FREE SHIPPING over $40
OVER 9000 FIVE-STAR REVIEWS
5% OFF ALL SUBSCRIPTIONS
100% HAPPINESS GUARANTEE
Analyze Diet
0
Home / Equine Research Bank / Equine Vet J / Equine proliferative enteropathy–a review of recent de...
Equine veterinary journal2013; 45(4); 403-409; doi: 10.1111/evj.12075

Equine proliferative enteropathy–a review of recent developments.

Abstract: Equine proliferative enteropathy (EPE) is a disease of foals caused by the obligate intracellular organism Lawsonia intracellularis. This emerging disease affects mainly weanling foals and causes fever, lethargy, peripheral oedema, diarrhoea, colic and weight loss. The diagnosis of EPE may be challenging and relies on the presence of hypoproteinaemia, thickening of segments of the small intestinal wall observed upon abdominal ultrasonography, positive serology and molecular detection of L. intracellularis in faeces. Although the clinical entity, diagnostic approach and treatment of EPE are well established and described, the epidemiology for this disease has remained largely unaddressed. This article focuses on new developments in the field of EPE, including epidemiology, pathophysiology, clinical signs, diagnosis, treatment and prevention.
© 2013 EVJ Ltd.
Get Full Text
Publication Date: 2013-05-15 PubMed ID: 23662705PubMed Central: PMC7163532DOI: 10.1111/evj.12075Google Scholar: Lookup
The Equine Research Bank provides access to a large database of publicly available scientific literature. Inclusion in the Research Bank does not imply endorsement of study methods or findings by Mad Barn.
LinkedInCopy
  • Journal Article
  • Review

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.

The article examines the disease equine proliferative enteropathy (EPE) in foals, investigating different aspects including its causes, symptoms, diagnosis, treatment, prevention, and its epidemiology, which has mostly been overlooked in other studies.

Equine Proliferative Enteropathy

  • Equine Proliferative Enteropathy (EPE) is a disease that affects foals, predominantly those that have been recently weaned.
  • The disease is caused by an obligate intracellular organism known as Lawsonia intracellularis and is considered to be an emerging disease in the field of veterinary science.
  • EPE can lead to several health issues in foals, including fever, lethargy, peripheral edema, diarrhea, colic, and weight loss.

Diagnosis of EPE

  • Diagnosing EPE can be a complicated process. The diagnosis is heavily reliant on the identification of certain key indicators, such as hypoproteinemia and the thickening of sections of the small intestinal wall, which can be seen through abdominal ultrasonography.
  • The presence of L. intracellularis in foal feces, as confirmed through molecular detection and positive serology, also helps in establishing the diagnosis of EPE.

Epidemiology of EPE

  • The study focuses significantly on the epidemiology of EPE, a subject that previous research has not sufficiently addressed. A better understanding of the disease’s epidemiology can drive more effective prevention and treatment strategies.

Treatment and Prevention of EPE

  • While the treatment methods and overall clinical approach to EPE are well established and described, the article highlights newer developments in this arena.
  • The prevention measures are also discussed, helping to provide a comprehensive analysis of how EPE can be managed and potentially eradicated in the future.

Cite This Article

APA
Pusterla N, Gebhart CJ. (2013). Equine proliferative enteropathy–a review of recent developments. Equine Vet J, 45(4), 403-409. https://doi.org/10.1111/evj.12075

Publication

Equine veterinary journal
ISSN: 2042-3306
NlmUniqueID: 0173320
Country: United States
Language: English
Volume: 45
Issue: 4
Pages: 403-409

Researcher Affiliations

Pusterla, N
  • Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, USA. npusterla@ucdavis.edu
Gebhart, C J

    MeSH Terms

    • Animals
    • Desulfovibrionaceae Infections / microbiology
    • Desulfovibrionaceae Infections / veterinary
    • Horse Diseases / pathology
    • Horses
    • Intestinal Diseases / microbiology
    • Intestinal Diseases / veterinary
    • Lawsonia Bacteria

