Inflammatory bowel disease (IBD) in horses: a retrospective study exploring the value of different diagnostic approaches.
Abstract: Diagnosing IBD in horses is challenging and requires a multimodal approach, since no conclusive diagnostic test is available. The objectives of this study were to provide an overview of population characteristics, results of applied diagnostic tests, treatment modalities and outcome in a large group of horses thought to have IBD and that were presented to four large equine referral hospitals, and to provide an exploratory investigation of possible associations between results of applied diagnostic tests, applied treatment modalities and outcome. A retrospective case series was performed across four large equine referral hospitals. Seventy-eight horses, thought to have IBD were included. Case history, clinical findings, diagnostic test results including oral glucose tolerance test (OGTT) and enteral biopsies (both duodenal and rectal), applied therapy and outcome were studied. A Chi-Square test was used to identify associations between results of diagnostic tests, treatment and outcome. P-values < 0.05 were considered significant. Results: Lethargy, diarrhoea, recurrent colic and weight loss were recorded in respectively 21,8%; 14,1%; 28,2% and 78,2% of cases. Over 70% of horses thought to have IBD had an abnormal OGTT. Only weight loss was significantly associated with aberrant enteral biopsy results, but not with abnormal OGTT results or low blood total protein. There was no association between an aberrant biopsy result and a disturbed OGTT. There was no association between either OGTT results or enteral biopsy results and a low blood total protein content, presence of gastric ulcer disease or an aberrant endoscopic aspect of the duodenal entrance. Conclusions: Weight loss is a highly prevalent symptom in IBD suspected horses. Enteral biopsies may be a useful diagnostic aid in the work-up of horses thought to suffer from IBD, however further research is required to demonstrate their true diagnostic value. Until more standardized scientific research is available, one should be careful with the interpretation of enteral biopsy results There is a need for better standardization of enteral biopsy procedures and the histopathological scoring of biopsies.
Publication Date: 2018-01-19 PubMed ID: 29351774PubMed Central: PMC5775604DOI: 10.1186/s12917-018-1343-1Google 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.
- Journal Article
- Multicenter Study
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 investigates the effectiveness of various diagnosis techniques for Inflammatory Bowel Disease (IBD) in horses. The researchers conducted retrospective case studies across four large equine referral hospitals, examining previous case histories, clinical findings, diagnostic test results, and treatment outcomes.
Study Design
- The study was a retrospective case series conducted across four large equine referral hospitals. It investigated 78 horses thought to have IBD.
- Information such as case history, clinical findings, diagnostic test results including oral glucose tolerance test (OGTT) and enteral biopsies (both duodenal and rectal), applied therapy and outcome were examined.
- Statistical tests were used to explore associations between results of diagnostic tests, treatment, and outcome. This included the Chi-Square test with P-values < 0.05 considered significant.
Results
- The results showed that symptoms like lethargy, diarrhea, recurrent colic, and weight loss were common among the cases studied.
- It was found that over 70% of horses thought to have IBD exhibited an abnormal glucose tolerance test (OGTT).
- Only weight loss was significantly associated with aberrant enteral biopsy results, but there was no correlation with abnormal OGTT results, low blood total protein, nor the presence of gastric ulcer disease.
- An aberrant biopsy result did not correlate with a disturbed OGTT, or with a low blood total protein content. There was also no association between biopsy results and an aberrant endoscopic view of the duodenal entrance.
Conclusions
- Weight loss was identified as a highly prevalent symptom in horses suspected of having IBD.
- Enteral biopsies were found to be potentially useful in diagnosing IBD in horses, but further research is necessary to verify their diagnostic value.
- The authors concluded that caution should be exercised in interpreting enteral biopsy results until more standardized scientific research is available.
- There is a need for better standardization of enteral biopsy procedures and the histopathological scoring of the biopsies to improve the diagnostic process for IBD in horses.
Cite This Article
APA
Boshuizen B, Ploeg M, Dewulf J, Klooster S, Bruijn M, Picavet MT, Palmers K, Plancke L, Cock H, Theelen M, Delesalle C.
