Grade IV gastric ulceration, pyloric aplasia, and an ectopic duodenal papilla in a 13-year-old Quarter Horse gelding evaluated for recurrent colic.

This research paper documents a case study on a horse that showed unusual symptoms of chronic colic due to some uncommon gastric disorders. It suggests that pyloric aplasia (underdeveloped pylorus) and ectopic duodenal papilla (misplaced duodenal papilla) should be considered in similar cases which usually get diagnosed as recurrent colic.

Objective of the Case Study

• The objective was to provide a detailed analysis of the unusual clinical signs and findings postmortem in a Quarter horse experiencing recurrent colic, which was unresponsive to conventional treatment methods.

Study Approach and Methods

• The subject was a 13-year-old Quarter Horse gelding that was brought to the research center as it showed chronic signs of colic which were unresponsive to on-farm management.
• An initial physical examination and rectal palpation did not reveal any abnormalities.
• However, a nasogastric tube procedure resulted in a massive gastric reflux of around 31 liters, indicating severe gastric dilation.
• Further gastroscopy revealed a high-degree gastric ulceration, an abnormally positioned gastric outlet, and the presence of an abnormally located (ectopic) duodenal papilla emitting bile into the stomach.

Findings and Treatment

• In consideration of the findings, an immediate treatment plan was designed involving gastroprotective agents, promobility agents, and dietary changes.
• The treatment, unfortunately, failed to produce substantial results, leading to multiple instances of severe colic.
• The health deterioration led to the decision to euthanize the horse, followed by an autopsy examination.
• The postmortem analysis confirmed that the gastric outflow tract directly led into the proximal duodenum, without a discernible pyloric sphincter (pyloric aplasia).
• The misplaced duodenal papilla, responsible for the leaking bile into the stomach, was traced back to the liver.

Conclusions

• This case study highlights the need to consider rare gastric malfunctions in horses presenting chronic colic symptoms.
• Both pyloric aplasia and ectopic duodenal papilla are previously unreported disorders in equine literature.
• This case emphasizes their potential existence and manifestation to raise awareness, underscoring the importance of thorough diagnosis in horses with unresponsive colic symptoms.