    References

    This article includes 63 references
    1. Lawson GH, Gebhart CJ. Proliferative enteropathy.. J. Comp. Pathol. 2000 122, 77‐100.
      pubmed: 10684678
    2. McOrist S, Gebhart CJ. Genus Lawsonia .. Manual of Systematic Bacteriology 2005 pp 940‐943.
    3. Duhamel GE, Wheeldon EB. Intestinal adenomatosis in a foal.. Vet. Pathol. 1982 19, 447‐449.
      pubmed: 7090144
    4. Williams NM, Harrison LR, Gebhart CJ. Proliferative enteropathy in a foal caused by Lawsonia intracellularis‐like bacterium.. J. Vet. Diagn. Invest. 1996 8, 254‐256.
      pubmed: 8744752
    5. Frank N, Fishman CE, Gebhart CJ. Lawsonia intracellularis proliferative enteropathy in a weanling foal.. Equine Vet. J. 1998 30, 549‐552.
      pubmed: 9844976
    6. Brees DJ, Sondhoff AH, Kluge JP, Andreasen CB, Brown CM. Lawsonia intracellularis‐like organism infection in a miniature foal.. J. Am. Vet. Med. Assoc. 1999 215, 511‐515.
      pubmed: 10461636
    7. Lavoie JP, Drolet R, Parsons D, Leguillette R, Sauvageau R, Shapiro J, Houle L, Hallé G, Gebhart CJ. Equine proliferative enteropathy: a cause of weight loss, colic, diarrhoea and hypoproteinemia in foals on three breeding farms in Canada.. Equine Vet. J. 2000 32, 418‐425.
      pubmed: 11037264
    8. Schumacher J, Schumacher J, Rolsma M, Brock KV, Gebhart CJ. Surgical and medical treatment of an Arabian filly with proliferative enteropathy caused by Lawsonia intracellularis .. J. Vet. Intern. Med. 2000 14, 630‐632.
      pubmed: 11110386
    9. Bihr TP. Protein‐losing enteropathy caused by Lawsonia intracellularis in a weanling foal.. Can. Vet. J. 2003 44, 65‐66.
      pmc: PMC340023pubmed: 12619560
    10. McClintock SA, Collins AM. Lawsonia intracellularis proliferative enteropathy in a weanling foal in Australia.. Aust. Vet. J. 2004 82, 750‐752.
      pubmed: 15648934
    11. Deprez P, Chiers K, Gebhart CJ, Ducatelle R, Lefère L, van Vanschandevijl K, Loon G. Lawsonia intracellularis infection in a 12‐month‐old colt in Belgium.. Vet. Rec. 2005 157, 774‐776.
      pubmed: 16339981
    12. Dauvillier J, Picandet V, Harel J, Gottschalk M, Desrosiers R, Jean D, Lavoie JP. Diagnostic and epidemiological features of Lawsonia intracellularis enteropathy in 2 foals.. Can. Vet. J. 2006 47, 689‐691.
      pmc: PMC1482453pubmed: 16898113
    13. Sampieri F, Hinchcliff KW, Toribio RE. Tetracycline therapy of Lawsonia intracellularis enteropathy in foals.. Equine Vet. J. 2006 38, 89‐92.
      pubmed: 16411593
    14. Wuersch K, Huessy D, Koch C, Oevermann A. Lawsonia intracellularis proliferative enteropathy in a filly.. J. Vet. Med. A Physiol. Pathol. Clin. Med. 2006 53, 17‐21.
      pubmed: 16411902
    15. Feary DJ, Gebhart CJ, Pusterla N. Lawsonia intracellularis proliferative enteropathy in a foal.. Schweiz. Arch. Tierheilkd 2007 149, 129‐133.
      pubmed: 17410971
    16. Frazer ML. Lawsonia intracellularis infection in horses: 2005–2007.. J. Vet. Intern. Med. 2008 22, 1243‐1248.
      pubmed: 18681919
    17. McGurrin MK, Vengust M, Arroyo LG, Baird JD. An outbreak of Lawsonia intracellularis infection in a standardbred herd in Ontario.. Can. Vet. J. 2008 48, 927‐930.
      pmc: PMC1950111pubmed: 17966333
    18. Guimarães‐Ladeira CV, Palhares MS, Oliveira JS, Ramirez MA, Guedes RM. Faecal shedding and serological cross‐sectional study of Lawsonia intracellularis in horses in the state of Minas Gerais, Brazil.. Equine Vet. J. 2009 41, 593‐596.
      pubmed: 19803056
