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Acta veterinaria Scandinavica2014; 56(1); 35; doi: 10.1186/1751-0147-56-35

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.

Abstract: Recurrent colic and unexplained weight loss despite good appetite and adequate feeding and management practices are common conditions in the horse. However, little information has been published on the systematic diagnostic evaluation, response to treatment, prognostic factors or outcome of either presentation. The aims of this study were to 1) identify possible prognostic indicators and 2) report the short- and long-term response to treatment with corticosteroid therapy of a variety of horses with a presumptive diagnosis of inflammatory bowel disease (IBD). Thirty-six horses with a history of recurrent colic and/or unexplained weight loss were screened with a detailed clinical, clinicopathological and diagnostic imaging examination. Twenty horses were subsequently selected that had findings consistent with inflammatory bowel disease based on the fulfilment of one or more of the following additional inclusion criteria: hypoproteinaemia, hypoalbuminaemia, malabsorption, an increased intestinal wall thickness on ultrasonographic examination or histopathological changes in rectal biopsy. These 20 horses were treated with a standardized larvicidal anthelmintic regime and a minimum of three weeks of corticosteroid therapy. Results: The initial response to treatment was good in 75% (15/20) of horses, with a 3-year survival rate of 65% (13/20). The overall 3-year survival in horses that responded to initial treatment (12/15) was significantly higher (P = 0.031) than in those that did not respond to initial treatment (1/5). The peak xylose concentration was significantly (P = 0.048) higher in survivors (1.36 ± 0.44 mmol/L) than non-survivors (0.94 ± 0.36 mmol/L). Conclusions: The overall prognosis for long-term survival in horses with a presumptive diagnosis of IBD appears to be fair to moderate, and the initial response to anthelmintic and corticosteroid therapy could be a useful prognostic indicator. The findings of the present study suggest that a low peak xylose concentration in absorption testing is associated with a less favourable prognosis, supporting the use of this test.
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Publication Date: 2014-06-03 PubMed ID: 24894126PubMed Central: PMC4055252DOI: 10.1186/1751-0147-56-35Google Scholar: Lookup
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Summary

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This study focuses on evaluating potential prognostic factors and treatment responses in horses suspected of having inflammatory bowel disease (IBD). The findings suggest that initial reaction to corticosteroid therapy and anthelmintics may indicate long-term prognosis, with those responding positively showing a significantly higher three-year survival rate. An important diagnostic tool appeared to be xylose concentration measurements, with lower values associated with less favourable prognoses.

Introduction

  • The research examines issues such as recurrent colic and unexplained weight loss in horses, which are common problems but under-researched.
  • The study focuses on the diagnostic evaluation, treatment response, prognostic factors, and outcomes related to these health problems in horses, in this case with a ‘presumptive diagnosis’ of inflammatory bowel disease (IBD).

Methods

  • A group of 36 horses with a history of recurrent colic and/or unexplained weight loss was initially selected.
  • These horses underwent detailed clinical, clinicopathological, and diagnostic imaging examinations.
  • From this initial group, 20 horses showing symptoms consistent with IBD were chosen, based on additional criteria such as low protein levels in the blood (hypoproteinaemia), low albumin levels (hypoalbuminaemia), malabsorption, increased intestinal wall thickness (visible on ultrasonographic examination), or changes in the tissue of the rectum (visible on biopsy).
  • The selected horses were treated with a standardized anthelmintic regime to target parasites and a minimum of three weeks of corticosteroid therapy to control inflammation.

Results

  • The initial response to the treatment was positive in 75% of the horses (15 out of 20), and the three-year survival rate was 65% (13 out of 20).
  • There was a significant difference in the three-year survival rate of horses that responded positively to the treatment initially (12 out of 15) compared to those that did not (1 out of 5).
  • Peak xylose concentration, a measure used to assess the intestine’s ability to absorb substances, was significantly higher in surviving horses, implying that lower xylose concentration levels are associated with a less favourable prognosis.

Conclusions

  • The overall prognosis for long-term survival of horses with a presumptive diagnosis of IBD seems to be fair to moderate.
  • The initial response to treatment could be a valuable prognostic indicator, potentially allowing for a better understanding of individual treatment outcomes.
  • A low peak xylose concentration could indicate a poorer prognosis, recommending the use of this specific test in diagnosing and determining the severity of IBD.

Cite This Article

APA
Kaikkonen R, Niinistö K, Sykes B, Anttila M, Sankari S, Raekallio M. (2014). 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, 56(1), 35. https://doi.org/10.1186/1751-0147-56-35

Publication

Acta veterinaria Scandinavica
ISSN: 1751-0147
NlmUniqueID: 0370400
Country: England
Language: English
Volume: 56
Issue: 1
Pages: 35

Researcher Affiliations

Kaikkonen, Ritva
    Niinistö, Kati
    • Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, P,O, Box 57, FI-00014 Helsinki, Finland. kati.niinisto@helsinki.fi.
    Sykes, Benjamin
      Anttila, Marjukka
        Sankari, Satu
          Raekallio, Marja

            MeSH Terms

            • Adrenal Cortex Hormones / therapeutic use
            • Animals
            • Anthelmintics / therapeutic use
            • Horse Diseases / diagnosis
            • Horse Diseases / drug therapy
            • Horses
            • Inflammatory Bowel Diseases / diagnosis
            • Inflammatory Bowel Diseases / drug therapy
            • Inflammatory Bowel Diseases / veterinary
            • Prognosis
            • Prospective Studies
            • Time Factors
            • Treatment Outcome

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            Citations

            This article has been cited 9 times.
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            3. Kranenburg LC, Bouwmeester BF, van den Boom R. Findings and Prognosis in 149 Horses with Histological Changes Compatible with Inflammatory Bowel Disease. Animals (Basel) 2024 May 30;14(11).
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            4. Vokes J, Lovett A, Sykes B. Equine Gastric Ulcer Syndrome: An Update on Current Knowledge. Animals (Basel) 2023 Apr 5;13(7).
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