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Comparative Gastroenterology

UT CG Home || CGS || CGS eCase || Contact: Dr. Frank Andrews || UT College of Veterinary Medicine

 

 
A 13 year old American Quarter Horse gelding (male castrate) presents to your clinic at 10:00 am with a history intermittent abdominal pain (colic) since last evening. The owner tells you that the horse has been having mild abdominal pain approximately once weekly over the past 3 to 4 months. The RDVM gave a dose of Torbugesic (10 mg, IV) last night and it alleviated the pain for several hours. The horse was mildly painful this morning so the RDVM referred the horse to your clinic for evaluation. On presentation the horse is mildly depressed but responsive to external stimuli and had a slightly thin body condition. The horse is not painful, but has a mildly increased heart rate (56 bpm, normal: 20-48 bpm) and normal rectal temperature (99 F) and respiratory rate (24 breaths/min). Abdominal sounds are decreased on the right side and there are tympanic sounds over the cecum (in the right paralumbar fossa). Rectal examination reveals thickened loops of small intestine and distended subjectively thickened large intestine. You perform an abdominal ultrasound and in the left flank you see the above structures (see image above). The PCV (37%) is within normal limits, but TS (5.4 g/dl, 6.5-8.0) is decreased.
 
Authors:
Drs. Frank Andrews & Linden Craig
The University of Tennessee
College of Veterinary Medicine

 

  • What’s your diagnosis?

  • What other diagnostic tests would be helpful in determining the diagnosis?

  • What treatment(s) would be appropriate?

 
DIAGNOSIS

The most likely cause of the colic and hypoproteinemia in this horse is an infiltrative bowel disease resulting in a protein losing enteropathy. The most likely diagnosis is eosinophilic enteritis or enterocolitis, since there is thickening of the small (ultrasound) and large intestines (rectal findings). Further diagnostic tests should include abdominocentesis, D-Xylose or glucose absorption test, and a rectal biopsy. If the rectal biopsy is negative then an exploratory laparotomy should be performed and a biopsy of lesions in the small and large intestine should be done. Treatment usually involves corticosteroid therapy, starting with an initial dose of dexamethasone, 0.1 mg/kg, IM, once daily for 1 week then slowly tapering to a maintenance dose of approximately 0.05 mg/kg, IM, EOD.

 
 

See biopsy below from this horse taken during abdominal surgery.