    19. Merlo JL, Sheats MK, Elce Y, Hunter S, Breuhaus BA. Outbreak of Lawsonia intracellularis on a standardbred farm in North Carolina.. Equine Vet. Educ. 2009 21, 179‐182.
    20. Shimizu C, Shibahara T, Takai S, Kasuya K, Chikuba T, Murakoshi N, Kobayashi H, Kubo M. Lawsonia intracellularis and virulent Rhodococcus equi infection in a thoroughbred colt.. J. Comp. Pathol. 2010 143, 303‐308.
      pubmed: 20471028
    21. Van Den Wollenberg L, Butler CM, de Houwers DJ, Grootv MW, van Panhuijzen H, van Maanen C, Oldruitenborgh‐Oosterbaan MM. Lawsonia intracellularis‐associated proliferative enteritis in weanling foals in the Netherlands.. Tijdschr. Diergeneeskd 2011 136, 565‐570.
      pubmed: 22111417
    22. Cooper DM, Gebhart CJ. Comparative aspects of proliferative enteritis.. J. Am. Vet. Med. Assoc. 1998 212, 1446‐1451.
      pubmed: 9589135
    23. Al‐Ghamdi M. Characterization of Proliferative Enteropathy in Horses . 2003 PhD Thesis, University of Minnesota.
    24. Jordan DM, Knittel JP, Schwartz KJ, Roof MB, Hoffman LJ. A Lawsonia intracellularis transmission study using a pure culture inoculated seeder‐pig sentinel model.. Vet. Microbiol. 2004 104, 83‐90.
      pubmed: 15530742
    25. Friedman M, Bednár V, Klimes J, Smola J, Mrlík V, Literák I. Lawsonia intracellularis in rodents from pig farms with the occurrence of porcine proliferative enteropathy.. Lett. Appl. Microbiol. 2008 47, 117‐121.
      pubmed: 18673433
    26. Collins AM, Fell S, Pearson H, Toribio JA. Colonisation and shedding of Lawsonia intracellularis in experimentally inoculated rodents and in wild rodents on pig farms.. Vet. Microbiol. 2011 150, 384‐388.
      pubmed: 21349664
    27. Vannucci FA, Pusterla N, Mapes SM, Gebhart C. Evidence of host adaptation in Lawsonia intracellularis infections.. Vet. Res. 2012 43, 53‐65.
      pmc: PMC3443049pubmed: 22715937
    28. Pusterla N, Mapes S, Rejmanek D, Gebhart C. Detection of Lawsonia intracellularis by real‐time PCR in the faeces of free‐living animals from equine farms with documented occurrence of equine proliferative enteropathy.. J. Wildl. Dis. 2008 44, 992‐998.
      pubmed: 18957657
    29. Pusterla N, Mapes S, Gebhart C. A follow up study on the investigation of the occurrence of Lawsonia intracellularis infection in wild and feral animals captured on horse properties with equine proliferative enteropathy.. Vet. J. 2012 194, 253‐255.
      pubmed: 22627048
    30. Pusterla N, Wattanaphansak S, Mapes S, Collier J, Hill J, DiFrancesco M, Gebhart C. Oral infection of weanling foals with an equine isolate of Lawsonia intracellularis, agent of equine proliferative enteropathy.. J. Vet. Intern. Med. 2010 24, 622‐627.
      pubmed: 20337907
    31. Pusterla N, Sanchez‐Migallon Guzman D, Vannucci FA, Mapes S, White A, DiFrancesco M, Gebhart C. Transmission of Lawsonia intracellularis to weanling foals using faeces from experimentally infected rabbits.. Vet. J. 2013 195, 241‐243.
      pubmed: 22841447
    32. Collins AM, Love RJ. Re‐challenge of pigs following recovery from proliferative enteropathy.. Vet. Microbiol. 2007 120, 381‐386.
      pubmed: 17188822
    33. Pusterla N, Vannucci FA, Mapes MS, Nogradi N, Collier JR, Hill JA, DiFrancesco M, White AM, Akana NK, Simonek G, Gebhart CJ. Efficacy of an avirulent live vaccine against Lawsonia intracellularis in the prevention of proliferative enteropathy in experimentally infected weanling foals.. Am. J. Vet. Res. 2012 73, 741‐746.
      pubmed: 22533409
    34. Collins A, Love RJ, Pozo J, Smith SH, McOrist S. Studies on the ex vivo survival of Lawsonia intracellularis .. J. Swine Health Prod. 2000 8, 211‐215.
