[A gastrointestinal stromal tumour of the caecum in a pony with colic].
Abstract: A 25-year-old pony mare was presented to the clinic with preliminarily reported severe acute colic. The pony during the previous week had shown inappetence, apathy and fever of unknown origin. Clinical examination and placement of a gastric tube were indicative of a secondary gastric dilation. Rectal exploration found moderate caecal meteorism with a tensed and painful medial taenia as well as a dilated and fluid-filled small intestine. In addition, a solid, mobile, non-painful structure of approximately 10 cm diameter was palpated ventrally. A hyperechogenic mass close to the caecum was detected using ultrasonography of the abdomen in the right flank. The peritoneal fluid was an exudate with cytological signs of an acute to subacute peritonitis. Blood analysis showed markedly increased plasma lactate concentration and a marginal neutrophilia and lymphopenia, with a total leukocyte count of 6 G/l. Because the owners refused consent for a laparotomy and the pony showed increased signs of severe pain despite conservative medical treatment, it was euthanized. The main findings on necropsy were extensive adherence of the caecal apex to the right and left colon and the ileum as well as a neoplasia in the lumen of the caecal apex. The mass, which was covered with a mucous membrane, had a tough consistency. The cut surface was grey-white to beige-coloured and multilobular with numerous necrotic and acute haemorrhagic areas. According to histopathological and immunohistochemical findings, the mass was characterized as a gastrointestinal stromal tumour (GIST), a rare neoplasia in horses.
Publication Date: PubMed ID: 25327153
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Summary
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The research article describes the clinical presentation, diagnostic tests, treatment options, and post-mortem findings of a 25-year-old pony mare that was found to have a rare gastrointestinal stromal tumour (GIST) in the caecum, a part of its digestive system.
Symptoms and Initial Diagnostic Procedures
- The pony initially exhibited symptoms of severe colic, including loss of appetite, lethargy, and an unexplained fever.
- A clinical examination and the insertion of a gastric tube revealed secondary gastric dilation.
- A rectal exploration found a distended and painful caecum, a part of the large intestine, and a dilated, fluid-filled small intestine.
- A solid, mobile, non-painful mass of approximately 10 cm in diameter was detected.
- Ultrasonography of the abdomen revealed a hyperechogenic mass located near the caecum.
- Testing of the peritoneal fluid showed signs of acute to subacute peritonitis.
- Analysis of the pony’s blood found an increased plasma lactate concentration and slight changes in the white blood cell count.
Interventions and Necropsy Findings
- The pony’s condition worsened, showing increased signs of severe pain, even with conservative medical treatment.
- Due to owners refusing surgery and the worsening condition of the pony, euthanasia was performed.
- The post-mortem examination (necropsy) identified adhesion of the caecal apex (the top part of the caecum) to the right and left colon and the ileum (the final section of the small intestine).
- Additionally, a solid mass was discovered in the caecum’s lumen (inner space). This mass was covered with a mucous membrane, had a firm texture, and displayed numerous necrotic and acute haemorrhagic areas. The cut surface of the mass was grey-white to beige and multilobular.
Final Diagnosis
- Based on the histopathological and immunohistochemical tests performed on the tumour, it was determined that the mass was a gastrointestinal stromal tumour (GIST).
- GISTs are rare types of neoplasia (uncontrolled, abnormal growth of cells) that occur in horses, which marked this as a unique case.
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[A gastrointestinal stromal tumour of the caecum in a pony with colic].
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