FREE SHIPPING over $40
OVER 9000 FIVE-STAR REVIEWS
5% OFF ALL SUBSCRIPTIONS
100% HAPPINESS GUARANTEE
Analyze Diet
0
Home / Equine Research Bank / Can Vet J / Acute diarrhea in horses: A multicenter Canadian retrospecti...
The Canadian veterinary journal = La revue veterinaire canadienne2022; 63(10); 1033-1042;

Acute diarrhea in horses: A multicenter Canadian retrospective study (2015 to 2019).

Abstract: This study describes the clinicopathological findings, diagnostic approach, treatment, and factors associated with non-survival of diarrheic horses admitted to 4 Canadian university teaching hospitals between 2015 and 2019. A total of 300 horses, ≥1-year-old, with acute diarrhea were included and represented 1.6% (300/18 481; range: 0.7 to 3%) of admissions during that period, 70% of the horses survived to discharge. Testing for enteropathogens was limited to a single fecal culture for Salmonella spp. in most cases. An enteropathogen was identified in 14% (42/300) of the horses, but in the hospital with higher testing rates enteropathogens were detected in 29% (16/55) of cases. Neorickettsia risticii was the pathogen most frequently detected (31%, 32/102). Antimicrobial drugs and plasma were administered to 57 and 8% of the cases, respectively. Laminitis occurred in 24/298 (8%) of the horses. A multivariable regression model identified an association between non-survival of diarrheic horses and colic signs, increased heart rate, packed cell volume, creatinine concentration, and decreased total protein concentration. A standardized approach for pathogen detection in diarrheic horses is not consistent among Canadian veterinary teaching hospitals, and testing for known pathogens is limited. Signs of colic, severe dehydration, endotoxemia, and hypoproteinemia are associated with non-survival of diarrheic horses. Diarrhée aiguë chez le cheval : une étude rétrospective canadienne multicentrique (2015 à 2019). Cette étude décrit les résultats clinicopathologiques, l’approche diagnostique, le traitement et les facteurs associés à la non-survie de chevaux diarrhéiques admis dans quatre hôpitaux universitaires canadiens entre 2015 et 2019. Un total de 300 chevaux, ≥1 an, atteints de diarrhée aiguë ont été inclus et représentaient 1,6 % (300/18 481; intervalle : 0,7 à 3 %) des admissions au cours de cette période. Soixante-dix pourcents des chevaux ont survécu jusqu’à leur congé. La recherche d’agents entéropathogènes était limitée à une seule culture fécale pour Salmonella spp. dans la plupart des cas. Un agent entéropathogène a été identifié chez 14 % (42/300) des chevaux, mais à l’hôpital avec des taux de dépistage plus élevés, des agents entéropathogènes ont été détectés dans 29 % (16/55) des cas. Neorickettsia risticii était l’agent pathogène le plus fréquemment détecté (31 %, 32/102). Des médicaments antimicrobiens et du plasma ont été administrés respectivement à 57 et 8 % des cas. Une fourbure est survenue chez 24/298 (8 %) des chevaux. Un modèle de régression multivarié a identifié une association entre la non-survie des chevaux diarrhéiques et les signes de coliques, l’augmentation de la fréquence cardiaque, l’hématocrite, la concentration de créatinine et la diminution de la concentration totale de protéines. Une approche normalisée pour la détection des agents pathogènes chez les chevaux diarrhéiques n’est pas uniforme dans les hôpitaux d’enseignement vétérinaires canadiens, et les tests pour les agents pathogènes connus sont limités. Des signes de coliques, de déshydratation sévère, d’endotoxémie et d’hypoprotéinémie sont associés à la non-survie des chevaux diarrhéiques.(Traduit par Dr Serge Messier).
Copyright and/or publishing rights held by the Canadian Veterinary Medical Association.
Get Full Text
Publication Date: 2022-10-04 PubMed ID: 36185796PubMed Central: PMC9484212
The Equine Research Bank provides access to a large database of publicly available scientific literature. Inclusion in the Research Bank does not imply endorsement of study methods or findings by Mad Barn.
LinkedInCopy
  • Journal Article
  • Multicenter Study

Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

This research study reviews the clinic findings, diagnosis, treatment, and factors influencing survival rates of horses admitted with acute diarrhea to four Canadian teaching hospitals from 2015 to 2019.