(2018).
Inflammatory bowel disease (IBD) in horses: a retrospective study exploring the value of different diagnostic approaches.
BMC Vet Res, 14(1), 21.
https://doi.org/10.1186/s12917-018-1343-1 Publication
Researcher Affiliations
- Department of Virology, Parasitology and Immunology, Research Group of Comparative Physiology, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.
- Wolvega Equine Clinic, Oldeholtpade, Wolvega, The Netherlands.
- Department of Pathobiology, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands.
- Department of Obstetrics, Reproduction and Herd health, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.
- Department of Equine Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands.
- Wolvega Equine Clinic, Oldeholtpade, Wolvega, The Netherlands.
- DBP Veterinary Services, Moerbeke-Waas, Belgium.
- De Morette Equine Clinic, Asse, Belgium.
- Department of Virology, Parasitology and Immunology, Research Group of Comparative Physiology, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.
- Veterinary Pathology Services/Medvet laboratory, Antwerp, Belgium.
- Department of Equine Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands.
- Department of Virology, Parasitology and Immunology, Research Group of Comparative Physiology, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium. Catherine.Delesalle@ugent.be.
MeSH Terms
- Animals
- Biopsy / veterinary
- Blood Proteins / analysis
- Female
- Glucose Tolerance Test / veterinary
- Horse Diseases / diagnosis
- Horse Diseases / therapy
- Horses
- Inflammatory Bowel Diseases / diagnosis
- Inflammatory Bowel Diseases / therapy
- Inflammatory Bowel Diseases / veterinary
- Male
- Retrospective Studies
- Stomach Ulcer / veterinary
- Treatment Outcome
- Weight Loss
Conflict of Interest Statement
ETHICS APPROVAL: All samples were collected for diagnostic purposes. All horse owners signed informed consent forms. CONSENT FOR PUBLICATION: Not applicable for this study. COMPETING INTERESTS: The authors declare that they have no competing interests. PUBLISHER’S NOTE: Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
References
This article includes 35 references
- Kalck KA. Inflammatory bowel disease in horses. Vet Clin North Am Equine Pract 2009;25:303–315.
- Schumacher J, Edwards JF, Cohen ND. Chronic idiopathic inflammatory bowel diseases of the horse. J Vet Intern Med 2000;14:258–265.
- Mair TS, Pearson GR, Divers TJ. Malabsorption syndromes in the horse. Equine Vet Educ 2006;18:299–308.
- Kemper DL, Perkins GA, Schumacher J, Edwards JF, valentines BA, divers TJ, Cohen ND. Equine lymphocytic-plasmacytic enterocolitis: a retrospective study of 14 cases. Equine Vet J 2000;32:108–112.
- Mair TS, Hillyer MH, Taylor FG, Pearson GR. Small intestinal malabsorption in the horse: an assessment of the specificity of the oral glucose tolerance test. Equine Vet J 1991;23:344–346.
- Barr B. Infiltrative Intestinal disease. Vet Clin North Am Equine Pract 2006;22:e1–e7.
- Jones SL, Blikslager AT. Malabsorption syndromes and maldigestion: Pathophysiology, assessment, management and outcome. In: Equine Internal Medicine 2nd edition, Reed SM, editor. Saunders, Elsevier. St. Louis Missouri; 2004. Chapter 13.4.
- Murphy D, Rei SWJ, Love S. Modified oral glucose tolerance test as an indicator of small intestinal pathology in horses. Vet Rec 1997;140:342–343.
- Olofsson K, Hjertner B, Fossum C, Press CM, Lindberg R. Expression of T helper type 17 (Th17)-associated cytokines and TLR 4 and their correlation with Foxp3 positive cells in rectal biopsies of horses with clinical signs of IBD. Vet J 2015;206:97–104.
