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Topic:Hepatitis
Hepatitis in horses refers to inflammation of the liver, which can arise from various causes including infectious agents, toxins, or immune-mediated processes. This condition affects the liver's ability to perform essential functions such as detoxification, metabolism, and protein synthesis. In horses, hepatitis can manifest in different forms, including acute and chronic, each with distinct clinical presentations and pathological findings. Diagnostic approaches often involve a combination of clinical evaluation, biochemical testing, imaging, and liver biopsy to determine the underlying cause and severity of the disease. This page compiles peer-reviewed research studies and scholarly articles that explore the etiology, pathophysiology, diagnostic methods, and management strategies for hepatitis in equine patients.
Hepatic encephalopathy associated with extensive hepatic diaphragmatic herniation in an adult horse. Diaphragmatic hernia in horses is a rare condition, most commonly presenting with signs of colic and, less frequently, respiratory compromise. Hepatic herniation through a diaphragmatic defect with secondary hepatic failure and encephalopathy has rarely been documented in horses. Methods: A 5-year-old Mangalarga Marchador stallion was evaluated for progressive neurological deterioration, including obtundation, head pressing, ataxia, and circling. Serum biochemistry revealed severe hepatobiliary dysfunction, characterised by increased gamma-glutamyl transferase and alkaline phosphatase activiti...
Pharmaceutical and Nutraceutical Therapies for Liver Disease. Liver dysfunction may reduce the metabolism of drugs that undergo extensive hepatic processing. This will lead to reduced clearance and elimination, and can cause accumulation of the drug, increasing the risk of toxicity. Pentoxifylline and ursodeoxycholic acid are 2 pharmaceuticals that can provide benefits for a variety of equine hepatic diseases. Nutraceuticals are frequently used in horses with hepatopathy, targeting oxidative stress, inflammation, and hepatocellular injury. Neutraceuticals such as S-adenosylmethionine, silymarin and vitamin E are most commonly used although extensive rese...
Viral Hepatitis. Since 2012, 2 viral causes of hepatitis have been identified in horses. Much remains to be discovered about their transmission, risk factors for clinical disease, diagnosis, and treatment approaches. Equine parvovirus-hepatitis has been identified as the cause of acute hepatic necrosis, previously known as Theiler's disease. Equine hepacivirus is recognized as a cause of chronic fibrosing hepatitis. Diagnosis relies on ruling out other causes of hepatitis and documenting infection by serum or liver polymerase chain reaction. There is no direct antiviral for either condition and treatments are ...
Miscellaneous Equine Liver Conditions. Miscellaneous equine liver conditions not covered in other chapters include chronic active hepatitis, Tyzzer's disease, seasonal idiopathic hepatitis, neoplasia, and idiopathic persistent hyperbilirubinemia. Chronic active hepatitis refers to inflammatory and fibrotic liver disease with an unknown cause. Treatment is aimed at reducing inflammation. Tyzzer's disease is caused by Clostridium piliforme infection and causes acute necrotizing hepatitis in foals. Successful treatment with antimicrobial therapy and supportive care is rare. Seasonal idiopathic hepatitis is a winter disease of Midweste...
Prognosis of Equine Liver Diseases. Prognostic information in equine liver disease can be gleaned from historical, clinical, clinicopathological, ultrasonographic, and histopathological features. However, given the multiple causes and subtypes of liver disease affecting horses worldwide, prognostic data might not be suitable for universal application across all cases. Most evidence has been established for horses with chronic hepatopathies and extrapolation to acute cases should be avoided. In chronic liver disease the presence and severity of clinical signs and serum markers including total globulins, albumin, and bile acids ar...
Chronic hepatitis in horses with persistent equine hepacivirus infection. Equine hepacivirus (EqHV) is closely related to hepatitis C virus (HCV), which causes persistent infection and chronic hepatitis in people. Information on persistent EqHV infection and hepatitis is limited. Objective: To report 19 cases of chronic hepatitis and persistent EqHV infection. Methods: Mixed retrospective and prospective case series. Methods: Inclusion criteria were: (1) chronic hepatitis, defined as persistently increased serum liver biomarkers, increased serum liver biomarkers accompanied by histopathological evidence of chronicity, for example, fibrosis, or both; (2) positive ser...
Epidemiology and risk factors of equine parvovirus-hepatitis, hepacivirus, Pegivirus caballi, and Pegivirus equi in horses from the Southern United States. Over the past decade, newly identified equine hepatotropic flavi- and parvoviruses, such as equine parvovirus-hepatitis (EqPV-H) and equine hepacivirus (EqHV), have generated considerable scientific and clinical interest. Pegiviruses, including Pegivirus (P.) caballi and P. equi, are also recognized and known to frequently cause persistent infections. However, comprehensive epidemiological data in the United States remain limited. This study analyzed 1195 equine serum samples collected from university-owned horses and diagnostic submissions across Alabama, Georgia, and Texas. Quantitative PCR ...