Research Study Overview

  • The study represents a comprehensive review of cases from four Canadian university teaching hospitals, analyzing data from 300 horses suffering from acute diarrhea, which constituted 1.6% of total admissions during the period from 2015 to 2019.
  • Overall, 70% of these affected horses survived to discharge, demonstrating a significant survival rate despite the condition.

Finding and Treatment

  • Examination for enteropathogens (pathogens that cause gastrointestinal diseases) was predominantly done through a single fecal culture test. An enteropathogen was detected in about 14% of the cases; however, in the hospital with a higher testing rate, the enteropathogen detection rate was as high as 29%.
  • The most commonly detected enteropathogen was found in 31% of tested cases.
  • It was observed that antimicrobial drugs were used as a primary mode of treatment in approximately 57% of cases, while plasma was administered in 8% of cases.
  • Interestingly, 8% of the horses developed laminitis, a serious disease that affects the feet of hoofed animals during the course of the treatment.

Association with Non-Survival

  • A multivariable regression model was developed to identify factors that had a direct association with non-survival in the horses. The model showed that signs of colic, an increased heart rate, increased packed cell volume, heightened creatinine concentration, and decreased total protein concentration were significantly associated with non-survival in diarrheic horses.
  • This suggests that while the horses were admitted for acute diarrhea, other co-morbid conditions or clinicopathological factors significantly impacted their survival chances.

Limitations and Inferences

  • The study also noted that there is no consistent approach for pathogen detection in diarrheic horses among the Canadian veterinary teaching hospitals. The utilization of tests to detect known pathogens seems to be limited.
  • Based on the findings, key factors associated with the non-survival outcome include signs of colic, intense dehydration, endotoxemia (toxins present in the bloodstream), and hypoproteinemia (abnormally low levels of protein in the blood).

Cite This Article

APA
Gomez DE, Leclere M, Arroyo LG, Li L, John E, Afonso T, Payette F, Darby S. (2022). Acute diarrhea in horses: A multicenter Canadian retrospective study (2015 to 2019). Can Vet J, 63(10), 1033-1042.

Publication

The Canadian veterinary journal = La revue veterinaire canadienne
ISSN: 0008-5286
NlmUniqueID: 0004653
Country: Canada
Language: English
Volume: 63
Issue: 10
Pages: 1033-1042

