Equine Idiopathic Hemorrhagic Cystitis: Is It Idiopathic or More Likely to Be Exercise-Associated?
Abstract: Recently, a syndrome called "equine idiopathic hemorrhagic cystitis" was described and clinical features compared with bladder neoplasia. In this case report, we describe a case of hemorrhagic cystitis with a favorable outcome in a high-performance dressage horse, in which exercise intensity might be the etiologic factor for the development of bladder-wall hyperplasia and hematuria. A 14-year-old Warmblood gelding was presented with a history of hematuria of 2-day duration. The high-level dressage horse had performed on the previous 3 weekends and was trained at least three times a week at performance intensity level. Sonographically, the dorsal bladder wall was about 1.5 cm thick and the different layers of the bladder wall could not be differentiated. Endoscopy revealed that the bladder was highly edematous and showed diffuse submucosal bleeding. Histopathological differential diagnoses were severe reactive hyperplasia or a low-grade transitional cell carcinoma. Four months later, bladder wall thickness had decreased to 1.0 cm and the different layers of the bladder wall were easily visible sonographically. Endoscopy showed a normal bladder mucosa. On histopathology, hyperplasia of the epithelium was significantly decreased. A diet low in calcium was recommended after the checkup, and the owners started working the horse very lightly for 2 days a week. Over the following 2 months, hematuria had not recurred. In conclusion, it seems likely that hemorrhagic cystitis in this horse was exercise-associated, but as repeated provocation by high exercise intensity was not performed in this case, this remains an assumption.
Copyright © 2019 Elsevier Inc. All rights reserved.
Publication Date: 2019-04-04 PubMed ID: 31203985DOI: 10.1016/j.jevs.2019.03.212Google Scholar: Lookup
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Summary
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The research article investigates a condition called “equine idiopathic hemorrhagic cystitis” (EIHC) in a high-performance dressage horse and posits that the development of bladder-wall hyperplasia and hematuria could be tied to high-intensity exercise.
Overview of the Study
- The study focuses on the case of a 14-year-old Warmblood gelding dressage horse that experienced hematuria (blood in urine) for two days. The horse had been performing at high-intensity levels three times a week and participated in competitions for three consecutive weekends prior to the diagnosis.
- Initial sonographic examination revealed a significantly thick, 1.5 cm, dorsal bladder wall. Its layers were indistinguishable, demonstrating possible hyperplasia (abnormal increase in cellular production).
- Endoscopy performed on the horse showed a highly edematous bladder, marked by diffuse submucosal bleeding.
- The histopathological diagnosis suggested either severe reactive hyperplasia or a low-grade transitional cell carcinoma. However, the exact cause couldn’t be determined.
Observations and Treatment
- Four months post-initial diagnosis, a considerable decrease in bladder wall thickness was noted. The bladder wall was measured to be 1.0 cm thick and the different layers of the bladder wall could be identified clearly in sonographic scans.
- The horse’s bladder had returned to its normal state as determined by endoscopy. Histopathology showed a significant decrease in epithelial hyperplasia.
- The horse was put on a low-calcium diet and its exercise regimen was limited to light work two days a week. Following this change, there was no recurrence of hematuria over the next two months.
Conclusion
- The researchers concluded that EIHC in the horse was possibly linked to high-intensity exercise. However, as high-intensity exercise wasn’t repeated during the study, this correlation remains an assumption.
- The study brings to light the need for further investigation into the probable association between high-intensity exercise and EIHC in horses.
Cite This Article
APA
Barton AK, Kershaw O, Gruber AD, Gehlen H.
(2019).
Equine Idiopathic Hemorrhagic Cystitis: Is It Idiopathic or More Likely to Be Exercise-Associated?
J Equine Vet Sci, 78, 6-9.
https://doi.org/10.1016/j.jevs.2019.03.212 Publication
Researcher Affiliations
- Equine Clinic, Freie Universitaet Berlin, Berlin, Germany. Electronic address: Ann-Kristin.Barton@fu-berlin.de.
- Institute of Veterinary Pathology, Freie Universitaet Berlin, Berlin, Germany.
- Institute of Veterinary Pathology, Freie Universitaet Berlin, Berlin, Germany.
- Equine Clinic, Freie Universitaet Berlin, Berlin, Germany.
MeSH Terms
- Animals
- Cystitis / veterinary
- Hematuria / veterinary
- Hemorrhage / veterinary
- Horses
- Male
- Neoplasm Recurrence, Local / veterinary
- Physical Conditioning, Animal
Citations
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