horses, thought to have IBD were included. Case history, clinical findings, diagnostic test results including oral glucose tolerance test (OGTT) and enteral biopsies (both duodenal and rectal), applied therapy and outcome were studied. A Chi-Square test was used to identify associations between results of diagnostic tests, treatment and outcome. P-values < 0.05 were considered significant. RESULTS Lethargy, diarrhoea, recurrent colic and weight loss were recorded in respectively 21,8%; 14,1%; 28,2% and 78,2% of cases. Over 70% of horses thought to have IBD had an abnormal OGTT. Only weight loss was significantly associated with aberrant enteral biopsy results, but not with abnormal OGTT results or low blood total protein. There was no association between an aberrant biopsy result and a disturbed OGTT. There was no association between either OGTT results or enteral biopsy results and a low blood total protein content, presence of gastric ulcer disease or an aberrant endoscopic aspect of the duodenal entrance. CONCLUSIONS Weight loss is a highly prevalent symptom in IBD suspected horses. Enteral biopsies may be a useful diagnostic aid in the work-up of horses thought to suffer from IBD, however further research is required to demonstrate their true diagnostic value. Until more standardized scientific research is available, one should be careful with the interpretation of enteral biopsy results There is a need for better standardization of enteral biopsy procedures and the histopathological scoring of biopsies.
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Affiliation(s)
- Berit Boshuizen
- Department of Virology, Parasitology and Immunology, Research Group of Comparative Physiology, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.,Wolvega Equine Clinic, Oldeholtpade, Wolvega, The Netherlands
| | - Margreet Ploeg
- Department of Pathobiology, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - Jeroen Dewulf
- Department of Obstetrics, Reproduction and Herd health, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Sanne Klooster
- Department of Equine Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - Marco de Bruijn
- Wolvega Equine Clinic, Oldeholtpade, Wolvega, The Netherlands
| | | | | | - Lukas Plancke
- Department of Virology, Parasitology and Immunology, Research Group of Comparative Physiology, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Hilde De Cock
- Veterinary Pathology Services/Medvet laboratory, Antwerp, Belgium
| | - Mathijs Theelen
- Department of Equine Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - Catherine Delesalle
- Department of Virology, Parasitology and Immunology, Research Group of Comparative Physiology, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.
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Mora Pereira M, Groover E, Wooldridge A, Caldwell F. Review of glucocorticoid therapy in horses. Part 2: Clinical use of systemic glucocorticoids in horses. EQUINE VET EDUC 2016. [DOI: 10.1111/eve.12624] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- M. Mora Pereira
- J. T. Vaughan Large Animal Teaching Hospital; Auburn University; Alabama USA
| | - E. Groover
- J. T. Vaughan Large Animal Teaching Hospital; Auburn University; Alabama USA
| | - A. Wooldridge
- J. T. Vaughan Large Animal Teaching Hospital; Auburn University; Alabama USA
| | - F. Caldwell
- J. T. Vaughan Large Animal Teaching Hospital; Auburn University; Alabama USA
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Cuming RS, Groover ES, Wooldridge AA, Caldwell FJ. Review of glucocorticoid therapy in horses. Part 1: Pharmacology. EQUINE VET EDUC 2016. [DOI: 10.1111/eve.12555] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Affiliation(s)
- R. S. Cuming
- J. T. Vaughan Large Animal Teaching Hospital Auburn University Alabama USA
| | - E. S. Groover
- J. T. Vaughan Large Animal Teaching Hospital Auburn University Alabama USA
| | - A. A. Wooldridge
- J. T. Vaughan Large Animal Teaching Hospital Auburn University Alabama USA
| | - F. J. Caldwell
- J. T. Vaughan Large Animal Teaching Hospital Auburn University Alabama USA
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Castagnetti C, Mariella J. Anti-inflammatory Drugs in Equine Neonatal Medicine. Part II: Corticosteroids. J Equine Vet Sci 2015. [DOI: 10.1016/j.jevs.2015.02.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Kaikkonen R, Niinistö K, Sykes B, Anttila M, Sankari S, Raekallio M. Diagnostic evaluation and short-term outcome as indicators of long-term prognosis in horses with findings suggestive of inflammatory bowel disease treated with corticosteroids and anthelmintics. Acta Vet Scand 2014; 56:35. [PMID: 24894126 PMCID: PMC4055252 DOI: 10.1186/1751-0147-56-35] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2013] [Accepted: 05/26/2014] [Indexed: 11/27/2022] Open
Abstract
Background Recurrent colic and unexplained weight loss despite good appetite and adequate feeding and management practices are common conditions in the horse. However, little information has been published on the systematic diagnostic evaluation, response to treatment, prognostic factors or outcome of either presentation. The aims of this study were to 1) identify possible prognostic indicators and 2) report the short- and long-term response to treatment with corticosteroid therapy of a variety of horses with a presumptive diagnosis of inflammatory bowel disease (IBD). Thirty-six horses with a history of recurrent colic and/or unexplained weight loss were screened with a detailed clinical, clinicopathological and diagnostic imaging examination. Twenty horses were subsequently selected that had findings consistent with inflammatory bowel disease based on the fulfilment of one or more of the following additional inclusion criteria: hypoproteinaemia, hypoalbuminaemia, malabsorption, an increased intestinal wall thickness on ultrasonographic examination or histopathological changes in rectal biopsy. These 20 horses were treated with a standardized larvicidal anthelmintic regime and a minimum of three weeks of corticosteroid therapy. Results The initial response to treatment was good in 75% (15/20) of horses, with a 3-year survival rate of 65% (13/20). The overall 3-year survival in horses that responded to initial treatment (12/15) was significantly higher (P = 0.031) than in those that did not respond to initial treatment (1/5). The peak xylose concentration was significantly (P = 0.048) higher in survivors (1.36 ± 0.44 mmol/L) than non-survivors (0.94 ± 0.36 mmol/L). Conclusions The overall prognosis for long-term survival in horses with a presumptive diagnosis of IBD appears to be fair to moderate, and the initial response to anthelmintic and corticosteroid therapy could be a useful prognostic indicator. The findings of the present study suggest that a low peak xylose concentration in absorption testing is associated with a less favourable prognosis, supporting the use of this test.
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Gaschen L. Ultrasonography of Small Intestinal Inflammatory and Neoplastic Diseases in Dogs and Cats. Vet Clin North Am Small Anim Pract 2011; 41:329-44. [DOI: 10.1016/j.cvsm.2011.01.002] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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BITHELL SONIA, HABERSHON-BUTCHER JOCELYNL, BOWEN IMARK, HALLOWELL GAYLED. REPEATABILITY AND REPRODUCIBILITY OF TRANSABDOMINAL ULTRASONOGRAPHIC INTESTINAL WALL THICKNESS MEASUREMENTS IN THOROUGHBRED HORSES. Vet Radiol Ultrasound 2010; 51:647-51. [DOI: 10.1111/j.1740-8261.2010.01715.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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