Researcher Affiliations

Gomez, Diego E
  • Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada (Gomez, Arroyo, Li); Department of Clinical Sciences, Faculté de médecine vétérinaire, Université de Montréal, Saint-Hyacinthe, Québec, Canada (Leclere, Payette). Department of Health Management, Atlantic Veterinary College, University of Prince Edward Island, Charlottetown, Prince Edward Island, Canada (John); Department of Large Animal Clinical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada (Afonso). Brazos Valley Equine Hospital, Salado, Texas, USA (Darby).
Leclere, Mathilde
  • Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada (Gomez, Arroyo, Li); Department of Clinical Sciences, Faculté de médecine vétérinaire, Université de Montréal, Saint-Hyacinthe, Québec, Canada (Leclere, Payette). Department of Health Management, Atlantic Veterinary College, University of Prince Edward Island, Charlottetown, Prince Edward Island, Canada (John); Department of Large Animal Clinical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada (Afonso). Brazos Valley Equine Hospital, Salado, Texas, USA (Darby).
Arroyo, Luis G
  • Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada (Gomez, Arroyo, Li); Department of Clinical Sciences, Faculté de médecine vétérinaire, Université de Montréal, Saint-Hyacinthe, Québec, Canada (Leclere, Payette). Department of Health Management, Atlantic Veterinary College, University of Prince Edward Island, Charlottetown, Prince Edward Island, Canada (John); Department of Large Animal Clinical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada (Afonso). Brazos Valley Equine Hospital, Salado, Texas, USA (Darby).
Li, Lynna
  • Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada (Gomez, Arroyo, Li); Department of Clinical Sciences, Faculté de médecine vétérinaire, Université de Montréal, Saint-Hyacinthe, Québec, Canada (Leclere, Payette). Department of Health Management, Atlantic Veterinary College, University of Prince Edward Island, Charlottetown, Prince Edward Island, Canada (John); Department of Large Animal Clinical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada (Afonso). Brazos Valley Equine Hospital, Salado, Texas, USA (Darby).
John, Emily
  • Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada (Gomez, Arroyo, Li); Department of Clinical Sciences, Faculté de médecine vétérinaire, Université de Montréal, Saint-Hyacinthe, Québec, Canada (Leclere, Payette). Department of Health Management, Atlantic Veterinary College, University of Prince Edward Island, Charlottetown, Prince Edward Island, Canada (John); Department of Large Animal Clinical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada (Afonso). Brazos Valley Equine Hospital, Salado, Texas, USA (Darby).
Afonso, Tiago
  • Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada (Gomez, Arroyo, Li); Department of Clinical Sciences, Faculté de médecine vétérinaire, Université de Montréal, Saint-Hyacinthe, Québec, Canada (Leclere, Payette). Department of Health Management, Atlantic Veterinary College, University of Prince Edward Island, Charlottetown, Prince Edward Island, Canada (John); Department of Large Animal Clinical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada (Afonso). Brazos Valley Equine Hospital, Salado, Texas, USA (Darby).
Payette, Flavie
  • Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada (Gomez, Arroyo, Li); Department of Clinical Sciences, Faculté de médecine vétérinaire, Université de Montréal, Saint-Hyacinthe, Québec, Canada (Leclere, Payette). Department of Health Management, Atlantic Veterinary College, University of Prince Edward Island, Charlottetown, Prince Edward Island, Canada (John); Department of Large Animal Clinical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada (Afonso). Brazos Valley Equine Hospital, Salado, Texas, USA (Darby).
Darby, Shannon
  • Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada (Gomez, Arroyo, Li); Department of Clinical Sciences, Faculté de médecine vétérinaire, Université de Montréal, Saint-Hyacinthe, Québec, Canada (Leclere, Payette). Department of Health Management, Atlantic Veterinary College, University of Prince Edward Island, Charlottetown, Prince Edward Island, Canada (John); Department of Large Animal Clinical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada (Afonso). Brazos Valley Equine Hospital, Salado, Texas, USA (Darby).

MeSH Terms

  • Animals
  • Anti-Infective Agents
  • Canada / epidemiology
  • Colic / veterinary
  • Creatinine
  • Diarrhea / epidemiology
  • Diarrhea / veterinary
  • Horse Diseases / microbiology
  • Horses
  • Retrospective Studies

