Eosinophilic Inflammation and Equine Herpesvirus-1 Associated With Haemorrhagic Cystitis in a Horse. Case Report.
Abstract: Equine idiopathic haemorrhagic cystitis (EIHC) is a recently described form of aseptic cystitis in horses in which there is no discernible underlying cause. This case report describes a 9-year-old Thoroughbred gelding that presented with stranguria, pollakiuria, and haematuria. Cystoscopy revealed ulceration and haemorrhage of the bladder mucosa, diffuse mural hyperaemia and marked urine sedimentation. Histopathological evaluation of the bladder revealed chronic active ulcerative neutrophilic, lymphoplasmacytic, and eosinophilic cystitis. There was no bacterial or fungal growth upon culture but polymerase chain reaction (PCR) testing and sequencing for equine herpesvirus-1 (EHV-1) on bladder mucosa was positive. Conservative therapy with broad spectrum antimicrobials and non-steroidal anti-inflammatory therapy yielded complete resolution of clinical signs with significant improvement of macroscopic lesions in 14 days. Although a positive EHV-1 PCR suggests a viral cause, the horse's clinical signs, histology and recovery rate are more consistent with equine idiopathic haemorrhagic cystitis (EIHC). Neutrophilic and lymphoplasmacytic inflammation is a known feature of EIHC but eosinophilic infiltrates have not been previously described. The significance of the eosinophilic involvement is not certain; however, their presence has been associated with fungal, viral, parasitic, and immune-mediated aetiologies in other body systems. This is the first report of a horse with possible EIHC in Australia, as well as the first case with eosinophilic infiltrates and testing positive for EHV-1.
Copyright © 2022 Elsevier Inc. All rights reserved.
Publication Date: 2022-11-04 PubMed ID: 36343833DOI: 10.1016/j.jevs.2022.104161Google Scholar: Lookup
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Summary
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This research case report investigates a thoroughbred horse suffering from equine idiopathic haemorrhagic cystitis (EIHC) and equine herpesvirus-1 (EHV-1). The horse’s condition and recovery indicate that EIHC could be the main cause, despite the positive results for EHV-1. This is the first documented Australian case of this type, with eosinophilic infiltrates being an unreported symptom in such cases until now.
Case Description
- A 9-year-old Thoroughbred gelding presented with severe urinary conditions including straining to urinate (stranguria), frequent urination (pollakiuria), and bloody urine (haematuria).
- Cystoscopy revealed extensive damage to the bladder’s lining, including ulceration and bleeding, overall hyperaemia (increased blood flow), and considerable urine sedimentation.
Pathological Examination
- The bladder’s histopathological assessment revealed severe inflammation with active sores. The inflammation included neutrophils, lymphocytes, plasma cells, and surprisingly, eosinophils, a type of white blood cells not typically linked with EIHC.
- No bacterial or fungal infection was detected upon culture, suggesting the inflammation was not due to these typical causes.
- PCR testing detected the presence of equine herpesvirus-1 (EHV-1) on the horse’s bladder lining.
Treatment and Outcome
- The horse was given conservative treatment with broad-spectrum antimicrobials to fight potential infection and non-steroidal anti-inflammatory drugs to reduce inflammation and pain.
- Within two weeks of treatment, all clinical signs related to urinary trouble resolved significantly, and there was notable improvement in the bladder’s lesions.
Key Findings
- Despite the presence of EHV-1, the horse’s main illness was likely EIHC. The clinical signs, pathological findings, and impressive recovery rate point to this conclusion.
- This is the first reported case of EIHC in Australia, which broadens the geographical range of this equine disease.
- This is also the first recorded occurrence of eosinophilic infiltrates in a horse suffering from this illness. Eosinophils are often found during infections involving fungi, viruses, parasites, or immune-mediated causes in other body systems.
Cite This Article
APA
Easther R, Manthorpe E, Woolford L, Kawarizadeh A, Hemmatzadeh F, Ferlini Agne G.
(2022).
Eosinophilic Inflammation and Equine Herpesvirus-1 Associated With Haemorrhagic Cystitis in a Horse. Case Report.
J Equine Vet Sci, 119, 104161.
https://doi.org/10.1016/j.jevs.2022.104161 Publication
Researcher Affiliations
- School of Animal and Veterinary Science, Roseworthy Campus, The University of Adelaide, South Australia, Australia.
- School of Animal and Veterinary Science, Roseworthy Campus, The University of Adelaide, South Australia, Australia.
- School of Animal and Veterinary Science, Roseworthy Campus, The University of Adelaide, South Australia, Australia.
- School of Animal and Veterinary Science, Roseworthy Campus, The University of Adelaide, South Australia, Australia.
- School of Animal and Veterinary Science, Roseworthy Campus, The University of Adelaide, South Australia, Australia.
- School of Animal and Veterinary Science, Roseworthy Campus, The University of Adelaide, South Australia, Australia. Electronic address: gustavo.ferliniagne@adelaide.edu.au.
MeSH Terms
- Horses
- Animals
- Male
- Herpesvirus 1, Equid
- Horse Diseases / diagnosis
- Cystitis / diagnosis
- Cystitis / veterinary
- Hematuria / etiology
- Hematuria / veterinary
- Hemorrhage / diagnosis
- Hemorrhage / veterinary
- Eosinophilia / veterinary
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