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Home / Equine Research Bank / Vet Rec / Differentiating Strongylus vulgaris-associated, non-strangul...
The Veterinary record2022; 192(3); e2538; doi: 10.1002/vetr.2538

Differentiating Strongylus vulgaris-associated, non-strangulating intestinal infarctions from idiopathic peritonitis and acute colitis in horses.

Abstract: Horses with non-strangulating intestinal infarction (NSII) are often misdiagnosed with idiopathic peritonitis or acute colitis. Early diagnosis is essential to ensure early surgical intervention and improve survival. Clinical and laboratory data from horses admitted to the University of Copenhagen Large Animal Teaching Hospital with NSII, idiopathic peritonitis or acute colitis between 2009 and 2018 were used for univariate comparisons and a multivariable logistic regression model for prediction of NSII. Two hundred and thirty-one horses were included. A multivariable model for the prediction of NSII included gastric reflux (more than 5 L) (odds ratio [OR] 8.7; 95% confidence interval [CI] 2.1-36.2), abnormal findings palpated per rectum (intestinal dilatations/impactions [OR 4.43; 95% CI 1.43-13.38], colon displacements [OR 23.16; 95% CI 5.26-101.97] or intestinal mass [OR 179.7; 95% CI 23.5-1375.5]), white blood cell count (OR 1.2; 95% CI 1.1-1.4), packed cell volume (OR 0.9; 95% CI 0.8-0.9), age (OR 0.9; 95% CI 0.8-1.0) and heart rate (OR 1.1; 95% CI 1.0-1.1). The model had a low false positive rate (5%), but a high false negative rate (50%). Due to the retrospective nature of the study, sample collection was inconsistent, resulting in missing values. The model had some capability in predicting NSII. However, the high risk of false negatives means that exploratory laparotomy should be considered in horses with peritonitis of unknown aetiology in areas where Strongylus vulgaris is prevalent and occurrence of idiopathic peritonitis is low.
© 2022 The Authors. Veterinary Record published by John Wiley & Sons Ltd on behalf of British Veterinary Association.
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Publication Date: 2022-12-25 PubMed ID: 36567639DOI: 10.1002/vetr.2538Google Scholar: Lookup
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  • Journal Article

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 identifies markers that could help differentiate Strongylus vulgaris-associated non-strangulating intestinal infarction (NSII) from idiopathic peritonitis and acute colitis in horses; however, it reveals high occurrences of false negatives that limit the effectiveness of this predictive model.

Research Context

  • The study addressed a common misdiagnosis problem in equine health, where horses with non-strangulating intestinal infarction (NSII) associated with the parasite Strongylus vulgaris are often mistaken with idiopathic peritonitis or acute colitis. This is problematic since early and correct diagnosis is crucial for successful surgical intervention and improved survival rates.

Methodology

  • Researchers used clinical and laboratory data from horses admitted to the University of Copenhagen Large Animal Teaching Hospital with NSII, idiopathic peritonitis, or acute colitis from 2009 to 2018.
  • New models were created using univariate comparisons and multivariable logistic regression for predicting NSII.

Findings

  • The study involved 231 horses and resulted in a predictive model containing several variables. These include a high volume of gastric reflux (more than 5 Litres), abnormal findings palpated per rectum such as intestinal dilations/impactions, colon displacements or intestinal mass, white blood cell count, packed cell volume, age, and heart rate.
  • The model predicted NSII with a low false positive rate (5%), but a high false negative rate (50%).

Conclusions and Recommendations

  • The model was found to have some ability in predicting NSII. However, due to the study’s retrospective nature, some data were found inconsistent, leading to missing information that might have affected the model.
  • Despite this, the model was still considered useful but caution is required due to the high risk of false negatives. Hence, exploratory laparotomy, a surgical procedure to investigate the abdomen, should still be considered for diagnosing horses with peritonitis of unknown origin, especially in areas where the parasite Strongylus vulgaris is common and idiopathic peritonitis is rare.

Cite This Article

APA
Poulsen L, Henriksson FV, Dahl M, Honoré ML, Olsen SN, Leifsson PS, Staerk-Østergaard J, Jacobsen S, Pihl TH. (2022). Differentiating Strongylus vulgaris-associated, non-strangulating intestinal infarctions from idiopathic peritonitis and acute colitis in horses. Vet Rec, 192(3), e2538. https://doi.org/10.1002/vetr.2538

Publication

The Veterinary record
ISSN: 2042-7670
NlmUniqueID: 0031164
Country: England
Language: English
Volume: 192
Issue: 3
Pages: e2538