- Kaikkonen R, Niinisto K, Sykes B, Anttila M, Sankari S, Raekallio M. Diagnostic evaluation and short-term outcome as indicators of long-term prognosis in horses with findings suggestive of inflammatory bowel disease treated with corticosteroids and anthelmintics. Acta Vet Scand 2014;56:35.
- Divers TJ, Pelligrini-Masini A, McDonough S. Diagnosis of inflammatory bowel disease in a hackney pony by gastroduodenal endoscopy and biopsy and successful treatment with corticosteroids. Equine Vet Educ 2006;18:284–287.
- Trachsel DS, Grest P, Nitzl D, Wunderlin-Stähli P, Wehrli Eser M. Diagnostische Aufarbeitung der chronischen Darmentzündung beim Pferd. Schweiz Arch Tierheilk 2010;152:418–424.
- Brown CM, Slocombe RF, Derksen FJ. Fiberoptic gastroduodenoscopy in the horse. J Am Vet Med Assoc 1985;186:965–968.
- Lindbergh R, Nygren A, Persson SG. Rectal biopsy diagnosis in horses with clinical signs of intestinal disorders: a retrospective study of 116 cases. Equine Vet J 1996;28:275–284.
- Freeman SL, Mason PJ, Staley C. Comparison of ultrasonographic and histologic assessment of normal and strangulating intestine in the horse. Eur. J. Ultrasound 2001;13(Suppl 5).
- Davis JL, Jones SL. Examination For disorders of the gastrointestinal tract, In: Equine internal medicine, 2nd edition, Merchant T, editor, Saunders, Elsevier. St. Louis Missouri; 2004. p. 769–779.
- Merritt AM, Cimprich RE, Beech J. Granulomatous enteritis in nine horses. J Am Vet Med Assoc 1976;169:603–609.
- Scott EA, Heidel JR, Snyder SP, Ramirez S, Whitler WA. Inflammatory bowel disease in horses: 11 cases (1988-1998). J Am Vet Med Assoc 1999;214:1527–1530.
- Schumacher J, Moll HD, Spano JS, Barone LM, Powers RD. Effect of intestinal resection on two juvenile horses with granulomatous enteritis. J Vet Intern Med 1990;4:153–156.
- Southwood LL, Kawcak CE, Trotter GW, Stashak TS, Frisbie DD. Idiopathic focal eosinophilic enteritis associated with small intestinal obstruction in 6 horses. Vet Surg 2000;29:415–419.
- Ricketts SW. Rectal biopsy- a piece of the diagnostic jigsaw puzzle. Equine Vet J 1996;28:254–255.
- Gibson KT, Alders RG. Eosinophilic enterocolitis and dermatitis in two horses. Equine Vet J 1987;19:247–252.
- Metcalfe LV, More SJ, Duggan V, Katz LM. A retrospective study of horses investigated for weight loss despite a good appetite (2002-2011). Equine Vet J 2013;45:340–345.
- Subasinghe D, Nawarathna NM, Samarasekera DN. Disease characteristics of IBD: findings from a tertiary care centre in South Asia. J Gastrointest Surg 2011;15:1562–1567.
- Betteridge JD, Armbruster SP, Maydonovitch C, Veerappan GR. IBD prevalence by age, gender, race, and geographic location in the US military health care population. Inflamm Bowel Dis 2013;19:1421–1427.
- Kostic AD, Xavier RJ, Gevers D. The microbiome in inflammatory bowel disease: current status and the future ahead. Gastroenterology 2014;146:1489–1499.
- Schaubeck M, Haller D. Reciprocal interaction of diet and microbiome in inflammatory bowel diseases. Curr Opin Gastroenterol 2015;31:464–470.
- van der Kolk JH, van Putten LA, Mulder CJ, Grinwis GC, Reijm M, Butler CM, von Blomberg BM. Gluten-dependent antibodies in horses with inflammatory small bowel disease (ISBD). Vet Q 2012;21:3–11.
- Kerbyson N, Knottenbelt D. Intestinal Biopsies for investigating and managing inflammatory bowel disease in horses. In Pract 2017;37:347–358.