    35. Guedes RM. Porcine Proliferative Enteropathy: Diagnosis, Immune Response and Pathogenesis . 2002 PhD Thesis, University of Minnesota.
    36. Jacoby RO. Transmissible ileal hyperplasia of hamsters.. Am. J. Pathol. 1978 91, 433‐444.
      pmc: PMC2018310pubmed: 655259
    37. Vannucci FA, Foster DN, Gebhart CJ. Comparative transcriptional analysis of homologous pathogenic and non‐pathogenic Lawsonia intracellularis isolates in infected porcine cells.. PLoS ONE 2012 7, e46708.
      doi: 10.1371/journal.pone.0046708pmc: PMC3463550pubmed: 23056413google scholar: lookup
    38. Page AE, Fallon LH, Bryant UK, Horohov DW, Luna TW, Marsh PS, Slovis NM, Sprayberry KA, Loynachan AT. Acute deterioration and death with necrotizing enteritis associated with Lawsonia intracellularis in 4 weanling foals.. J. Vet. Intern. Med. 2012 26, 1476‐1480.
      pubmed: 23039901
    39. Guedes RM, Gebhart CJ. Onset and duration of faecal shedding, cell‐mediated and humoral immune responses in pigs after challenge with a pathogenic isolate or attenuated vaccine strain of Lawsonia intracellularis .. Vet. Microbiol. 2003 91, 35‐145.
      pubmed: 12458163
    40. Guedes RM, Gebhart CJ. Evidence of cell‐mediated immune response and specific local mucosal immunoglobulin (Ig) A production against Lawsonia intracellularis in experimentally infected swine.. Can. J. Vet. Res. 2010 74, 97‐101.
      pmc: PMC2851731pubmed: 20592838
    41. McOrist S, MacIntyre N, Stokes CR, Lawson GH. Immunocytological responses in porcine proliferative enteropathies.. Infect. Immun. 1992 60, 4184‐4191.
      pmc: PMC257451pubmed: 1398929
    42. Page AE, Loynachan AT, Bryant U, Stills HF, Adams AA, Gebhart CJ, Pusterla N, Horohov DW. Characterization of the interferon gamma response to Lawsonia intracellularis using an equine proliferative enteropathy challenge (EPE) model.. Vet. Immunol. Immunopathol. 2011 143, 55‐65.
      pubmed: 21719114
    43. Pusterla N, Mapes S, Gebhart C. Lawsonia intracellularis‐specific interferon γ gene expression by peripheral blood mononuclear cells in vaccinated and naturally infected foals.. Vet. J. 2012 192, 249‐251.
      pubmed: 21689957
    44. Smith DG, Mitchell SC, Nash T, Rhind S. Gamma interferon influences intestinal epithelial hyperplasia caused by Lawsonia intracellularis infection in mice.. Infect. Immun. 2000 68, 6737‐6743.
      pmc: PMC97774pubmed: 11083789
    45. Wong DM, Alcott CJ, Sponseller BA, Young JL, Sponseller BT. Impaired intestinal absorption of glucose in 4 foals with Lawsonia intracellularis infection.. J. Vet. Intern. Med. 2009 23, 940‐944.
      pubmed: 19566855
    46. Vannucci FA, de Borges EL, Oliveira JSV, Guedes RMC. Intestinal absorption and histomorphometry of Syrian hamsters (Mesocricetus auratus) experimentally infected with Lawsonia intracellularis .. Vet. Microbiol. 2010 145, 286‐291.
      pubmed: 20418028
    47. Pusterla N, Jackson R, Wilson R, Collier J, Mapes S, Gebhart C. Temporal detection of Lawsonia intracellularis using serology and real‐time PCR in Thoroughbred horses residing on a farm endemic for equine proliferative enteropathy.. Vet. Microbiol. 2009 136, 173‐176.
      pubmed: 19019573
    48. Nathues H, Holthaus K, Beilage E. Quantification of Lawsonia intracellularis in porcine faeces by real‐time PCR.. J. Appl. Microbiol. 2009 107, 2009‐2016.
      pubmed: 19548889
