Diagnostic and Clinical Course of Small Colon Recurrent Impaction Associated with Severe Myenteric Ganglionopathy in A Mare.

The research focuses on a specific medical issue faced by a 10-year-old Dutch Warmblood mare, involving recurrent small colon impaction possibly linked to severe myenteric ganglionopathy. Through examination over several months and eventual surgical intervention, a more complete picture of the mare’s condition was established; however, it posed further questions on the primary or secondary nature of neuromuscular functional disorders in such conditions.

Background and Objectives

• The focus of the research is a thorough investigation and understanding of the causes and suitable treatment protocols for recurrent small colon impactions, a common disorder in horses.
• The study subject is a ten-year-old mare who presented with recurrent colic, and each physical examination revealed a small colon impaction. This led the researchers to consider various differential diagnoses.

Investigation and Diagnosis

• The mare was sent for exploratory laparoscopy upon second hospitalization, but no related abnormality to the small colon was found.
• Due to the recurrent nature of the mare’s condition, an exploratory laparotomy was conducted during the third hospitalisation.
• Surgical biopsies of the caecum, large and small colon were performed, and lymphomonocytic enteritis and mild myenteric ganglionitis were diagnosed.

Resulting Complications and Further Actions

• The mare’s condition worsened a few days after the laparotomy, presenting with tachycardia, fever, and abundant gastric reflux.
• Due to rapidly deteriorating conditions, the owner elected for euthanasia.
• A post-mortem examination ultimately revealed severe chronic lymphocytic enterocolitis and typhlitis associated with a significant depletion of myenteric ganglion bodies, a severe form of myenteric ganglionopathy.

Significances and Conclusions

• This in-depth case study raises questions about the primary and secondary nature of disorders associated with the enteric neuromuscular function. It suggests that recurring small colon impactions in horses may be secondary to more severe conditions, such as myenteric ganglionopathy associated with chronic intestinal pseudo-obstruction.
• While the study ends on a negative note with the mare’s demise, the detailed diagnostic process and subsequent findings could be vital in understanding similar conditions and aiding early interventions in the future.