Dexamethasone for treatment of multisystemic eosinophilic epitheliotropic disease in a horse.
Abstract: A 4-year-old Paint mare was examined because of respiratory tract infection, dermatitis, and weight loss of 2 months' duration. Initial examination revealed generalized pruritic dermatitis, ocular and nasal discharges, and stranguria. Laboratory abnormalities included leukopenia and hypoalbuminemia. Further examination of the respiratory tract revealed grade III of IV pharyngitis and pyogranulomatous pneumonia. Endoscopic examination of the bladder revealed a prolific mass at the junction of the bladder and urethra. Hypoproteinemia was suspected to be caused by protein-losing enteropathy. On histologic examination, skin, rectal, pharyngeal, and urethral biopsy specimens were characterized by infiltration of eosinophils and lymphocytes, and a diagnosis of multisystemic eosinophilic epitheliotropic disease was made. The horse improved following treatment with dexamethasone, trimethoprim-sulfamethoxazole, and an antihistamine and was discharged after 19 days of hospitalization. Treatment with dexamethasone was continued for 4 weeks after hospitalization but was then discontinued. Eight months after discharge, the horse was performing as a pleasure horse and did not require any medical treatment. Multisystemic eosinophilic epitheliotropic disease is typically associated with a poor prognosis in horses. The dermatitis, protein-losing enteropathy, and lower respiratory tract disease in this horse were consistent with previous reports; however, pharyngitis and urethritis have not, to our knowledge, been previously reported in horses with this disease.
Publication Date: 2003-11-19 PubMed ID: 14621221DOI: 10.2460/javma.2003.223.1320Google Scholar: Lookup
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Summary
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The research reports on a 4-year-old mare that was diagnosed with multisystemic eosinophilic epitheliotropic disease, a typically lethal condition in horses, and was successfully treated with dexamethasone, making a full recovery.
Case Overview
- The subject of the study was a 4-year-old Paint mare who was presenting symptoms of respiratory infection, dermatitis, and weight loss that had been ongoing for 2 months.
- Upon examination, the mare was found to have generalized pruritic dermatitis, ocular and nasal discharges, and stranguria.
- Lab tests revealed leukopenia and hypoalbuminemia. Additional examination showed grade III of IV pharyngitis and pyogranulomatous pneumonia.
- Endoscopic examination identified a mass at the junction of the bladder and urethra; hypoproteinemia was suspected to be due to protein-losing enteropathy.
Diagnosis and Treatment
- Biopsies taken from the skin, rectum, pharynx, and urethra showed infiltration of eosinophils and lymphocytes, leading to a diagnosis of multisystemic eosinophilic epitheliotropic disease.
- The mare’s condition improved after being treated with dexamethasone, trimethoprim-sulfamethoxazole, and an antihistamine. After 19 days of hospitalization, she was discharged and continued dexamethasone treatment for an additional 4 weeks.
Recovery and Finding Summary
- Eight months after her discharge, the horse was in good health and did not need any medical treatment. The prognosis for horses diagnosed with multisystemic eosinophilic epitheliotropic disease is typically poor, so this case is significant.
- The presented symptoms of dermatitis, protein-losing enteropathy, and respiratory disease are consistent with previous reports on the disease. However, the symptoms of pharyngitis and urethritis had not previously been reported in horses with this condition.
Cite This Article
APA
McCue ME, Davis EG, Rush BR, Cox JH, Wilkerson MJ.
(2003).
Dexamethasone for treatment of multisystemic eosinophilic epitheliotropic disease in a horse.
J Am Vet Med Assoc, 223(9), 1320-1281.
https://doi.org/10.2460/javma.2003.223.1320 Publication
Researcher Affiliations
- Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan, KS 66506, USA.
MeSH Terms
- Animals
- Dexamethasone / therapeutic use
- Eosinophilia / drug therapy
- Eosinophilia / pathology
- Eosinophilia / veterinary
- Female
- Gastrointestinal Diseases / drug therapy
- Gastrointestinal Diseases / pathology
- Gastrointestinal Diseases / veterinary
- Glucocorticoids / therapeutic use
- Horse Diseases / drug therapy
- Horse Diseases / pathology
- Horses
- Prognosis
- Respiratory Tract Diseases / drug therapy
- Respiratory Tract Diseases / pathology
- Respiratory Tract Diseases / veterinary
- Skin Diseases / drug therapy
- Skin Diseases / pathology
- Skin Diseases / veterinary
- Treatment Outcome
Citations
This article has been cited 4 times.- Villagrán CC, Vogt D, Gupta A, Fernández EA. Inflammatory bowel disease characterized by multisystemic eosinophilic epitheliotropic disease (MEED) in a horse in Saskatchewan, Canada. Can Vet J 2021 Nov;62(11):1190-1194.
- Archer DC, Costain DA, Sherlock C. Idiopathic focal eosinophilic enteritis (IFEE), an emerging cause of abdominal pain in horses: the effect of age, time and geographical location on risk. PLoS One 2014;9(12):e112072.
- Kaikkonen R, Niinistö K, Sykes B, Anttila M, Sankari S, Raekallio M. Diagnostic evaluation and short-term outcome as indicators of long-term prognosis in horses with findings suggestive of inflammatory bowel disease treated with corticosteroids and anthelmintics. Acta Vet Scand 2014 Jun 3;56(1):35.
- Enriquez CK, Long AE, de Solis CN, Habecker PL, Nolen-Walston R. Clinical Presentation and Diagnosis of Multisystemic Eosinophilic Epitheliotropic Disease in a Miniature Donkey: A Case Report. J Vet Intern Med 2025 Jul-Aug;39(4):e70172.
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