    49. Pusterla N, Mapes S, Johnson C, Slovis N, Page A, Gebhart C. Comparison of faeces versus rectal swabs for the molecular detection of Lawsonia intracellularis in foals with equine proliferative enteropathy.. J. Vet. Diagn. Invest. 2010 22, 741‐744.
      pubmed: 20807932
    50. Richter B, Ladinig A, Nedorost N, Weissenböck H. A TaqMan quantitative polymerase chain reaction assay for the detection of Lawsonia intracellularis in faecal and tissue samples from pigs.. J. Vet. Diagn. Invest. 2010 22, 70‐73.
      pubmed: 20093686
    51. Guedes RM, Gebhart CJ, Winkelman NL, Mackie‐Nuss RA, Marsteller TA, Deen J. Comparison of different methods for diagnosis of porcine proliferative enteropathy.. Can. J. Vet. Res. 2002 66, 99‐107.
      pmc: PMC226990pubmed: 11989741
    52. Guedes RM, Gebhart CJ, Winkelman NL, Mackie‐Nuss RA. A comparative study of an indirect fluorescent antibody test and an immunoperoxidase monolayer assay for the diagnosis of porcine proliferative enteropathy.. J. Vet. Diagn. Invest. 2002 14, 420‐423.
      pubmed: 12296397
    53. Boesen HT, Jensen TK, Møller K, Nielsen LH, Jungersen G. Evaluation of a novel enzyme‐linked immunosorbent assay for serological diagnosis of porcine proliferative enteropathy.. Vet. Microbiol. 2005 109, 105‐112.
      pubmed: 15975740
    54. Wattanaphansak S, Asawakarn T, Gebhart CJ, Deen J. Development and validation of an enzyme‐linked immunosorbent assay for the diagnosis of porcine proliferative enteropathy.. J. Vet. Diagn. Invest. 2008 20, 170‐177.
      pubmed: 18319429
    55. Bowen M. Antimicrobial stewardship: time for change.. Equine Vet. J. 2013 45, 127‐129.
      pubmed: 23368774
    56. Frazer M. Sale price and race earnings in horses previously diagnosed by Lawsonia intracellularis .. J. Vet. Intern. Med. 2011 25, 677‐678.
    57. Pusterla N, Higgins JC, Smith P, Mapes S, Gebhart CJ. Epidemiological survey on farms with documented occurrence of equine proliferative enteropathy due to Lawsonia intracellularis .. Vet. Rec. 2008 163, 156‐158.
      pubmed: 18677000
    58. Kroll JJ, Roof MB, McOrist S. Evaluation of protective immunity in pigs following oral administration of an avirulent live vaccine of Lawsonia intracellularis .. Am. J. Vet. Res. 2004 65, 559‐565.
      pubmed: 15141873
    59. McOrist S, Smits RJ. Field evaluation of an oral attenuated Lawsonia intracellularis vaccine for porcine proliferative enteropathy (ileitis).. Vet. Rec. 2007 161, 26‐28.
      pubmed: 17617542
    60. Pusterla N, Hilton H, Wattanaphansak S, Collier J, Mapes SM, Stenbom RM, Gebhart CJ. Evaluation of the humoral immune response and faecal shedding in weanling foals after oral and intra‐rectal administration of an avirulent live vaccine of Lawsonia intracellularis .. Vet. J. 2009 182, 458‐462.
      pubmed: 18835201
    61. Pusterla N, Collier J, Mapes SM, Wattanaphasak S, Gebhart CJ. Effects of administration of an avirulent live vaccine of Lawsonia intracellularis on mares and foals.. Vet. Rec. 2009 164, 783‐785.
      pubmed: 19542553
    62. Pusterla N, Jackson R, Mapes SM, Noland J, Stenbom RM, Gebhart CJ. Lawsonia intracellularis: humoral immune response and faecal shedding in weanling foals following intra‐rectal administration of frozen‐thawed or lyophilized avirulent vaccine.. Vet. J. 2010 186, 110‐112.
      pubmed: 19699124
    63. Nogradi N, Slovis NM, Gebhart CJ, Wolfsdorf KE, McCracken JL, Scoggin CF, Kass PH, Mapes SM, Toth B, Lundquist ML, Pusterla N. Evaluation of the field efficacy of an avirulent live Lawsonia intracellularis vaccine in foals.. Vet. J. 2012 192, 511‐513.
      pubmed: 21741284