References

This article includes 44 references
  1. Arroyo L, Arnold CE, Barham M. Science-in-brief: Report on the Havemeyer Foundation workshop on acute colitis of the adult horse.. Equine Vet J 2020;52:163–164.
    pmc: PMC7163712pubmed: 32034964
  2. Luethy D, Feldman R, Stefanovski D, Aitken MR. Risk factors for laminitis and nonsurvival in acute colitis: Retrospective study of 85 hospitalized horses (2011–2019). J Vet Intern Med 2021;35:2019–2025.
    pmc: PMC8295695pubmed: 33938584
  3. Nomura M, Kuroda T, Tamura N, Muranaka M, Niwa H. Mortality, clinical findings, predisposing factors and treatment of Clostridioides difficile colitis in Japanese thoroughbred racehorses.. Vet Rec 2020;187:e14.
    pubmed: 32201380
  4. Ruby R, Magdesian KG, Kass PH. Comparison of clinical, microbiologic, and clinicopathologic findings in horses positive and negative for Clostridium difficile infection.. J Am Vet Med Assoc 2009;234:777–784.
    pubmed: 19284345
  5. Weese JS, Staempfli HR, Prescott JF. A prospective study of the roles of Clostridium difficile and enterotoxigenic Clostridium perfringens in equine diarrhoea.. Equine Vet J 2001;33:403–409.
    pubmed: 11469775
  6. Cohen ND, Woods AM. Characteristics and risk factors for failure of horses with acute diarrhea to survive: 122 cases (1990–1996). J Am Vet Med Assoc 1999;214:382–390.
    pubmed: 10023402
  7. Sage SE, Bedenice D, McKinney CA. Assessment of the impact of age and of blood-derived inflammatory markers in horses with colitis.. J Vet Emerg Crit Care (San Antonio) 2021;31:779–787.
    pubmed: 34432936
  8. Teymournejad O, Lin M, Bekebrede H. Isolation and molecular analysis of a novel Neorickettsia species that causes Potomac Horse Fever.. MBio 2020;11:e03429–19.
    pmc: PMC7042704pubmed: 32098825
  9. Gohari IM, Arroyo L, Macinnes JI, Timoney JF, Parreira VR, Prescott JF. Characterization of Clostridium perfringens in the feces of adult horses and foals with acute enterocolitis.. Can J Vet Res 2014;78:1–7.
    pmc: PMC3878003pubmed: 24396174
  10. Durán MC, Marqués FJ. Detection of Neorickettsia risticii, the agent of Potomac horse fever, in a Gypsy Vanner stallion from Manitoba.. Can Vet J 2016;57:293–295.
    pmc: PMC4751770pubmed: 26933267
  11. Heller MC, McClure J, Pusterla N, Pusterla JB, Stahel S. Two cases of Neorickettsia (Ehrlichia) risticii infection in horses from Nova Scotia.. Can Vet J 2004;45:421–423.
    pmc: PMC548627pubmed: 15206592
  12. Arroyo LG, Moore A, Bedford S. Potomac horse fever in Ontario: Clinical, geographic, and diagnostic aspects.. Can Vet J 2021;62:622–628.
    pmc: PMC8118184pubmed: 34219771
  13. Arroyo LG, Staempfli H, Weese JS. Molecular analysis of Clostridium difficile isolates recovered from horses with diarrhea.. Vet Microbiol 2007;120:179–183.
    pubmed: 17112686
  14. Ravary B, Fecteau G, Higgins R, Paré J, Lavoie JP. (Prevalence of infections caused by Salmonella spp. in cattle and horses at the Veterinary Teaching Hospital of the Faculty of Veterinary Medicine of the University of Montreal). Can Vet J 1998;39:566–572.
    pmc: PMC1539438pubmed: 9752593
  15. Schofield F. An investigation into an endemic disease of horses (occurring chiefly in Kent and Essex counties of the Province of Ontario). Rep Ontario Vet Coll 1924;49:41–49.
  16. Baird JD, Arroyo LG. Historical aspects of Potomac horse fever in Ontario (1924–2010). Can Vet J 2013;54:565–572.
    pmc: PMC3659452pubmed: 24155447
  17. Shapiro J, Thomson G. Potomac horse fever in eastern Ontario.. Can Vet J 1995;36:448.
    pmc: PMC1686982pubmed: 7585427
  18. McLaughlin B, Gough J. Potomac horse fever in southwestern Ontario.. Can Vet J 1996;37:367–368.
    pmc: PMC1576412pubmed: 8689598
  19. Willette JA, Kopper JJ, Kogan CJ, Seguin MA, Schott HC. Effect of season and geographic location in the United States on detection of potential enteric pathogens or toxin genes in horses ≥6-mo-old.. J Vet diagnostic Investig 2022;34:407–411.
    pmc: PMC9254065pubmed: 34763559
  20. Kopper JJ, Willette JA, Kogan CJ, Seguin A, Bolin SR, Schott HC. Detection of pathogens in blood or feces of adult horses with enteric disease and association with outcome of colitis.. J Vet Intern Med 2021;35:2465–2472.
    pmc: PMC8478065pubmed: 34382708
  21. Schoster A, Kunz T, Lauper M, Graubner C, Schmitt S, Weese JS. Prevalence of Clostridium difficile and Clostridium perfringens in Swiss horses with and without gastrointestinal disease and microbiota composition in relation to Clostridium difficile shedding.. Vet Microbiol 2019;239:108433.
    pubmed: 31767096