Researcher Affiliations

Poulsen, Lea
  • Medicine and Surgery Section, Department of Veterinary Clinical Sciences, University of Copenhagen, Copenhagen, Denmark.
Henriksson, Frida V
  • Medicine and Surgery Section, Department of Veterinary Clinical Sciences, University of Copenhagen, Copenhagen, Denmark.
Dahl, Melissa
  • Medicine and Surgery Section, Department of Veterinary Clinical Sciences, University of Copenhagen, Copenhagen, Denmark.
Honoré, Marie Louise
  • Medicine and Surgery Section, Department of Veterinary Clinical Sciences, University of Copenhagen, Copenhagen, Denmark.
Olsen, Susanne N
  • Medicine and Surgery Section, Department of Veterinary Clinical Sciences, University of Copenhagen, Copenhagen, Denmark.
Leifsson, Páll S
  • Pathobiological Sciences, Department of Veterinary and Animal Sciences, University of Copenhagen, Copenhagen, Denmark.
Staerk-Østergaard, Jacob
  • Animal Welfare and Disease Control, Department of Veterinary and Animal Sciences, University of Copenhagen, Copenhagen, Denmark.
Jacobsen, Stine
  • Medicine and Surgery Section, Department of Veterinary Clinical Sciences, University of Copenhagen, Copenhagen, Denmark.
Pihl, Tina H
  • Medicine and Surgery Section, Department of Veterinary Clinical Sciences, University of Copenhagen, Copenhagen, Denmark.

MeSH Terms

  • Animals
  • Horses
  • Strongylus
  • Retrospective Studies
  • Colitis / diagnosis
  • Colitis / veterinary
  • Intestinal Obstruction / surgery
  • Intestinal Obstruction / veterinary
  • Peritonitis / diagnosis
  • Peritonitis / veterinary
  • Vascular Diseases / veterinary
  • Infarction / complications
  • Infarction / veterinary
  • Horse Diseases / epidemiology

