Phlegmonous gastritis in 2 yearling horses.
Abstract: Phlegmonous gastritis was diagnosed in 2 yearling fillies that were presented with a 1-wk history of fever, lethargy, and hypoproteinemia, associated with a previous diagnosis of equine proliferative enteropathy based on clinical signs and PCR assay detection of Lawsonia intracellularis in fecal samples. Abdominal ultrasound revealed enlargement of the stomach and expansion of its submucosal layer with hypoechoic fluid, as well as thickened hypomotile small intestinal segments. Given the poor prognosis and poor response to treatment, both horses were euthanized, one on the day of presentation and the other after 3 wk of intensive medical management including a combination of antimicrobials, analgesics, and intravenous colloids. At autopsy, acute mural gastritis characterized by severe submucosal edema with suppurative inflammation (i.e., phlegmonous gastritis) and necroulcerative enteritis compatible with the necrotizing form of equine proliferative enteropathy were identified in both horses. The gastric inflammation was associated with thrombosis and mixed bacterial populations, including Clostridium perfringens, that were confined to the submucosa without evidence of mucosal involvement; toxin genes compatible with C. perfringens type C were identified in one case. Human phlegmonous gastritis is an uncommon, often-fatal pyogenic infection that is often associated with mucosal injury, bacteremia, or immunocompromise. Our finding of this unusual gastric lesion in 2 horses with similar signalment, clinical disease, and spectrum of postmortem lesions suggests a similar etiopathogenesis that possibly involves local, regional, or distant hematogenous origin, and should be considered a potential complication of gastrointestinal mucosal compromise in horses.
Publication Date: 2022-01-10 PubMed ID: 35000510PubMed Central: PMC9254054DOI: 10.1177/10406387211065044Google Scholar: Lookup
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- Journal Article
Summary
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The study explores cases of Phlegmonous gastritis in two fillies which were previously diagnosed with equine proliferative enteropathy. Despite rigorous treatment, both horses were euthanized due to lack of progress. An autopsy revealed acute gastritis and necroulcerative enteritis. The researchers hypothesize a correlation between these occurrences and gastrointestinal mucosal compromise in horses.
Problem Area
- The researchers studied two yearling fillies that manifested symptoms of poorly responsive to treatment, chronic lethargy, and hypoproteinemia.
- Both horses had been previously diagnosed with equine proliferative enteropathy, a disease commonly affecting the intestinal lining in horses.
Conducted Research and Findings
- The teams carried out abdominal ultrasonographic examinations which revealed stomach enlargement and expansion of its submucosal layer with hypoechoic fluid. Additionally, a thickening and reduced motion of the small intestines were observed.
- Both filies were euthanized, due to poor prognosis and lack of improvement with treatment. One was put down on the day of presentation while the other survived three weeks of rigorous medical management including intense antimicrobials, analgesics, and intravenous colloids administration.
- An autopsy was then conducted on the horses which revealed acute mural gastritis (severe submucosal edema with suppurative inflammation) – a condition referred to as Phlegmonous gastritis.
- The autopsy also highlighted necroulcerative enteritis, a condition that aligns with the final stages of equine proliferative enteropathy.
- The inflammation observed in the stomach was linked with thrombosis and mixed bacterial populations that were confined to the submucosa without mucosal involvement. This inflammation presented toxin genes aligned with a type C strain.
Implications and Conclusions
- The occurrences of Phlegmonous gastritis, an uncommon and often fatal gastric lesion generally associated with mucosal injury, bacteremia, or immunocompromise in humans, in the two horses suggested the likelihood of a similar etiopathogenesis in horses.
- The postmortem lesions and clinical manifestations in the horses, as well as the similarity in their age and breed, strengthen this theory.
- The researchers concluded that this could also be viewed as a potential complication of gastrointestinal mucosal compromise in horses, and recommend further research into the disease’s prevalence in the equine population and possible treatment methods.
Cite This Article
APA
Engiles JB, Uzal FA, Navarro MA, Reef VB, Bender SJ.
(2022).
Phlegmonous gastritis in 2 yearling horses.
J Vet Diagn Invest, 34(3), 429-438.
https://doi.org/10.1177/10406387211065044 Publication
Researcher Affiliations
- Departments of Pathobiology, School of Veterinary Medicine, University of Pennsylvania, Kennett Square, PA, USA.
- Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, Kennett Square, PA, USA.
- California Animal Health and Food Safety Laboratory, San Bernardino Branch, University of California-Davis, Davis, CA, USA.
- California Animal Health and Food Safety Laboratory, San Bernardino Branch, University of California-Davis, Davis, CA, USA.
- Instituto de Patología Animal, Facultad de Ciencias Veterinarias, Universidad Austral de Chile, Chile.
- Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, Kennett Square, PA, USA.
- Departments of Pathobiology, School of Veterinary Medicine, University of Pennsylvania, Kennett Square, PA, USA.
MeSH Terms
- Abdomen / pathology
- Acute Disease
- Animals
- Female
- Gastritis / diagnosis
- Gastritis / pathology
- Gastritis / veterinary
- Horse Diseases / pathology
- Horses
- Inflammation / veterinary
- Intestinal Diseases / veterinary
- Lawsonia Bacteria
Conflict of Interest Statement
Declaration of conflicting interests: The authors declare no potential conflicts of interest with respect to the research,authorship, and/or publication of this article.
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