Good response to oxymetholone in adult aplastic anemia. In Thailand, stem cell transplantation and horse antithymocyte globulin (ATG) are not accessible for most adult aplastic anemia (AA) patients. Alternative therapies are required. We conducted a cohort study of 110 adult AA patients treated with oxymetholone alone for at least 30 days from 2013 to 2023. Response at month 6 and prognostic factors were evaluated. The mean age was 63.4 years old and 58.2% were female. Severe and very severe AA (SAA/VSAA) comprised 64.5% and 3.6%, respectively. The initial oxymetholone daily dose was 150 mg in 66.4%. The overall response was 56.4% (50.7% for SAA/V...
Campylobacter jejuni hepatitis in a horse: case report and literature review. spp. can cause gastroenteritis, hepatitis, bacteremia, and abortions in domestic animals and humans. Some spp. are zoonotic. To our knowledge, hepatitis caused by has not been reported in horses. Here we present a case of acute necrosuppurative hepatitis caused by infection in a 3-y-old gelding, and we review the literature on infections in various animal species. The horse had a one-week history of weight loss and weakness before becoming recumbent and dying. Grossly, the liver had rounded edges and was mottled. There were ecchymoses on the gastric serosa, and a large amount of mucoid, p...
Computed tomographic angiography of a presumed acquired transhepatic portosystemic shunt in a miniature horse filly. A 1-year-old Miniature Horse filly was presented for chronic lethargy and hyporexia. Elevated liver enzymes, bile acids, and ammonia were noted on bloodwork. The primary differential diagnosis was a portosystemic shunt (PSS). Three-phase computed tomographic angiography findings were consistent with a transhepatic portosystemic shunt. Percutaneous liver biopsy confirmed severe diffuse hepatic changes, most likely due to chronic pyrrolizidine alkaloid toxicosis, and medical management was elected. Based on an extensive literature review, this is the first report of a transhepatic portosystemic ...
Detection of Equine Parvovirus-Hepatitis Virus and Equine Hepacivirus in Archived Sera from Horses in France and Australia. Reports of newly discovered equine hepatotropic flavi- and parvoviruses have emerged throughout the last decade in many countries, the discovery of which has stimulated a great deal of interest and clinical research. Although commonly detected in horses without signs of disease, equine parvovirus hepatitis (EqPV-H) and equine hepacivirus (EqHV) have been associated with liver disease, including following the administration of contaminated anti-toxin. Our aim was to determine whether EqPV-H and EqHV are present in Australian horses and whether EqPV-H was present in French horses and to examine ...
First National Prevalence in Italian Horse Population and Phylogenesis Highlight a Fourth Sub-Type Candidate of Equine Hepacivirus. Equine hepacivirus (EqHV, Flaviviridae, hepacivirus) is a small, enveloped RNA virus generally causing sub-clinical hepatitis with occasional fatalities. EqHV is reported in equids worldwide, but for Italy data are limited. To address this, a survey study was set up to estimate prevalence at a national level and among different production categories (equestrian; competition; work and meat; reproduction) and national macro-regions (North, Central, South, and Islands). Data obtained testing 1801 horse serum samples by Real-Time RT PCR were compared within the categories and regions. The NS3 frag...
Naturally acquired equine parvovirus-hepatitis is associated with a wide range of hepatic lesions in horses. Equine parvovirus-hepatitis (EqPV-H) is the causative agent of Theiler's disease, or severe acute hepatic necrosis, in horses. However, it is poorly understood whether EqPV-H is associated with other histologic findings in horses with clinical liver disease. The objective of this study was to examine the prevalence and severity of EqPV-H infections in diagnostic liver samples. Archived formalin-fixed, paraffin-embedded (FFPE) liver samples (n = 98) from Cornell University and University of California, Davis, collected between 2007 and 2022 were evaluated for 15 individual histologic features a...
Serological Evidence of Hepatitis E Virus Infection in Brazilian Equines. Hepatitis E virus (HEV) infection has been demonstrated in various animal species; those recognized as potential zoonotic reservoirs pose a considerable risk to public health. In Brazil, HEV-3 is the only genotype identified in humans and swine nationwide, in a colony-breeding cynomolgus monkey and, recently, in bovines and capybara. There is no information regarding HEV exposure in the equine population in Brazil. This study aimed to investigate anti-HEV antibodies and viral RNA in serum samples from horses slaughtered for meat export and those bred for sport/reproduction purposes. We used a ...
