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BMC veterinary research2022; 18(1); 149; doi: 10.1186/s12917-022-03248-x

Clinical features and treatment response to differentiate idiopathic peritonitis from non-strangulating intestinal infarction of the pelvic flexure associated with Strongylus vulgaris infection in the horse.

Abstract: Peritonitis in horses secondary to non-strangulating infarction (NSII) has a guarded prognosis, even after intestinal resection. In contrast, horses with idiopathic peritonitis respond well to medical treatment. Affected horses in both cases often show signs of both colic and systemic inflammation, but early diagnosis is crucial for optimal treatment and an accurate prognosis. One cause of NSII is thrombus formation secondary to Strongylus vulgaris larval migration. There has been a documented increase in S. vulgaris prevalence in Sweden since the implementation of selective anthelmintic treatment in 2007, which subsequently could result in a rise in NSII cases. In a retrospective clinical study, medical records from cases diagnosed with NSII of the pelvic flexure or idiopathic peritonitis from three equine referral hospitals in Sweden during 2017-2020 were reviewed. Information including demographic data, relevant medical history, and clinical- and laboratory parameters were obtained from patient records. To facilitate the differentiation between cases of idiopathic peritonitis and cases with confirmed NSII of the pelvic flexure, the aim of the study was to compare clinical and laboratory parameters, clinical progression and initial response to antimicrobial treatment. A secondary aim was to compare survival-rates. Results: Horses with NSII (n = 20) were significantly more likely to present during the winter months with a poorer response to medical treatment within 48 h. Cases of idiopathic peritonitis (n = 107) had a 100% survival rate with medical treatment, although one case required surgical correction of a colon displacement. In comparison, all confirmed NSII cases were non-responsive to antimicrobial treatment, with a survival rate to discharge of 50% after colon resection. Specific rectal findings and peripheral blood neutropenia were strongly associated with NSII. Conclusions: In Sweden, idiopathic peritonitis cases still predominate over S. vulgaris associated NSII cases and have an excellent survival rate with antimicrobial treatment. However, horses presenting with septic peritonitis during the winter months with a palpable rectal mass and displaying fever and colic signs beyond 48 h of medical treatment are likely to suffer from NSII of the pelvic flexure and should be considered for abdominal surgery.
© 2022. The Author(s).
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Publication Date: 2022-04-23 PubMed ID: 35461295PubMed Central: PMC9034621DOI: 10.1186/s12917-022-03248-xGoogle Scholar: Lookup
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Summary

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The research study focuses on differentiating idiopathic peritonitis from non-strangulating intestinal infarction (NSII) in horses, highlighting the clinical features and response to treatments. It presents a comparative analysis between the two conditions and acknowledges the significant role of early diagnosis in determining the course of treatment and prognosis.

Research Methodology

  • The study is a retrospective clinical review of medical records from cases diagnosed with NSII of the pelvic flexure or idiopathic peritonitis. This data was taken from three equine referral hospitals in Sweden from 2017 to 2020.
  • The researchers obtained various pieces of information for their study, including demographical data, relevant medical history, and clinical laboratory parameters from the patient records.
  • The primary aim of this research was to distinguish between cases of idiopathic peritonitis and NSII of the pelvic flexure by comparing various factors such as clinical and laboratory parameters, clinical progression, and the initial response to antimicrobial treatment.
  • The secondary aim was to evaluate and compare the survival rates of the two conditions.

Research Findings

  • The research found that horses with NSII are more likely to show up during winter and they generally have a less favorable response to medical treatment within the first 48 hours.
  • Horses suffering from idiopathic peritonitis had a 100% survival rate with medical treatment, though surgical intervention was necessary in one case for rectifying a colon displacement.
  • On the contrary, horses with NSII were not responsive to antimicrobial treatments and had a survival rate of 50% after undergoing colon resection.
  • Particular rectal findings and the presence of a lesser number of neutrophils in the blood i.e., neutropenia, were strongly associated with NSII.

Conclusions

  • The study concludes that in Sweden, the cases of idiopathic peritonitis are still greater in number as compared to NSII cases related to S.vulgaris. However, those horses that exhibit septic peritonitis during the winter months and exhibit persistence of symptoms like a palpable rectal mass, fever, and colic signs, despite more than 48 hours of medical treatment, are more likely to have NSII of the pelvic flexure. Therefore, they should be considered for abdominal surgery.
  • The study emphasizes the importance of early diagnosis for optimizing the treatment plan and achieving accurate prognosis.

Cite This Article

APA
Hedberg-Alm Y, Tydén E, Tamminen LM, Lindström L, Anlén K, Svensson M, Riihimäki M. (2022). Clinical features and treatment response to differentiate idiopathic peritonitis from non-strangulating intestinal infarction of the pelvic flexure associated with Strongylus vulgaris infection in the horse. BMC Vet Res, 18(1), 149. https://doi.org/10.1186/s12917-022-03248-x

Publication

BMC veterinary research
ISSN: 1746-6148
NlmUniqueID: 101249759
Country: England
Language: English
Volume: 18
Issue: 1
Pages: 149
PII: 149

Researcher Affiliations

Hedberg-Alm, Ylva
  • Department of Biomedical Science and Veterinary Public Health, Parasitology Unit, Swedish University of Agricultural Sciences, Uppsala, Sweden. ylva.hedberg.alm@uds.slu.se.
  • Equine Clinic, University Animal Hospital, Swedish University of Agricultural Sciences, Uppsala, Sweden. ylva.hedberg.alm@uds.slu.se.
Tydén, Eva
  • Department of Biomedical Science and Veterinary Public Health, Parasitology Unit, Swedish University of Agricultural Sciences, Uppsala, Sweden.
Tamminen, Lena-Mari
  • Department of Clinical Sciences, Veterinary Epidemiology Unit, Swedish University of Agricultural Sciences, Uppsala, Sweden.
Lindström, Lisa
  • Department of Biomedical Science and Veterinary Public Health, Pathology Unit, Swedish University of Agricultural Sciences, Uppsala, Sweden.
Anlén, Karin
  • Specialist Equine Hospital, Evidensia Animal Hospital, Helsingborg, Sweden.
Svensson, Maria
  • Equine Clinic, University Animal Hospital, Swedish University of Agricultural Sciences, Uppsala, Sweden.
Riihimäki, Miia
  • Department of Clinical Sciences, Equine Medicine Unit, Swedish University of Agricultural Sciences, Uppsala, Sweden.

MeSH Terms

  • Animals
  • Colic / veterinary
  • Gastrointestinal Diseases / veterinary
  • Horse Diseases / diagnosis
  • Horse Diseases / drug therapy
  • Horse Diseases / epidemiology
  • Horses
  • Infarction / complications
  • Infarction / diagnosis
  • Infarction / veterinary
  • Peritonitis / diagnosis
  • Peritonitis / drug therapy
  • Peritonitis / veterinary
  • Retrospective Studies
  • Strongylus
  • Vascular Diseases / veterinary

Conflict of Interest Statement

The authors declare that they have no competing interests.

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Citations

This article has been cited 5 times.
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  4. Hedberg-Alm Y, Tydén E, Tamminen LM, Lindström L, Anlén K, Svensson M, Riihimäki M. Correction: Clinical features and treatment response to differentiate idiopathic peritonitis from non‑strangulating intestinal infarction of the pelvic flexure associated with Strongylus Vulgaris infection in the horse. BMC Vet Res 2025 Apr 14;21(1):265.
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