  22. Thean S, Elliott B, Riley TV. Clostridium difficile in horses in Australia — A preliminary study.. J Med Microbiol 2011;60:1188–1192.
    pubmed: 21436371
  23. Dunkel B, Johns IC. Antimicrobial use in critically ill horses.. J Vet Emerg Crit Care (San Antonio) 2015;25:89–100.
    pubmed: 25582245
  24. Weese JS, Toxopeus L, Arroyo L. Clostridium difficile associated diarrhoea in horses within the community: Predictors, clinical presentation and outcome.. Equine Vet J 2006;38:185–188.
    pubmed: 16536390
  25. Arroyo LG, Sears W, Gomez DE. Plasma transfusions in horses with typhlocolitis/colitis.. Can Vet J 2019;60:193–196.
    pmc: PMC6340250pubmed: 30705457
  26. Hassel DM, Smith PA, Nieto JE, Beldomenico P, Spier SJ. Di-tri-octahedral smectite for the prevention of post-operative diarrhea in equids with surgical disease of the large intestine: Results of a randomized clinical trial.. Vet J 2009;182:210–214.
    pubmed: 19097815
  27. Mattei DN, Kopper JJ, Sanz MG. Equine coronavirus-associated colitis in horses: A retrospective study.. J Equine Vet Sci 2020;87:102906.
    pmc: PMC7126555pubmed: 32172908
  28. Manship AJ, Blikslager AT, Elfenbein JR. Disease features of equine coronavirus and enteric salmonellosis are similar in horses.. J Vet Intern Med 2019;33:912–917.
    pmc: PMC6430874pubmed: 30632200
  29. Bertin FR, Reising A, Slovis NM, Constable PD, Taylor SD. Clinical and clinicopathological factors associated with survival in 44 horses with equine neorickettsiosis (Potomac horse Fever). J Vet Intern Med 2013;27:1528–1534.
    pubmed: 24118378
  30. Mair TS, Smith LJ. Survival and complication rates in 300 horses undergoing surgical treatment of colic. Part 2: Short-term complications.. Equine Vet J 2005;37:303–309.
    pubmed: 16028617
  31. Dolente BA, Beech J, Lindborg S, Smith G. Evaluation of risk factors for development of catheter-associated jugular thrombophlebitis in horses: 50 cases (1993–1998). J Am Vet Med Assoc 2005;227:1134–1141.
    pubmed: 16220676
  32. Geraghty TE, Love S, Taylor DJ, Heller J, Mellor DJ, Hughes KJ. Assessment of subclinical venous catheter-related diseases in horses and associated risk factors.. Vet Rec 2009;164:227–231.
    pubmed: 19234323
  33. Staempfli HR, Townsend HG, Prescott JF. Prognostic features and clinical presentation of acute idiopathic enterocolitis in horses.. Can Vet J 1991;32:232–237.
    pmc: PMC1481315pubmed: 17423769
  34. Stewart MC, Hodgson JL, Kim H, Hutchins DR, Hodgson DR. Acute febrile diarrhoea in horses: 86 cases (1986–1991). Aust Vet J 1995;72:41–44.
    pubmed: 7779031
  35. Berryhill EH, Magdesian KG, Aleman M, Pusterla N. Clinical presentation, diagnostic findings, and outcome of adult horses with equine coronavirus infection at a veterinary teaching hospital: 33 cases (2012–2018). Vet J 2019;248:95–100.
    pmc: PMC7110482pubmed: 31113572
  36. Kambayashi Y, Bannai H, Tsujimura K, Hirama A, Ohta M, Nemoto M. Outbreak of equine coronavirus infection among riding horses in Tokyo, Japan.. Comp Immunol Microbiol Infect Dis 2021;77:101668.
    pubmed: 34004508
  37. Hassel DM, Hill AE, Rorabeck RA. Association between hyperglycemia and survival in 228 horses with acute gastrointestinal disease.. J Vet Intern Med 2009;23:1261–1265.
    pubmed: 19780927
  38. Archer DC, Pinchbeck GL, Proudman CJ. Factors associated with survival of epiploic foramen entrapment colic: A multicentre, international study.. Equine Vet J Suppl 2011;39:56–62.
    pubmed: 21790755
  39. Ecke P, Hodgson DR, Rose RJ. Induced diarrhoea in horses. Part 1: Fluid and electrolyte balance.. Vet J 1998;155:149–159.
    pubmed: 9564268
  40. Gomez DE, Arroyo LG, Stämpfli HR, Cruz LE, Oliver OJ. Physicochemical interpretation of acid-base abnormalities in 54 adult horses with acute severe colitis and diarrhea.. J Vet Intern Med 2013;27:548–553.
    pubmed: 23551698
  41. Carlson GP, Bruss M. Fluid, electrolyte, and acid-base balance.. In: Kaneko J, Harvey J, Bruss M, editors. Clinical Biochemistry of Domestic Animals. 6th ed. New York, New York: Elsevier; 2008. pp. 529–559.
  42. Porta F, Takala J, Weikert C. Effects of prolonged endotoxemia on liver, skeletal muscle and kidney mitochondrial function.. Crit Care 2006;10:R118.
    pmc: PMC1750984pubmed: 16895596
  43. Durward A, Mayer A, Skellett S. Hypoalbuminaemia in critically ill children: Incidence, prognosis, and influence on the anion gap.. Arch Dis Child 2003;88:419–422.
    pmc: PMC1719575pubmed: 12716714
  44. Collins LG, Tyler DE. Experimentally induced phenylbutazone toxicosis in ponies: Description of the syndrome and its prevention with synthetic prostaglandin E2.. Am J Vet Res 1985;46:1605–1615.
    pubmed: 3862357