First Insight into the Seroepidemiology of Hepatitis E Virus (HEV) in Dogs, Cats, Horses, Cattle, Sheep, and Goats from Bulgaria. In recent years, hepatitis E virus (HEV) infection has been found to be widespread among different animal species worldwide. In Bulgaria, high HEV seropositivity was found among pigs (60.3%), wild boars (40.8%), and East Balkan swine (82.5%). The aim of the present study was to establish the seroprevalence of HEV among dogs, cats, horses, cattle, sheep, and goats in Bulgaria. In total, 720 serum samples from six animal species were randomly collected: dogs-90 samples; cats-90; horses-180; cattle-180; sheep-90; and goats-90. The serum samples were collected from seven districts of the country: ...
Preliminary evaluation of hepatitis A virus cell receptor 1/kidney injury molecule 1 in healthy horses treated with phenylbutazone. To investigate if hepatitis A virus cell receptor 1/kidney injury molecule 1 (HAVCR1/KIM1) in urine is detectable concurrently with increases in serum creatinine concentrations in horses receiving a recommended dose of phenylbutazone (PBZ) for 7 days. Methods: Preliminary study. Methods: Ten clinically healthy horses with normal physical examination and laboratory work were randomly assigned to PBZ or placebo groups (5 each). The PBZ group received PBZ at 4.4 mg/kg mixed with corn syrup orally every 12 hours. The placebo group received corn syrup orally every 12 hours. Both groups were tre...
Prevalence of equine parvovirus-hepatitis in healthy broodmares in Ontario, Canada. Equine parvovirus-hepatitis (EqPV-H) was first reported from the serum and liver tissue of a horse diagnosed with Theiler's disease in the United States in 2018. Theiler's disease, also known as equine serum hepatitis, is a severe hepatitis with fulminant hepatic necrosis. The disease has most frequently been reported following the administration of equine-origin biological products; however, it has also been reported in in-contact horses with no prior biologic administration. EqPV-H has been detected in clinically healthy horses in North America (USA, Canada), Europe (Germany, Austria, Sloven...
Biochemical and Hematological Indexes of Liver Dysfunction in Horses. In the present review, the authors, based on the multiple functions performed by the liver, analyze the multiple biochemical and hematological changes as an expression of altered liver function in the horse. The liver performs important metabolic functions related to the synthesis, degradation, and excretion of various substances. Modification of these functions can be evaluated and diagnosed by determining serum concentrations of several serum analytes, including enzymes and other endogenous substances. Hepatocellular enzymes, such as sorbitol dehydrogenase-SDH and glutamate dehydrogenase-GLD...
A seasonal idiopathic hepatitis syndrome in horses presented to a Midwestern veterinary teaching hospital. To report history, clinical examination findings, clinicopathologic findings, diagnostic test results, treatment, and outcome in horses with a novel idiopathic hepatitis syndrome. 13 client-owned horses. Medical records of horses that were presented with fever and increased blood liver enzyme activity over a 16-month period were reviewed (December 1, 2020, to April 1, 2022). Collected data included signalment, history, clinical and clinicopathologic findings, diagnostic test results, treatment, clinical progression, and short-term outcome. Affected horses were presented between December and Ap...
European College of Equine Internal Medicine consensus statement on equine flaviviridae infections in Europe. Horses and other equids can be infected with several viruses of the family Flaviviridae, belonging to the genus Flavivirus and Hepacivirus. This consensus statement focuses on viruses with known occurrence in Europe, with the objective to summarize the current literature and formulate clinically relevant evidence-based recommendations regarding clinical disease, diagnosis, treatment, and prevention. The viruses circulating in Europe include West Nile virus, tick-borne encephalitis virus, Usutu virus, Louping ill virus and the equine hepacivirus. West Nile virus and Usutu virus are mosquito-bor...
Molecular surveillance of equine parvovirus-hepatitis from oral, nasal, vaginal, and semen specimens collected from horses living in Korea. Equine parvovirus-hepatitis (EqPV-H) is one of the etiological agents of Theiler's disease, causing fulminant hepatitis; however, its transmission route and pathogenesis remain unclear. In the present study, we aimed to determine EqPV-H shedding in oral/nasal/vaginal swabs or semen samples from horses living in Korea using nested polymerase chain reaction. We then used the data obtained to investigate various risk factors associated with EqPV-H including viral shedding, hepatopathological changes, and genetic diversity. Our data revealed occurrence of EqPV-H shedding in these animals (oral: 3/...