- Wilderjans H. Advances in standing laparoscopy. Proc. European Veterinary Conference Voorjaarsdagen The Hague, The Netherlands 19–21 of April 2017 p.1–5.
- Batt RM. Oral sugar tests for diagnosis of small intestinal disease. Equine Vet J 1991;23:325–326.
- Walker MM, Talley NJ. Clinical value of duodenal biopsies – beyond the diagnosis of celiac disease. Pathol Res Pract 2011;207:538–544.
- Packer M, Patterson-Kane JC, Smith KC, Durham AE. Quantification of immune cell populations in the lamina propria of equine jejuna biopsy specimens. J Comp Pathol 2005;132:90–95.
- Tossens M, Borde L, Amory M. The diagnostic value of equine rectal and duodenal biopsies. Proc. ECEIM Cong Edinburgh UK 4th of Febr 2012.
- Lindberg R, Nyggren A, Perssn SGB. Rectal biopsy diagnosis in horses with clinical signs of intestinal disorders: a retrospective study of 116 cases. Equine Vet J 1996;28:275–284.
Citations
This article has been cited 10 times.- Pekkarinen HM, Simola U, Niinistö KE, Syrjä PES. Clinical features, diagnostic findings, and treatment response in Finnish horses examined for equine inflammatory bowel disease. Acta Vet Scand 2025 Dec 3;68(1):2.
- Verhaar N, Hammer E, Reineking W, Hewicker-Trautwein M, Geburek F. Ex vivo comparison of full-thickness biopsy techniques in the equine small intestine. Vet Surg 2025 Jan;54(1):208-218.
- Sävilammi T, Alakangas RR, Häyrynen T, Uusi-Heikkilä S. Gut Microbiota Profiling as a Promising Tool to Detect Equine Inflammatory Bowel Disease (IBD). Animals (Basel) 2024 Aug 18;14(16).
- Kranenburg LC, Bouwmeester BF, van den Boom R. Findings and Prognosis in 149 Horses with Histological Changes Compatible with Inflammatory Bowel Disease. Animals (Basel) 2024 May 30;14(11).
- Siwińska N, Żak-Bochenek A, Paszkowska M, Karczewski M, Długopolska D, Haider W. Retrospective Evaluation of the Most Frequently Observed Histological Changes in Duodenal and Rectal Mucosal Biopsies in Horses with Recurrent Colic. Animals (Basel) 2022 Dec 13;12(24).
- Hostetter JM, Uzal FA. Gastrointestinal biopsy in the horse: overview of collection, interpretation, and applications. J Vet Diagn Invest 2022 May;34(3):376-388.
- Villagrán CC, Vogt D, Gupta A, Fernández EA. Inflammatory bowel disease characterized by multisystemic eosinophilic epitheliotropic disease (MEED) in a horse in Saskatchewan, Canada. Can Vet J 2021 Nov;62(11):1190-1194.
- Hashimoto-Hill S, Alenghat T. Inflammation-Associated Microbiota Composition Across Domestic Animals. Front Genet 2021;12:649599.
- Ritter S, Zadik-Weiss L, Almogi-Hazan O, Or R. Cannabis, One Health, and Veterinary Medicine: Cannabinoids' Role in Public Health, Food Safety, and Translational Medicine. Rambam Maimonides Med J 2020 Jan 30;11(1).
- DeNotta SL, Divers TJ. Clinical Pathology in the Adult Sick Horse: The Gastrointestinal System and Liver. Vet Clin North Am Equine Pract 2020 Apr;36(1):105-120.
Use Nutrition Calculator
Check if your horse's diet meets their nutrition requirements with our easy-to-use tool Check your horse's diet with our easy-to-use tool
Talk to a Nutritionist
Discuss your horse's feeding plan with our experts over a free phone consultation Discuss your horse's diet over a phone consultation
Submit Diet Evaluation
Get a customized feeding plan for your horse formulated by our equine nutritionists Get a custom feeding plan formulated by our nutritionists