    Citations

    This article has been cited 6 times.
    1. Yeh JY. Prevalence and associated risk factors for Lawsonia intracellularis infection in farmed rabbits: A serological and molecular cross-sectional study in South Korea. Front Vet Sci 2023;10:1058113.
      doi: 10.3389/fvets.2023.1058113pubmed: 36846246google scholar: lookup
    2. Kirthika P, Park S, Jawalagatti V, Lee JH. Evaluation of host and bacterial gene modulation during Lawsonia intracellularis infection in immunocompetent C57BL/6 mouse model. J Vet Sci 2022 May;23(3):e41.
      doi: 10.4142/jvs.21274pubmed: 35332712google scholar: lookup
    3. Bengtsson RJ, Wee BA, Yebra G, Bacigalupe R, Watson E, Guedes RMC, Jacobson M, Stadejek T, Archibald AL, Fitzgerald JR, Ait-Ali T. Metagenomic sequencing of clinical samples reveals a single widespread clone of Lawsonia intracellularis responsible for porcine proliferative enteropathy. Microb Genom 2020 Apr;6(4).
      doi: 10.1099/mgen.0.000358pubmed: 32238228google scholar: lookup
    4. Bohlin AM, Olsen SN, Laursen SH, Öhman A, van Galen G. Lawsonia intracellularis associated equine proliferative enteropathy in Danish weanling foals. Acta Vet Scand 2019 Mar 8;61(1):12.
      doi: 10.1186/s13028-019-0447-3pubmed: 30850006google scholar: lookup
    5. Hwang JM, Seo MJ, Yeh JY. Lawsonia intracellularis in the feces of wild rodents and stray cats captured around equine farms. BMC Vet Res 2017 Aug 11;13(1):233.
      doi: 10.1186/s12917-017-1155-8pubmed: 28800756google scholar: lookup
    6. Uzal FA, Diab SS. Gastritis, Enteritis, and Colitis in Horses. Vet Clin North Am Equine Pract 2015 Aug;31(2):337-58.
      doi: 10.1016/j.cveq.2015.04.006pubmed: 26048413google scholar: lookup
    Subscribe to our newsletter
    Join 99,357 horse owners like you who receive our email updates on horse health and nutrition.