References

This article includes 39 references
  1. Duncan JL, Pirie HM. The life cycle of Strongylus vulgaris in the horse.. Res Vet Sci 1972;13(4):374-9.
  2. Duncan JL, Pirie HM. The pathogenesis of single experimental infections with Strongylus vulgaris in foals.. Res Vet Sci 1975;18(1):82-93.
  3. Pihl TH, Nielsen MK, Olsen SN, Leifsson PS, Jacobsen S. Nonstrangulating intestinal infarctions associated with Strongylus vulgaris: clinical presentation and treatment outcomes of 30 horses (2008-2016).. Equine Vet J 2018;50(4):474-80.
  4. Nielsen MK, Jacobsen S, Olsen SN, Bousquet E, Pihl T. Nonstrangulating intestinal infarction associated with Strongylus vulgaris in referred Danish equine cases.. Equine Vet J 2016;48(3):376-9.
  5. Drudge JH. Clinical aspects of Strongylus vulgaris infection in the horse. Emphasis on diagnosis, chemotherapy, and prophylaxis.. Vet Clin North Am Large Anim Pract 1979;1(2):251-65.
  6. Staempfli HR, Townsend HG, Prescott JF. Prognostic features and clinical presentation of acute idiopathic enterocolitis in horses.. Can Vet J 1991;32(4):232-37.
  7. Saville WJ, Hinchcliff KW, Moore BR, Kohn CW, Reed SM, Mitten LA. Necrotizing enterocolitis in horses: a retrospective study.. J Vet Intern Med 1996;10(4):265-70.
  8. Odelros E, Kendall A, Hedberg-Alm Y, Pringle J. Idiopathic peritonitis in horses: a retrospective study of 130 cases in Sweden (2002-2017).. Acta Vet Scand 2019;61(1):18.
  9. Southwood LL. Acute abdomen.. Clin Tech Equine Pract 2006;5(2):112-26.
  10. Belgrave RL, Dickey MM, Arheart KL, Cray C. Assessment of serum amyloid a testing of horses and its clinical application in a specialized equine practice.. J Am Vet Med Assoc 2013;243(1):113-9.
  11. Milomir K, Bernhard H, Wolfgang S, Joseph T, Zoran T. Survival and evaluation of clinical and laboratory variables as prognostic indicators in horses hospitilized with acute diarrhea: 342 cases (1995-2015).. Acta Vet Brno 2017;67(3):356-65.
  12. Desrochers A, White NA. Diagnostic approach to colic.. The equine acute abdomen Wiley; 2017. p. 221-62.
  13. Nielsen MK, Vidyashankar AN, Olsen SN, Monrad J, Thamsborg SM. Strongylus vulgaris associated with usage of selective therapy on Danish horse farms-is it reemerging?. Vet Parasitol 2012;189(2-4):260-6.
  14. Tydén E, Enemark HL, Franko MA, Höglund J, Osterman-Lind E. Prevalence of Strongylus vulgaris in horses after ten years of prescription usage of anthelmintics in Sweden.. Vet Parasitol X 2019;2:100013.
  15. Jürgenschellert L, Krücken J, Bousquet E, Bartz J, Heyer N, Nielsen MK. Occurrence of strongylid nematode parasites on horse farms in Berlin and Brandenburg, Germany, with high seroprevalence of Strongylus vulgaris infection.. Front Vet Sci 2022;9:892920.
  16. Pihl TH, Scheepers E, Sanz M, Goddard A, Page P, Toft N. Influence of disease process and duration on acute phase proteins in serum and peritoneal fluid of horses with colic.. J Vet Intern Med 2015;29(2):651-8.
  17. Thoefner MB, Ersbøll BK, Jansson N, Hesselholt M. Diagnostic decision rule for support in clinical assessment of the need for surgical intervention in horses with acute abdominal pain.. Can J Vet Res 2003;67(1):20-9.
  18. Andersen UV, Howe DK, Dangoudoubiyam S, Toft N, Reinemeyer CR, Lyons ET. SvSXP: a Strongylus vulgaris antigen with potential for prepatent diagnosis.. Parasit Vectors 2013;6(1):1-13.
  19. Henderson ISF, Mair TS, Keen JA, Shaw DJ, Mcgorum BC. Study of the short- and long-term outcomes of 65 horses with peritonitis.. Vet Rec 2008;163(10):293-7.
  20. Mair TS. Colic-other conditions.. Saunders Elsevier 1st ed; 2002.
  21. Mair TS, Hillyer MH. Recurrent colic in the mature horse: a retrospective review of 58 cases.. Equine Vet J 1997;29(6):421-4.
  22. Sutton GA, Dahan R, Turner D, Paltiel O. A behaviour-based pain scale for horses with acute colic: scale construction.. Vet J 2013;196(3):394-401.
  23. Shaw SD, Stämpfli H. Diagnosis and treatment of undifferentiated and infectious acute diarrhea in the adult horse.. Vet Clin North Am Equine Pract 2018;34(1):39-53.
  24. Henderson ISF. Diagnostic and prognostic use of L-lactate measurement in equine practice.. Equine Vet Educ 2013;25(9):468-75.
  25. Dunkel B, Kapff JE, Naylor RJ, Boston R. Blood lactate concentrations in ponies and miniature horses with gastrointestinal disease.. Equine Vet J 2013;45(6):666-70.
  26. Latson KM, Nieto JE, Beldomenico PM, Snyder JR. Evaluation of peritoneal fluid lactate as a marker of intestinal ischaemia in equine colic.. Equine Vet J 2005;37(4):342-6.
  27. Delesalle C, Dewulf J, Lefebvre RA, Schuurkes JA, Proot J, Lefere L. Determination of lactate concentrations in blood plasma and peritoneal fluid in horses with colic by an Accusport analyzer.. J Vet Intern Med 2007;21(2):293-301.
  28. Radcliffe RM, Divers TJ, Fletcher DJ, Mohammed H, Kraus MS. Evaluation of L-lactate and cardiac troponin I in horses undergoing emergency abdominal surgery.. J Vet Emerg Crit Care 2012;22(3):313-9.
  29. Shearer TR, Norby B, Carr EA. Peritoneal fluid lactate evaluation in horses with nonstrangulating versus strangulating small intestinal disease.. J Equine Vet Sci 2018;61:18-21.
  30. da Costa ÁHC, da Silva Correia G, de Medeiros Assis D, Melo HM, Nunes VNA, Nobrega GD. Prognostic measurement for equines with colic.. Comp Clin Path 2020;29(5):1083-6.
  31. Pihl TH, Scheepers E, Sanz M, Goddard A, Page P, Toft N. Acute-phase proteins as diagnostic markers in horses with colic.. J Vet Emerg Crit Care 2016;26(5):664-74.
  32. Jacobsen S, Andersen PH. The acute phase protein serum amyloid a (SAA) as a marker of inflammation in horses.. Equine Vet Educ 2007;19(1):38-46.
  33. Nielsen MK, Mittel L, Grice A, Erskine M, Graves E, Vaala W. AAEP parasite control guidelines.. AAEP Proceedings 2012. p. 1-24.
  34. Nielsen MK, Vidyashankar AN, Gravatte HS, Bellaw J, Lyons ET, Andersen UV. Development of Strongylus vulgaris-specific serum antibodies in naturally infected foals.. Vet Parasitol 2014;200(3-4):265-70.
  35. Hedberg-Alm Y, Penell J, Riihimäki M, Osterman-Lind E, Nielsen MK, Tydén E. Parasite occurrence and parasite management in Swedish horses presenting with gastrointestinal disease-a case-control study.. Animals 2020;10(4):638.
  36. Honoré ML, Nielsen MK, Olsen SN, Leifsson PS, Jacobsen S, PTH. Study on survival of nonstrangulating intestinal infarctions associated with Strongylus vulgaris: treatment outcomes of 39 horses (2008-2019).. Madison, WI, USA; WAAVP. 2019.
  37. Southwood LL, Russell G. The use of clinical findings in the identification of equine peritonitis cases that respond favorably to medical therapy: retrospective study.. J Vet Emerg Crit Care 2007;17(4):382-90.
  38. Arndt S, Kilcoyne I, Vaughan B, Dechant JE. Clinical and diagnostic findings, treatment, and short- and long-term survival in horses with peritonitis: 72 cases (2007-2017).. Vet Surg 2021;50(2):323-35.
  39. Yamout SZ, Nieto JE, Beldomenico PM, Dechant JE, leJeune S, Snyder JR. Peritoneal and plasma D-lactate concentrations in horses with colic.. Vet Surg 2011;40(7):817-24.
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