Prevalence and pathology of equine parvovirus-hepatitis in racehorses from New York racetracks. Theiler's disease, a.k.a. equine serum hepatitis, is a devastating, highly fatal disease of horses. Equine parvovirus-hepatitis (EqPV-H) has been identified as the likely cause of this disease. While the incidence of Theiler's disease is low, the prevalence of EqPV-H DNA in horses is high, with up to 37% in some regions, suggesting that subclinical or persistent infection is common. To determine the prevalence and pathogenicity of EqPV-H infection at New York racetracks, DNA was extracted from archived formalin-fixed, paraffin-embedded liver tissues from racehorses submitted for necropsy to th...
Nasal transmission of equine parvovirus hepatitis. Equine parvovirus hepatitis (EqPV-H) is highly prevalent and causes subclinical to fatal hepatitis, which can occur in outbreaks. Whereas iatrogenic transmission is well documented, the mode of horizontal transmission is not known. The virus is shed in nasal, oral and fecal secretions, and PO transmission has been reported in a single horse. Objective: Investigate the efficiency of PO and nasal transmission of EqPV-H in a larger cohort. Methods: Prospective experimental transmission study. Eleven EqPV-H-negative horses were inoculated with 5 × 10 genome equivalents EqPV-H. Serum PCR and s...
Infection of young foals with Equine Parvovirus-Hepatitis following a fatal non-biologic case of Theiler’s disease. Theiler's disease (TD) is a (sub-)acute hepatitis in adult horses and one of the most common causes of acute hepatic failure. Recent findings indicate that equine parvovirus hepatitis (EqPV-H) likely causes TD and that its transmission occurs via iatrogenic and/or natural routes. Following the death of an EqPV-H positive mare with TD, close-contact mares and foals in the same paddock were monitored to evaluate if there was any evidence of EqPV-H. For this purpose, the serum of close contact horses was examined 6 and 42 days after the mare's death for the presence of EqPV-H DNA and changes in l...
Fetoplacental pathology of equine abortion, premature birth, and neonatal loss due to Chlamydia psittaci. This report describes the fetoplacental pathology of associated abortion, premature birth, and neonatal loss in 46 of 442 equine abortion investigations between 2015 and 2019. Seven abortions, 26 premature births, and 13 neonatal deaths with positive polymerase chain reaction (PCR) were evaluated. In 83% of cases (38/46), infection was considered as the primary cause of loss based on quantitative PCR (qPCR) confirmation, pathological findings, and exclusion of other causes, and was supported by immunolabeling in fetoplacental lesions. Lymphohistiocytic placentitis with vasculitis (36/38) af...
Dose-Dependent Hepacivirus Infection Reveals Linkage between Infectious Dose and Immune Response. More than 70 million people worldwide are still infected with the hepatitis C virus 30 years after its discovery, underscoring the need for a vaccine. To develop an effective prophylactic vaccine, detailed knowledge of the correlates of protection and an immunocompetent surrogate model are needed. In this study, we describe the minimum dose required for robust equine hepacivirus (EqHV) infection in equids and examined how this relates to duration of infection, seroconversion, and transcriptomic responses. To investigate mechanisms of hepaciviral persistence, immune response, and immune-media...
The history of Theiler’s disease and the search for its aetiology. Theiler's disease (serum hepatitis) may occur in outbreaks or as single cases of acute hepatitis and is often associated with prior administration of equine-origin biologics approximately 4-10 weeks before the onset of clinical signs. Cases have also been described without any prior administration of blood products. The clinical disease has a low morbidity but high mortality and only adult horses are affected. The course of the disease is short, with horses either dying or completely recovering in a few days. Pathology in affected horses is predominantly centrilobular hepatocyte necrosis with ...
Surveillance of hepatitis E virus in the horse population of Korea: A serological and molecular approach. Hepatitis E virus (HEV) is an emerging zoonotic pathogen causing hepatitis worldwide. Despite the prevalent evidence of interspecies HEV infection in various animal species, the role of horses in HEV epidemiology remains unclear. In this study, we investigated the prevalence of HEV infection in 283 blood and 114 fecal samples from 397 horses using sandwich enzyme-linked immunosorbent assay and nested reverse transcription-polymerase chain reaction. Among the 283 serum samples, 35 were positive for anti-HEV antibodies (12.4%; 95% confidence interval: 8.8-16.8), and four of the five sampling reg...
Clostridial Diseases of Horses: A Review. The clostridial diseases of horses can be divided into three major groups: enteric/enterotoxic, histotoxic, and neurotoxic. The main enteric/enterotoxic diseases include those produced by Clostridium perfringens type C and Clostridioides difficile, both of which are characterized by enterocolitis. The main histotoxic diseases are gas gangrene, Tyzzer disease, and infectious necrotic hepatitis. Gas gangrene is produced by one or more of the following microorganisms: C. perfringens type A, Clostridium septicum, Paeniclostridium sordellii, and Clostridium novyi type A, and it is characterized by ...