Citations

This article has been cited 5 times.
  1. Matté YA, Baldasso DZ, Rezende MA, Lui JFM, Seibel AC, Guizzo JA, Frandoloso R, Kreutz LC. Immunological insights into the occurrence of Lawsonia intracellularis in horses from southern Brazil using flow cytometry. Vet World 2025 Apr;18(4):755-762.
    doi: 10.14202/vetworld.2025.755-762pubmed: 40453941google scholar: lookup
  2. Gomez DE, Kopper JJ, Byrne DP, Renaud DL, Schoster A, Dunkel B, Arroyo LG, Mykkanen A, Gilsenan WF, Pihl TH, Lopez-Navarro G, Tennent-Brown BS, Hostnik LD, Mora-Pereira M, Marques F, Gold JR, DeNotta SL, Desjardins I, Stewart AJ, Kuroda T, Schaefer E, Oliver-Espinosa OJ, Agne GF, Uberti B, Veiras P, Delph Miller KM, Gialleti R, John E, Toribio RE. Treatment approaches to horses with acute diarrhea admitted to referral institutions: A multicenter retrospective study. PLoS One 2024;19(11):e0313783.
    doi: 10.1371/journal.pone.0313783pubmed: 39565809google scholar: lookup
  3. Haywood LMB, Sheahan BJ. A Review of Epithelial Ion Transporters and Their Roles in Equine Infectious Colitis. Vet Sci 2024 Oct 7;11(10).
    doi: 10.3390/vetsci11100480pubmed: 39453072google scholar: lookup
  4. Hallowell KL, Hepworth-Warren KL, Dembek K. An updated description of bacterial pneumonia in adult horses and factors associated with death. J Vet Intern Med 2024 Sep-Oct;38(5):2766-2775.
    doi: 10.1111/jvim.17141pubmed: 39005215google scholar: lookup
  5. Giraldo AF, Carballo R, Serrenho RC, Tran V, Valverde A, Renaud DL, Gomez DE. Association of the type of metabolic acidosis and non-survival of horses with colitis. Can Vet J 2023 Nov;64(11):1044-1050.
    pubmed: 37915775
Subscribe to our newsletter
Join 99,357 horse owners like you who receive our email updates on horse health and nutrition.