Multiple small-intestine intussusceptions: a complication of purpura haemorrhagica in a horse.

This research paper describes the unusual case of a Belgian draft horse stallion presenting symptoms of purpura haemorrhagica, an autoimmune disorder, subsequently developing multiple small-intestine intussusceptions, a rare and severe complication not previously reported in equine treatment for this disease.

Case Presentation

• The Belgian draft horse stallion in the study displayed common symptoms of purpura haemorrhagica, including oedema or swelling of the distal limbs, ventral abdomen and head, blood spots under the skin (ecchymotic haemorrhages) of mucous membranes, nosebleeds (epistaxis), fever, lethargy, unwillingness to move, and refusal to eat (anorexia).
• Upon testing, the horse’s blood showed a greatly increased gamma-globulin fraction, which suggests a heightened immune response, and it turned out that strangles, a highly infectious equine disease, had been reported in a neighbouring farm in the months prior to the horse’s presentation of symptoms.

Treatment and Deterioration

• The horse initially responded well to the therapy that consisted of benzylpenicillin, an antibiotic; flunixin, a pain and inflammation reliever; and dexamethasone, a steroid that reduces inflammation and alters the immune response.
• On the fourth day of hospitalization, however, the horse’s condition suddenly worsened, showing symptoms of severe endotoxemia, a condition where harmful bacterial toxins are present in the bloodstream, and signs of an obstruction in the small intestine.
• Due to its deteriorating health state, probably poor prognosis, and economic considerations, the decision was made to euthanize the horse.

Autopsy Findings

• Upon necropsy, or animal autopsy, it was found that the horse had large serosal haemorrhages in both the small and large intestines, as well as multiple instances of jejunojejunal intussusceptions, a condition where one section of the small intestine ‘telescopes’ into another section.
• The occurrence of intussusception is a well-documented complication in children with Henoch-Schönlein purpura, a human autoimmune disease similar to purpura haemorrhagica in horses, but it was never reported before in a horse suffering from purpura haemorrhagica, making this case unique.

Conclusion

• The research paper concludes by emphasizing that this is the first known report of intussusception as a complication of purpura haemorrhagica in a horse, highlighting the need for further investigation and awareness of this possibility in equine treatment.